The Role of Emotion in Cancer Surgery Decisions: Applying Concepts From Decision Psychology
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

Formal Research Training – An Essential Aspect for Surgical Residency?
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

OpTrust: An Effective Educational Bundle for Enhancing Faculty-resident Intraoperative Entrustment
Objective: The purpose of this study was to measure the efficacy of a novel faculty and resident educational bundle focused on development of faculty-resident behaviors and entrustment in the operating room. Summary Background Data: As surgical training environments are orienting to entrustable professional activities (EPAs), successful transitions to this model will require significant faculty and resident development. Identifying an effective educational initiative which prepares faculty and residents for optimizing assessment, teaching, learning, and interacting in this model is critical. Methods: From...
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Meaningful Patient-centered Outcomes 1 Year Following Cardiac Surgery
Objective: To evaluate meaningful, patient-centered outcomes including alive-at-home status and patient-reported quality of life 1 year after cardiac surgery. Background: Long-term patient-reported quality of life after cardiac surgery is not well understood. Current operative risk models and quality metrics focus on short-term outcomes. Methods: In this combined retrospective/prospective study, cardiac surgery patients at an academic institution (2014–2015) were followed to obtain vital status, living location, and patient-reported outcomes (PROs) at 1 year using the NIH Patient-Reported Outcomes M...
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Quality of Reporting on Guideline, Protocol, or Algorithm Implementation in Adult Trauma Centers: A Systematic Review
Conclusions: Significant opportunity exists to improve the utility of guideline implementation reports in adult trauma settings, particularly in the domains of study context and the implications of context for study outcomes. (Source: Annals of Surgery)
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Outcomes From Brain Death Donors With Previous Cardiac Arrest Accepted for Pancreas Transplantation: A Single-center Retrospective Analysis
Conclusion: CaDBD donors are suitable for routine pancreas transplantation without increasing EGF risk, and in those with longer CAT it may be prudent to postpone donation a few days to allow a thorough evaluation of organ damage following cardiac arrest. (Source: Annals of Surgery)
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Algorithm for Resecting Hepatocellular Carcinoma in the Caudate Lobe
Conclusions: Our algorithm-oriented strategy is appropriate for the resection of HCC originating in the caudate lobe because of the acceptable surgical safety and curability. (Source: Annals of Surgery)
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

A Clinical Nomogram for Predicting Node-positive Disease in Esophageal Cancer
Objective: We developed and validated a nomogram predicting the likelihood of occult lymph node metastases in surgically resectable esophageal cancers. Background: Patients with esophageal cancer with positive lymph nodes benefit from neoadjuvant therapy, but limitations in current clinical staging techniques mean nodal metastases often go undetected preoperatively. Methods: The National Cancer Database was queried for patients with clinical T1-3N0M0 cancer undergoing upfront esophagectomy from 2004 to 2014. Multivariable logistic regression was used to develop the risk model using both statistical signif...
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Targeting the Hedgehog Pathway Using Itraconazole to Prevent Progression of Barrett's Esophagus to Invasive Esophageal Adenocarcinoma
Conclusion: Itraconazole significantly decreases EAC development and SHH expression in a preclinical animal model of BM. In humans, BE tissue expresses higher SHH, Indian Hedgehog, and bone morphogenic protein levels than normal squamous esophageal epithelium. (Source: Annals of Surgery)
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Implementation Strategies and the Uptake of the World Health Organization Surgical Safety Checklist in Low and Middle Income Countries: A Systematic Review and Meta-analysis
Conclusions: The SSC is used with high fidelity and penetration is associated with improved clinical outcomes in LMICs. Implementation appears well supported by a small number of tailored strategies. Further application of implementation science methodology is required among the global surgical community. (Source: Annals of Surgery)
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: META-ANALYSIS Source Type: research

A Randomized Controlled Trial of Endovenous Laser Ablation Versus Mechanochemical Ablation With ClariVein in the Management of Superficial Venous Incompetence (LAMA Trial)
Objective: This RCT compares the clinical, technical and quality of life outcomes after EVLA and MOCA. Summary of Background Data: Thermal ablation is the current mainstay treatment for SVI. Newer nonthermal methods of treatment have been developed which do not require the use of tumescent anesthesia. The potential advantages of these newer methods should be tested in RCTs to ascertain their role in the future treatments of SVI. Methods: This single-center RCT enrolled patients with symptomatic, unilateral, single-axis SVI. Eligible patients were equally randomized to either EVLA or MOCA, both with concom...
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: RANDOMIZED CLINICAL TRIAL Source Type: research

A Decade of Damage Control Resuscitation: New Transfusion Practice, New Survivors, New Directions
Conclusions: There have been remarkable reductions in mortality after major trauma hemorrhage in recent years. Mortality rates continue to be high and there remain important opportunities for further improvements in these patients. (Source: Annals of Surgery)
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Management of Gastroschisis: Results From the NETS: 2G: Study, a Joint British, Irish, and Canadian Prospective Cohort Study of 1268 Infants
Objective: In infants with gastroschisis, outcomes were compared between those where operative reduction and fascial closure were attempted ≤24 hours of age (PC), and those who underwent planned closure of their defect>24 hours of age following reduction with a pre-formed silo (SR). Summary of Background Data: Inadequate evidence exists to determine how best to treat infants with gastroschisis. Methods: A secondary analysis was conducted of data collected 2006–2008 using the British Association of Pediatric Surgeons Congenital Anomalies Surveillance System, and 2005–2016 using the Ca...
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Outcomes of Graves’ Disease Patients Following Antithyroid Drugs, Radioactive Iodine, or Thyroidectomy as the First-line Treatment
Conclusions: GD patients who received surgery as an initial treatment appeared to have lower chances of all-cause mortality, CVD, AF, psychological disease, diabetes, and hypertension in the long-term when compared to those treated with ATD or RAI. The surgery group had the lowest relapse and direct healthcare costs among the 3 treatment modalities. This long-term cohort study suggested surgery may have a larger role to play as an initial treatment for GD patients. (Source: Annals of Surgery)
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Histologic Subtype Defines the Risk and Kinetics of Recurrence and Death for Primary Extremity/Truncal Liposarcoma
Conclusions: Histologic subtype is the factor most strongly associated with DSD, DR, and LR in extremity/truncal LPS. Both risk and timing of adverse outcomes vary by subtype. These data may guide selective use of systemic therapy for patients with round cell and pleomorphic LPS, which carry a high risk of DR, and radiotherapy for LPS subtypes at high risk of LR when treated with surgery alone. (Source: Annals of Surgery)
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

The Significance of Visceral Protection in Preventing Enteroatmospheric Fistulae During Open Abdomen Treatment in Patients With Secondary Peritonitis: A Propensity Score-matched Case-control Analysis
Conclusion: VPL effectively prevents EAF formation during OAT in patients with peritonitis. We recommend the consistent use of VPL as part of a standardized OAT treatment algorithm. (Source: Annals of Surgery)
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Management of Locally Advanced Pancreatic Cancer: Results of an International Survey of Current Practice
Conclusions: In an international cohort of pancreas surgeons, there is substantial variation in management preferences, perceived contraindications to surgery, and the propensity to consider exploration in LAPC. These results emphasize the importance of a robust and nuanced multidisciplinary discussion for each patient, and suggest an evolving concept of “resectability.” (Source: Annals of Surgery)
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

The Prognostic Impact of Primary Tumor Site Differs According to the KRAS Mutational Status: A Study By the International Genetic Consortium for Colorectal Liver Metastasis
Conclusions: This study demonstrated, for the first time, that the prognostic impact of primary tumor side differs according to KRAS mutational status. RS tumors were associated with worse survival only in patients with wild-type tumors. (Source: Annals of Surgery)
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Elective Surgery for Diverticulitis and the Risk of Recurrence and Ostomy
Conclusions: Elective resection for uncomplicated diverticulitis decreases the risk of recurrence, still 6% to 15% will recur within 5 years of surgery. The risk of ostomy is not lower after elective resection, and considering colostomies related to resection, ostomy prevention should not be considered an appropriate indication for elective surgery. (Source: Annals of Surgery)
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

The Role of Commercial Health Insurance Characteristics in Bariatric Surgery Utilization
Conclusions: Insurance plan types with higher cost sharing have lower utilization of bariatric surgery. Underinsurance may represent a newly identified barrier to surgical care that should be addressed by advocates and policymakers. (Source: Annals of Surgery)
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Lymph Node Response to Neoadjuvant Chemotherapy as an Independent Prognostic Factor in Metastatic Esophageal Cancer
Objective: The aim of this study was to evaluate primary tumor (PT) and lymph node (LN) responses to neoadjuvant chemotherapy (NACT) for predicting long-term survival in patients with metastatic esophageal cancer (EC). Background: In evaluating NACT responses in patients with EC, imaging modalities typically target the PT in the esophagus, which is unmeasurable. Targeting measurable organs, like positive LNs, might provide more accurate assessments. Methods: We enrolled 251 patients with EC and clinically positive LNs that underwent curative resections, after triplet NACT. The percent reduction of PT area...
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Outcomes of 100 Patients More Than 4 Years After POEM for Achalasia
Objective: We aim to describe the long-term follow-up data from our institution's POEM experience. Summary Background Data: Per-oral endoscopic myotomy (POEM) is a well-established endoscopic therapy for achalasia with excellent short-term efficacy, but long-term outcomes data are limited. Methods: Patients older than 4 years removed from POEM for treatment of achalasia were studied. Clinical success was defined as an Eckardt Symptom (ES) score ≤3 and freedom from reintervention for achalasia. Patients underwent esophagogastroduodenoscopy (EGD), high-resolution manometry, impedance planimetry, and ti...
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

The Impact of Complications and Pain on Patient Satisfaction
Conclusions: Patients who experienced postoperative complications and pain were less likely to be highly satisfied or have no regret. Notably, postoperative pain had a more significant effect on satisfaction and regret after surgery, suggesting focused postsurgical pain management is an opportunity to substantially improve patient experiences. More research and patient education are needed for managing expectations of postoperative pain, and use of adjuncts and regional anesthesia. (Source: Annals of Surgery)
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Barriers to Pursuing a Career in Surgery: An Institutional Survey of Harvard Medical School Students
This study aimed to elucidate current medical student perceptions on barriers to a career in surgery, with a particular focus on gender-specific differences. Summary Background Data: Although gender parity in medical school composition has been reached, women continue to be underrepresented in the field of surgery. Methods: An anonymous, single-institution, internet-based survey conducted at Harvard Medical School. Results: Approximately 720 medical students were surveyed and 261 completed the questionnaire (36.3%; 58.6% women, 41% men, 0.4% transgender). Overall, there was no significant gender differ...
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Patterns and Trends of Gun Violence Against Women in the United States
Conclusions: Female victims of gun violence are increasing and more recent years have been marked with higher rates of firearm injuries, particularly among younger women. These data suggest that improved public health strategies and policies may be beneficial in reducing gun violence against US women. (Source: Annals of Surgery)
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Empowering Surgeons, Anesthesiologists, and Obstetricians to Incorporate Environmental Sustainability in the Operating Room
Conclusion: Climate change adversely impacts patient health, and disproportionately impacts the most vulnerable patients. SAO contribute to the problem through their resource-intensive work in the OR and are uniquely positioned to lead efforts to improve the environmental sustainability of the OR. (Source: Annals of Surgery)
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: REVIEW PAPERS Source Type: research

Placebo Surgery Controlled Trials: Do They Achieve What They Set Out To Do? A Systematic Review
Conclusions: Trialists need to factor additional time and sites into future placebo surgery controlled trials. A robust reporting framework of projected and actual trial design is imperative for trialists to learn from their predecessors. Review Registration: PROSPERO (CRD42019133296) (Source: Annals of Surgery)
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: REVIEW PAPERS Source Type: research

The Prognostic Role of β-Catenin Mutations in Desmoid-type Fibromatosis Undergoing Resection Only: A Meta-analysis of Individual Patient Data
Conclusions: Primary sporadic DTFs harboring a CTNNB1 S45F mutation have a higher risk of recurrence after surgery compared to T41A, S45P, and WT DTF, but this association seems to be mediated by tumor size. (Source: Annals of Surgery)
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: META-ANALYSES Source Type: research

Anaphylactic Reaction Rates to Blue Dyes Used for Sentinel Lymph Node Mapping: Systematic Review and Meta-analysis
Objective: The primary objective of this study was to quantify the risk of anaphylaxis to blue dyes used in SLNB for cancer. Secondary outcomes included the identification of factors that may influence this risk. Summary of Background Data: Blue dyes are widely used to help identify sentinel lymph nodes in oncological surgery. The rate of severe allergic reactions to blue dyes remains a controversial topic, with the true incidence and influencing factors uncertain. Methods: A systematic review and meta-analysis was performed to identify all studies which report on the incidence of severe adverse reactions...
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: META-ANALYSES Source Type: research

Prophylactic Single-use Negative Pressure Dressing in Closed Surgical Wounds After Incisional Hernia Repair: A Randomized, Controlled Trial
Objective: A randomized controlled trial (RCT) was undertaken to evaluate whether the prophylactic application of a specific single-use negative pressure (sNPWT) dressing on closed surgical incisions after incisional hernia (IH) repair decreases the risk of surgical site occurrences (SSOs) and the length of stay. Background: The sNPWT dressings have been associated to several advantages like cost savings and prevention of SSOs like seroma, hematoma, dehiscence, or wound infection (SSI) in closed surgical incisions. But this beneficious effect has not been previously studied in cases of close wounds after abdomin...
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: RANDOMIZED CONTROLLED TRIALS Source Type: research

Robotic Versus Laparoscopic Ventral Hernia Repair: One-year Results From a Prospective, Multicenter, Blinded Randomized Controlled Trial
Conclusion: This study confirms that robotic ventral hernia repair is safe when compared to laparoscopy. Further studies are needed to confirm these findings. (Source: Annals of Surgery)
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: RANDOMIZED CONTROLLED TRIALS Source Type: research

Preoperative Hepatic and Regional Arterial Chemotherapy in Patients Who Underwent Curative Colorectal Cancer Resection: A Prospective, Multi-center, Randomized Controlled Trial
Objective: To evaluate the effects of the addition of preoperative hepatic and regional arterial chemotherapy (PHRAC) on prognosis of stage II and III colorectal cancer (CRC) in a multicenter setting. Summary of Background Data: Our previous single-center pilot trial suggested that PHRAC in combination with surgical resection could reduce the occurrence of liver metastasis (LM) and improve survival in CRC patients. Methods: A prospective multi-center randomized controlled trial was conducted from December 2008 to December 2012 at 5 hospitals in China. Eligible patients with clinical stage II or III CRC wh...
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: RANDOMIZED CONTROLLED TRIALS Source Type: research

Long-term Outcomes of a Randomized Controlled Trial of Single-incision Versus Multi-port Laparoscopic Colectomy for Colon Cancer
Conclusions: Even though the results of the 5-year OS and RFS in this trial were exploratory and underpowered, there were no statistically significant differences between the SILC and MPC arms. SILC may be an acceptable treatment option for select patients with colon cancer. (Source: Annals of Surgery)
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: RANDOMIZED CONTROLLED TRIALS Source Type: research

The Covid-19 Pandemic: Lessons Learned for Sustained Trauma Preparedness and Responses
The emergence of coronavirus disease 2019 (COVID-19) that is caused by the SARS-CoV-2 virus has led to an overwhelming strain on healthcare delivery. This pandemic has created a sustained stress on the modern healthcare system, with unforeseen and potential drastic effects. Although the initial focus during this pandemic has been preparedness and response directed to the pandemic itself, traumatic injury has continued to remain a common problem that requires immediate evaluation and care to provide optimal outcomes. The State of Washington had the first reported case and death related to COVID-19 in the United States. Harb...
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: COVID-19 Source Type: research

One of the Most Important Phone Calls of My Career
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: FEATURES Source Type: research

Association of Surgeon Representation on NIH Study Sections With Receipt of Funding by Surgeon-scientists
Objective: Our goal was to evaluate the relationship between surgeon representation on NIH study sections and success in grant funding. Summary of Background Data: NIH funding for surgeon-scientists is declining. Prior work has called for increased surgeon participation in the grant review process as a strategy to increase receipt of funding by surgeon-scientists. Methods: A retrospective review of surgeon (primary department: General, Urology, Orthopedic, Ophthalmology, Otolaryngology, Neurosurgery) representation on NIH study sections and receipt of funding was performed using NIH Research Portfolio Onl...
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: FEATURES Source Type: research

Surgeons, Go Find a Coach
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: FEATURES Source Type: research

Association of a Statewide Surgical Coaching Program With Clinical Outcomes and Surgeon Perceptions
Conclusions: This statewide surgical coaching program was perceived as valuable and surgeons reported numerous practice changes. Operative times improved, but there was no significant improvement in risk-adjusted outcomes. (Source: Annals of Surgery)
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: FEATURES Source Type: research

Residential Segregation and Health Care Segregation: Separate But Not Equal
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: FEATURES Source Type: research

The Impact of Racial Residential Segregation on Colorectal Cancer Outcomes and Treatment
Conclusions: Black patients with colorectal cancer living in more segregated counties are significantly more likely to present at advanced stage and have worse cancer-specific survival. Enduring structural racism in the form of residential segregation has strong impacts on the colorectal cancer outcomes. (Source: Annals of Surgery)
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: FEATURES Source Type: research

Is It Safe to Manage Acute Cholecystitis Nonoperatively During Pregnancy? A Nationwide Analysis of Morbidity According to Management Strategy: Erratum
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - April 15, 2021 Category: Surgery Tags: ERRATUM Source Type: research

Graves’ Disease in Children Versus Adults: What is Most Important With Regards to Management
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - April 15, 2021 Category: Surgery Tags: BRIEF CLINICAL REPORTS Source Type: research

Hyperthyroidism Symptoms, Management, and Outcomes in Children and Adults Seeking Definitive Surgical Treatment
Conclusions: Children with hyperthyroidism were more likely to present with hoarseness and difficulty concentrating than adults. Concentration and communication are critical skills in developing children, and early intervention with definitive therapy may improve such symptoms. (Source: Annals of Surgery)
Source: Annals of Surgery - April 15, 2021 Category: Surgery Tags: BRIEF CLINICAL REPORTS Source Type: research

Comment on “Trends in Published Clinical Trial Phases Among Surgical Specialties, 2007–2017”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - April 15, 2021 Category: Surgery Tags: BRIEF CLINICAL REPORTS Source Type: research

Trends in Published Clinical Trial Phases Among Surgical Specialties, 2007–2017
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - April 15, 2021 Category: Surgery Tags: BRIEF CLINICAL REPORTS Source Type: research

The Feeling of Consequence: One Trauma Surgeon, the U.S. Senate, and the SAVE Act
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - April 15, 2021 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

Competency-based Surgical Training and Entrusted Professional Activities – Perfect Match or a Procrustean Bed?
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - April 15, 2021 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

Addressing Contemporary Management of Vascular Trauma: Optimization of Patient Care Through Collaboration
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - April 15, 2021 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

Particle Size Distributions in Surgical Smoke Generated by Advanced Energy Devices: A Meaningful Perspective From an Experimental Study in the Time of COVID-19
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - April 15, 2021 Category: Surgery Tags: COVID-19 Source Type: research

Promoting Diversity and Inclusion in Surgical Societies: Representation Matters
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - April 15, 2021 Category: Surgery Tags: EQUITY AND SOCIAL JUSTICE Source Type: research