Prediction of Suicide and Nonfatal Self-harm After Bariatric Surgery: A Risk Score Based on Sociodemographic Factors, Lifestyle Behavior, and Mental Health: A Nonrandomized Controlled Trial
Conclusions: Our findings suggest that male sex, psychiatric disorder history, and sleep difficulties are important predictors for nonfatal self-harm and suicide in postbariatric patients. High-risk patients who undergo surgery might require regular postoperative psychosocial monitoring to reduce the risk for future self-harm behaviors. (Source: Annals of Surgery)
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

True Short Esophagus in Gastroesophageal Reflux Disease: Old Controversies With New Perspectives
Objective: To explore the true short esophagus (TSE) frequency and long-term results of patients undergoing gastroesophageal reflux disease (GERD) or hiatus hernia (HH) surgery. Background: The existence and treatment of TSE during GERD/HH surgery is controversial. Satisfactory long-term results have been achieved with and without surgical techniques dedicated to TSE. Methods: In 311 consecutive patients undergoing minimally invasive surgery for GERD/HH, the distance between the endoscopically-localized gastroesophageal junction (GEJ) and the apex of the diaphragmatic hiatus after maximal thoracic esophag...
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Comparing Perioperative Mortality and Morbidity of Minimally Invasive Esophagectomy Versus Open Esophagectomy for Esophageal Cancer: A Nationwide Retrospective Analysis
Objective: We compared the surgical outcomes of minimally invasive esophagectomy (MIE) and open esophagectomy (OE) for esophageal cancer. Summary Background Data: MIE has become a widespread procedure. However, the definitive advantages of MIE over OE at a nationwide level have not been established. Methods: We analyzed patients who underwent esophagectomy for clinical stage 0 to III esophageal cancer from April 2014 to March 2017 using a Japanese inpatient database. We performed propensity score matching to compare in-hospital mortality and morbidities between MIE and OE, accounting for clustering of pat...
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Coaching as a Mechanism to Challenge Surgical Professional Identities
Conclusions: Participation in a coaching program challenged how surgeons thought of themselves in relationship to social and peer expectations. Our results indicate that surgeons do feel peer and social pressures related to identity but are much more complex and nuanced than has been previously discussed. The safe space of intentional coaching allowed participants to practice vulnerability without the pressures of sometimes caustic professional norms. Participants in this study viewed coaching as the way to improve the culture of surgery. (Source: Annals of Surgery)
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Simulated Volume-Based Regionalization of Complex Procedures: Impact on Spatial Access to Care
This study simulates the regionalization of pancreatectomies to assess its impact on spatial access in terms of patient driving times. Background: Although policies to regionalize complex procedures to high-volume centers may improve outcomes, the impact on patient access is unknown. Methods: Patients who underwent pancreatectomies from 2005 to 2014 were identified from California's statewide database. Round-trip driving times between patients’ home ZIP code and hospital addresses were calculated via Google Maps. Regionalization was simulated by eliminating hospitals performing (Source: Annals of Surgery)
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

A Quantitative Analysis of Surgical Smoke Exposure as an Occupational Hazard
Objective: We hypothesized that OR airborne PM was different in quantity and mutagenic potential than office air and cigarette smoke. Summary of Background Data: Exposure to surgical smoke has been equated to cigarette smoking and thought to be hazardous to health care workers despite limited data. Methods: PM was measured during 15 operations in ORs with 24.8 ± 2.0 air changes/h, and in controls (cigarettes, office air with 1.9–2.9 air changes/h). Mutagenic potential was assessed by gamma Histone 2A family member X staining of DNA damage in small airway epithelial cells co-cultured with ...
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Prevention of Firearm Violence Through Specific Types of Community-based Programming: An Eastern Association for the Surgery of Trauma Evidence-based Review
Conclusions: Gun violence may be mitigated by community-based efforts, such as gun buybacks or violence prevention programs. These programs come with caveats, notably community cultural relevance and proper support and funding from local leadership. Level of Evidence: Review, Decision, level III. (Source: Annals of Surgery)
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: REVIEW PAPERS Source Type: research

Postoperative Work and Activity Restrictions After Abdominal Surgery: A Systematic Review
Conclusions: This systematic review identified gaps in our understanding of what is best for patients recovering from abdominal surgery. Randomized controlled trials are crucial in safely optimizing the recovery period. (Source: Annals of Surgery)
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: REVIEW PAPERS Source Type: research

A Systematic Review and Meta-analysis on the Impact of Proficiency-based Progression Simulation Training on Performance Outcomes
Objective: To analyze all published prospective, randomized, and blinded clinical studies on the proficiency-based progression (PBP) training using objective performance metrics. Background: The benefit of PBP methodology to learning clinical skills in comparison to conventional training is not settled. Methods: Search of PubMed, Cochrane library's Central, EMBASE, MEDLINE, and Scopus databases, from inception to 1st March 2020. Two independent reviewers extracted the data. The Medical Education Research Study Quality Instrument (MERSQI) was used to assess the methodological quality of included studies. R...
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: META-ANALYSES Source Type: research

Types, Safety, and Efficacy of Limb Distalization for Inadequate Weight Loss After Roux-en-Y Gastric Bypass: A Systematic Review and Meta-analysis With a Call for Standardized Terminology
Conclusions: LD has an encouraging rate of resolution of comorbidities. A judicious patient selection is essential for better weight loss after LD. Type I LD with total alimentary limb length ≥350 cm was associated with less risk of malnutrition. PEM is a life-threatening complication that may require revisional surgery years after LD. Future studies on LD, adopting standardized surgical practice and terminology, will allow a more conclusive assessment of the outcome of the procedure. (Source: Annals of Surgery)
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: META-ANALYSES Source Type: research

Art Heals: Randomized Controlled Study Investigating the Effect of a Dedicated In-house Art Gallery on the Recovery of Patients After Major Oncologic Surgery
Introduction: We sought to investigate the effect of exposure to a dedicated art gallery during the perioperative period on the recovery of patients undergoing major oncologic procedures. Methods: Eighty patients were randomized into 2 arms; standard of care versus exposure to art. All patients completed a survey assessing their baseline art knowledge, and 4 poststudy validated questionnaires assessing their pain (Pain Rating Scale), hope (Herth Hope Index), anxiety (State-Trait Anxiety Inventory for Adults), and mental wellbeing (Warwick-Edinburgh Mental Wellbeing Scale). A linear model adjusted for baseline sc...
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: RANDOMIZED CONTROLLED TRIALS Source Type: research

Immediate Oral Refeeding in Patients With Mild and Moderate Acute Pancreatitis: A Multicenter, Randomized Controlled Trial (PADI trial)
Objective: To establish the optimal time to start oral refeeding in mild and moderate acute pancreatitis (AP) to reduce hospital length-of-stay (LOS) and complications. Summary Background Data: Oral diet is essential in mild and moderate AP. The greatest benefits are obtained if refeeding starts early; however, the definition of “early” remains controversial. Methods: This multicenter, randomized, controlled trial (NCT03829085) included patients with a diagnosis of mild or moderate AP admitted consecutively to 4 hospitals from 2017 to 2019. Patients were randomized into 2 treatment groups: imm...
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: RANDOMIZED CONTROLLED TRIALS Source Type: research

A Randomized Phase II Trial of Adjuvant Hepatic Arterial Infusion and Systemic Therapy With or Without Panitumumab After Hepatic Resection of KRAS Wild-type Colorectal Cancer
Conclusions: The addition of Pmab to HAI FUDR + SYS FOLFIRI showed promising activity without increased biliary toxicity and should be further investigated in a larger trial. (Source: Annals of Surgery)
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: RANDOMIZED CONTROLLED TRIALS Source Type: research

A Randomized Clinical Trial Evaluating the Efficacy and Quality of Life of Antibiotic-only Treatment of Acute Uncomplicated Appendicitis: Results of the COMMA Trial
Objective: Evaluate the efficacy and quality of life associated with conservative treatment of acute uncomplicated appendicitis. Summary background data: Conservative management with antibiotics only has emerged as a potential treatment option for acute uncomplicated appendicitis. However the reported failure rates are highly variable and there is a paucity of data in relation to quality of life. Methods: Symptomatic patients with radiological evidence of acute, uncomplicated appendicitis were randomized to either intravenous antibiotics only or undergo appendectomy. Results: One hundred eighty-six...
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: RANDOMIZED CONTROLLED TRIALS Source Type: research

Tracheostomy for COVID-19 Respiratory Failure: Multidisciplinary, Multicenter Data on Timing, Technique, and Outcomes
Conclusion: Early, percutaneous tracheostomy was associated with improved outcomes compared to surgical tracheostomy in a multi-institutional series of ventilated patients with COVID-19. (Source: Annals of Surgery)
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: COVID-19 Source Type: research

Black Medical Student Considerations in the Era of Virtual Interviews
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

Commentary on “Hotel Room #1438”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

Hotel Room #1438
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

Board Certification – A Remnant of Days Past or Reflection of a Commitment to Lifelong Learning and Professionalism?
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: FEATURES Source Type: research

Is Initial Board Certification Associated With Better Early Career Surgical Outcomes?
Conclusion: Patients undergoing partial colectomy by an early career general surgeon have decreased odds of severe complications and death when their surgeon is board certified. (Source: Annals of Surgery)
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: FEATURES Source Type: research

Gentrification in America – The Potential Deadly Consequences
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: FEATURES Source Type: research

Firearm Violence, Access to Care, and Gentrification: A Moving Target for American Trauma Systems
Objective: We aimed to determine whether gentrification predicts the movement of shooting victims over time and if this process has decreased access to care. Background: Trauma centers remain fixed in space, but the populations they serve do not. Nationally, gentrification has displaced disadvantaged communities most at risk for violent injury, potentially decreasing access to care. This process has not been studied, but an increase of only 1 mile from a trauma center increases shooting mortality up to 22%. Methods: We performed a cross-sectional study utilizing Philadelphia Police Department (PPD) and Pe...
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: FEATURES Source Type: research

Implementation of Enhanced Recovery Pathways in the Real World: Change is Hard
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: FEATURES Source Type: research

Clinical and Economic Outcomes of Enhanced Recovery Dissemination in Michigan Hospitals
Objective: To evaluate real-world effects of enhanced recovery protocol (ERP) dissemination on clinical and economic outcomes after colectomy. Summary Background Data: Hospitals aiming to accelerate discharge and reduce spending after surgery are increasingly adopting perioperative ERPs. Despite their efficacy in specialty institutions, most studies have lacked adequate control groups and diverse hospital settings and have considered only in-hospital costs. There remain concerns that accelerated discharge might incur unintended consequences. Methods: Retrospective, population-based cohort including patien...
Source: Annals of Surgery - July 15, 2021 Category: Surgery Tags: FEATURES Source Type: research

Response to the Comment on “Meta-analysis of Effect of Volume (Hospital and Operator) on Carotid Revascularization Outcomes”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

Response to the Comment on “The Prevalence of Lymph Node Metastases in Patients With T1 Esophageal Adenocarcinoma A Retrospective Review of Esophagectomy Specimens”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

Comment on “Long Term Outcome of Surgery Versus Conservative Management for Recurrent and Ongoing Complaints After an Episode of Diverticulitis. 5-year Follow-up Results of a Multicenter Randomized Control Trial (DIRECT-trial)”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

Response to the Comment on “Preoperative Ultrasound Assessment of Regional Lymph Nodes in Melanoma Patients Does Not Provide Reliable Staging: Results From a Large Multicenter Trial”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

Comment on “Preoperative Ultrasound Assessment of Regional Lymph Nodes in Melanoma Patients Does Not Provide Reliable Nodal Staging: Results From a Large Multicenter Trial”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

Response to the Comment on “Effect of Microvascular Invasion Risk on Early Recurrence of Hepatocellular Carcinoma After Surgery and Radiofrequency Ablation”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

Comment on “Effect of Microvascular Invasion Risk on Early Recurrence of Hepatocellular Carcinoma After Surgery and Radiofrequency Ablation”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

Comment on “Survival Following Liver Transplantation for Patients With Nonresectable Liver-only Colorectal Metastases”: What if Those Lesions are Gone?
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

Commentary on: Intraoperative Celiac Plexus Block With Preperitoneal Infusion Reduces Opioid Usage in Major Hepato-pancreato-biliary Surgery: A Pilot Study
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: BRIEF CLINICAL REPORTS Source Type: research

Intraoperative Celiac Plexus Block With Preperitoneal Infusion Reduces Opioid Usage in Major Hepato-pancreato-biliary Surgery: A Pilot Study
Conclusions: CPB can be considered as part of a multimodal approach for postoperative pain management in open hepato-pancreato-biliary surgeries. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: BRIEF CLINICAL REPORTS Source Type: research

Surgeons and Machines Can Learn From Operative Video: Will the System Let Them?
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: BRIEF CLINICAL REPORTS Source Type: research

A Computer Vision Platform to Automatically Locate Critical Events in Surgical Videos: Documenting Safety in Laparoscopic Cholecystectomy
Conclusions: Deep learning models for workflow analysis can be used to reliably locate critical events in surgical videos and document CVS in LC. Further studies are needed to assess the clinical impact of surgical data science solutions for safer laparoscopic cholecystectomy. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: BRIEF CLINICAL REPORTS Source Type: research

What a Reduction in Disparities Can Look Like…and What it Signifies
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: DISPARITIES, DIVERSITY AND SOCIAL JUSTICE Source Type: research

Disparities in Surgical Readmissions and Use of Observation Status in Hip and Knee Replacements: A Retrospective Cohort Study
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: DISPARITIES, DIVERSITY AND SOCIAL JUSTICE Source Type: research

What's in a System? The Uncertain Meaning of Health System Affiliation in Surgery
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

Preoperative Cognitive Evaluations: An Opportunity to Protect the Vulnerable Brain
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

A Call for Caution in Overinterpreting Exceptional Outcomes After Radical Surgery for Pancreatic Cancer: Let the Data Speak
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

Perioperative Symptoms: A New Frontier for Surgical Palliative Care
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

Readmission After Lobectomy for Lung Cancer: Not All Complications Contribute Equally
Conclusions: Complications are the main driver of readmission after lobectomy for lung cancer. The highest risk was related to postoperative events requiring a procedure or medical therapy necessitating inpatient care. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Impact of Trainee Participation on Inguinal Hernia Repair Outcome: A Study Based on the Swedish Hernia Register
Objective: The aim of this study was to investigate whether differences in postoperative outcome exist between open inguinal hernia repairs performed by surgical trainees and those performed by specialist surgeons. Summary of Background Data: Inguinal hernia repair is the prototype educational surgical procedure. The impact of trainee participation on postoperative outcome is still controversial and despite earlier studies no reliable hernia-specific data exist. Methods: The study cohort was based on the Swedish Hernia Register and consisted of 61,161 cases of male patients aged 18 years and older with op...
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA): Zone I Balloon Occlusion Time Affects Spinal Cord Injury in the Nonhuman Primate Model
Conclusions: REBOA limits mortality in the primate model of severe hemorrhagic shock. However, unopposed balloon inflation in the distal thoracic aorta for 60 minutes results in high rates of spinal cord ischemia, an effect mitigated by limiting balloon inflation to 30 minutes. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Prior Resection of the Primary Tumor Prolongs Survival After Peptide Receptor Radionuclide Therapy of Advanced Neuroendocrine Neoplasms
Objective: The aim of the study was to compare impact on survival after resection of primary tumors (PTs) after peptide receptor radionuclide therapy (PRRT). Background: PRRT is a highly effective therapeutic option to treat locally advanced or metastatic neuroendocrine neoplasms (NENs). Methods: We retrospectively analyzed the data of 889 patients with advanced NEN (G1-G3, stage IV) treated with at least 1 cycle of PRRT. In 486 of 889 patients (55%, group 1), PT had been removed before PRRT. Group 2 constituted 403 patients (45%) with no prior PT resection. Progression-free survival (PFS) and overall sur...
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Left-sided Portal Hypertension After Pancreaticoduodenectomy With Resection of the Portal Vein/Superior Mesenteric Vein Confluence in Patients With Pancreatic Cancer: A Project Study by the Japanese Society of Hepato-Biliary-Pancreatic Surgery
Objective: The aim of this study was to evaluate how often left-sided portal hypertension (LPH) develops and how LPH affects the long-term outcomes of patients with pancreatic cancer treated with pancreaticoduodenectomy (PD) and resection of the portal vein (PV)/superior mesenteric vein (SMV) confluence. Summary Background Data: Little is known about LPH after PD with resection of the PV/SMV confluence. Methods: Overall, 536 patients who underwent PD with PV/SMV resection were enrolled. Among them, we mainly compared the SVp group [n=285; the splenic vein (SV) was preserved] and the SVr group (n = 227; th...
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

New Nodal Staging for Primary Pancreatic Neuroendocrine Tumors: A Multi-institutional and National Data Analysis
Objective: To determine the prognostic role of metastatic lymph node (LN) number and the minimal number of LNs for optimal staging of patients with pancreatic neuroendocrine tumors (pNETs). Background: Prognosis relative to number of LN metastasis (LNM), and minimal number of LNs needed to evaluate for accurate staging, have been poorly defined for pNETs. Methods: Number of LNM and total number of LN evaluated (TNLE) were assessed relative to recurrence-free survival (RFS) and overall survival (OS) in a multi-institutional database. External validation was performed using Surveillance, Epidemiology and En...
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Procedure-specific Training for Robot-assisted Distal Pancreatectomy
Objective: To train practicing surgeons in robot-assisted distal pancreatectomy (RADP) and assess the impact on 5 domains of healthcare quality. Background: RADP may reduce the treatment burden compared with open distal pancreatectomy (ODP), but studies on institutional training and implementation programs are scarce. Methods: A retrospective, single-center, cohort study evaluating surgical performance during a procedure-specific training program for RADP (January 2006 to September 2017). Baseline and unadjusted outcomes were compared “before training” (ODP only; June 2012). Exclusion criteria...
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Intraoperative Increase of Portal Venous Pressure is an Immediate Predictor of Posthepatectomy Liver Failure After Major Hepatectomy: A Prospective Study
Objectives: The aim of this study was to assess intraoperative changes of hepatic macrohemodynamics and their association with ascites and posthepatectomy liver failure (PHLF) after major hepatectomy. Summary of Background Data: Large-scale ascites and PHLF remain clinical challenges after major hepatectomy. No study has concomitantly evaluated arterial and venous liver macrohemodynamics in patients undergoing liver resection. Methods: Portal venous pressure (PVP), portal venous flow (PVF), and hepatic arterial flow (HAF) were measured intraoperatively pre- and postresection in 67 consecutive patients wit...
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research