Circulating MicroRNAs in Small-bowel Neuroendocrine Tumors: A Potential Tool for Diagnosis and Assessment of Effectiveness of Surgical Resection
Conclusions: Our study represents the largest global profiling of serum miRNAs in SBNET patients, and the first to evaluate ongoing serum miRNA expression changes after surgical resection. Serum miR-125b-5p and miR-362–5p have potential to be used to detect RSD/RCD. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Mental Skills in Surgery: Lessons Learned From Virtuosos, Olympians, and Navy Seals
Conclusions: Establishing a taxonomy for mental skills in surgery may help in the development of robust mental skills training programs to promote optimal surgeon wellness and performance. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Surgical Repair of Congenital Diaphragmatic Hernia After Extracorporeal Membrane Oxygenation Cannulation: Early Repair Improves Survival
Objective: To determine the optimal timing of congenital diaphragmatic hernia (CDH) repair after extracorporeal membrane oxygenation (ECMO) cannulation Summary Background Data: The timing of CDH repair after ECMO cannulation remains a controversial topic due to studies with low power or strong selection bias. Methods: This is a 2-aim retrospective cohort study based on the CDH Study Group registry for the period of 2007–2017. Aim 1—Compare On versus After ECMO repair. Aim 2—Compare Early versus Late repair on ECMO. In order to minimize selection bias and account for non-repairs, subjects...
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Long-term Reintervention After Endovascular Abdominal Aortic Aneurysm Repair
Conclusions: All patients retain a high likelihood of reintervention after EVR, but clinical factors at the time of repair can predict those at highest risk. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Risk of Lymphedema Following Contemporary Treatment for Breast Cancer: An Analysis of 7617 Consecutive Patients From a Multidisciplinary Perspective
Objective: The aim of this study was to identify the comprehensive risk factors for lymphedema, thereby enabling a more informed multidisciplinary treatment decision-making. Summary Background Data: Lymphedema is a serious long-term complication in breast cancer patients post-surgery; however, the influence of multimodal therapy on its occurrence remains unclear. Methods: We retrospectively collected treatment-related data from 5549 breast cancer patients who underwent surgery between 2007 and 2015 at our institution. Individual radiotherapy plans were reviewed for regional nodal irradiation (RNI) field d...
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Recurrence in Patients Achieving Pathological Complete Response After Neoadjuvant Treatment for Advanced Pancreatic Cancer
Conclusions: A pCR following neoadjuvant therapy in patients with advanced PDAC is associated with remarkable survival, although recurrence occurs in about half of patients. Nevertheless, patients with pCR and recurrence respond well to treatment and survival remains encouraging. Advanced molecular characterization and longitudinal liquid biopsy may offer additional assistance with understanding tumor biologic behavior after achieving a pCR. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

A Predictive Model for Nodal Metastases in Patients With Appendiceal Cancers
Conclusions: The risk for nodal metastases in patients with appendiceal cancers can be quantified with reasonable accuracy using a predictive model incorporating patient age, sex, tumor histology, T-stage, and grade. This can help inform clinical decision making regarding the need for a right hemicolectomy following appendectomy. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Management of Pneumoperitoneum: Role and Limits of Nonoperative Treatment
Conclusions: Operative intervention is associated with reduced mortality in patients with pneumoperitoneum and peritonitis. In the absence of peritonitis, operative treatment is associated with increased morbidity and nonhome discharge. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Patients Undergoing Ileoanal Pouch Surgery Experience a Constellation of Symptoms and Consequences Representing a Unique Syndrome: A Report From the Patient-Reported Outcomes After Pouch Surgery (PROPS) Delphi Consensus Study
Conclusions: This study is the first to identify key functional outcomes after pouch surgery with direct input from a large panel of ileoanal pouch patients. The inclusion of patients in all stages of the consensus process allowed for a true patient-centered approach in defining the core domains that should be focused on in future studies of pouch function. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Long-term Comparison of Robotic and Laparoscopic Gastrectomy for Gastric Cancer: A Propensity Score-weighted Analysis of 2084 Consecutive Patients
Conclusions: After balancing covariates, RG demonstrated reliable surgical outcomes from the beginning. Long-term survival after RG and LG for GC was similar. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Mapping of Lymph Node Metastasis From Esophagogastric Junction Tumors: A Prospective Nationwide Multicenter Study
Conclusion: The study accurately identified the distribution of lymph node metastases from EGJ tumors and the optimal extent of subsequent lymph node dissection. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

System Factors Affecting Patient Safety in the OR: An Analysis of Safety Threats and Resiliency
Conclusions: Through a detailed human factors analysis of elective laparoscopic general surgery cases, this study provided a quantitative analysis of the existing safety threats and resilience supports in a modern endoscopic operating room. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Variation in Intraoperative and Postoperative Utilization for 3 Common General Surgery Procedures
Conclusions: Surgeons are significant drivers of variation in surgical supply costs and procedure time, but much less so for postoperative LOS. Intraoperative and postoperative utilization profiles can be generated for individual surgeons and may be an important tool for reducing surgical costs. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Consensus Guidelines for the Use of Fluorescence Imaging in Hepatobiliary Surgery
Conclusions: The Shanghai consensus recommendations offer practical tips and techniques to augment the safety and technical feasibility of ICG fluorescence-guided hepatobiliary surgery, including laparoscopic cholecystectomy, liver segmentectomy, and liver transplantation. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: REVIEW PAPERS Source Type: research

Intraoperative Red Blood Cell Transfusion Decision-making: A Systematic Review of Guidelines
The objective of this work was to carry out a systematic review of clinical practice guidelines (CPGs) pertaining to intraoperative red blood cell (RBC) transfusions, in terms of indications, decision-making, and supporting evidence base. Summary of Background Data: RBC transfusions are common during surgery and there is evidence of wide variability in practice. Methods: Major electronic databases (MEDLINE, EMBASE, and CINAHL), guideline clearinghouses and Google Scholar were systematically searched from inception to January 2019 for CPGs pertaining to indications for intraoperative RBC transfusion. Eligible ...
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: REVIEW PAPERS Source Type: research

Outcomes of Laparoscopic Redo Fundoplication in Patients With Failed Antireflux Surgery: A Systematic Review and Meta-analysis
Conclusions: LRF is a feasible and safe procedure that provides symptom relief and improved QoL to the vast majority of patients. Although heterogeneously assessed, recurrence rates seem to be low. LRF should be considered a valuable treatment modality for patients with failed antireflux surgery. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: META-ANALYSES Source Type: research

The Impact of Prehabilitation on Patient Outcomes in Hepatobiliary, Colorectal, and Upper Gastrointestinal Cancer Surgery: A PRISMA-Accordant Meta-analysis
Objective: To determine the impact of prehabilitation on hospital length of stay, functional capacity, complications, and mortality after surgery in patients with hepatobiliary, colorectal, and upper gastrointestinal cancer. Background: “Prehabilitation” encompasses exercise, nutrition, and psychosocial interventions to optimize health before surgery. The benefits of prehabilitation are ill-defined. Methods: Medline, Embase and Cochrane Databases were searched systematically for the terms “prehabilitation AND exercise,” “perioperative care AND cancer surgery,” and &ldqu...
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: META-ANALYSES Source Type: research

Intermittent Pneumatic Compression in Addition to Standard Prophylaxis of Postoperative Venous Thromboembolism in Extremely High-risk Patients (IPC SUPER): A Randomized Controlled Trial
Conclusions: Among patients with a Caprini score of ≥11 who received standard prophylaxis for VTE, adjunctive IPC resulted in a significantly lower incidence of asymptomatic venous thrombosis. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: RANDOMIZED CONTROLLED TRIALS Source Type: research

Feasibility and Safety of Laparoscopic Complete Mesocolic Excision (CME) for Right-sided Colon Cancer: Short-term Outcomes. A Randomized Clinical Study
Objective: The aim of this prospective clinical study is to compare short-term outcome of laparoscopic right hemicolectomy using the Complete Mesocolic Excision (CME group) with patients who underwent conventional right-sided colonic resection (NCME group). Summary Background Data: Although CME with central vascular ligation in laparoscopic right hemicolectomy is associated with a significant decrease in local recurrence rates and improvements in cancer-related 5-year survival, there may be additional risks associated with this technique because of increased surgical complications. As a result, there is controve...
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: RANDOMIZED CONTROLLED TRIALS Source Type: research

International Delphi Expert Consensus on Safe Return to Surgical and Endoscopic Practice: From the Coronavirus Global Surgical Collaborative
Conclusions: The Delphi process resulted in 99 recommendations. These consensus statements provide expert guidance, based on scientific methodology, for the safe resumption of surgical activities during the COVID-19 pandemic. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: COVID-19 Source Type: research

Short-term Effects of Canceled Elective Procedures Due to COVID-19: Evidence From the Veterans Affairs Healthcare System
Conclusions: The pause in elective surgical cases was not associated with short-term adverse outcomes in VA hospitals, suggesting appropriate surgical case triage and management. Further study will be essential to determine if the delayed cases were associated with longer-term effects. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: COVID-19 Source Type: research

Analysis of COVID-19 Patients With Acute Respiratory Distress Syndrome Managed With Extracorporeal Membrane Oxygenation at US Academic Centers
Conclusions: In this large US study of patients with COVID-19 and ARDS managed with ECMO, the in-hospital mortality is high but much lower than initial reports. Future research is needed to evaluate which patients with COVID-19 and ARDS would benefit from ECMO. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: COVID-19 Source Type: research

How Hospitals Can Save Lives and Themselves: Lessons on Patient Flow From the COVID-19 Pandemic
This article lays out a tested strategy that surgical and hospital leaders can use to overcome clinical and financial strain, emphasizing the experience at 2 leading North American medical centers. By classifying the time and resource needs of surgical patients and smoothing the flow of surgical admissions over all days of the week, hospitals can dramatically improve hospital efficiency, the quality of care and timely access to care for emergent and urgent surgeries. Through and beyond the time of COVID, smoothing the flow of surgical patients is a key means to restore hospital vitality and improve the care of all patients...
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

The Left Hepatic Bile Duct Is Not Longer?!
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

Extended Right-hemihepatectomy Is Preferred for Perihilar Cholangiocarcinoma
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

Oncological Superiority of Right-sided Hepatectomy Over Left-sided Hepatectomy as Surgery for Perihilar Cholangiocarcinoma: Truth or Biased View?
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

Prosthetic Mesh for Prevention of Parastomal Hernia: Neither Benefit nor “Meshed Ups”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: FEATURES Source Type: research

Meta-analysis and Systematic Review of the Use of a Prosthetic Mesh for Prevention of Parastomal Hernia
Conclusions: Based on this meta-analysis including the latest RCT on the prevention of PSH, the use of a mesh should not be recommended. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: FEATURES Source Type: research

Beyond Burnout
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: FEATURES Source Type: research

The Role of Personal Accomplishment in General Surgery Resident Well-being
Conclusion: PA is a distinct metric of resident well-being, associated with job satisfaction and attrition. Drivers of PA differ by PGY level and may be targets for intervention to promote resident wellness and engagement. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: FEATURES Source Type: research

Comprehensive Characterization of the General Surgery Residency Learning Environment and the Association With Resident Burnout
Conclusions: Resident burnout is independently associated with multiple aspects of the learning environment, including workload, social support, meaning in work, and mistreatment. Efforts to help programs identify and address weaknesses in a targeted fashion may improve trainee burnout. (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: FEATURES Source Type: research

Geopolitics of Liver Anatomy: It's Cantlie's Fault!
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: FEATURES Source Type: research

Proposal of a New Comprehensive Notation for Hepatectomy: The “New World” Terminology
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - June 17, 2021 Category: Surgery Tags: FEATURES Source Type: research

Comment on “Falciform Patch for Laparoscopic Subtotal Cholecystectomy to Decrease Biliary Fistulas: A Technical Review”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: BRIEF CLINICAL REPORTS Source Type: research

Falciform Patch for Laparoscopic Subtotal Cholecystectomy to Decrease Biliary Fistulas: A Technique Review
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: BRIEF CLINICAL REPORTS Source Type: research

Biomarker Development in IPMN: The Problem of the Known Unknowns and the Unknown Unknowns
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: BRIEF CLINICAL REPORTS Source Type: research

Noninvasive Discrimination of Low and High-risk Pancreatic Intraductal Papillary Mucinous Neoplasms
Conclusions: This study highlights the synergistic predictive value of combining a novel serum protein signature with conventional clinical characteristics to risk-stratify IPMN patients. If these findings are supported by larger validation studies, they might enable more rational decision-making in clinical management of IPMN patients in conjunction with clinical guidelines. (Source: Annals of Surgery)
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: BRIEF CLINICAL REPORTS Source Type: research

Unforeseen Collateral Damage of COVID-19 With the Virtualization of Fellowship Interviews
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

Practical Guidance for Early Identification of Barriers in Surgical Telehealth Clinics
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - May 19, 2021 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

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