Long-term Outcomes of the FIRST Trial: What Have we Missed?
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - April 17, 2020 Category: Surgery Tags: FEATURES Source Type: research

Cumulative Effect of Flexible Duty-hour Policies on Resident Outcomes: Long-term Follow-up Results From the FIRST Trial
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - April 17, 2020 Category: Surgery Tags: FEATURES Source Type: research

Comment on “Prognostic Factors of Survival After Neoadjuvant Treatment and Resection for Initially Unresectable Pancreatic Cancer”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - March 20, 2020 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

Response to the Comment on “‘Prognostic Factors of Survival After Neoadjuvant Treatment and Resection for Initially Unresectable Pancreatic Cancer’: What Is Good for the Surgeon Is Just as Good for the Patient?” The Case of Unresectable Pancreatic Cancer After Neoadjuvant Treatment
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - March 20, 2020 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

Comment on “Implant-Based Breast Reconstruction With Acellular Dermal Matrix. Safety Data From an Open-Label, Multicenter, Randomized, Controlled Trial in the Setting of Breast Cancer Treatment”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - March 20, 2020 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

Response to the Comment on “The S100A10 Pathway Mediates an Occult Hyperfibrinolytic Subtype in Trauma Patients”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - March 19, 2020 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

Comment on “The S100A10 Pathway Mediates an Occult Hyperfibrinolytic Subtype in Trauma Patients”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - March 19, 2020 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

Response to the Comment on “Prognostic Factors of Survival After Neoadjuvant Treatment and Resection for Initially Unresectable Pancreatic Cancer”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - March 19, 2020 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

Comment on Prognostic Factors of Survival After Neoadjuvant Treatment and Resection for Initially Unresectable Pancreatic Cancer
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - March 19, 2020 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

Response: the Comment on “Prognostic Factors of Survival After Neoadjuvant Treatment and Resection for Initially Unresectable Pancreatic Cancer”: What Is Good for the Surgeon Is Just as Good for the Patient?” The Case of Unresectable Pancreatic Cancer After Neoadjuvant Treatment
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - March 19, 2020 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

Comment on “Prognostic Factors of Survival After Neoadjuvant Treatment and Resection for Initially Unresectable Pancreatic Cancer”: What Is Good for the Surgeon Is Just as Good for the Patient?
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - March 19, 2020 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

Commentary to “Implant-Based Breast Reconstruction With Acellular Dermal Matrix. Safety Data From an Open-Label, Multicenter, Randomized, Controlled Trial in the Setting of Breast Cancer Treatment”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - March 19, 2020 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

Comment on “Pouch Versus No Pouch Following Total Gastrectomy: Meta-analysis of Randomized and Nonrandomized Studies”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - March 19, 2020 Category: Surgery Tags: LETTERS TO THE EDITOR Source Type: research

A Model for Academic Symbiosis
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - March 19, 2020 Category: Surgery Tags: COMMENTARY ON BRIEF CLINICAL REPORT Source Type: research

Establishing and Coordinating a Nationwide Multidisciplinary Study Group: Lessons Learned by the Dutch Pancreatic Cancer Group
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - March 19, 2020 Category: Surgery Tags: BRIEF CLINICAL REPORT Source Type: research

Variation in Surgical Treatment of Abdominal Aortic Aneurysms With Small Aortic Diameters in the Netherlands
Objective: To evaluate reasons to deviate from aneurysm diameter thresholds, and focus on the difference in how Dutch vascular surgical units (VSUs) perceive their deviation and their actual deviation. Background: Guidelines recommend surgical treatment for asymptomatic abdominal aortic aneurysms (AAAs) with a diameter of at least 55 mm for men and 50 mm for women. We evaluate reasons to deviate from these guidelines, and focus on the difference in how Dutch vascular surgical units (VSUs) perceive their deviation and their actual deviation. Methods: All patients undergoing elective AAA repair between 2013 and 2...
Source: Annals of Surgery - March 19, 2020 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Impact of Reduced Preincision Antibiotic Infusion Time on Surgical Site Infection Rates: A Retrospective Cohort Study
Objective: Our objective was to determine the impact of total preincision infusion time on surgical site infections (SSIs) and establish an optimal time threshold for subsequent prospective study. Background: SSIs remain a major cause of morbidity. Although regulated, the total time of infusion of preincision antibiotics varies widely. Impact of infusion time on SSI risk is poorly understood. Methods: All consecutive patients (n = 46,791) undergoing inpatient surgical intervention were retrospectively enrolled (2014–2015) and monitored for 1 year. Primary outcomes: the presence of SSI infection as predicted b...
Source: Annals of Surgery - March 19, 2020 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Is Less More? A Microsimulation Model Comparing Cost-effectiveness of the Revised American Thyroid Association's 2015 to 2009 Guidelines for the Management of Patients With Thyroid Nodules and Differentiated Thyroid Cancer
Conclusions: The ATA 2015 Guidelines represent a cost-effective strategy regarding AS and extent of surgery. (Source: Annals of Surgery)
Source: Annals of Surgery - March 19, 2020 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Smaller Inguinal Hernias are Independent Risk Factors for Developing Chronic Postoperative Inguinal Pain (CPIP): A Registry-based Multivariable Analysis of 57, 999 Patients
Objective: Impact of inguinal hernia defect size as stratified by the European Hernia Society (EHS) classification I to III on the rate of chronic postoperative inguinal pain (CPIP). Background: CPIP is the most important complication after inguinal hernia repair. The impact of hernia defect size according to the EHS classification on CPIP is unknown. Methods: In total, 57,999 male patients from the Herniamed registry undergoing primary unilateral inguinal hernia repair including a 1-year follow-up were selected between September 1, 2009 and November 30, 2016. Using multivariable analysis, the impact of EHS inguina...
Source: Annals of Surgery - March 19, 2020 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Association of MRI T2 Signal Intensity With Desmoid Tumor Progression During Active Observation: A Retrospective Cohort Study
Objective: The aim of this study was to identify predictors of desmoid progression during observation. Summary of Background Data: Untreated desmoids can grow, remain stable, or regress, but reliable predictors of behavior have not been identified. Methods: Primary or recurrent desmoid patients were identified retrospectively from an institutional database. In those managed with active observation who underwent serial magnetic resonance imaging (MRIs) with T2-weighted sequences, baseline tumor size was recorded, and 2 radiologists independently estimated the percentage of tumor volume showing hyperintense T2 signal...
Source: Annals of Surgery - March 19, 2020 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Importance of Normalization of CA19-9 Levels Following Neoadjuvant Therapy in Patients With Localized Pancreatic Cancer
Objective: Carbohydrate antigen 19-9 (CA19-9) is a prognostic marker for patients with pancreatic cancer (PC), but its value as a treatment biomarker is unclear. Summary Background Data: Although CA19-9 is an established prognostic marker for patients with PC, it is unclear how CA19-9 monitoring should be used to guide multimodality treatment and what level of change in CA19-9 constitutes a meaningful treatment response. Methods: CA19-9 measurements at diagnosis (pretx), after completion of all planned neoadjuvant therapy (preop), and after surgery (postop) were analyzed in patients with localized PC who had an ele...
Source: Annals of Surgery - March 19, 2020 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Downregulated Pancreatic Beta Cell Genes Indicate Poor Prognosis in Patients With Pancreatic Neuroendocrine Neoplasms
Objective: To predict metachronous liver metastasis after pancreatectomy for pancreatic neuroendocrine neoplasms (Pan-NENs). Summary of Background Data: Liver metastasis determines the prognosis of patients with Pan-NENs, but no index exists in the WHO 2017 classification for this prediction. Methods: Between April 2014 and March 2018, resected primary tumors from 20 patients with or without simultaneous liver metastasis were examined using genome-wide gene expression analysis. For validation analysis, resected primary tumors from 62 patients without simultaneous liver metastasis were examined for PAX6 expression. ...
Source: Annals of Surgery - March 19, 2020 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Comprehensive Complication Index Validates Improved Outcomes Over Time Despite Increased Complexity in 3707 Consecutive Hepatectomies
Objective: The aim of this study was to evaluate trends over time in perioperative outcomes for patients undergoing hepatectomy. Background: As perioperative care and surgical technique for hepatectomy have improved, the indications for and complexity of liver resections have evolved. However, the resulting effect on the short-term outcomes over time has not been well described. Methods: Consecutive patients undergoing hepatectomy during 1998 to 2015 at 1 institution were analyzed. Perioperative outcomes, including the comprehensive complication index (CCI), were compared between patients who underwent hepatectomy ...
Source: Annals of Surgery - March 19, 2020 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Microsatellite Instability (MSI) as an Independent Predictor of Pathologic Complete Response (PCR) in Locally Advanced Rectal Cancer: A National Cancer Database (NCDB) Analysis
Objective: The relationship between microsatellite instability (MSI) and response to neoadjuvant chemoradiation in rectal cancer is not well understood. Background: We utilized the National Cancer Database (NCDB) to investigate the association between MSI and pathologic complete response (pCR) in this patient population. Methods: We analyzed 5086 patients between 2010 and 2015 with locally advanced rectal cancer who were tested for MSI and treated definitively with chemoradiation followed by surgery. Primary comparison groups were between 4450 MSI-negative(−) and 636 MSI-positive(+) patients. Multivariable re...
Source: Annals of Surgery - March 19, 2020 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Reintervention After Antireflux Surgery for Gastroesophageal Reflux Disease in England
Conclusion: At least 3.6% of patients may require surgical reintervention and 59.5% medical therapy following antireflux surgery in England. The influence of patient characteristics and hospital volume highlights the need for patient selection and surgical experience in successful antireflux surgery. (Source: Annals of Surgery)
Source: Annals of Surgery - March 19, 2020 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Workload, Recurrence, Quality of Life and Long-term Efficacy of Endoscopic Therapy for High-grade Dysplasia and Intramucosal Esophageal Adenocarcinoma
Conclusions: Endotherapy is successful in most patients, but multiple sessions are usually required and disease progression can occur. Once CRIM is achieved, recurrence is common and mandates continued endoscopic follow-up. QOL is impaired with endotherapy, but alimentary satisfaction and oncologic outcomes support esophageal preservation with endotherapy for patients with HGD or IMC. (Source: Annals of Surgery)
Source: Annals of Surgery - March 19, 2020 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Prognostic Nutritional Index, Tumor-infiltrating Lymphocytes, and Prognosis in Patients with Esophageal Cancer
Objective: To determine whether prognostic nutritional index (PNI) affects clinical outcome through local immunity in esophageal cancers. Background: PNI is an indicator of nutritional status and systemic immune competence, and has attracted attention as a prognostic biomarker. Tumor-infiltrating lymphocytes (TILs) are a specific histological feature of human cancers, reflecting an individual's immunological tumor response. Methods: Using a nonbiased database of 337 curatively resected esophageal cancers, we evaluated the relationship between PNI, TILs status, CD8 expression by immunohistochemical staining, and cli...
Source: Annals of Surgery - March 19, 2020 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

NASA-TLX Assessment of Surgeon Workload Variation Across Specialties
Objective: With advancements in surgical equipment and procedures, human–system interactions in operating rooms affect surgeon workload and performance. Workload was measured across surgical specialties using surveys to identify potential predictors of high workload for future performance improvement. Summary Background Data: Surgical instrumentation and technique advancements have implications for surgeon workload and human–systems interactions. To understand and improve the interaction of components in the work system, NASA-Task Load Index can measure workload across various fields. Baseline workload mea...
Source: Annals of Surgery - March 19, 2020 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Provider Characteristics Associated With Outpatient Opioid Prescribing After Surgery
Objective: To characterize differences in postoperative opioid prescribing across surgical, nonsurgical, and advanced practice providers. Background: There is a critical need to identify best practices around perioperative opioid prescribing. To date, differences in postoperative prescribing among providers are poorly understood. Methods: This is a retrospective multicenter analysis of commercial insurance claims from a statewide quality collaborative. We identified 15,657 opioid-naïve patients who underwent a range of surgical procedures between January 2012 and October 2015 and filled an opioid prescription ...
Source: Annals of Surgery - March 19, 2020 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Pressure Injury
This article encompasses dedicated sections on the full spectrum of the pressure related pathologies including “conventional pressure ulcers”, “medical device related pressure injuries”, “pressure injuries in mucosal membranes”, “pressure injuries in pediatric population”, “pressure injury at end of life”, and the “role of pressure in pathogenesis of diabetic foot ulcers”. (Source: Annals of Surgery)
Source: Annals of Surgery - March 19, 2020 Category: Surgery Tags: REVIEW PAPERS Source Type: research

The 100 Most Cited Papers in the History of the American Surgical Association
Conclusions: The top 100 most cited publications from the ASA are highly impactful, landmark studies representing a diverse array of subject matter, investigators, study design, institutions, and countries. These influential publications have immensely advanced surgical science over the decades and should serve as inspiration for all surgeons and surgical investigators. (Source: Annals of Surgery)
Source: Annals of Surgery - March 19, 2020 Category: Surgery Tags: REVIEW PAPERS Source Type: research

A Systematic Review and Meta-analysis on Omentoplasty for the Management of Abdominoperineal Defects in Patients Treated for Cancer
Conclusions: This meta-analysis revealed no beneficial effect of omentoplasty on presacral abscess formation and perineal wound healing after APR, while it increases the likelihood of developing a perineal hernia. These findings do not support the routine use of omentoplasty in APR for cancer. (Source: Annals of Surgery)
Source: Annals of Surgery - March 19, 2020 Category: Surgery Tags: META-ANALYSIS Source Type: research

Effect of Remote Ischemic Preconditioning Conducted in Living Liver Donors on Postoperative Liver Function in Donors and Recipients Following Liver Transplantation: A Randomized Clinical Trial
Conclusions: RIPC did not improve liver function in living donor hepatectomy. However, RIPC performed in liver donors may be beneficial for postoperative liver function in recipients after living donor liver transplantation. (Source: Annals of Surgery)
Source: Annals of Surgery - March 19, 2020 Category: Surgery Tags: RANDOMIZED CONTROLLED TRIALS Source Type: research

Perioperative FOLFOX 4 Versus FOLFOX 4 Plus Cetuximab Versus Immediate Surgery for High-Risk Stage II and III Colon Cancers: A Phase II Multicenter Randomized Controlled Trial (PRODIGE 22)
Background: Perioperative chemotherapy has proven valuable in several tumors, but not in colon cancer (CC). Objective: The aim of this study was to evaluate the efficacy and safety of perioperative chemotherapy in patients with locally advanced nonmetastatic CC. Methods: This is a French multicenter randomized phase II trial in patients with resectable high-risk T3, T4, and/or N2 CC on baseline computed tomography (CT) scan. Patients were randomized to receive either 6 months of adjuvant FOLFOX after colectomy (control) or perioperative FOLFOX for 4 cycles before surgery and 8 cycles after (FOLFOX peri-op). In RAS ...
Source: Annals of Surgery - March 19, 2020 Category: Surgery Tags: RANDOMIZED CONTROLLED TRIALS Source Type: research

The Bouffant Hat Debate and the Illusion of Quality Improvement
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - March 19, 2020 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

Direct Contracting in Medicare: Opportunity and Risk for Surgeons
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - March 19, 2020 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

The Dutch Institute for Clinical Auditing: Achieving Codman's Dream on a Nationwide Basis
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - March 19, 2020 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

Locoregional Therapy, Pathologic Response, and HCC Recurrence After Liver Transplantation: Highlighting Success and Looking Toward the Future
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - March 19, 2020 Category: Surgery Tags: FEATURES Source Type: research

Pathologic Response to Pretransplant Locoregional Therapy is Predictive of Patient Outcome After Liver Transplantation for Hepatocellular Carcinoma: Analysis From the US Multicenter HCC Transplant Consortium
Objective: The aim of the study was to determine the rate, predictors, and impact of complete pathologic response (cPR) to pretransplant locoregional therapy (LRT) in a large, multicenter cohort of hepatocellular carcinoma (HCC) patients undergoing liver transplantation (LT). Background: LRT is used to mitigate waitlist dropout for patients with HCC awaiting LT. Degree of tumor necrosis found on explant has been associated with recurrence and overall survival, but has not been evaluated in a large, multicenter study. Methods: Comparisons were made among patients receiving pre-LT LRT with (n = 802) and without (n = ...
Source: Annals of Surgery - March 19, 2020 Category: Surgery Tags: FEATURES Source Type: research

Addressing Sexual Harassment in Surgical Training
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - March 19, 2020 Category: Surgery Tags: FEATURES Source Type: research

Understanding the Barriers to Reporting Sexual Harassment in Surgical Training
Conclusion: Sexual harassment occurs in surgical training and is rarely reported. Many residents who are harassed question if the behavior they experienced was harassment or feel that reporting would be ineffectual—leading to frequent nonreporting. Surgical training programs should provide all-level education on sexual harassment and delineate the best mechanism for resident reporting of sexual harassment. (Source: Annals of Surgery)
Source: Annals of Surgery - March 19, 2020 Category: Surgery Tags: FEATURES Source Type: research

Reforming Views About Residency Duty Hour Reform
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - March 19, 2020 Category: Surgery Tags: FEATURES Source Type: research

Duty Hour Reform and the Outcomes of Patients Treated by New Surgeons
Objective: The aim of the study was to address the controversy surrounding the effects of duty hour reform on new surgeon performance, we analyzed patients treated by new surgeons following the transition to independent practice. Summary Background Data: In 2003, duty hour reform affected all US surgical training programs. Its impact on the performance of new surgeons remains unstudied. Methods: We studied 30-day mortality among 1,483,074 Medicare beneficiaries undergoing general and orthopedic operations between 1999 and 2003 (“traditional“ era) and 2009 and 2013 (“modern” era). The operati...
Source: Annals of Surgery - March 19, 2020 Category: Surgery Tags: FEATURES Source Type: research

Comment on “The Long-term Risk of Venous Thromboembolism After Blunt Splenic Injury Managed by Embolization”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - February 21, 2020 Category: Surgery Tags: BRIEF CLINICAL REPORTS Source Type: research

The Long-term Risk of Venous Thromboembolism After Blunt Splenic Injury Managed by Embolization
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - February 21, 2020 Category: Surgery Tags: BRIEF CLINICAL REPORTS Source Type: research

Comment on “The Contribution of the Deportalized Lobe to Liver Regeneration in Tourniquet-ALPPS”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - February 21, 2020 Category: Surgery Tags: BRIEF CLINICAL REPORTS Source Type: research

The Contribution of the Deportalized Lobe to Liver Regeneration in Tourniquet-ALPPS
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - February 21, 2020 Category: Surgery Tags: BRIEF CLINICAL REPORTS Source Type: research

The American Association of Endocrine Surgeons Guidelines for the Definitive Surgical Management of Thyroid Disease in Adults
Conclusions: Evidence-based guidelines were created to assist clinicians in the optimal surgical management of thyroid disease. (Source: Annals of Surgery)
Source: Annals of Surgery - February 21, 2020 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Is Dedicated Research Time During Surgery Residency Associated With Surgeons’ Future Career Paths?: A National Study
We examined associations between participation in ≥1 year of research during general surgery residency and each of full-time academic-medicine faculty appointment and mentored-K and/or Research Project Grant (RPG, including R01 and other) awards. Summary Background Data: Many surgeons participate in ≥1 year of research during residency; however, the relationship between such dedicated research during general surgery residency and surgeons’ career paths has not been investigated in a national study. Methods: We analyzed deidentified data through August 2014 from the Association of American Medical Colleges...
Source: Annals of Surgery - February 21, 2020 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

The Changing Face of Emergency General Surgery: A 20-year Analysis of Secular Trends in Demographics, Diagnoses, Operations, and Outcomes
Conclusions: This 20-year epidemiological study of all EGS hospital episodes in Scotland has enhanced our understanding of secular trends of EGS, including demographics, diagnoses, operations, and outcomes. These data will help inform stakeholders in EGS service planning and delivery, as well as in surgical training, what has occurred in recent history. (Source: Annals of Surgery)
Source: Annals of Surgery - February 21, 2020 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research