Comparative Effectiveness of Vertical Sleeve Gastrectomy Versus Roux-en-Y Gastric Bypass for Diabetes Treatment: A Claims-based Cohort Study
Conclusions: In a large claims-based, nationwide cohort of bariatric patients with diabetes, those undergoing RYGB were more likely to come off all medications than those undergoing VSG. Patients with diabetes should consider this potential benefit of RYGB when making informed decisions about obesity treatments. (Source: Annals of Surgery)
Source: Annals of Surgery - April 15, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Prediction Model of Long-term Survival After Esophageal Cancer Surgery
Conclusions: These models showed good performance for predicting long-term survival after esophageal cancer surgery and may thus be useful for patients in planning their lives and to guide the postoperative treatment and follow-up. (Source: Annals of Surgery)
Source: Annals of Surgery - April 15, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

An International Comparison of the Management of Gastrointestinal Surgical Emergencies in Octogenarians—England Versus United States: A National Population-based Cohort Study
Conclusion: Surgery is used less commonly in England for emergency gastrointestinal conditions in octogenarians, which may be associated with a high rate of in-hospital mortality from these conditions compared with the USA. (Source: Annals of Surgery)
Source: Annals of Surgery - April 15, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Long-term Health Outcomes and Health System Costs Associated With Surgical Site Infections: A Retrospective Cohort Study
Conclusion: SSIs, especially deep/organ space SSI, contribute to adverse health outcomes and health care costs across the entire year after surgery. Our findings highlight the importance of effective prevention/monitoring strategies targeting both short- and long-term consequences of SSI. (Source: Annals of Surgery)
Source: Annals of Surgery - April 15, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Where Is the Value in Ambulatory Versus Inpatient Surgery?
Objective: The aim of this study was to estimate the effect of index surgical care setting on perioperative costs and readmission rates across 4 common elective general surgery procedures. Summary Background Data: Facility fees seem to be a driving force behind rising US healthcare costs, and inpatient-based fees are significantly higher than those associated with ambulatory services. Little is known about factors influencing where patients undergo elective surgery. Methods: All-payer claims data from the 2014 New York and Florida Healthcare Cost and Utilization Project were used to identify 73,724 indivi...
Source: Annals of Surgery - April 15, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Natural Language Processing in Surgery: A Systematic Review and Meta-analysis
Objective: The aim of this study was to systematically assess the application and potential benefits of natural language processing (NLP) in surgical outcomes research. Summary Background Data: Widespread implementation of electronic health records (EHRs) has generated a massive patient data source. Traditional methods of data capture, such as billing codes and/or manual review of free-text narratives in EHRs, are highly labor-intensive, costly, subjective, and potentially prone to bias. Methods: A literature search of PubMed, MEDLINE, Web of Science, and Embase identified all articles published starting ...
Source: Annals of Surgery - April 15, 2021 Category: Surgery Tags: REVIEW PAPER Source Type: research

Heavyweight Mesh Is Superior to Lightweight Mesh in Laparo-endoscopic Inguinal Hernia Repair: A Meta-analysis and Trial Sequential Analysis of Randomized Controlled Trials
Conclusion: HWM should be used in laparo-endoscopic repairs of direct or large inguinal hernias to reduce recurrence rates. LWM provide no benefit in indirect hernias. (Source: Annals of Surgery)
Source: Annals of Surgery - April 15, 2021 Category: Surgery Tags: META ANALYSES Source Type: research

A Systematic Review of Minimally Invasive Trans-thoracic Liver Resection to Examine Intervention Description, Governance, and Outcome Reporting of an Innovative Technique
Conclusions: Technical details and governance procedures were poorly described. Outcomes focussed on short term details alone. Transparency is needed for reporting the introduction of new surgical techniques to allow their safe dissemination. (Source: Annals of Surgery)
Source: Annals of Surgery - April 15, 2021 Category: Surgery Tags: META ANALYSES Source Type: research

Resection of Cavity Shave Margins in Stage 0–III Breast Cancer Patients Undergoing Breast Conserving Surgery: A Prospective Multicenter Randomized Controlled Trial
Objective: Single-center studies have demonstrated that resection of cavity shave margins (CSM) halves the rate of positive margins and re-excision in breast cancer patients undergoing partial mastectomy (PM). We sought to determine if these findings were externally generalizable across practice settings. Methods: In this multicenter randomized controlled trial occurring in 9 centers across the United States, stage 0–III breast cancer patients undergoing PM were randomly assigned to either have resection of CSM (“shave” group) or not (“no shave” group). Randomization occurred intrao...
Source: Annals of Surgery - April 15, 2021 Category: Surgery Tags: RANDOMIZED CONTROLLED TRIALS Source Type: research

Impact of Facilitation of Early Mobilization on Postoperative Pulmonary Outcomes After Colorectal Surgery: A Randomized Controlled Trial
Conclusions: In this randomized controlled trial, staff-directed facilitation of early mobilization did not improve postoperative pulmonary function or reduce PPCs within an enhanced recovery pathway for colorectal surgery. Trial Registration: ClinicalTrials.gov Identifier: NCT02131844. (Source: Annals of Surgery)
Source: Annals of Surgery - April 15, 2021 Category: Surgery Tags: RANDOMIZED CONTROLLED TRIALS Source Type: research

Assessment of Robotic Versus Laparoscopic Distal Gastrectomy for Gastric Cancer: A Randomized Controlled Trial
Objective: To evaluate the short-term outcomes of patients with GC who received RDG or LDG. Summary Background Data: Despite the increasing use of RDG in patients with GC, its safety and efficacy compared to those of LDG have not been elucidated in a randomized controlled trial. Methods: Three hundred patients with cT1-4a and N0/+ between September 2017 and January 2020 were enrolled in this randomized controlled trial at a high-volume hospital in China. The short-term outcomes were compared between the groups. Results: The modified intention-to-treat analysis included data from 283 patients (RDG g...
Source: Annals of Surgery - April 15, 2021 Category: Surgery Tags: RANDOMIZED CONTROLLED TRIALS Source Type: research

Estimating the Impact of Extended Delay to Surgery for Stage I Non-small-cell Lung Cancer on Survival
Objective: The purpose of this study is to evaluate the impact of extended delay to surgery for stage I NSCLC. Summary of Background Data: During the COVID-19 pandemic, patients with NSCLC may experience delays in care, and some national guidelines recommend delays in surgery by>3 months for early NSCLC. Methods: Using data from the National Lung Screening Trial, a multi-center randomized trial, and the National Cancer Data Base, a multi-institutional oncology registry, the impact of “early” versus “delayed” surgery (surgery received 0–30 vs 90–120 days after dia...
Source: Annals of Surgery - April 15, 2021 Category: Surgery Tags: COVID-19 Source Type: research

The Cost of Quarantine: Projecting the Financial Impact of Canceled Elective Surgery on the Nation's Hospitals
Conclusions: Strategies to mitigate the predicted revenue loss of $22.3B due to major elective surgery cessation will vary with hospital-specific supply-demand equilibrium. If patient demand is slow to return, hospitals should focus on marketing of services; if hospital capacity is constrained, efficient capacity expansion may be beneficial. Finally, rural and urban nonteaching hospitals may face increased financial risk which may exacerbate care disparities. (Source: Annals of Surgery)
Source: Annals of Surgery - April 15, 2021 Category: Surgery Tags: COVID-19 Source Type: research

What Matters Most for Older Surgical Patients
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - April 15, 2021 Category: Surgery Tags: FEATURES Source Type: research

Functional Effects of Intervening Illnesses and Injuries After Hospitalization for Major Surgery in Community-living Older Persons
Conclusions: Intervening illnesses/injuries are common in the year after major surgery, and those leading to hospitalization and ED visit are strongly associated with adverse functional outcomes, with effect sizes larger than those of traditional risk factors. (Source: Annals of Surgery)
Source: Annals of Surgery - April 15, 2021 Category: Surgery Tags: FEATURES Source Type: research

Invited Commentary on The Role of Race and Gender in the Career Experiences of Black/African-American Academic Surgeons: A Survey of the Society of Black Academic Surgeons and a Call to Action
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - April 15, 2021 Category: Surgery Tags: FEATURES Source Type: research

The Role of Race and Gender in the Career Experiences of Black/African American Academic Surgeons: A Survey of the Society of Black Academic Surgeons and a Call to Action
Objective: To determine the role of race and gender in the career experience of Black/AA academic surgeons and to quantify the prevalence of experience with racial and gender bias stratified by gender. Summary of Background Data: Compared to their male counterparts, Black/African American women remain significantly underrepresented among senior surgical faculty and department leadership. The impact of racial and gender bias on the academic and professional trajectory of Black/AA women surgeons has not been well-studied. Methods: A cross-sectional survey regarding demographics, employment, and perceived ba...
Source: Annals of Surgery - April 15, 2021 Category: Surgery Tags: FEATURES Source Type: research

Comment on “Acute Thrombosis of Lower Limbs Arteries in the Acute Phase and After Recovery From COVID19 Infection”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - March 20, 2021 Category: Surgery Tags: BRIEF CLINICAL REPORTS Source Type: research

Acute Thrombosis of Lower Limbs Arteries in the Acute Phase and After Recovery From COVID19
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - March 20, 2021 Category: Surgery Tags: BRIEF CLINICAL REPORTS Source Type: research

Comment on “The Value of Hepatic Vein Stent Placement as a Bridge Therapy on Treating Hepatic Alveolar Echinococcosis Presenting With Budd-Chiari Syndrome”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - March 20, 2021 Category: Surgery Tags: BRIEF CLINICAL REPORTS Source Type: research

The Value of Hepatic Vein Stent Placement as a Bridge Therapy on Treating Hepatic Alveolar Echinococcosis Presenting With Budd-Chiari Syndrome
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - March 20, 2021 Category: Surgery Tags: BRIEF CLINICAL REPORTS Source Type: research

Comment on “Association Between Missed Doses of Chemoprophylaxis and Venous Thromboembolism Incidence in a Statewide Colectomy Cohort”
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - March 20, 2021 Category: Surgery Tags: BRIEF CLINICAL REPORTS Source Type: research

Association Between Missed Doses of Chemoprophylaxis and VTE Incidence in a Statewide Colectomy Cohort
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - March 20, 2021 Category: Surgery Tags: BRIEF CLINICAL REPORTS Source Type: research

Another Step Toward Becoming a Transplant Community
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - March 20, 2021 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

Multisystem Inflammatory Syndrome in Children Mimicking Surgical Pathologies: What Surgeons Need to Know about MIS-C
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - March 20, 2021 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

Of Fistula and Football
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - March 20, 2021 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

Smoking and Nicotine Effects on Surgery: Is Nicotine Replacement Therapy (NRT) a Safe Option?
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - March 20, 2021 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

The Day the Computers Went Down
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - March 20, 2021 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

Introduction of the Surgical Providers Assessment and Response to Climate Change (SPARC2) Tool: One Small Step Toward Reducing the Carbon Footprint of Surgical Care
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - March 20, 2021 Category: Surgery Tags: SURGICAL PERSPECTIVES Source Type: research

Changes in Surgeries and Therapeutic Procedures During the COVID-19 Outbreak: A Longitudinal Study of Acute Care Hospitals in Japan
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - March 20, 2021 Category: Surgery Tags: COVID-19 Source Type: research

Surgical Procedures in Veterans Affairs Hospitals During the COVID-19 Pandemic
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - March 20, 2021 Category: Surgery Tags: COVID-19 Source Type: research

Act Justly and Approach Humbly: Minority Trainees’ Perspective on Learning to Study Race in the Surgical Sciences
No abstract available (Source: Annals of Surgery)
Source: Annals of Surgery - March 20, 2021 Category: Surgery Tags: EQUITY AND SOCIAL JUSTICE Source Type: research

The Missing Chapter: The Education of Surgery and Anesthesiology Trainees as Civic Advocates
The SARS-CoV-2 pandemic has highlighted existing systemic inequities that adversely affect a variety of communities in the United States. These inequities have a direct and adverse impact on the healthcare of our patient population. While civic engagement has not been cultivated in surgical and anesthesia training, we maintain that it is inherent to the core role of the role of a physician. This is supported by moral imperative, professional responsibility, and a legal obligation. We propose that such civic engagement and social justice activism is a neglected, but necessary aspect of physician training. We propose the imp...
Source: Annals of Surgery - March 20, 2021 Category: Surgery Tags: EQUITY AND SOCIAL JUSTICE Source Type: research

Influence of Oral Antibiotics Following Discharge on Organ Space Infections in Children With Complicated Appendicitis
Conclusions: Use of oral antibiotics following discharge may decrease organ space infections in children with complicated appendicitis, and those presenting with high-severity disease may be most likely to benefit. (Source: Annals of Surgery)
Source: Annals of Surgery - March 20, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Preoperative Ultrasound Assessment of Regional Lymph Nodes in Melanoma Patients Does not Provide Reliable Nodal Staging: Results From a Large Multicenter Trial
Conclusion: In the MSLT-II screening phase population, SN tumor volume was usually too small to be reliably detected by US. For accurate nodal staging to guide the management of melanoma patients, US is not an effective substitute for SN biopsy. (Source: Annals of Surgery)
Source: Annals of Surgery - March 20, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Radiographic and Serologic Predictors of Pathologic Major Response to Preoperative Therapy for Pancreatic Cancer
Objective: We sought to identify potential radiologic and serologic markers of pancreatic tumor response to therapy, using pathologic major response (pMR) as the objective endpoint. Background: We previously demonstrated that a pMR to preoperative therapy, defined as detection of (Source: Annals of Surgery)
Source: Annals of Surgery - March 20, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Morphologic Factors Predict Pain Relief Following Pancreatic Head Resection in Chronic Pancreatitis Description of the Chronic Pancreatitis Pain Relief (CPPR) Score
This study analyzes the clinicopathologic findings and their impact on outcome of patients so as to identify which patients benefit most from surgical treatment in chronic pancreatitis, especially in regard to pain relief. Summary Background Data: The predominant symptom of chronic pancreatitis is chronic pain resulting in reduced quality of life. It is well known that the main reason for development of the disease is abuse of alcohol and nicotine, but only little data on factors influencing outcome are available. Methods: One thousand one hundred forty-six consecutive patients who underwent surgery for chron...
Source: Annals of Surgery - March 20, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Surgery for Recurrent Hepatocellular Carcinoma: Achieving Long-term Survival
Objective: To evaluate the long-term outcomes of surgery for recurrent hepatocellular carcinoma (HCC). Background: HCC recurs with high incidence after liver resection. Little is known about long-term outcomes of patients undergoing surgery for recurrent HCC. Methods: Among 989 patients who underwent R0/R1 liver resection for HCC between 1995 and 2014, 676 patients who exhibited recurrence were included. Repeat surgery was performed in 128 patients (RS group), and not in the remaining 548 patients (NS group). Prognostic value after repeat surgery was evaluated by comparing survival after recurrence (SAR) ...
Source: Annals of Surgery - March 20, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Parenchymal Sparing Anatomical Liver Resections With Full Laparoscopic Approach: Description of Technique and Short-term Results
Conclusions: A precise preoperative planning and a standardized surgical technique allow to pursue the oncological quality of AR enhancing the safety of the parenchyma sparing principle, reducing surgical stress through a laparoscopic approach. (Source: Annals of Surgery)
Source: Annals of Surgery - March 20, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Clinical Evaluation of Intraoperative Near Misses in Laparoscopic Rectal Cancer Surgery
Objective: To investigate the frequency, nature, and severity of intraoperative adverse near miss events within advanced laparoscopic surgery and report any associated clinical impact. Background: Despite implementation of surgical safety initiatives, the intraoperative period is poorly documented with evidence of underreporting. Near miss analyses are undertaken in high-risk industries but not in surgical practice. Methods: Case video and data from 2 laparoscopic total mesorectal excision randomized controlled trials were analyzed (ALaCaRT ACTRN12609000663257, 2D3D ISRCTN59485808). Intraoperative adverse...
Source: Annals of Surgery - March 20, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Enhanced Recovery Pathway Benefits Patients Undergoing Nonelective Colorectal Surgery
Conclusions: Patients undergoing nonelective colorectal surgery after ER or hospital transfer admission benefit from the use of an ERP, demonstrating decreased LOS and costs without an increase in complications. (Source: Annals of Surgery)
Source: Annals of Surgery - March 20, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Evaluating the Effect of Surgical Skill on Outcomes for Laparoscopic Sleeve Gastrectomy: A Video-based Study
Background: Prior studies have demonstrated a correlation between surgical skill and complication rates after laparoscopic Roux-en-Y gastric bypass. However, the impact of surgical skill on a similar but less technically challenging procedure such as sleeve gastrectomy (SG) is unknown. Methods: Practicing bariatric surgeons (n = 25) participating in a statewide quality improvement collaborative submitted an unedited deidentified video of a representative laparoscopic SG. Videos were obtained between 2015 and 2016 and were rated by bariatric surgeons in a blinded fashion using a validated instrument that assesses...
Source: Annals of Surgery - March 20, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Five-year Longitudinal Cohort Study of Reinterventions After Sleeve Gastrectomy and Roux-en-Y Gastric Bypass
Objective: To compare the long-term risks of reintervention following sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) in a large surgical cohort. Background: The use of SG has increased dramatically relative to RYGB for the treatment of obesity. However, long-term risks following SG compared with RYGB have not been adequately defined in a large population-based study. Methods: A retrospective longitudinal cohort study of all adult health-plan members undergoing SG or RYGB for obesity in a multistate integrated health care system from January 2005 through September 2015. The risks of nutritiona...
Source: Annals of Surgery - March 20, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Frequency and Implications of Paratracheal Lymph Node Metastases in Resectable Esophageal or Gastroesophageal Junction Adenocarcinoma
Objective: We aimed to evaluate the frequency of paratracheal lymph nodes (LN) metastases and their prognostic influence. Summary Background Data: Paratracheal LNs are considered regional nodes in the esophageal cancer classification, but their metastatic rate and influence on survival remain unclear. Methods: One thousand one hundred ninety-nine patients with resectable esophageal or gastroesophageal junction adenocarcinoma (EAC) (January 2002 and December 2016) in our Gastrointestinal Medical Oncology Database were analyzed. Paratracheal LNs were defined as1R, 1L, 2R, 2L, 4R, and 4L, according to the 8t...
Source: Annals of Surgery - March 20, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Postsurgical Opioid Prescriptions and Risk of Long-term Use: An Observational Cohort Study Across the United States
Conclusions: Between 2005 and 2015, the amounts of opioids prescribed for postoperative pain increased dramatically, and receipt of larger volume of opioids was associated with increased risk of long-term opioid therapy. (Source: Annals of Surgery)
Source: Annals of Surgery - March 20, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Identification of Plasma Proteome Signatures Associated With Surgery Using SOMAscan
Conclusion: SOMAscan can identify novel and clinically relevant surgery-induced protein changes. Ultimately, proteomics may provide insights about pathways by which surgical stress contributes to postoperative outcomes. (Source: Annals of Surgery)
Source: Annals of Surgery - March 20, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Impact of Oral Immunonutrition on Postoperative Morbidity in Digestive Oncologic Surgery: A Nation-wide Cohort Study
The objective of the present study was to assess the effect of preoperative immunonutrition on a nationwide scale. Background: According to international guidelines, immunonutrition should be prescribed before major oncologic digestive surgery to decrease postoperative morbidity. Nevertheless, this practice remains controversial. Methods: We used a prospective national health database named “Echantillon généraliste des Bénéficiaires.” Patients were selected with ICD10 codes of cancer and digestive surgery procedures from 2012 to 2016. Two groups were identified: with re...
Source: Annals of Surgery - March 20, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

An Assessment of Patient, Caregiver, and Clinician Perspectives on the Post-discharge Phase of Care
Conclusions: Patients live the day-to-day of recovery, whereas caregivers and clinicians also contemplate more expansive concerns. Incorporating relevant perceptions into traditional clinical outcomes and concepts could enhance the surgical experience for all stakeholders. (Source: Annals of Surgery)
Source: Annals of Surgery - March 20, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

Frailty in Older Patients Undergoing Emergency Laparotomy: Results From the UK Observational Emergency Laparotomy and Frailty (ELF) Study
Conclusions: A fifth of older adults undergoing emergency laparotomy are frail. The presence of frailty is associated with greater risks of postoperative mortality and morbidity and is independent of age. Frailty scoring should be integrated into acute surgical assessment practice to aid decision-making and development of novel postoperative strategies. (Source: Annals of Surgery)
Source: Annals of Surgery - March 20, 2021 Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research

A Proposed Blueprint for Operative Performance Training, Assessment, and Certification
Conclusions: A competency-based operative skill assessment can be incorporated into surgical training, assessment, and certification. The time has come to develop a systematic approach to this issue as a means of demonstrating professional standards worthy of the public trust. (Source: Annals of Surgery)
Source: Annals of Surgery - March 20, 2021 Category: Surgery Tags: REVIEW PAPERS Source Type: research