Development and Validation of Procedure-Specific Risk Score for Predicting Postoperative Pulmonary Complication: A NSQIP Analysis
The objective of this study was to develop and validate procedure-specific risk scores for the six procedures with highest rates of PPCs. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - June 18, 2019 Category: Surgery Authors: Carrie A. Foster, Eric J. Charles, Florence E. Turrentine, Min-Woong Sohn, Irving L. Kron, R Scott Jones Tags: Original Scientific Article Source Type: research

Impact of Race, Insurance Status, and Primary Language on the Presentation, Treatment, and Outcomes of Patients with Pancreatic Adenocarcinoma at a Safety-Net Hospital
Differences in outcomes for pancreatic adenocarcinoma among previously identified high risk demographic groups may be attenuated at hospitals that treat relatively high volumes of these vulnerable populations. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - June 15, 2019 Category: Surgery Authors: Praveen Sridhar, Priya Misir, Hyunjee Kwak, Susanna WL. deGeus, Frederick T. Drake, Michael R. Cassidy, David A. McAneny, Jennifer F. Tseng, Teviah E. Sachs Tags: Original Scientific Article Source Type: research

Who Would Have Benefitted from the Prehospital Use of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA)? An Autopsy Study
Non-compressible truncal hemorrhage is the leading cause of trauma patient mortality. In this paper, we use an autopsy review to identify patients who may have been candidates for prehospital deployment of the resuscitative endovascular balloon occlusion of the aorta catheter and unique characteristics of candidates for its placement. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - June 5, 2019 Category: Surgery Authors: Reynold Henry, Kazuhide Matsushima, Rachel N. Henry, Victor Wong, Zachary Warriner, Aaron Strumwasser, Christopher P. Foran, Kenji Inaba, Todd E. Rasmussen, Demetrios Demetriades Tags: Original Scientific Article Source Type: research

Cluster-Randomized Trial of Opiate-Sparing Analgesia after Discharge from Elective Hip Surgery
This study assessed the efficacy of multimodal analgesia and impact of conservative opiate prescribing after discharge from hip surgery. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - June 5, 2019 Category: Surgery Authors: Andrew N. Fleischman, Majd Tarabichi, Carol Foltz, Gabriel Makar, William J. Hozack, Matthew S. Austin, Antonia F. Chen, Opioid Prescription in Orthopedic Surgery after Discharge Research Group Source Type: research

Patient Satisfaction and Pain Control Using an Opioid-Sparing Postoperative Pathway
Opioids are overprescribed after surgical procedures, leading to dependence and diversion into the community. This can be mitigated by evidence-based prescribing practices. We investigated the feasibility of an opioid-sparing pain management strategy after surgical procedures. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 30, 2019 Category: Surgery Authors: Alexander Hallway, Joceline Vu, Jay Lee, William Palazzolo, Jennifer Waljee, Chad Brummett, Michael Englesbe, Ryan Howard Tags: Original scientific article Source Type: research

June 2019 Featured Articles, Volume 228
Get credit right away by taking all CME tests online http://jacscme.facs.org (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 22, 2019 Category: Surgery Tags: Continuing medical education program Source Type: research

Invited Commentary
Dr Zmijewski and colleagues provide an important and insightful study evaluating the optimal surgical remedy for uremic hyperparathyroidism (UHPT). Renal failure-induced vitamin D dysregulation and hyperphosphatemia causes hypocalcemia, ultimately driving parathyroid hyperplasia and the development of UHPT.1 Uremic hyperparathyroidism causes a myriad of end-organ effects, including bone and cardiovascular complications. Furthermore, for patients undergoing renal transplantation, graft failure is higher in poorly controlled UHPT patients. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 22, 2019 Category: Surgery Authors: Taylor C. Brown, Peter S. Yoo Tags: New England surgical society article Source Type: research

Invited Commentary
In this important article, Bryant and colleagues compare outcomes for managing frail trauma patients. The interdisciplinary care protocol that they established and implemented had a significant impact on the delirium and 30-day readmission risk for frail patients. These improvements represent meaningful quality metrics for older patients, and in other studies, have been associated with a reduction in overall mortality.1 Additionally, the authors have demonstrated that this care pathway can be implemented with education and use of pre-existing multidisciplinary teams. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 22, 2019 Category: Surgery Authors: Andrew R. Doben Tags: New England surgical society article Source Type: research

Invited Commentary
In recent years, the concept of frailty, which encompasses a more total assessment of patient well-being and resilience, has found favor as a predictor of treatment outcomes. As demographic and socioeconomic forces combine to increase the number of frail patients in the population, medicine must develop better tools for identifying such patients so that appropriate interventions may be implemented. The goals of such steps should be 2-fold, improving patient care and wisely managing the cost of delivery. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 22, 2019 Category: Surgery Authors: Peter J. Mazzaglia Tags: New England surgical society article Source Type: research

Invited Commentary
To bring surgical management of appendiceal carcinoids into the 21st century, Heller and colleagues, from the Yale School of Medicine, took a clever approach using the National Cancer Database (NCDB) to evaluate surgeon adherence to the current guidelines and the impact of any deviation on overall survival. The authors identified 3,189 patients in the NCDB with appendiceal carcinoid who underwent either appendectomy (n  = 1,893) or right hemicolectomy (n = 1,305) as their definitive treatment. Contrary to National Comprehensive Cancer Network (NCCN) and North American Neuroendocrine Tumor Society (NANETS) guideli...
Source: Journal of the American College of Surgeons - May 22, 2019 Category: Surgery Authors: Laura A. Lambert Tags: New England surgical society article Source Type: research

Invited Commentary
Care of the emergency general surgery (EGS) patient has been undergoing a slow but persistent change since early in the year 2000, as the concept of the model of acute care surgery (ACS) has become more popular. Slow and steady evaluation of the current processes involved in the management of acute nontraumatic surgical illness mirrors the response to trauma care that began in the 1980s. That research into trauma care has matured to the degree that we now enjoy. We are now consistently seeing the benefits derived from similar scrutiny and research applied to EGS patients. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 22, 2019 Category: Surgery Authors: Jonathan D. Gates Tags: New England surgical society article Source Type: research

Invited Commentary
Ductal carcinoma in situ (DCIS) is considered to be a noninvasive, nonobligate precursor lesion that demonstrates a wide variability in  its ability to progress to invasive disease. Studies report that 13% to 50% of DCIS cases will progress to invasive ductal carcinoma.1-4 Despite its frequency and extensively studied nature, DCIS remains a process surrounded by controversy and unknowns, the most striking of which is the lack of id entifiable, reliable markers that predict disease progression. Oseni and colleagues certainly use their current work to highlight yet another unknown as it relates to the correlation of rac...
Source: Journal of the American College of Surgeons - May 22, 2019 Category: Surgery Authors: Jennifer LaFemina Tags: New England surgical society article Source Type: research

Invited Commentary
Dr Clark and colleagues have reviewed and highlighted the risks of moose-motor vehicle collisions in Northern New England and focused on the enormous number of overall animal-motor vehicle collisions in the US. The Federal Highway Administration estimates that there are 300,000 motor vehicle-animal collisions annually, resulting in 26,000 injuries and 200 deaths in the US per year. The authors have pointed out quite clearly that both moose and deer frequently become entangled with motor vehicles, occasionally resulting in fatality. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 22, 2019 Category: Surgery Authors: Paul H. Kispert Tags: New England surgical society article Source Type: research

Invited Commentary
The authors analyzed data from NSQIP to demonstrate that patients undergoing emergency general surgery (EGS) operations after transfer from another acute care facility or emergency room had higher risks of 30-day mortality (10.8%) and morbidity when compared with patients directly admitted to the hospital where they received operations (3.1% mortality). Although this finding of increased mortality associated with transfer agrees with previous studies using administrative data,1 the authors use the clinical elements within NSQIP to develop a robust 3:1 propensity score-matched analysis. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 22, 2019 Category: Surgery Authors: Brent C. White Tags: New England surgical society article Source Type: research

Invited Commentary
Dr Li and colleagues present a single-institutional experience with extended lymphadenectomy for gastric cancer. The series includes 520 patients undergoing operation for gastroesophageal carcinoma over 2 decades. The authors uniquely classify patients as having D0/D1 vs D1+/D2 lymphadenectomy. In this nomenclature, D1+ is a D2 dissection that does not include station 10 (splenic hilum). Patients did not routinely undergo pancreatosplenectomy. The extent of dissection was classified retrospectively by review of the operative notes for details describing an extended lymphadenectomy; if this description was not included, it ...
Source: Journal of the American College of Surgeons - May 22, 2019 Category: Surgery Authors: Timothy L. Fitzgerald Tags: New England surgical society article Source Type: research

Invited Commentary
Dr Heshmati and colleagues looked retrospectively at the outcomes of bariatric surgery (BS) in patients with concurrent inflammatory bowel disease (IBD). Our overall knowledge of the relationship between obesity and the immune system, particularly looking at inflammation and gut microbiota, is still quite limited, but we can begin to learn about these relationships with retrospective reviews such as this one. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 22, 2019 Category: Surgery Authors: John R. Romanelli Tags: New England surgical society article Source Type: research

Invited Commentary
Transfusion of allogenic red blood cells is associated with adverse effects including transfusion reaction, transmission of disease, lung injury, volume overload, and immunosuppression. In the operative patient, allogenic red blood cell transfusion is associated with an increased risk of postoperative wound infection and poorer outcomes.1 Retrospective studies have suggested a link with poorer disease-free and overall survival in patients who receive allogenic blood transfusion and have resection of colorectal cancer2 as well as in patients having resection of colorectal liver metastases. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 22, 2019 Category: Surgery Authors: Dougald C. MacGillivray Tags: New England surgical society article Source Type: research

Invited Commentary
Complicated or fulminant forms of Clostridium difficile infection (CDI) in adults may cause sepsis and hemodynamic collapse despite maximal medical therapy, necessitating emergent operative treatment. This scenario evokes difficult decisions about operative timing and the nature of the operation itself. The standard operative procedure has been emergent total abdominal colectomy (TAC) with end ileostomy and a stapled rectal stump.1 Operative mortality has been persistently high, and patients surviving the resection have poor long-term survival. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 22, 2019 Category: Surgery Authors: John P. Welch Tags: New England surgical society article Source Type: research

Contents
(Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 22, 2019 Category: Surgery Source Type: research

Editorial Board
(Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 22, 2019 Category: Surgery Source Type: research

Who Hurts More? A Multicenter Prospective Study of In-Hospital Opioid Use in Pediatric Trauma Patients in the Midwest
More than 80% of pediatric trauma patients received an opioid in the first 48 hours of hospitalization, although exposure varied by age, injury, and acuity. Amount of opioid increased with child age, injury severity, and fracture, and one-third of children received more than 100 morphine milligrams equivalent in 48 hours. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 21, 2019 Category: Surgery Authors: Carlos A. Pelaez, Jonathan W. Davis, Sarah K. Spilman, Hope M. Guzzo, Kristel M. Wetjen, Kimberly A. Randell, Henry W. Ortega, Graeme J. Pitcher, Justin Kenardy, Marizen R. Ramirez Tags: Original Scientific Article Source Type: research

Proceedings from the Medical Summit on Firearm Injury Prevention: A Public Health Approach to Reduce Death and Disability in the US
An historic meeting of 43 major medical and injury prevention organizations and the American Bar Association (ABA) was hosted by the American College of Surgeons (ACS), February 10-11, 2019. Leaders of these professional organizations met with the goal of building consensus around opportunities to work together to address the growing problem of firearm injury and death in the United States. A multidisciplinary planning committee invited speakers who are leading experts and researchers in this field to review the epidemiology of firearm injury, discuss structural violence and the social determinants of health, review the pu...
Source: Journal of the American College of Surgeons - May 17, 2019 Category: Surgery Authors: Eileen M. Bulger, Deborah A. Kuhls, Brendan T. Campbell, Stephanie Bonne, Rebecca M. Cunningham, Marian Betz, Rochelle Dicker, Megan L. Ranney, Chris Barsotti, Stephen Hargarten, Joseph V. Sakran, Frederick P. Rivara, Thea James, Dorian Lamis, Gary Timmer Tags: Special Article Source Type: research

Ongoing Challenges in Clinical Assessment of Nodal Status in T1 Esophageal Adenocarcinoma
Reliable tools to identify nodal metastasis in early esophageal cancer are limited. External validation of two published risk-assessment scores demonstrated high false positive rate with minimal false negatives. Better diagnostic methods are needed to maximize use of organ-preserving therapy for early stage disease. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 17, 2019 Category: Surgery Authors: Tamar Nobel, Arianna Barbetta, Meier Hsu, Kay See Tan, Smita Sihag, Manjit S. Bains, David Jones, Daniela Molena Tags: Original Scientific Article Source Type: research

Multicenter Observational Study Examining the Implementation of Enhanced Recovery within the Virginia Surgical Quality Collaborative in Patients Undergoing Elective Colectomy
Implementation of enhanced recovery protocols through the Virginia Surgical Quality Collaborative was associated with reduction in length of stay and complications in patients undergoing elective laparoscopic colectomy. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 17, 2019 Category: Surgery Authors: Traci L. Hedrick, Robert H. Thiele, Taryn E. Hassinger, Jean Donovan, H David Reines, Edward Damico, Sandy Fogel, James E. Jones, Jorge Posadas, R Scott Jones, Florence E. Turrentine Tags: Original Scientific Article Source Type: research

Surgical Program Accreditation and Case Logs: What Is the Meaning of the Minima?
A Brief History of Program Accreditation (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 16, 2019 Category: Surgery Authors: John R. Potts, The Next Accreditation System (NAS, Case Minima, Individual Competence Tags: Education Source Type: research

Pulse Pressure as an Early Warning of Hemorrhage in Trauma Patients
In patients who are not hypotensive in the resuscitation bay, narrowed pulse pressure is an independent predictor of active hemorrhage requiring blood product transfusion and intervention for hemorrhage control. Additionally, the probability of active hemorrhage increases as pulse pressure narrows. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 16, 2019 Category: Surgery Authors: Erika M. Priestley, Kenji Inaba, Saskya Byerly, Subarna Biswas, Monica D. Wong, Lydia Lam, Elizabeth Benjamin, Demetrios Demetriades Tags: Original Scientific Article Source Type: research

Management of Uncomplicated Acute Appendicitis as Day Case Surgery: Can Outcomes of a Prospective Study Be Reproduced in Real Life?
The aim of this study was to evaluate the real-life feasibility of day case surgery for uncomplicated appendicitis. The proportion of patients with success was 95%. The unplanned consultation rate was 15%, the unplanned hospitalization rate was 4%, and the unplanned reoperation rate was 0%. Day case surgery constitutes progress in surgery. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 13, 2019 Category: Surgery Authors: Charles Sabbagh, Lor éna Masseline, Gérard Grelpois, Alexandre Ntouba, Jeanne Dembinski, Jean-Marc Regimbeau Tags: Original Scientific Article Source Type: research

Gut Microbiome and Colon Cancer: A Plausible Explanation for Dietary Contributions to Cancer
This is a review of how modern day sequencing provides a fresh opportunity to consider environmental causes of cancer, specifically through our emerging understanding of the human microbiome. It is a story of how microbes shape the gut environment and impact human health, including the insidious transformation of nutrients into tumors. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 10, 2019 Category: Surgery Authors: Heidi Nelson, Nicholas Chia Source Type: research

Conditional Recurrence-Free Survival after Resection of Colorectal Liver Metastases: Persistent Deleterious Association with RAS and TP53 Co-Mutation
Conditional recurrence-free survival probability, ie recurrence probability after a given interval without recurrence is useful for updating prognosis in patients undergoing resection of colorectal liver metastases. RAS/TP53 co-mutation has a persistent deleterious association with recurrence for patients free from recurrence at 1 year and 2 years. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 2, 2019 Category: Surgery Authors: Yoshikuni Kawaguchi, Heather A. Lillemoe, Elena Panettieri, Yun Shin Chun, Ching-Wei D Tzeng, Thomas A. Aloia, Scott Kopetz, Jean-Nicolas Vauthey Tags: Original Scientific Article Source Type: research

Development and Validation of the Ventral Hernia Repair Outcomes Reporting App for Clinician and Patient Engagement (ORACLE)
Patient engagement is an increasingly important component of surgical decision- making. Given the many factors associated with successful ventral hernia repair (VHR), we developed and validated the Outcomes Reporting App for CLinical and Patient Engagement (ORACLE) tool to help facilitate preoperative surgeon-patient discussions regarding VHR. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 2, 2019 Category: Surgery Authors: Ivy N. Haskins, Molly A. Olson, Thomas G. Stewart, Michael J. Rosen, Benjamin K. Poulose Tags: Original Scientific Article Source Type: research

Insulin-Like Growth Factor and SLC12A7 Dysregulation: A Novel Signaling Hallmark of Non-Functional Adrenocortical Carcinomas
This study analyzes the role of insulin-like growth factor (IGF) signaling in adrenocortical carcinoma. Our results demonstrate that IGF1 overexpression caused, in part, by gene copy amplification, is associated with non-functional, early stage tumors as well as aberrant expression of the metastasis promoting gene SL12AC7. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - April 26, 2019 Category: Surgery Authors: Taylor C. Brown, Norman G. Nicolson, Adam Stenman, C Christofer Juhlin, Courtney E. Gibson, Glenda G. Callender, Reju Korah, Tobias Carling Tags: New England Surgical Society Article Source Type: research

A Tale of Two Kidneys: Differences in Graft Survival for Kidneys Allocated to Simultaneous Liver Kidney Transplant Compared with Contralateral Kidney from the Same Donor
Despite a higher early mortality rate in simultaneous liver kidney transplant recipients, long-term renal graft survival after simultaneous liver kidney transplantation is longer than that of same-donor kidneys allocated to kidney transplant alone. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - April 26, 2019 Category: Surgery Authors: Robert M. Cannon, Eric G. Davis, Christopher M. Jones Tags: Western Surgical Association Article Source Type: research

Acute Care Emergency General Surgery Model: Assigning Priority
I read with great interest the article entitled, “Acute care surgery model and outcomes in emergency general surgery” in the Journal of the American College of Surgeons, by To and colleagues.1 This is the first multi-institutional study that showed significant reduction (31%) of 30-day mortality in emergency general surgery (EGS) cases in an a cute care surgery (ACS) model compared with that of the general surgery service (GSS) model. It delivered an important message worldwide, where EGS is being delivered in the GSS model by surgeons with subspecialty interests or with suboptimal training in EGS. (Source: Jou...
Source: Journal of the American College of Surgeons - April 25, 2019 Category: Surgery Authors: Badri M. Shrestha Tags: Letter Source Type: research

Firearms and Alcohol
In their study, “State Level Firearm Concealed Carry Legislation and Rates of Homicide and Other Violent Crime,” Hamill and colleagues1 attempt to answer the question of whether increased numbers of individuals carrying concealed weapons would result in increased gun violence. The authors state that their stati stical technique is sufficiently rigorous to answer this question definitively and, as a result of their findings, that a recommendation to de-emphasize the role of concealed-carry in gun violence should be adopted by the surgical community. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - April 25, 2019 Category: Surgery Authors: Lewis Zulick Tags: Letter Source Type: research

Integration of Transversus Abdominis Plane Block in the Multimodal Analgesia for Outpatient General Surgical Procedures
We read with interest the article entitled “Standardization of Outpatient Procedure (STOP) Narcotics: A Prospective Non-Inferiority Study to Reduce Opioid Use in Outpatient General Surgical Procedures” by Hartford and colleagues.1 We congratulate them. The authors used a STOP narcotics intervention in patients undergoing laparoscopic cho lecystectomy and open hernia repair, which involved patient and healthcare provider education and multimodal analgesia with opioid reduction strategies. Although no differences were noted in the postoperative pain scores, the analysis showed a significant reduction in opioid pr...
Source: Journal of the American College of Surgeons - April 25, 2019 Category: Surgery Authors: Hytham K.S. Hamid, Iqbal Z. Khan Tags: Letter Source Type: research

May 2019 Featured Articles, Volume 228
Get credit right away by taking all CME tests online http://jacscme.facs.org (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - April 25, 2019 Category: Surgery Tags: Continuing medical education program Source Type: research

Correction
The abstract, “Surgical Safety Checklist Use and Outcomes in a Large, Multi-National Cohort of Emergency Laparotomy Patients,” which appeared in the October 2018 Supplement of the Journal of the American College of Surgeons, Volume 227, Number 4 (Supplement 1), page S133, listed the author and affiliations in correctly. The correct author information for this abstract is GlobalSurg Collaborative, and the correct affiliations are: National Institute for Health Research Unit on Global Surgery at the universities of Edinburgh, Birmingham, and Warwick, United Kingdom. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - April 25, 2019 Category: Surgery Tags: Correction Source Type: research

Contents
(Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - April 25, 2019 Category: Surgery Source Type: research

Editorial Board
(Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - April 25, 2019 Category: Surgery Source Type: research

Incidence and Cause of Potentially Preventable Death after Civilian Public Mass Shooting in the US
The incidence and severity of civilian public mass shooting (CPMS) events continue to rise. Understanding the wounding pattern and incidence of potentially preventable death (PPD) after CPMS is key to updating prehospital response strategy. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - April 25, 2019 Category: Surgery Authors: E Reed Smith, Babak Sarani, Geoff Shapiro, Stephen Gondek, Lisbi Rivas, Tammy Ju, Bryce RH. Robinson, Jordan M. Estroff, John Fudenberg, Richard Amdur, Roger Mitchell Tags: Original scientific article Source Type: research

Incidence and Cause of Potentially Preventable Death after Civilian Public Mass Shootings in the US
This study found a 16% potentially preventable death rate (PPD) after public mass shooting events, mainly due to gunshots to the chest. Training civilian bystanders on ways to address all causes of PPD and rapid extrication of victims to professional medical care is the optimal strategy to minimize PPD after these events. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - April 25, 2019 Category: Surgery Authors: E Reed Smith, Babak Sarani, Geoff Shapiro, Stephen Gondek, Lisbi Rivas, Tammy Ju, Bryce RH. Robinson, Jordan M. Estroff, John Fudenberg, Richard Amdur, Roger Mitchell Tags: Original Scientific Article Source Type: research

Plasma Transfusion Products and Contamination with Cellular and Associated Pro-Inflammatory Debris
Stored plasma units from trauma center blood banks were highly contaminated with leukocytes and platelets at levels greater than 15-fold higher than sufficient to elicit ex vivo inflammatory responses. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - April 25, 2019 Category: Surgery Authors: Yong B. Tan, Richard R. Rieske, Jon P. Audia, Viktor M. Pastukh, Gina C. Capley, Mark N. Gillespie, Alison A. Smith, Danielle M. Tatum, Juan C. Duchesne, Matt E. Kutcher, Jeffrey D. Kerby, Jon D. Simmons Tags: Original Scientific Article Source Type: research

Hospital Operative Volume and Quality Indication for General Surgery Operations Performed Emergently in Geriatric Patients
Within the growing geriatric population, there is an increasing need for emergency operations. Optimizing outcomes can require a structured system of surgical care based on key quality indicators. To investigate this, the current study sought to answer 2 questions. First, to what degree does hospital emergency operative volume impact mortality for geriatric patients undergoing emergency general surgery (EGS) operations? Second, at what procedure-specific hospital volume will geriatric patients undergoing an emergency operation achieve at or better than average mortality risk? (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - April 18, 2019 Category: Surgery Authors: Robert D. Becher, Michael P. DeWane, Nitin Sukumar, Marilyn J. Stolar, Thomas M. Gill, Robert M. Becher, Adrian A. Maung, Kevin M. Schuster, Kimberly A. Davis Tags: New England surgical society article Source Type: research

Hospital Operative Volume Is an Essential Quality Indicator for General Surgery Operations Performed Emergently in Geriatric Patients
Survival rates for geriatric patients were significantly higher when emergency general surgery (EGS) operations were performed at hospitals with higher emergency geriatric operative volumes. Operative volume seems to be a key quality indicator and determinant of survival for older EGS patients, and a principle driver of variation in EGS-hospital performance. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - April 18, 2019 Category: Surgery Authors: Robert D. Becher, Michael P. DeWane, Nitin Sukumar, Marilyn J. Stolar, Thomas M. Gill, Robert M. Becher, Adrian A. Maung, Kevin M. Schuster, Kimberly A. Davis Tags: New England Surgical Society Article Source Type: research

Clinical Significance of Esophageal Outflow Resistance Imposed by a Nissen Fundoplication
Attention has been focused on the amplitude of esophageal body contraction to avoid persistent dysphagia after a Nissen fundoplication. The current recommended level is a contraction amplitude in the distal third of esophagus above the fifth percentile. We hypothesized that a more physiologic approach is to measure outflow resistance imposed by a fundoplication, which needs to be overcome by the esophageal contraction amplitude. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - April 15, 2019 Category: Surgery Authors: Shahin Ayazi, Steven R. DeMeester, Jeffrey A. Hagen, Joerg Zehetner, Ross M. Bremner, John C. Lipham, Peter F. Crookes, Tom R. DeMeester Tags: Original scientific article Source Type: research

Surgical Outcomes in Lateral Abdominal Wall Reconstruction: A Comparative Analysis of Surgical Techniques
This study demonstrates a clear superiority of the pillar-anchored repair technique compared with the direct repair technique in reducing hernia recurrence. The study also shows that closure type (bridged vs reinforced), defect area, and mesh type do not affect recurrence rate. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - April 15, 2019 Category: Surgery Authors: Sahil K. Kapur, Jun Liu, Donald P. Baumann, Charles E. Butler Tags: Original Scientific Article Source Type: research

Clinical Significance of the Esophageal Outflow Resistance Imposed by a Nissen Fundoplication
Outflow resistance of the fundoplication must be (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - April 15, 2019 Category: Surgery Authors: Shahin Ayazi, Steven R. DeMeester, Jeffrey A. Hagen, Joerg Zehetner, Ross M. Bremner, John C. Lipham, Peter F. Crookes, Tom R. DeMeester Tags: Original Scientific Article Source Type: research

Increasing Incidence of Colon Cancer in the Young: Assessing the Tumor Biology
Early onset colon cancer has distinct tumor biology compared with late-onset. Cartilage oligomeric matrix protein plays a significant role in colon cancer aggressiveness and should be considered as a potential prognostic biomarker for early detection and surveillance of aggressive early onset colon cancer, which is associated with a poorer prognosis. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - April 14, 2019 Category: Surgery Authors: Valentine N. Nfonsam, Hunter Jecius, Debbie Chen, Pamela N. Omesiete, Agnes N. Ewongwo, Emad Elquza, Aaron J. Scott, Jana Jandova Tags: Western Surgical Association Article Source Type: research

Persistently Elevated Glucagon-Like Peptide-1 Levels among Critically Ill Surgical Patients after Sepsis and Development of Chronic Critical Illness and Dismal Long-Term Outcomes
Glucagon-like peptide-1 (GLP-1) is a gut-derived incretin hormone that stimulates insulin secretion, cellular glucose uptake, and has immune-regulatory functions. Glucagon-like peptide-1 is markedly altered after trauma and sepsis, but the implications remain unclear. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - April 13, 2019 Category: Surgery Authors: Scott C. Brakenridge, Frederick A. Moore, Nicole R. Mercier, Michael Cox, Quron Wu, Lyle L. Moldawer, Alicia M. Mohr, Philip A. Efron, R. Stephen Smith Tags: Western surgical association article Source Type: research

Persistently Elevated Glucagon-Like Peptide 1 Levels Among Critically-Ill Surgical Patients After Sepsis and Development of Chronic Critical Illness and Dismal Long-Term Outcomes
Glucagon-like peptide-1 (GLP-1) is a gut-derived incretin hormone. Elevated GLP-1 after sepsis is a predictor of death or persistent organ dysfunction. Persistently elevated GLP-1 levels are predictive of death or severe functional disability at 6-months after operation. Persistently elevated GLP-1 levels may be a marker of a non-resolving catabolic state. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - April 13, 2019 Category: Surgery Authors: Scott C. Brakenridge, Frederick A. Moore, Nicole R. Mercier, Michael Cox, Quron Wu, Lyle L. Moldawer, Alicia M. Mohr, Philip A. Efron, R Stephen Smith Tags: Western Surgical Association Article Source Type: research