Digit Replantation Outcomes at High-Volume Hospitals
Hand and finger injury results in more than 4.8 million emergency room visits in the US each year.1 Traumatic amputation accounts for many of these, with an incidence of 7.5/100,000 person-years.2 Though not all patients are candidates for replantation, advances in microvascular technique have expanded indication, especially in tertiary care centers. Replantation has a high level of patient satisfaction and can be cost-effective.3,4 (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 25, 2021 Category: Surgery Authors: Aaron L. Morgan, Sarah E. Sasor Tags: Invited Commentary Source Type: research

Invited Commentary
Posterior retroperitoneoscopic adrenalectomy (PRA) offers numerous benefits compared with traditional laparoscopic operation. It provides direct access to the retroperitoneal space and can avoid intraperitoneal adhesions from earlier operations. In their article “Contemporary Experience of Posterior Retroperitoneoscopic Adrenalectomy in the US,” Chiu and colleagues1 described a large experience, including 249 cases in 7 years' time. The authors used this technique for a variety of adrenal pathologies, including pheochromocytoma, aldosteronoma, and nonfu nctioning adenomas predominantly. (Source: Journal of the ...
Source: Journal of the American College of Surgeons - May 25, 2021 Category: Surgery Authors: Matthew A. Nehs Tags: New England surgical society article Source Type: research

Invited Commentary
In this interesting article, the authors highlighted the importance of sleep to the wellbeing of hospitalized surgical patients.1 Although inpatient sleep disturbances have been evaluated extensively in critically ill patients, the authors are to be commended for examining an elective surgical population. Through a series of questionnaire instruments and information from Fitbit devices, the authors demonstrated that sleep disturbances are common. Notably, most elective surgical patients in their cohort received little to no sleep on the first postoperative night. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 25, 2021 Category: Surgery Authors: Damien Carter Tags: New England surgical society article Source Type: research

Invited Commentary
Breast cancer-related lymphedema (BCRL) results in a significant disease burden in the US, and subsequently, a high cost burden. It is estimated that approximately 20% of breast cancer survivors experience BCRL, and although de-escalation of axillary surgery has reduced surgical BCRL, nodal radiation bears an expanded role, and given the improvements in overall survival, the evolving rates of BCRL remain uncertain.1 Further, while breast cancer is the most commonly associated cancer, survivors of gynecologic cancer, head and neck cancer, and melanoma, sarcoma, and urologic tumors may also experience treatment-related lymph...
Source: Journal of the American College of Surgeons - May 25, 2021 Category: Surgery Authors: David Linshaw, Jennifer S. Gass Tags: New England surgical society article Source Type: research

Invited Commentary
In the last decade, considerable work has been done to de-escalate local treatment for breast cancer. One aim of this effort is to minimize the risk of lymphedema, a dreaded but common side effect. In the US, approximately 200,000 new cases of lymphedema are diagnosed annually, with millions of breast cancer survivors affected. Although lymphedema is not curable, treatment options exist, and emerging surgical techniques may offer relief for select patients. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 25, 2021 Category: Surgery Authors: Brigid Killelea 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 25, 2021 Category: Surgery Source Type: research

Editorial Board
(Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 25, 2021 Category: Surgery Source Type: research

Timing of Complication and Failure to Rescue after Hepatectomy: Single-Institution Analysis of 28 Years of Hepatic Surgery
Morbidity after hepatectomy remains a significant, potentially preventable, outcome. Understanding the pattern of complications and rescue pathways is critical for the development of targeted initiatives intended to salvage patients after operative morbidity. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 20, 2021 Category: Surgery Authors: Lily V. Saadat, Debra A. Goldman, Mithat Gonen, Kevin C. Soares, Alice C. Wei, Vinod P. Balachandran, T Peter Kingham, Jeffrey Drebin, William R. Jarnagin, Michael I. D'Angelica Tags: Original scientific article Source Type: research

Timing of Complication and Failure to Rescue after Hepatectomy: Single-Institution Analysis of 28-Years of Hepatic Surgery
Morbidity after hepatectomy remains prevalent despite improvement in mortality. While complications such as liver failure have decreased due to advances in surgical technique and perioperative care, infectious complications are notable. Initiatives to improve early recognition and treatment of these complications are warranted. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 20, 2021 Category: Surgery Authors: Lily V. Saadat, Debra A. Goldman, Mithat Gonen, Kevin C. Soares, Alice C. Wei, Vinod P. Balachandran, T Peter Kingham, Jeffrey Drebin, William R. Jarnagin, Michael I. D ’Angelica Tags: Original Scientific Article Source Type: research

Molecular Peritoneal Staging for Pancreatic Ductal Adenocarcinoma Using Mutant KRAS Droplet-Digital Polymerase Chain Reaction: Results of a Prospective Clinical Trial
This prospective clinical study demonstrates the feasibility of mutant KRAS DNA detection in the peritoneal lavage fluid of patients undergoing staging laparoscopy for pancreatic ductal adenocarcinoma using droplet digital polymerase chain reaction, which produces quantifiable results. Presence of mutant KRAS was associated with clinically positive laparoscopy. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 19, 2021 Category: Surgery Authors: Jennifer A. Yonkus, Roberto Alva-Ruiz, Amro M. Abdelrahman, Jennifer L. Leiting, Amber R. Schneider, Travis E. Grotz, Sean P. Cleary, Rory L. Smoot, David M. Nagorney, Michael L. Kendrick, Benjamin R. Kipp, Mark J. Truty Tags: Western Surgical Association Article Source Type: research

Anatomical Considerations and Tips for Laparoscopic and Robotic-Assisted Enhanced-View Totally Extraperitoneal Rives-Stoppa Repair for Midline Hernia
The enhanced-view totally extraperitoneal (eTEP) approach fulfills all modern principles for the repair of ventral hernias. In the hands of well-trained hernia surgeons, the approach is safe and effective and improves the patient ’s quality of life, as demonstrated in more than 30 publications in the last 2 years. However, the eTEP approach is a complex operation that requires in-depth understanding of the extraperitoneal abdominal wall anatomy, including its neurovascular structures and natural boundaries. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 18, 2021 Category: Surgery Authors: Jorge Daes, Igor Belyansky Tags: Surgeon at Work Source Type: research

Immunosuppression and Clostridioides (Clostridium) difficile Infection Risk in Metabolic and Bariatric Surgery Patients
Immunosuppressant use increases risk of Clostridioides (Clostridium) difficile infection. To date, no studies have analyzed the relationship between immunosuppressant use and C  difficile infections after metabolic and bariatric surgery (MBS). (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 17, 2021 Category: Surgery Authors: Elisa Morales-Marroquin, Luyu Xie, Madhuri Uppuluri, Jaime P. Almandoz, Nestor de la Cruz-Mu ñoz, Sarah E. Messiah Tags: Original scientific article Source Type: research

Committed to Better Outcomes: Reducing Infection after Surgery Across the Ontario Surgical Quality Improvement Network
In 2015, the Ontario Surgical Quality Improvement Network was established to create a community of practice for Ontario hospitals to improve surgical quality. A provincial campaign to decrease postsurgical infections was launched in  2017. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 17, 2021 Category: Surgery Authors: Timothy D. Jackson, Tricia Beath, Nancy Ahmad, Pierrette Price Arsenault, Azusa Maeda, David Schramm, Husein Moloo, Avery Nathens Tags: Original scientific article Source Type: research

State-Level Examination of Clinical Outcomes and Costs for Robotic and Laparoscopic Approach to Diaphragmatic Hernia Repair
Published studies evaluating the effect of robotic assistance on clinical outcomes and costs of care in diaphragmatic hernia repair (DHR) have been limited. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 17, 2021 Category: Surgery Authors: Sujay Kulshrestha, Haroon M. Janjua, Corinne Bunn, Michael Rogers, Christopher DuCoin, Zaid M. Abdelsattar, Fred A. Luchette, Paul C. Kuo, Marshall S. Baker Tags: Western surgical association article Source Type: research

Teaching Effective Informed Consent Communication Skills in the Virtual Surgical Clerkship
We developed a virtual curriculum to teach the process of obtaining informed consent to medical students in the setting of the COVID-19 pandemic. 88% of students surveyed reported an increase in competency in at least 1 communication domain post-activity but remarked on its inability to replace in-person clinical encounters. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 17, 2021 Category: Surgery Authors: Joyce H. Pang, Esme Finlay, Sally Fortner, Bradley Pickett, Ming-Li Wang Tags: Western Surgical Association Article Source Type: research

Committed to Better: Reducing Infection after Surgery across the Ontario Surgical Quality Improvement Network
A provincial campaign to decrease postoperative infection was launched in 2017 across Ontario hospitals that participated in the provincial NSQIP collaborative. The 1-year campaign resulted in clinically significant reduction in the rate of surgical site infection and urinary tract infection and a trend for decreased pneumonia incidence among participating hospitals. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 17, 2021 Category: Surgery Authors: Timothy Jackson, Tricia Beath, Nancy Ahmad, Pierrette Price Arsenault, Azusa Maeda, David Schramm, Husein Moloo, Avery Nathens Tags: Original Scientific Article Source Type: research

Immunosuppression and Clostridium difficile Infection Risk in Metabolic and Bariatric Surgery Patients
This study showed for the first time that immunosuppressant increased postmetabolic and bariatric surgery Clostridium difficile infection risk by 95% in comparison with patients who also underwent operation but were not consuming immunosuppressant. Increased attention to metabolic and bariatric surgery patients taking immunosuppressant is needed. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 17, 2021 Category: Surgery Authors: Elisa Morales-Marroquin, Luyu Xie, Madhuri Uppuluri, Jaime P. Almandoz, Nestor de la Cruz-Mu ñoz, Sarah E. Messiah Tags: Original Scientific Article Source Type: research

Using NSQIP Data to Reduce Institutional Postoperative Pneumonia Rates in Non-ICU Patients: A Plan-Do-Study-Act Approach
The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) is a program designed to measure and improve surgical care quality. In 2015, the study institution formed a multidisciplinary team to address the poor adult postoperative pneumonia performance (worst decile). (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 17, 2021 Category: Surgery Authors: Daniel M. Alligood, Daniel Albo, Steffen E. Meiler, Sarah MI. Cartwright, Allen Kelly, Hongyan Xu, Muhammad Saeed Tags: Original Scientific Article Source Type: research

State-Level Examination of Clinical Outcomes and Cost for Robotic and Laparoscopic Approach to Diaphragmatic Hernia Repair
Operative management of diaphragmatic hernia continues to evolve, with increased use of robotic assistance. For patients undergoing minimally invasive repair, robotic assistance is associated with increased length of stay and index hospitalization cost without clear clinical benefit. Laparoscopic repair is the most cost-effective approach. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 17, 2021 Category: Surgery Authors: Sujay Kulshrestha, Haroon M. Janjua, Corinne Bunn, Michael Rogers, Christopher DuCoin, Zaid M. Abdelsattar, Fred A. Luchette, Paul C. Kuo, Marshall S. Baker Tags: Western Surgical Association Article Source Type: research

Trauma Laparotomy in the UK: A Prospective National Service Evaluation
Patients undergoing emergency abdominal trauma surgery after injury in the UK mostly (90%) received attending-delivered care. The overall mortality rate was 9%. Patients who activated the major hemorrhage protocol accounted for 45% of the study cohort but 97% of death and 96% of blood components transfused. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 17, 2021 Category: Surgery Authors: Max ER. Marsden, Paul ED. Vulliamy, Rich Carden, David N. Naumann, Ross A. Davenport, National Trauma Research and Innovation Collaborative (NaTRIC) Tags: Original Scientific Article Source Type: research

Transplant Surgery Pipeline: A Report from the American Society of Transplant Surgeons Pipeline Taskforce
Transplant surgery is one of the least competitive and sought after surgical fellowships for US trained residents. Residents have limited exposure to transplantation and a resident's experience in transplant may influence their decision to pursue a career in transplantation. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 17, 2021 Category: Surgery Authors: Ralph Cutler Quillin, Alexander R. Cortez, Leigh Anne Dageforde, Anthony Watkins, Kelly M. Collins, Jacqueline Garonzik-Wang, Jamie M. Glorioso, Amit D. Tevar, Jean C. Emond, Dorry L. Segev Tags: Original Scientific Article Source Type: research

Debunking the Myth on Surgical Site Infection
We appreciate the comments in the letter1 concerning the literature evidence about surgical attire and its association with surgical site infection2; however, further clarification is warranted. As noted in our Methods section, both the 2015 and 2019 Association of periOperative Registered Nurses (AORN) Guidelines for Perioperative Practice: Surgical Attire3,4 documents were used as the initial starting points for the literature review, with the 2019 AORN Guideline recommendations4 used for corroboration with the literature review. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 15, 2021 Category: Surgery Authors: Wendy Jo Svetanoff, Shawn D. St Peter Tags: Letter Source Type: research

Surgical Scrubbing and Attire in the Operating Room and ICU: A Multicultural Guide
In response to the challenges faced as diverse students when first encountering the intricacies of scrubbing into the operating room (OR), we have prepared a rudimentary surgical skills guide to supplement the knowledge of students and educators alike. In keeping with the need to adapt standard protocols to accommodate religious and cultural practices, this guide focuses on hijab, natural hair, dastar, protective styles, and beard protocol in the OR. It addresses some of the personal protective equipment (PPE) needs of Muslims, Orthodox Jews, Sikhs, and groups maintaining beards as a part of cultural or religious practices...
Source: Journal of the American College of Surgeons - May 12, 2021 Category: Surgery Authors: Rewan Abdelwahab, Aisha Aden, Brenda Bearden, Alaa Sada, J Michael Bostwick Tags: Education Source Type: research

Call to Action on the Categorization of Sex, Gender, Race, and Ethnicity in Surgical Research
Words matter. This statement has taken on heightened meaning as we collectively struggle to achieve equity for groups who experience systemic barriers to equity. Language is powerful and reflects, even shapes, the prevailing culture of the times. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 4, 2021 Category: Surgery Authors: Jeffry Nahmias, Tanya L. Zakrison, Elliott R. Haut, Onaona Gurney, Bellal Joseph, Kimberly Hendershot, Mira Ghneim, Anne Stey, Mark H. Hoofnagle, Zinzi Bailey, Rishi Rattan, Joseph B. Richardson, Ariel P. Santos, Ben Zarzaur Tags: Education Source Type: research

Association of periOperative Registered Nurses Addresses Inaccuracies in Critique of Guideline for Surgical Attire
In response to the article “Debunking the Myth: What You Really Need to Know about Clothing, Electronic Devices, and Surgical Site Infection,” 1 the Association of Perioperative Registered Nurses (AORN) would like to clarify the many misguided interpretations in the article. It is of special concern that their article and conclusions are based on the 2015 Guideline for Surgical Attire and will very possibly lead to further misunderstandings. AORN’s Guideline for Surgical Attire was revised and published in 2019; therefore, it replaces any earlier version of the guideline. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 4, 2021 Category: Surgery Authors: Lisa Spruce Tags: Letter Source Type: research

I Am Not Comfortable with This: Application to Scope of Practice
Dr Gregory J Jurkovich lays out a cogent argument on how surgeons can shirk their obligations by backing away from difficult cases by claiming not to be comfortable with the challenge.1 This is human nature, and many of us try to fight it. If the surgeon refers away a difficult case, then there are missed opportunities. However, there is not a political advantage. Not so with mid-level practitioners like nurse practitioners. These providers lobby for more licensure privileges. They then take easy diagnostic and treatment problems and refer away those that “they are not comfortable” with, even if it is within th...
Source: Journal of the American College of Surgeons - May 4, 2021 Category: Surgery Authors: John F. Maher Tags: Letter Source Type: research

The Making of a Surgeon: Time to Retool the Resident Experience
The Scudder Oration series historically represents a pinnacle of surgical scholarship. The 2020 lecture by Dr Jurkovich continues that legacy in his essay: “I Am Not Comfortable with This.”1 (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 4, 2021 Category: Surgery Authors: Patrick A. Cleary Tags: Letter Source Type: research

Use and Cost-Effectiveness of Gasless Laparoscopy: The Road Ahead
Thank you for your interest and appreciative comments on our article “Evaluation of Gasless Laparoscopy as a Tool for Minimal Access Surgery in Low-to Middle-Income Countries: A Phase II Noninferiority Randomized Controlled Study.”1 (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 4, 2021 Category: Surgery Authors: Anurag Mishra, Lovenish Bains, Jesudian Gnanaraj, Noel Aruparayil Tags: Letter Source Type: research

Call to Action on the Categorization of Sex, Gender, Race and Ethnicity in Surgical Research
Words matter. This statement has taken on heightened meaning as we collectively struggle to achieve equity for groups who suffer from systemic barriers to equity. Language is powerful and reflects, even shapes, the prevailing culture of the times. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 4, 2021 Category: Surgery Authors: Jeffry Nahmias, Tanya L. Zakrison, Elliott R. Haut, Onaona Gurney, Bellal Joseph, Kimberly Hendershot, Mira Ghneim, Anne Stey, Mark H. Hoofnagle, Zinzi Bailey, Rishi Rattan, Joseph B. Richardson, Ariel P. Santos, Ben Zarzaur Tags: Education Source Type: research

Does ATLS Training Work? 10-Year Follow-Up of ATLS India Program
Studies evaluating the efficacy of ATLS in low- and middle-income countries are limited. We followed up ATLS providers certified by the ATLS India program over a decade (2009 to 2019), aiming to measure the benefits in knowledge, skills, attitude and their attrition over time. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 3, 2021 Category: Surgery Authors: Amulya Rattan, Amit Gupta, Subodh Kumar, Sushma Sagar, Suresh Sangi, Neerja Bannerjee, Radhesh Nambiar, Vinod Jain, Parli Ravi, Mahesh C. Misra Tags: Original scientific article Source Type: research

Association Between Trimester and Outcomes after Cholecystectomy During Pregnancy
Conventional philosophy promotes the second trimester as the ideal time during pregnancy for cholecystectomy. However, literature supporting this belief is sparse. The purpose of this study is to examine the association of trimester and clinical outcomes after cholecystectomy during pregnancy. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 3, 2021 Category: Surgery Authors: Vincent Cheng, Kazuhide Matsushima, Matthew Ashbrook, Koji Matsuo, Morgan Schellenberg, Kenji Inaba, Kulmeet Sandhu Tags: Western surgical association article Source Type: research

Applying the Exploration, Preparation, Implementation, Sustainment (EPIS) Framework to Safe Surgery 2020 Implementation in Tanzania ’s Lake Zone
Safe Surgery 2020 implementation in Tanzania ’s Lake Zone was examined through the EPIS implementation framework. The Exploration phase revealed the need for a multicomponent intervention to improve surgical quality. The Preparation phase identified how to build a receptive climate. The Active Implementation phase found improvements in teamw ork and organizational learning. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 3, 2021 Category: Surgery Authors: Shehnaz Alidina, Noor Zanial, John G. Meara, David Barash, Ladislaus Buberwa, Bwire Chirangi, Augustino Hellar, Steve Kisakye, Adelina Mazhiqi, William Mnyonyela, Meck P. Nyanda, Cheri Reynolds, Florian Tinuga, Sarah Maongezi, Ntuli A. Kapologwe Source Type: research

Reconstruction in Women with T4 Breast Cancer after Neoadjuvant Chemotherapy: When Is It Safe?
Despite limited evidence regarding its safety, immediate reconstruction (IR) is increasingly offered to women with T4 breast cancer. We compared outcomes following IR, delayed reconstruction (DR), and no reconstruction (NR) in patients treated with neoadjuvant chemotherapy (NAC) and postmastectomy radiation therapy (PMRT) for T4 disease. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 3, 2021 Category: Surgery Authors: Kate R. Pawloski, Andrea V. Barrio, Mary L. Gemignani, Varadan Sevilimedu, Tiana Le, Joseph Dayan, Monica Morrow, Audree B. Tadros Tags: Original Scientific Article Source Type: research

Does Advanced Trauma Life Support Training work? 10-Year Follow Up of Advanced Trauma Life Support India Program
Advanced Trauma Life Support (ATLS) India surveyed providers certified from 2009-2019. Among 2,500 providers surveyed, 1,030 (41.2%) responded. Profound benefits in knowledge (98%), psychomotor (96%), and organization skills (97%) of trauma management were reported, lasting beyond 2 years. ATLS improves trauma management in low and middle-income countries, especially in non-trauma system settings. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - May 3, 2021 Category: Surgery Authors: Amulya Rattan, Amit Gupta, Subodh Kumar, Sushma Sagar, Suresh Sangi, Neerja Bannerjee, Radhesh Nambiar, Vinod Jain, Parli Ravi, Mahesh C. Misra Tags: Original Scientific Article Source Type: research

Evidence Review for the American College of Surgeons Quality Verification Part II: Processes for Reliable Quality Improvement
Following decades of experience supporting surgical quality and safety by the American College of Surgeons, the ACS Quality Verification Program (ACS QV) was developed to help hospitals improve surgical quality, safety, and reliability. This review is the second of a three-part review aiming to synthesize the evidence supporting the main principles of the ACS QV program. Evidence was systematically reviewed for five principles: case review, peer review, credentialing and privileging, data for surveillance, and continuous quality improvement using data. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - April 30, 2021 Category: Surgery Authors: Chelsea P. Fischer, Q Lina Hu, Annie B. Wescott, Melinda Maggard-Gibbons, David B. Hoyt, Clifford Y. Ko Tags: Collective Review Source Type: research

Correction
The abstract, “Comparison of Bilateral Percutaneous Femoral Access with Surgical Femoral Access for Endovascular Aneurysm Repair in Patients with Ruptured Abdominal Aortic Aneurysm,” which appeared in the October 2020 issue of the Journal of the American College of Surgeons, Volume 231, Number 4, Supplement 2 , page e67, was published without the full author list. The correct author information for this abstract is: Daniela Medina, BS, Ahsan Zil-E-Ali, MBBS (MD), MPH, Faisal Aziz, MBBS, FACS. The authors apologize for this error. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - April 22, 2021 Category: Surgery Tags: Correction Source Type: research

Use of Thrombin Generation to Guide Therapy in Trauma Patients
One of the most prevalent causes of preventable death in trauma is injury-induced coagulopathy. This is described by the inability of trauma patients to form clot and overall hypocoagulability.1,2 Despite the high prevalence of this problem in rapidly bleeding patients, the majority of them paradoxically present with elevated thrombin generation (TG).2 (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - April 22, 2021 Category: Surgery Authors: Paula Ferrada Tags: Invited Commentary Source Type: research

Trauma, Metabolomics, Outcomes, and Secrets of the Sphinx
Trauma remains a leading cause of mortality in all age groups, with an increasing global impact as the population ages.1 Advances in pre-hospital care, damage control surgery, and blood-based damage control resuscitation have led to significant improvement in initial survival from exsanguination after serious injury,2 but these patients often remain critically ill and are at risk for ongoing sequelae, including organ failure,3 development of chronic critical illness,4 and late mortality after injury. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - April 22, 2021 Category: Surgery Authors: Timothy A. Pritts Tags: Invited Commentary Source Type: research

The Importance of Research
Commander William T Ryker, from “Star Trek: The Next Generation,” very astutely pointed out that “A cook is only as good as his ingredients.” This is a principle that holds true in several different areas, including medicine and research. Emergency general surgery (EGS) as a specialty represents the culmination of the ques t to respond to the changing nature of trauma surgery (increasing nonoperative management), the need to have adequate surgical coverage for emergency cases while not overly burdening other specialties, and especially, subspecialties, and the daily operating room schedule. (Source:...
Source: Journal of the American College of Surgeons - April 22, 2021 Category: Surgery Authors: Georgios Tsoulfas Tags: Invited Commentary Source Type: research

Reviewing the Interaction Between Cost, Quality, and Outcomes for Safe and Effective Hernia Repair: Which Technique Is Best?
Hernia repair is the most common outpatient procedure performed by general surgeons. Most inguinal hernia repair is performed via an open approach. The laparoscopic approach is still struggling to dominate the field, despite the first attempt to do so almost 4 decades ago.1 This practice is true in all countries, including the US. Despite that, we are seeing an uptick in robotically performed inguinal hernia repair. Intuitive Surgical, Inc, inventors of the da Vinci robot, first applied their robotic technology to humans in 1997; the first inguinal hernia was robotically repaired in 2001. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - April 22, 2021 Category: Surgery Authors: Shirin Towfigh Tags: Invited Commentary Source Type: research

Method, Material, and Machine: A Review for the Surgeon Using Three-Dimensional Printing for Accelerated Device Production
Physicians are at the forefront of identifying innovative targets to address current medical needs. 3D printing technology has emerged as a state-of-the-art method of prototyping medical devices or producing patient-specific models that is more cost-efficient, with faster turnaround time, in comparison to traditional prototype manufacturing. However, initiating 3D printing projects can be daunting due to the engineering learning curve, including the number of methodologies, variables, and techniques for printing from which to choose. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - April 22, 2021 Category: Surgery Authors: Helen Xun, Scott Clarke, Nusaiba Baker, Christopher Shallal, Erica Lee, Darya Fadavi, Alison Wong, Gerald Brandacher, Sung Hoon Kang, Justin M. Sacks Tags: Original scientific article Source Type: research

Contents
(Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - April 22, 2021 Category: Surgery Source Type: research

Editorial Board
(Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - April 22, 2021 Category: Surgery Source Type: research

Increased Use of Prehospital Tourniquet and Patient Survival: Los Angeles Countywide Study
Prehospital tourniquet use is increasing in Los Angeles County. In patients with extremity vascular injury, prehospital tourniquet placement was associated with improved survival and lower blood transfusion requirement, without an increased risk of delayed amputation. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - April 22, 2021 Category: Surgery Authors: Reynold Henry, Kazuhide Matsushima, Cameron Ghafil, Rachel N. Henry, Hailey Theeuwen, Adam C. Golden, Tiffany M. Abramson, Kenji Inaba Tags: Original Scientific Article Source Type: research

Women as Authors of Randomized Controlled Trials of Minimally Invasive Surgery: Systematic Review and Meta-Analysis of 3 Decades of Trials
Female authorship opportunities have lagged behind those of their male counterparts, with gender disparities most prominent in surgical specialties. Our objective was to determine trends of female first, last, and first or last authorships across time and surgical specialties and whether female first or last authorship was associated with journal impact factor. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - April 19, 2021 Category: Surgery Authors: Rashid K. Sayyid, Soum D. Lokeshwar, Amy N. Luckenbaugh, Mary E. Hall, Caitlin E. Jones, Diana E. Magee, Amanda E. Hird, Martha K. Terris, Zachary Klaassen, Christopher JD. Wallis Tags: Original scientific article Source Type: research

Surgeon vs Pathologist for Prediction of Pancreatic Fistula: Results from the Randomized Multicenter RECOPANC Study
In this study, we evaluated the fibrosis level at the pancreatic neck resection margin and correlated fibrosis and all clinico-pathologic parameters collected over the course of the Pancreatogastrostomy vs Pancreatojejunostomy for RECOnstruction (RECOPANC) study. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - April 19, 2021 Category: Surgery Authors: Sylvia Timme, Gian Kayser, Martin Werner, Stanislav Litkevych, Ambrus Gabor M àlyi, Tobias Keck, Peter Bronsert, Ulrich Friedrich Wellner, Ekaterina Petrova, Kim C. Honselmann, RECOPANC Review Group Tags: Original scientific article Source Type: research

A Leg to Stand On: Trauma Center Designation and Association with Rate of Limb Salvage in Patients Suffering Severe Lower Extremity Injury
Mangled extremities are one of the most difficult injuries for trauma surgeons to manage. We compare limb salvage rates for a limb-threatening lower extremity injury managed at Level I versus Level II trauma centers (TCs). (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - April 19, 2021 Category: Surgery Authors: Corinne Bunn, Sujay Kulshrestha, Bianca DiChiaro, Uma Maduekwe, Zaid M. Abdelsattar, Marshall S. Baker, Fred A. Luchette, Sonya Agnew Tags: Western Surgical Association Article Source Type: research

Surgeon vs Pathologist for the Prediction of Pancreatic Fistula: Results from the Randomized Multicenter RECOPANC Study
This post-hoc analysis of a multicenter trial of 261 pancreatic head resections demonstrates that histologically evaluated pancreatic fibrosis is an easily applicable and highly reproducible predictor of postoperative pancreatic fistula and is superior to surgically evaluated pancreatic texture. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - April 19, 2021 Category: Surgery Authors: Sylvia Timme, Gian Kayser, Martin Werner, Stanislav Litkevych, Ambrus Gabor M àlyi, Tobias Keck, Peter Bronsert, Ulrich Friedrich Wellner, Ekaterina Petrova, Kim C. Honselmann, RECOPANC Review Group Tags: Original Scientific Article Source Type: research

Total Thyroidectomy vs Thyroid Lobectomy for Localized Papillary Thyroid Cancer in Children: A Propensity-Matched Survival Analysis
Current guidelines recommend total thyroidectomy (TT) and radioablation for most papillary thyroid cancer (PTC) in children. These guidelines have been criticized as aggressive, especially for early-stage PTC, as it likely does not influence patient survival and results in life-long thyroid hormone replacement. We sought to study whether the extent of thyroidectomy (TT vs thyroid lobectomy [TL]) influences overall and disease-specific survival in children with localized PTC. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - April 19, 2021 Category: Surgery Authors: Kelvin Memeh, Brian Ruhle, Salman Alsafran, Tanaz Vaghaiwalla, Edwin Kaplan, Peter Angelos, Xavier M. Keutgen Tags: Western surgical association article Source Type: research

Perioperative Outcomes for Centers Routinely Admitting Postoperative Endovascular Aortic Aneurysm Repair to the ICU
Routine ICU use after endovascular aortic aneurysm repair was not associated with decreased perioperative complication, in-hospital mortality, and 1-year survival; however, it was associated with prolonged length of stay. Development of updated care pathways to include routine postoperative admission to lower acuity care units may reduce cost without compromising care. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - April 19, 2021 Category: Surgery Authors: Thomas W. Cheng, Alik Farber, Scott R. Levin, Mahmoud B. Malas, Karan Garg, Virendra I. Patel, Ahmed Kayssi, Denis Rybin, Rebecca B. Hasley, Jeffrey J. Siracuse Tags: New England Surgical Society Article Source Type: research