Early-onset gastric cancer is a distinct disease with worrisome trends and oncogenic features
Overall the incidence of gastric cancer is declining in the United States; however, the incidence of early-onset gastric cancer is increasing. We sought to elucidate clinical and genomic characteristics and risk factors for early-onset gastric cancer compared with late-onset gastric cancer. (Source: Surgery)
Source: Surgery - July 19, 2019 Category: Surgery Authors: John R. Bergquist, Jennifer L. Leiting, Elizabeth B. Habermann, Sean P. Cleary, Michael L. Kendrick, Rory L. Smoot, David M. Nagorney, Mark J. Truty, Travis E. Grotz Source Type: research

Reply to: Atomic bomb and CRISPR gene editing technology
We thank Tez et  al for their interest and commentary on our recent article entitled “CRISPR-mediated gene editing for the surgeon scientist.”1,2 The authors draw interesting parallels between past rapid advances in nuclear technology and the catastrophic effects on humanity with its unethical use and weaponiz ation. (Source: Surgery)
Source: Surgery - July 19, 2019 Category: Surgery Authors: Stephen J. O ’Brien, Susan Galandiuk Tags: Letter to the Editor Source Type: research

Discussion
Dr Robert C.G. Martin (Louisville, KY): Thank you for sending me the manuscript. Well presented. (Source: Surgery)
Source: Surgery - July 19, 2019 Category: Surgery Source Type: research

Discharge disposition to skilled nursing facility after emergent general surgery predicts a poor prognosis
Emergency general surgery can have a profound impact on the functional status of even previously independent patients. The role and influence of discharging a patient to a skilled nursing facility, however, remains largely unknown. (Source: Surgery)
Source: Surgery - July 18, 2019 Category: Surgery Authors: Anghela Z. Paredes, Azeem T. Malik, Marcus Cluse, Scott A. Strassels, Heena P. Santry, Daniel Eiferman, Christian Jones, Daniel Vazquez Source Type: research

Educational strategies to foster bedside teaching
The objective of this paper is to provide an overview of educational strategies to foster bedside teaching in the current clinical practice environment for surgical educators. General strategies include building a culture within the program that promotes the atmosphere of a learning community, and providing scaffolding for trainees that fosters gradual progression to autonomous practice. (Source: Surgery)
Source: Surgery - July 18, 2019 Category: Surgery Authors: Roger H. Kim, John D. Mellinger Source Type: research

Discussion
Dr Juan Asensio (Omaha, NE): This is an interesting retrospective large database 5-year study utilizing the National Quality Improvement Program (NSQIP) of the American College of Surgeons (ACS). The authors have clearly defined their objective, which is to characterize disposition of patients following emergency general surgery (EGS) utilizing NSQIP data, specifically to explore the impact of discharge to a Skilled Nursing Facilities (SNF) on 30-day readmissions, as well as to examine the incidence of post discharge complications and post discharge 30-day mortality. (Source: Surgery)
Source: Surgery - July 18, 2019 Category: Surgery Source Type: research

Opioid prescribing in minimally injured trauma patients: Effect of a state prescribing limit
Opioid-prescribing practices for minimally injured trauma patients are unknown. We hypothesized that opioid-prescribing frequency and morphine-equivalent doses prescribed have decreased in recent years, specifically surrounding an acute prescribing limit implemented in August 2017 mandating opioid prescriptions not exceed 210 morphine-equivalent doses. (Source: Surgery)
Source: Surgery - July 17, 2019 Category: Surgery Authors: Samuel J. Zolin, Vanessa P. Ho, Brian T. Young, Alexis R. Harvey, Kevin T. Beel, Esther S. Tseng, Laura R. Brown, Jeffrey A. Claridge Source Type: research

Total gastrectomy in patients with gastric adenocarcinoma: Is there an advantage to the minimally invasive approach?
Previous evaluations of the oncologic efficacy of minimally invasive approaches to total gastrectomy in gastric adenocarcinoma have been limited by sample size and duration of follow-up. (Source: Surgery)
Source: Surgery - July 17, 2019 Category: Surgery Authors: Patrick J. Sweigert, Emanuel Eguia, Marc H. Nelson, Sean P. Nassoiy, Lawrence M. Knab, Gerard Abood, Marshall S. Baker Source Type: research

Intrahepatic cholangiocarcinoma tumor burden: A classification and regression tree model to define prognostic groups after resection
Tumor burden is an important factor in defining prognosis among patients with primary and secondary liver cancers. Although the eighth edition of the American Joint Committee on Cancer staging system has changed the criteria for staging patients with intrahepatic cholangiocarcinoma to better define the effect of tumor burden on prognosis, the impact of intrahepatic cholangiocarcinoma tumor burden on overall survival has not been examined using a machine-learning tool. (Source: Surgery)
Source: Surgery - July 17, 2019 Category: Surgery Authors: Fabio Bagante, Gaya Spolverato, Katiuscha Merath, Matthew Weiss, Sorin Alexandrescu, Hugo P. Marques, Luca Aldrighetti, Shishir K. Maithel, Carlo Pulitano, Todd W. Bauer, Feng Shen, George A. Poultsides, Olivier Soubrane, Guillaume Martel, B. Groot Koerka Source Type: research

The effect of gender on operative autonomy in general surgery residents
This study examines the differences in the degree of operative autonomy given to female compared with male general surgery trainees. (Source: Surgery)
Source: Surgery - July 17, 2019 Category: Surgery Authors: Shari L. Meyerson, David D. Odell, Joseph B. Zwischenberger, Mary Schuller, Reed G. Williams, Jordan D. Bohnen, Gary L. Dunnington, Laura Torbeck, John T. Mullen, Samuel P. Mandell, Michael A. Choti, Eugene Foley, Chandrakanth Are, Edward Auyang, Jeffrey Source Type: research

Discussion
Dr Jason Smith (Louisville, KY): I want to thank the Central for the opportunity to discuss this paper. I want to thank the authors for providing me the manuscript and for doing just a phenomenal amount of work on a topic that is underrepresented in surgical literature. One of the key factors bolstering the impact of this manuscript is the indepth analysis and the amount of data that were collated from a lot of disparate sources to try to get a more complete picture of what's going on with the minimally injured trauma patients. (Source: Surgery)
Source: Surgery - July 17, 2019 Category: Surgery Source Type: research

Discussion
Dr Michael G. House (Indianapolis, IN): I would like to congratulate Dr Sweigert for the very easy, organized study and a very beautiful presentation. I think under the mentorship of Dr Marshall Baker, you have done a very nice analysis of patients with invasive gastric adenocarcinoma who were captured by the National Cancer Database. You focused on patients who underwent total gastrectomy. It's a large-scale study. It obviously had appropriate propensity matching between the surgical treatment groups, namely, those who underwent minimally invasive technique for total gastrectomy and those who underwent an open operation. (Source: Surgery)
Source: Surgery - July 17, 2019 Category: Surgery Source Type: research

Corrigendum to Commercial Quality “Awards” Are Not a Strong Indicator of Quality Surgical Care [Surgery 164 (2018) 379–386]
The authors regret that a table in our paper does not comply with the AHRQ Data Use Agreement for the Healthcare Cost and Utilization Project State Inpatient Database that states that no data observation involving less than or equal to 10 observations is to be published. In our manuscript, there are two individual tabulated cells in Table  II that provides baseline patient characteristics that are in violation of this provision. This represents an oversight on our part and an inadvertent failure to comply with the Data Use Agreement. (Source: Surgery)
Source: Surgery - July 16, 2019 Category: Surgery Authors: Adrienne N. Cobb, Taylor R. Erickson, Anai N. Kothari, Emanuel Eguia, Sarah A. Brownlee, Weiwei Yao, Hyunyou Choi, Victoria Greenberg, Joy Mboya, Michael Voss, Daniela Stan Raicu, Raffaella Settimi-Woods, Paul C. Kuo Tags: Corrigendum Source Type: research

Use of pharmacogenetic data to guide individualized opioid prescribing after surgery
Despite the current strategies aimed at avoiding opioid overprescription by implementing institutional guidelines, the use of opioids after surgical procedures remains highly variable. It is well known that opioids are activated by the cytochrome p450 CYP2D6 enzyme to exert pharmacologic effect. Individual variation in CYP2D6 activity affects drug metabolism, and genotyping can be performed to predict an individual ’s ability to metabolize CYP2D6 substrates. We postulate that the pharmacogenomic identification of patients with different opioid metabolism capacity may allow for the individualization of postsurgical op...
Source: Surgery - July 15, 2019 Category: Surgery Authors: Raffaele Rocco, Cornelius A. Thiels, Daniel S. Ubl, Ann M. Moyer, Elizabeth B. Habermann, Stephen D. Cassivi Source Type: research

The 2 faces of intentional self-inflicted injury: High in-hospital mortality, low postdischarge mortality, but high readmission rates
Intentional self-inflicted injuries present unique challenges in treatment and prevention. We hypothesized intentional self-inflicted injuries would have higher in-hospital and postdischarge mortality than nonintentional self-inflicted injuries trauma. (Source: Surgery)
Source: Surgery - July 15, 2019 Category: Surgery Authors: Katherine L. Howe, Bryan R. Collier, Jennifer L. Bath, Julian C. Lagoy, Tracey W. Criss, Emily R. Faulks, Daniel I. Lollar, Katie L. Bower, Tonja M. Locklear, Miguel A. Matos, Michael S. Nussbaum, Mark E. Hamill Source Type: research

Discussion
Dr John Mellinger (Springfield, IL): I want to thank Dr Rocco and his associates for providing a nicely written manuscript well before the meeting, allowing plenty of time to prepare some questions, so thank you. (Source: Surgery)
Source: Surgery - July 15, 2019 Category: Surgery Source Type: research

Discussion
Dr Dave Lal (Milwaukee, WI): I would first like to thank the Association for accepting me as a new member and allowing me the privilege of discussing this well-presented and informative study. (Source: Surgery)
Source: Surgery - July 15, 2019 Category: Surgery Source Type: research

Atomic bomb and clustered regularly interspaced short palindromic repeats gene editing technology
We read the article entitled “CRISPR-Mediated Gene Editing for the Surgeon Scientist” with great interest. The authors stated that “gene editing through the CRISPR-Cas9 editing system presents many new opportunities for the surgeon scientist.”1 We do not agree with the authors. (Source: Surgery)
Source: Surgery - July 12, 2019 Category: Surgery Authors: Mesut Tez, G ürdal Orhan, Barış Saylam Tags: Letter to the Editor Source Type: research

Impact of hospital safety-net status on failure to rescue after major cardiac surgery
Hospitals with safety-net status have been associated with inferior surgical outcomes and higher costs. The mechanism of this discrepancy, however, is not well understood. We hypothesized that discrepant rates of failure to rescue after complications of routine cardiac surgery would explain the observed inferior outcomes at safety-net hospitals. (Source: Surgery)
Source: Surgery - July 12, 2019 Category: Surgery Authors: Yas Sanaiha, Sarah Rudasill, Sohail Sareh, Alexandra Mardock, Habib Khoury, Boback Ziaeian, Richard Shemin, Peyman Benharash Source Type: research

Gas off, room lights on: Shedding light on the surgical resident ’s experience in open and laparoscopic surgery
The operative experience of today ’s surgery residents is different than years past. Although overall volume remains stable, the composition is changing. As such, trends in open versus laparoscopic surgery for general surgery residents were examined. (Source: Surgery)
Source: Surgery - July 12, 2019 Category: Surgery Authors: Ralph C. Quillin, Alexander R. Cortez, Mario A. Garcia, Leah K. Winer, Al-Faraaz Kassam, Joshua W. Kuethe, Timothy A. Pritts Source Type: research

Discussion
Dr Dimitrios Stefanidis (Indianapolis, IN): Thank you very much for the opportunity to discuss this paper. This is an interesting paper by Dr Quillin and his colleagues that was sent to me in advance of today's meeting. (Source: Surgery)
Source: Surgery - July 12, 2019 Category: Surgery Source Type: research

The millennials have arrived: What the surgeon educator needs to know to teach millennials
Numerous authors have described the millennial generation, defined as a cohort of people born between the early 1980s and late 1990s, as unique from preceding generations, such as Generation X and the baby boomers. Many surgical educators generally belong to elder generations, and there is some concern that intergenerational differences may be source of friction between teacher and learner. There is renewed interest in both addressing pedagogic strategies to train millennial surgery residents and providing the nonmillennial surgeon educator with instruction techniques best suited for millennials. (Source: Surgery)
Source: Surgery - July 11, 2019 Category: Surgery Authors: Peter A. Ebeling, Daniel L. Dent, Jason W. Kempenich Source Type: research

Postoperative opioid prescribing is not my job: A qualitative analysis of care transitions
Persistent opioid use is common after surgical procedures, and postoperative opioid prescribing often transitions from surgeons to primary care physicians in the months after surgery. It is unknown how surgeons currently transition these patients or the preferred approach to successful coordination of care. This qualitative study aimed to describe transitions of care for postoperative opioid prescribing and identify barriers and facilitators of ideal transitions for potential intervention targets. (Source: Surgery)
Source: Surgery - July 11, 2019 Category: Surgery Authors: Michael P. Klueh, Kenneth R. Sloss, Lesly A. Dossett, Michael J. Englesbe, Jennifer F. Waljee, Chad M. Brummett, Pooja A. Lagisetty, Jay S. Lee Source Type: research

Myeloid zinc finger-1 regulates expression of cancer-associated fibroblast and cancer stemness profiles in breast cancer
Osteopontin acts thru myeloid zinc finger-1 and transforming growth factor- β to drive the adoption of a cancer-associated fibroblast phenotype by local mesenchymal stem cells. Cancer-associated fibroblasts increase cancer cell stemness. (Source: Surgery)
Source: Surgery - July 10, 2019 Category: Surgery Authors: Marissa C. Kuo, Paul C. Kuo, Zhiyong Mi Source Type: research

Discussion
Dr Stephen Grobmyer (Cleveland, OH): I would like to thank the Association for the privilege of the floor. I would also like to congratulate the authors on another in a series of important contributions to our understanding of the cancer biology and the complex tumor microenvironment as it relates to crosstalk between breast tumor cells and the parenchymal stem cells. I think this paper highlights nicely how complex this interaction is and the interdependence of these cells on each other in sustaining themselves. (Source: Surgery)
Source: Surgery - July 10, 2019 Category: Surgery Source Type: research

Reflections on a leadership development program: Impacts on culture in a surgical environment
Although a growing body of literature has focused on the impacts leadership development programs have had on the individual surgeon, little effort has been focused on understanding the impacts these programs have had on surgical culture. The purpose of this study was to explore the impacts of implementing a leadership development program on the culture of the Department of Surgery at University of Michigan, Ann Arbor. (Source: Surgery)
Source: Surgery - July 8, 2019 Category: Surgery Authors: C. Ann Vitous, Sarah Shubeck, Arielle Kanters, Michael Mulholland, Justin B. Dimick Source Type: research

Teaching technical surgery
We present effective intraoperative teaching techniques and discuss the utilization of simulation to improve technical skills outside of the operating room. Adjuncts, including coaching, mental skills, and nontechnical-skill assessments, are also reviewed. Finally, an example of a clinical curriculum that incorporates best practices in teaching technical surgery is presented. (Source: Surgery)
Source: Surgery - July 8, 2019 Category: Surgery Authors: Elizabeth M. Huffman, John R. Martin, Dimitrios Stefanidis Source Type: research

Compliance with the Accreditation Council for Graduate Medical Education duty hours in a general surgery residency program: Challenges and solutions in a teaching hospital
The inception of work hour restrictions for resident physicians in 2003 created controversial changes within surgery training programs. On a recent Accreditation Council for Graduate Medical Education survey at our institution, we noted a discrepancy between low recorded violations of the duty hour restrictions and the surgery resident ’s perception of poor duty hour compliance. We sought to identify factors that lead to duty hour violations and to encourage accurate reporting among surgery trainees. (Source: Surgery)
Source: Surgery - July 8, 2019 Category: Surgery Authors: David F. Grabski, Bernadette J. Goudreau, Jacob R. Gillen, Susan Kirk, Wendy M. Novicoff, Philip W. Smith, Bruce Schirmer, Charles M. Friel Source Type: research

Correlation between air quality and lung cancer incidence: A county by county analysis
Poor air quality has previously been associated with lung cancer development, but the risks associated with regional differences in air quality are poorly understood. We investigated the association of air quality indices with development of lung cancer in all Texas counties. (Source: Surgery)
Source: Surgery - July 8, 2019 Category: Surgery Authors: Byron D. Hughes, Safa Maharsi, Ruth N. Obiarinze, Hemal B. Mehta, Shawn Nishi, Ikenna C. Okereke Source Type: research

Mesh reinforcement of paraesophageal hernia repair: Trends and outcomes from a national database
This study examines the trends and outcomes of mesh placement in paraesophageal hernia repair. (Source: Surgery)
Source: Surgery - July 6, 2019 Category: Surgery Authors: Kathryn A. Schlosser, Sean R. Maloney, Tanushree Prasad, Vedra A. Augenstein, Brant T. Heniford, Paul D. Colavita Source Type: research

Extent of surgery for low-risk thyroid cancer in the elderly: Equipoise in survival but not in short-term outcomes
Total thyroidectomy is more common than lobectomy for low-risk papillary thyroid cancer, despite equipoise in survival. Because postoperative morbidity increases with age, we aimed to investigate how the extent of thyroidectomy affects short-term outcomes among older patients. (Source: Surgery)
Source: Surgery - July 6, 2019 Category: Surgery Authors: Alan Zambeli-Ljepovi ć, Frances Wang, Michaela A. Dinan, Terry Hyslop, Michael T. Stang, Sanziana A. Roman, Julie A. Sosa, Randall P. Scheri Source Type: research

The role of surgical shunts in the treatment of pediatric portal hypertension
Portal diversion by surgical shunt plays a major role in the treatment of medically refractory portal hypertension. We evaluate our center ’s experience with surgical shunts for the treatment of pediatric portal hypertension. (Source: Surgery)
Source: Surgery - July 5, 2019 Category: Surgery Authors: Alexander R. Cortez, Al-Faraaz Kassam, Todd M. Jenkins, Christopher J. Nathan, Jaimie D. Nathan, Maria H. Alonso, Frederick C. Ryckman, Greg M. Tiao, Alexander J. Bondoc Source Type: research

Protective effect of phosphatidylserine blockade in sepsis induced organ dysfunction
Phosphatidylserine is usually an intracellularly oriented cell membrane phospholipid. Externalized phosphatidylserine on activated cells is a signal for phagocytosis. In sepsis, persistent phosphatidylserine exposure is also a signal for activation of the coagulation and inflammatory cascades. As such, phosphatidylserine may be a key molecule in sepsis induced cellular and organ injury. We hypothesize that phosphatidylserine blockade provides a protective effect in sepsis induced organ dysfunction. (Source: Surgery)
Source: Surgery - July 5, 2019 Category: Surgery Authors: Genna Beattie, Caitlin Cohan, Emily Miraflor, William Brigode, Gregory P. Victorino Source Type: research

Active involvement of family members in postoperative care after esophageal or pancreatic resection: A feasibility study
Active involvement of relatives has the potential to improve postoperative patient outcomes by prevention of complications sensitive to basic care and unplanned readmissions. The aim of this study was to assess the feasibility of a program in which relatives participated in postoperative care. (Source: Surgery)
Source: Surgery - July 5, 2019 Category: Surgery Authors: Anne Marthe Schreuder, Anne M. Eskes, Rosanna G.M. van Langen, Susan van Dieren, Els J.M. Nieveen van Dijkum Source Type: research

The future of general surgery training: A Canadian resident nationwide Delphi consensus statement
This study aimed to establish a nationwide, Delphi consensus statement on the perceptions of Canadian residents regarding the future of general surgery training. (Source: Surgery)
Source: Surgery - July 4, 2019 Category: Surgery Authors: Caroline Huynh, Nathalie Wong-Chong, Phil Vourtzoumis, Stephanie Lim, Wanda Marini, Gurp Johal, Matt Strickland, Amin Madani, Canadian Association of General Surgeons (CAGS) Resident Committee Source Type: research

Hepatic resection versus operative microwave ablation for single hepatocellular carcinoma ≤5 cm: A propensity score-matched analysis
Little evidence exists regarding the perioperative and oncologic benefits of microwave ablation for hepatocellular carcinoma. The aim of this study was to compare the efficacy of hepatic resection and operative microwave ablation (microwave coagulo-necrotic therapy) for single hepatocellular carcinoma ≤5 cm. (Source: Surgery)
Source: Surgery - July 3, 2019 Category: Surgery Authors: Tomoki Ryu, Yuko Takami, Yoshiyuki Wada, Takanobu Hara, Shin Sasaki, Hideki Saitsu Source Type: research

Survival of patients with borderline resectable pancreatic cancer who received neoadjuvant therapy and surgery
We report the survival of consecutive patients with borderline resectable pancreatic cancer who received neoadjuvant therapy before surgery. (Source: Surgery)
Source: Surgery - July 2, 2019 Category: Surgery Authors: Chad A. Barnes, Mariana I. Chavez, Susan Tsai, Mohammed Aldakkak, Ben George, Paul S. Ritch, Kulwinder Dua, Callisia N. Clarke, Parag Tolat, Catherine Hagen, William A. Hall, Beth A. Erickson, Douglas B. Evans, Kathleen K. Christians Source Type: research

Rehospitalization and resource use after inpatient admission for extracorporeal life support in the United States
With increasing dissemination and improved survival after extracorporeal life support, also called extracorporeal membrane oxygenation, the decrease in readmissions after hospitalization involving extracorporeal life support is an emerging priority. The present study aimed to identify predictors of early readmission after extracorporeal life support at a national level. (Source: Surgery)
Source: Surgery - July 2, 2019 Category: Surgery Authors: Yas Sanaiha, Behdad Kavianpour, Alexandra Mardock, Habib Khoury, Peter Downey, Sarah Rudasill, Peyman Benharash Source Type: research

Comparison of the recanalization rate and postthrombotic syndrome in patients with deep venous thrombosis treated with rivaroxaban or warfarin
In this article, we report the outcomes of patients with deep venous thrombosis in the lower limbs treated with the oral anticoagulant rivaroxaban or warfarin, focusing on the recanalization rate (measured with duplex ultrasound) and the incidence of postthrombotic syndrome. (Source: Surgery)
Source: Surgery - July 2, 2019 Category: Surgery Authors: Rafael de Athayde Soares, Marcelo Fernando Matielo, Francisco Cardoso Brochado Neto, M ônica Paschoal Nogueira, Rogério Duque Almeida, Roberto Sacilotto Source Type: research

Accurate preoperative prediction of unplanned 30-day postoperative readmission using 8 predictor variables
Unplanned postoperative readmissions are associated with high costs, may indicate poor care quality, and present a substantial opportunity for healthcare quality improvement. Patients want to know their risk of unplanned readmission, and surgeons need to know the risk to adequately counsel their patients. The Surgical Risk Preoperative Assessment System tool was developed from the American College of Surgeons National Surgical Quality Improvement Program dataset and is a parsimonious model using 8 predictor variables. (Source: Surgery)
Source: Surgery - July 1, 2019 Category: Surgery Authors: Douglas R. Gibula, Abhinav B. Singh, Michael R. Bronsert, William G. Henderson, Catherine Battaglia, Karl E. Hammermeister, Natalia O. Glebova, Robert A. Meguid Source Type: research

Features of synchronous versus metachronous metastasectomy in adrenal cortical carcinoma: Analysis from the US adrenocortical carcinoma database
Adrenocortical carcinoma is a rare, aggressive cancer. We compared features of patients who underwent synchronous versus metachronous metastasectomy. (Source: Surgery)
Source: Surgery - July 1, 2019 Category: Surgery Authors: Katherine M. Prendergast, Paula Marincola Smith, Thuy B. Tran, Lauren M. Postlewait, Shishir K. Maithel, Jason D. Prescott, Timothy M. Pawlik, Tracy S. Wang, Jason Glenn, Ioannis Hatzaras, Rivfka Shenoy, John E. Phay, Lawrence A. Shirley, Ryan C. Fields, Source Type: research

The impact of in-hospital complications on the long-term functional outcome of trauma patients: A multicenter study
The long-term consequences of in-hospital complications remain largely unknown. We sought to study the effect of complications on the long-term functional outcome of trauma patients. (Source: Surgery)
Source: Surgery - June 29, 2019 Category: Surgery Authors: Jae Moo Lee, Juan Herrera-Escobar, Michel Apoj, Syeda S. Al Rafai, Kelsey Han, Deepika Nehra, Ali Salim, Karen Brasel, George Kasotakis, George Velmahos, Adil Haider, Haytham M.A. Kaafarani Source Type: research

Complete and incomplete recurrent laryngeal nerve injury after thyroid and parathyroid surgery: Characterizing paralysis and paresis
Injury of the recurrent laryngeal nerve and consequent disorder of vocal fold movement is a typical complication in thyroid and parathyroid surgery. During postoperative laryngoscopy we observed not only a complete standstill (vocal fold paralysis), but also a hypomobility (paresis). In this prospective study, we investigated the difference in incidence and prognosis as well as risk-factors, intraoperative neuromonitoring, and symptoms between vocal fold paralysis and vocal fold paresis. (Source: Surgery)
Source: Surgery - June 28, 2019 Category: Surgery Authors: Max Schneider, Valerie Dahm, Christian Passler, Elisabeth Sterrer, Gudrun Mancusi, Robert Repasi, Elisabeth Gschwandtner, Elisabeth Fertl, Laura Handgriff, Michael Hermann Source Type: research

Enhanced recovery after surgery pathway for patients undergoing abdominal wall reconstruction
Pathways of enhanced recovery after surgery represent a standardized, multimodal approach to postoperative care with the goal of accelerating recovery without increasing morbidity. We hypothesized that implementation of an enhanced recovery after surgery pathway for abdominal wall reconstruction would result in a decreased duration of stay. (Source: Surgery)
Source: Surgery - June 28, 2019 Category: Surgery Authors: Jennifer Colvin, Michael Rosen, Ajita Prabhu, Steven Rosenblatt, Clayton Petro, Samuel Zolin, David Krpata Source Type: research

Body mass index: Implications on disease severity and postoperative complications in patients with Crohn ’s disease undergoing abdominal surgery
Obesity is increasing in prevalence among patients with Crohn ’s disease, but how body mass index affects disease severity and postoperative outcomes remains unknown. (Source: Surgery)
Source: Surgery - June 28, 2019 Category: Surgery Authors: Nicholas P. McKenna, Elizabeth B. Habermann, Martin D. Zielinski, Amy L. Lightner, Kellie L. Mathis Source Type: research

Gender differences among surgical fellowship program directors
Although women are increasingly represented in American surgery, data regarding sex and academic rank of the leadership of fellowship programs are lacking. (Source: Surgery)
Source: Surgery - June 27, 2019 Category: Surgery Authors: Amanda C. Filiberto, Christopher B. Le, Tyler J. Loftus, Lou A. Cooper, Christiana Shaw, George A. Sarosi, Atif Iqbal, Sanda A. Tan Source Type: research

Plasma lactate as a marker of metabolic health: Implications of elevated lactate for impairment of aerobic metabolism in the metabolic syndrome
Fasting lactate is elevated in metabolic diseases and could possibly be predictive of the risk of developing the metabolic syndrome. (Source: Surgery)
Source: Surgery - June 25, 2019 Category: Surgery Authors: Terry E. Jones, Walter J. Pories, Joseph A. Houmard, Charles J. Tanner, Donghai Zheng, Kai Zou, Paul M. Coen, Bret H. Goodpaster, William E. Kraus, G. Lynis Dohm Source Type: research

Quality assessment of the literature on surgical quality improvement
A proliferation of work on surgical quality improvement has brought about an increase in quality improvement publications. We assessed the quality of surgical quality improvement publications using the Standards of Quality Improvement Reporting Excellence (SQUIRE) guidelines. (Source: Surgery)
Source: Surgery - June 25, 2019 Category: Surgery Authors: Olivia A. Sacks, Andrew J. Lambour, Allison R. Wilcox, Shruthi Nammalwar, Sandra L. Wong Source Type: research

No refills: The durable impact of a multifaceted effort by surgical trainees to minimize the prescription of postoperative opioids
Surgeons have the opportunity to help offset the opioid epidemic by leading with practice changes. We sought to decrease the amount of opioid prescribed postoperatively through a multifaceted program. (Source: Surgery)
Source: Surgery - June 25, 2019 Category: Surgery Authors: Alexander S. Chiu, Mollie R. Freedman-Weiss, Raymond A. Jean, Elizabeth Cohen, Peter S. Yoo Source Type: research

Surgical education research: How to move beyond the survey
Surgical education serves as the foundation for high-quality, efficient patient care. Because clinical knowledge is gained and newer surgical techniques developed, this material is incorporated into the curricula of surgical trainees. Methods for studying this integration vary widely, however, providing data that, at times, is challenging to interpret in the context of patient care and outcomes. (Source: Surgery)
Source: Surgery - June 25, 2019 Category: Surgery Authors: Erin M. Corsini, Mara B. Antonoff Source Type: research