Outcomes of Hartmann´s procedure and subsequent intestinal restoration. Which patients are most likely to undergo reversal?
ConclusionsHP is associated with high morbidity and mortality. Restoration of intestinal continuity involves minor, but frequent, morbidity and a low mortality rate. Age and comorbidities can decrease, and even override, the decision to reverse HP. (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 22, 2019 Category: Surgery Source Type: research

With great interest we read the article ‘’Discrepancies between conventional and viscoelastic assays in identifying trauma induced coagulopathy ‘’ by JJ Sumislawski et al. in Am J Surg 2019
Publication date: Available online 21 February 2019Source: The American Journal of SurgeryAuthor(s): Karlijn J.P. van Wessem, Luke P.H. Leenen (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 22, 2019 Category: Surgery Source Type: research

The effects of propranolol and clonidine on bone marrow expression of hematopoietic cytokines following trauma and chronic stress
Publication date: Available online 21 February 2019Source: The American Journal of SurgeryAuthor(s): Tyler J. Loftus, Elizabeth S. Miller, Jessica K. Millar, Kolenkode B. Kannan, Ines G. Alamo, Philip A. Efron, Alicia M. MohrAbstractBac’kgroundAttenuating post-injury neuroendocrine stress abrogates persistent injury-associated anemia. Our objective was to examine the mechanisms by which propranolol and clonidine modulate this process. We hypothesized that propranolol and clonidine would decrease bone marrow expression of high-mobility group box-1 (HMGB1) and increase expression of stem cell factor (SCF) and B-cell ly...
Source: The American Journal of Surgery - February 22, 2019 Category: Surgery Source Type: research

Frailty as a Prognostic Factor for the Critically Ill Older Adult Trauma Patients
Publication date: Available online 22 February 2019Source: The American Journal of SurgeryAuthor(s): Mohammad Hamidi, Muhammad Zeeshan, Valeria Leon-Risemberg, Janko Nikolich-Zugich, Kamil Hanna, Narong Kulvatunyou, Abdul Tawab Saljuqi, Mindy Fain, Bellal JosephAbstractBackgroundFrailty is highly prevalent in the elderly and confers high risk for adverse outcomes. We aimed to assess the impact of frailty on critically ill older adult trauma patients.MethodsWe analyzed the ACS-TQIP(2010-2014) including all critically-ill trauma patients ≥65y. The modified frailty index (mFI) was calculated. Following stratified into frai...
Source: The American Journal of Surgery - February 22, 2019 Category: Surgery Source Type: research

Returns to the Operating Room after Breast Surgery at a Tertiary Care Medical Center
Publication date: Available online 20 February 2019Source: The American Journal of SurgeryAuthor(s): Brittany L. Murphy, Amy E. Glasgow, Elizabeth B. Habermann, Tina J. HiekenAbstractBackgroundEvaluation of returns to the operating room (RORs) may spur practice modifications to improve patient outcomes and hospital practices. We determined the frequency and indications for RORs after breast operations.MethodsWe identified patients ≥18 years who underwent a breast operation at our institution 1/1/14-1/13/17 and assessed ROR within 45-days. RORs were categorized as unplanned/planned, staged/unstaged, or unrelated procedur...
Source: The American Journal of Surgery - February 20, 2019 Category: Surgery Source Type: research

The Utility of CT Scan For the Diagnostic Evaluation of Acute Abdominal Pain
Publication date: Available online 20 February 2019Source: The American Journal of SurgeryAuthor(s): Timothy Bax, Matthew Macha, John MayberryAbstractAbdCT for the evaluation of AAP in the ED in the US may be excessive and is potentially (although rarely) misleading and harmful. A selective policy of ‘AbdUS first’ combined with an observation unit and/or surgeon evaluation prior to AbdCT is preferred to a ‘routine AbdCT’ policy. Repeated AbdCTs for abdominal pain are not recommended because of cumulative radiation exposure. Standardized and complete history and physical examination, such as that ori...
Source: The American Journal of Surgery - February 20, 2019 Category: Surgery Source Type: research

Poor compliance despite equal access: Military experience with screening breast MRI in high risk women
Publication date: Available online 20 February 2019Source: The American Journal of SurgeryAuthor(s): Woo S. Do, Jessica B. Weiss, Helen F. McGregor, Dominic M. Forte, Rowan R. Sheldon, Vance Y. SohnAbstractBackgroundUsing the military as a model for an equal-access, no-cost healthcare system, we sought to (1) describe screening breast MRI compliance rates and (2) identify patient-perceived barriers to screening.MethodsIn this retrospective cohort study of a prospectively maintained database at a tertiary level center, we compared compliance among women at ≥20% risk of developing breast cancer (Tyrer-Cuzick) and conducte...
Source: The American Journal of Surgery - February 20, 2019 Category: Surgery Source Type: research

The urban severity score (UISS) better predicts mortality following penetrating gunshot wounds (GSW)
Publication date: March 2019Source: The American Journal of Surgery, Volume 217, Issue 3Author(s): (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 17, 2019 Category: Surgery Source Type: research

Editorial Board
Publication date: March 2019Source: The American Journal of Surgery, Volume 217, Issue 3Author(s): (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 17, 2019 Category: Surgery Source Type: research

Table of Contents
Publication date: March 2019Source: The American Journal of Surgery, Volume 217, Issue 3Author(s): (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 17, 2019 Category: Surgery Source Type: research

Patterns of readmission among the elderly after hepatopancreatobiliary surgery
Publication date: March 2019Source: The American Journal of Surgery, Volume 217, Issue 3Author(s): (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 17, 2019 Category: Surgery Source Type: research

A targeted initiative to discharge surgical patients earlier in the day is associated with decreased length of stay and improved hospital throughput
Publication date: March 2019Source: The American Journal of Surgery, Volume 217, Issue 3Author(s): (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 17, 2019 Category: Surgery Source Type: research

Circulating thrombospondin-2 enhances prediction of malignant intraductal papillary mucinous neoplasm
Publication date: March 2019Source: The American Journal of Surgery, Volume 217, Issue 3Author(s): (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 17, 2019 Category: Surgery Source Type: research

Rectal resection following neoadjuvant therapy in a midwest community hospital setting: The case for standardization over centralization as the means to optimize rectal cancer outcomes in the United States
Publication date: March 2019Source: The American Journal of Surgery, Volume 217, Issue 3Author(s): (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 17, 2019 Category: Surgery Source Type: research

Degree of hypercalcemia correlates with parathyroidectomy but not with symptoms
Publication date: March 2019Source: The American Journal of Surgery, Volume 217, Issue 3Author(s): (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 17, 2019 Category: Surgery Source Type: research

Screening colonoscopy performed by colorectal surgeons: High-quality regardless of specialty
Publication date: March 2019Source: The American Journal of Surgery, Volume 217, Issue 3Author(s): (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 17, 2019 Category: Surgery Source Type: research

Quality that you cannot believe
Publication date: March 2019Source: The American Journal of Surgery, Volume 217, Issue 3Author(s): (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 17, 2019 Category: Surgery Source Type: research

Pancreaticoduodenectomy and placement of operative enteral access: Better or worse?
Publication date: March 2019Source: The American Journal of Surgery, Volume 217, Issue 3Author(s): (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 17, 2019 Category: Surgery Source Type: research

A simple algorithm to improve quality while reducing resource utilization in evaluation of suspected appendicitis
Publication date: March 2019Source: The American Journal of Surgery, Volume 217, Issue 3Author(s): (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 17, 2019 Category: Surgery Source Type: research

The impact of obesity on treatment choices and outcomes in operable breast cancer
Publication date: March 2019Source: The American Journal of Surgery, Volume 217, Issue 3Author(s): (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 17, 2019 Category: Surgery Source Type: research

A randomized double-blinded study to determine the effectiveness of utilizing intraperitoneal bupivacaine: Does it reduce post-operative opioid use following laparoscopic appendectomy?
Publication date: March 2019Source: The American Journal of Surgery, Volume 217, Issue 3Author(s): (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 17, 2019 Category: Surgery Source Type: research

Cancel that picc line order; cholecystostomy tube and short course of antibiotics
Publication date: March 2019Source: The American Journal of Surgery, Volume 217, Issue 3Author(s): (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 17, 2019 Category: Surgery Source Type: research

Laparoscopic placement of the LINX system in management of severe reflux after sleeve gastrectomy
Publication date: March 2019Source: The American Journal of Surgery, Volume 217, Issue 3Author(s): (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 17, 2019 Category: Surgery Source Type: research

Impact of extraction-site location on wound infection rates after laparoscopic colorectal resection
Publication date: March 2019Source: The American Journal of Surgery, Volume 217, Issue 3Author(s): (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 17, 2019 Category: Surgery Source Type: research

Do contradictions in TQIP measures affect perceptions of quality? An analysis of TQIP definitions on quality outcomes for placement OF ICP monitoring at a single level one Trauma Center
Publication date: March 2019Source: The American Journal of Surgery, Volume 217, Issue 3Author(s): (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 17, 2019 Category: Surgery Source Type: research

Effect of wound complications following mastectomy with reconstruction on breast cancer recurrence
Publication date: March 2019Source: The American Journal of Surgery, Volume 217, Issue 3Author(s): (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 17, 2019 Category: Surgery Source Type: research

Comparison of cost and outcomes in patients receiving thoracic epidural versus liposomal Bupivacaine for video-assisted thoracoscopic pulmonary resection
Publication date: March 2019Source: The American Journal of Surgery, Volume 217, Issue 3Author(s): (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 17, 2019 Category: Surgery Source Type: research

Melanoma: Improvement in guideline based care using a quality monitoring program. Comparison of melanoma care outcomes in a community-based teaching hospital
Publication date: March 2019Source: The American Journal of Surgery, Volume 217, Issue 3Author(s): (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 17, 2019 Category: Surgery Source Type: research

Did we prioritize quality improvement in general surgery: Time for a focus on outcomes and enhanced recovery care plans
Publication date: March 2019Source: The American Journal of Surgery, Volume 217, Issue 3Author(s): (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 17, 2019 Category: Surgery Source Type: research

A decade of experience with laparoscopic ventral hernia repairs
Publication date: March 2019Source: The American Journal of Surgery, Volume 217, Issue 3Author(s): (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 17, 2019 Category: Surgery Source Type: research

The danger zone: Injuries and conditions associated with immediately fatal motorcycle collisions in the state of Michigan
Publication date: March 2019Source: The American Journal of Surgery, Volume 217, Issue 3Author(s): (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 17, 2019 Category: Surgery Source Type: research

Does a fracture liaison service program minimize recurrent fragility fractures in the elderly with osteoporotic vertebral compression fractures
Publication date: March 2019Source: The American Journal of Surgery, Volume 217, Issue 3Author(s): (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 17, 2019 Category: Surgery Source Type: research

The emergency surgical airway: Bridging the gap from quality outcome to performance improvement through a novel simulation based curriculum
Publication date: March 2019Source: The American Journal of Surgery, Volume 217, Issue 3Author(s): (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 17, 2019 Category: Surgery Source Type: research

The role of academic achievements and psychometric measures in the ranking process
Publication date: March 2019Source: The American Journal of Surgery, Volume 217, Issue 3Author(s): (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 17, 2019 Category: Surgery Source Type: research

Clinical trial enrollment in patients with endocrine neoplasm: Parity achievable, but cancer
Publication date: Available online 14 February 2019Source: The American Journal of SurgeryAuthor(s): Patience Green, Electron KebebewAbstractBackgroundWe sought to assess participation of underrepresented minorities with endocrine neoplasms in clinical trials conducted in the National Cancer Institute’s (NCI) Intramural Research Program.MethodsWe performed a retrospective analysis of patients enrolled in Endocrine Oncology Branch (EOB) clinical trials, comparing demographics to regional and national demographics. We compared specific endocrine cancer patient data to data from NCI’s Surveillance, Epidemiology, a...
Source: The American Journal of Surgery - February 14, 2019 Category: Surgery Source Type: research

Reduction of lymphocele rate in patients undergoing sentinel node biopsy for melanoma by intraoperative placement of plant-based hemostatic powder: results of a prospective trial
ConclusionsIntra-operative placement of PBHP reduced the rate of lymphoceles in patients undergoing SNB for melanoma. (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 14, 2019 Category: Surgery Source Type: research

Transplant Surgery Enters A New Era: Increasing Immunosuppressive Medication Adherence Through Mobile Apps and Smart Watches
Publication date: Available online 14 February 2019Source: The American Journal of SurgeryAuthor(s): Dov Levine, Julia Torabi, Krystina Choinski, Juan P. Rocca, Jay A. GrahamAbstractThe high rate of immunosuppressive medication non-adherence in transplant recipients demands the search for a solution that targets modifiable risk factors and incorporates mobile health technology to better engage and educate patients. Kidney transplant recipients (kidneys alone or multi-organ) were randomized to receive a mobile app known as Transplant Hero, both the app and a smart watch, or neither. The coefficient of variability (CV) of ta...
Source: The American Journal of Surgery - February 14, 2019 Category: Surgery Source Type: research

Liposomal bupivacaine versus thoracic epidural: We need more evidence
Publication date: Available online 12 February 2019Source: The American Journal of SurgeryAuthor(s): Dominic V. Pisano (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 13, 2019 Category: Surgery Source Type: research

Effectiveness of surgery for recurrent cholangiocarcinoma: a single center experience and brief literature review
In this study, we reviewed our experiences and previous studies on surgery for recurrent cholangiocarcinoma (CCA).MethodsWe analyzed outcomes of 117 patients with recurrent CCA between 2000 and 2015. Twenty-one patients (17.9%) underwent surgical resection for recurrence, and the remaining 96 patients (82.1%) did not undergo resection. We evaluated patients’ clinicopathological features and prognoses between the two groups.ResultsPatients who underwent surgery were significantly associated with better overall survival after recurrence (HR=0.22, P
Source: The American Journal of Surgery - February 13, 2019 Category: Surgery Source Type: research

New barrier attire regulations in the operating room: a mandate without basis?
ConclusionsThese data question the rationale for the new more stringent operating room attire guidelines which burden hospitals with additional cost, time and resources, and could detract efforts to target important factors that really influence outcomes. (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 13, 2019 Category: Surgery Source Type: research

Risk factors and outcome of acute kidney injury in elderly trauma patients
ConclusionAKI in elderly trauma patients is associated with magnitude of injury and shock but not pre-existing medical comorbidities and it significantly increased the risk of death.Graphical abstract (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 13, 2019 Category: Surgery Source Type: research

Getting to the Bottom of Treatment of Rectal Prolapse in the Elderly: Analysis of the National Surgical Quality Improvement Program (NSQIP)
CONCLUSIONSAll 3 surgical approaches carry low morbidity among the sick, elderly. PR remains the predominant approach nationally. A paradigm shift accepting the safety of abdominal approaches is needed. There should also be less focus on age in the decision-making process of surgical treatment. (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 13, 2019 Category: Surgery Source Type: research

Needs Assessment Can Guide Creation of a “Resident-Optimized Clinic” in Surgery
ConclusionsMultiple themes have been identified as problematic for the clinic education experience. The ROC was rated positively by trainees suggesting thoughtful intervention to improve clinic results in a better clinic experience and more educational gain from the clinic environment. (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 13, 2019 Category: Surgery Source Type: research

Concomitant cholecystectomy during bariatric surgery: the jury is still out
ConclusionsThis study highlights the small number and poor quality of available studies referring to the role of simultaneous cholecystectomy during bariatric surgery. (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 13, 2019 Category: Surgery Source Type: research

Small Bowel Obstruction in a Virgin Abdomen
ConclusionPatients with SBO and virgin abdomen frequently have a benign etiology. Careful imaging review directed at subtle signs of an underlying malignancy is warranted. If non-operative management is chosen, close follow up is essential and it should include a careful personal and family history as well as updated colonoscopy. (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 13, 2019 Category: Surgery Source Type: research

Identifying Risk Factor for Development of Perioperative Venous Thromboembolism in Patients with Gastrointestinal Malignancy
ConclusionA prior history of atrial fibrillation independently predicts increased risk of developing VTE after surgery for GI malignancy. Improving understanding of the underlying VTE pathophysiology in these patients can help guide effective prevention strategies. (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 13, 2019 Category: Surgery Source Type: research

Colonoscopy Utilization in Rural Areas By General Surgeons: An Analysis of the National Ambulatory Medical Care Survey
Publication date: Available online 13 February 2019Source: The American Journal of SurgeryAuthor(s): Sreeya S. Komaravolu, Julia J. Kim, Supreet Singh, Aziz M. MerchantAbstractBackgroundOne in three adults above 50 years old have not been screened for colorectal cancer as of 2013.1 Rural areas have even lower screening and have more general surgeons compared to gastroenterologists2, offering surgeons as a reservoir for necessary services.MethodsPublic data from the 2006-2015 CDC National Ambulatory Medical Care Survey was analyzed using SAS. Number of colonoscopies performed by rural general surgeons, family medicine pract...
Source: The American Journal of Surgery - February 13, 2019 Category: Surgery Source Type: research

Too Fast, or not Fast Enough? The FAST Exam in Patients with Non-Compressible Torso Hemorrhage
Publication date: Available online 13 February 2019Source: The American Journal of SurgeryAuthor(s): Woo S. Do, Ronald Chang, Erin E. Fox, Charles E. Wade, John B. Holcomb, Matthew J. Martin, the NCTH Study Group, John B. Holcomb, Charles E. Wade, Erin E. Fox, Jeanette M. Podbielski, Jeffrey S. Tomasek, Ronald Chang, Stacia M. DeSantis, Thomas J. Greene, Charlton-Ouw, O. Clark West, Martin A. Schreiber, Lena Napolitano, Frederic Pieracci, Charles FoxAbstractBACKGROUNDFocused assessment with sonography for trauma (FAST) performance metrics are unknown in patients with non-compressible torso hemorrhage (NCTH).METHODSRetrospe...
Source: The American Journal of Surgery - February 13, 2019 Category: Surgery Source Type: research

Corrigendum to “Methocarbamol use is associated with decreased hospital length of stay in trauma patients with closed rib fractures” [Am J Surg 214/4 (2018) 738–742]
Publication date: Available online 12 February 2019Source: The American Journal of SurgeryAuthor(s): Asad E. Patanwala, Ohoud Aljuhani, Brian J. Kopp, Brian L. Erstad (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 12, 2019 Category: Surgery Source Type: research

The role of laparoscopic-guided transversus abdominis plane block in laparoscopic surgery.
Publication date: Available online 12 February 2019Source: The American Journal of SurgeryAuthor(s): Hytham K.S. Hamid, Iqbal Z. Khan (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 12, 2019 Category: Surgery Source Type: research