Opportunities for machine learning to improve surgical ward safety
Publication date: Available online 26 February 2020Source: The American Journal of SurgeryAuthor(s): Tyler J. Loftus, Patrick J. Tighe, Amanda C. Filiberto, Jeremy Balch, Gilbert R. Upchurch, Parisa Rashidi, Azra Bihorac (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 27, 2020 Category: Surgery Source Type: research

Non-hispanic blacks undergoing distal pancreatectomy have higher risk-adjusted rates of morbidity and are more likely to be high-cost outliers
Publication date: Available online 26 February 2020Source: The American Journal of SurgeryAuthor(s): Emanuel Eguia, Joseph N. Fahmy, Adrienne N. Cobb, Patrick Sweigert, Gerard V. Aranha, Gerard Abood, Paul C. Kuo, Marshall S. Baker (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 27, 2020 Category: Surgery Source Type: research

The effect of sociodemographic factors on outcomes and time to discharge after bariatric operations
Publication date: Available online 26 February 2020Source: The American Journal of SurgeryAuthor(s): Mary Elizabeth Guerra, Raymond A. Jean, Alexander S. Chiu, Dirk C. Johnson (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 27, 2020 Category: Surgery Source Type: research

Adhesive bowel obstruction: Incidence, recurrence and 30-day mortality in Danish women 1984–2013 – A national cohort study
Publication date: Available online 26 February 2020Source: The American Journal of SurgeryAuthor(s): C. Norrbom, M. Steding-Jessen, C. Agger, M. Osler, M. Krabbe- Sorensen, S.C. Rasmussen, A. Settnes, L. Nilas, E. Løkkegaard (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 27, 2020 Category: Surgery Source Type: research

Does negative pressure wound therapy with irrigation improve clinical outcomes? A randomized clinical trial in patients with diabetic foot infections
Publication date: Available online 27 February 2020Source: The American Journal of SurgeryAuthor(s): Lawrence A. Lavery, Kathryn E. Davis, Javier La Fontaine, J. David Farrar, Kavita Bhavan, Orhan K. Oz, Peter A. Crisologo (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 27, 2020 Category: Surgery Source Type: research

Gender and compensation among surgical specialties in the Veterans Health Administration
Publication date: Available online 27 February 2020Source: The American Journal of SurgeryAuthor(s): Jessica H. Maxwell, James A. Randall, Sarah M. Dermody, Adnan S. Hussaini, Hamsini Rao, Ajay S. Nathan, Sonya Malekzadeh, Jamie R. Litvack (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 27, 2020 Category: Surgery Source Type: research

Evaluating the educational effectiveness of an 8-week patient management course for surgical interns: A nine-year analysis
Publication date: Available online 25 February 2020Source: The American Journal of SurgeryAuthor(s): W. Christian Crannell, Camden Boes, Karen Brasel, Mackenzie R. Cook (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 27, 2020 Category: Surgery Source Type: research

Neuroendocrine metastases to the ovaries are significantly associated with small bowel neuroendocrine tumors and carcinomatosis
Publication date: Available online 25 February 2020Source: The American Journal of SurgeryAuthor(s): Kristen E. Limbach, SuEllen J. Pommier, Elizabeth Dewey, Enrique Leon, Rodney F. Pommier (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 27, 2020 Category: Surgery Source Type: research

Senior surgical resident autonomy and teaching assistant cases: A prospective observational study
Publication date: Available online 26 February 2020Source: The American Journal of SurgeryAuthor(s): Woo S. Do, Rowan R. Sheldon, Cody J. Phillips, Matthew J. Eckert, Vance Y. Sohn, Matthew J. Martin (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 27, 2020 Category: Surgery Source Type: research

Utilization of LCP-Tacrolimus (Envarsus XR) in simultaneous pancreas and kidney (SPK) transplant recipients
Publication date: Available online 24 February 2020Source: The American Journal of SurgeryAuthor(s): Julia Torabi, Athena Konicki, Juan P. Rocca, Maria Ajaimy, Alesa Campbell, Yorg Azzi, Cindy Pynadath, Luz Liriano-Ward, Enver Akalin, Milan Kinkhabwala, Jay A. Graham (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 26, 2020 Category: Surgery Source Type: research

Risk factors associated with positive resection margins in patients with adrenocortical carcinoma
Publication date: Available online 22 February 2020Source: The American Journal of SurgeryAuthor(s): Nicholas J. Skertich, John F. Tierney, Sitaram V. Chivukula, Nasim T. Babazadeh, Martin Hertl, Jennifer Poirier, Xavier M. KeutgenAbstractBackgroundPositive resection margins are associated with worse survival after surgery for adrenocortical carcinoma (ACC). We aimed to identify risk factors for positive margins post-resection.MethodsThe NCDB was queried for ACC patients from 2006 to 2015. Patients with positive versus negative resection margins post-surgery were compared using Chi-square tests. Survival based on adjuvant ...
Source: The American Journal of Surgery - February 23, 2020 Category: Surgery Source Type: research

The evolving role of SBAS – We’re getting in but we’re not going on
Publication date: Available online 4 February 2020Source: The American Journal of SurgeryAuthor(s): Malcolm V. Brock (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 23, 2020 Category: Surgery Source Type: research

Socioeconomic determinants of the surgical treatment of colorectal liver metastases
Publication date: Available online 21 February 2020Source: The American Journal of SurgeryAuthor(s): Naomi M. Sell, Neha Shafique, Hang Lee, Grace C. Lee, Kenneth K. Tanabe, Cristina R. Ferrone, Lawrence S. Blaszkowsky, Theodore S. Hong, Jennifer Wo, Motaz QadanAbstractObjectiveWe hypothesized that differences in resection rates of colorectal liver metastases exist based on socioeconomic status (SES) inequalities.MethodsThe NCDB was utilized to study patients of different median household income diagnosed with colon adenocarcinoma from 2010 to 2015.ResultsA total of 21,258 patients met inclusion criteria, of whom 3,587 (16...
Source: The American Journal of Surgery - February 23, 2020 Category: Surgery Source Type: research

Is trauma center designation associated with disparities in discharge to rehabilitation centers among elderly patients with Traumatic Brain Injury?
ConclusionBlack and Latino patients were less likely to be discharged to rehabilitation centers compared to White patients. The etiology of these disparities deserves further study. (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 21, 2020 Category: Surgery Source Type: research

The impact of cirrhosis on esophageal cancer surgery: An up-to-date meta-analysis
ConclusionsCirrhotic patients have higher odds of developing pulmonary complications, ascites, and anastomotic leak during the first postoperative month. Although, 30-day mortality was higher among cirrhotic patients after esophagectomy, liver disease does not seem to influence long-term prognosis. (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 21, 2020 Category: Surgery Source Type: research

Quetiapine therapy in critically injured trauma patients is associated with an increased risk of pulmonary complications
ConclusionsQuetiapine exposure in critically injured trauma patients was associated with increased risk of PC. Guidelines for treatment of delirium with quetiapine in critically injured trauma patients should account for this risk. (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 20, 2020 Category: Surgery Source Type: research

Post-thyroidectomy emergency room visits and readmissions: Assessment from the Collaborative Endocrine Surgery Quality Improvement Program (CESQIP)
ConclusionsStrategies to decrease hypocalcemia and improve perioperative care of patients with BMI>40 kg/m2 may improve post-thyroidectomy outcome. (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 20, 2020 Category: Surgery Source Type: research

Can the Emergency Surgery Score (ESS) predict outcomes in emergency general surgery patients with missing data elements? A nationwide analysis
ConclusionESS performs well in predicting outcomes in EGS patients even when one or more data elements are missing and remains a useful bedside tool for counseling EGS patients and for benchmarking the quality of EGS care. (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 20, 2020 Category: Surgery Source Type: research

Histomorphometric evaluation of the rat kidney submitted to warm ischemia and the protective effect of resveratrol
ConclusionsPreoperative administration of resveratrol has renoprotective effects, preventing the glomerular number reduction observed in warm ischemia. (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 20, 2020 Category: Surgery Source Type: research

The Emergency Surgery Score (ESS) accurately predicts outcomes in elderly patients undergoing emergency general surgery
ConclusionESS accurately predicts mortality and morbidity in the elderly EGS patient, but its accuracy in predicting morbidity decreases for nonagenarians. (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 18, 2020 Category: Surgery Source Type: research

Incidence and circumstances of pediatric fall-related injuries: Which fall variables matter?
ConclusionsPatient age, fall mechanism, landing surface, and landing position need to be considered with regard to injury severity and patient outcomes among pediatric fall patients. (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 18, 2020 Category: Surgery Source Type: research

A review of general surgery resident experience in common bile duct exploration in the ERCP era
Publication date: Available online 16 February 2020Source: The American Journal of SurgeryAuthor(s): Rachel L. Warner, K. Conley Coleman, Kelsey A. Musgrove, James M. Bardes, David C. Borgstrom, Daniel J. GraboAbstractBackgroundUse of minimally invasive techniques for management of common bile duct (CBD) stones has led to declining number of CBD explorations (CBDE) performed at teaching and non-teaching institutions. We evaluate the impact of this decline on surgery training in bile duct procedures.Study designNational operative data for general surgery residents (GSR) were examined from 2000 to 2018. Biliary operations in...
Source: The American Journal of Surgery - February 17, 2020 Category: Surgery Source Type: research

Comparison of skin closure techniques in patients undergoing open pancreaticoduodenectomy: A single center experience
This study evaluated closure techniques and incisional surgical site complications (SSCs) and incisional surgical site infections (SSIs) after pancreaticoduodenectomy (PD).MethodsRetrospective review of open PDs from 2015 to 2018 was performed. Outcomes were compared among closure techniques (subcuticular + topical skin adhesive (TSA); staples; subcuticular only). SSCs were defined as abscess, cellulitis, seroma, or fat necrosis. SSIs were defined according to the National Surgical Quality Improvement Program (NSQIP).ResultsPatients with subcuticular + TSA (n = 205) were less likely to develop...
Source: The American Journal of Surgery - February 17, 2020 Category: Surgery Source Type: research

Completion lymph node dissection for merkel cell carcinoma
ConclusionsIn SLNB positive MCC, CLND alone is associated with worse survival compared with treatment with adjuvant radiation or both CLND and adjuvant radiation. (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 17, 2020 Category: Surgery Source Type: research

Prognostic value of tumor size and minimal extrathyroidal extension in papillary thyroid carcinoma
Publication date: Available online 16 February 2020Source: The American Journal of SurgeryAuthor(s): Chol-Ho Shin, Jong-Lyel Roh, Dong Eun Song, Kyung-Ja Cho, Seung-Ho Choi, Soon Yuhl Nam, Sang Yoon KimAbstractBackgroundTumour size and extrathyroidal extension (ETE) may impact papillary thyroid carcinoma (PTC) outcomes. We therefore examined the prognostic value of tumour size and ETE for predicting posttreatment recurrence in PTC patients.MethodsA total of 2,902 patients who underwent thyroidectomy for previously untreated T1–T3 PTC (7th edition American Joint Committee on Cancer) at our tertiary referral center wer...
Source: The American Journal of Surgery - February 17, 2020 Category: Surgery Source Type: research

Contributing factors and short-term surgical outcomes of patients with early-onset rectal cancer
Publication date: Available online 16 February 2020Source: The American Journal of SurgeryAuthor(s): Agnes Ewongwo, Mohammad Hamidi, Zana Alattar, Oluwatosin P. Ayotunde, Hina A. Tiwari, Emad Elquza, Aaron Scott, Kamil Hanna, Valentine NfonsamAbstractIntroductionThe aim of this study was to evaluate patient factors that contribute to increased incidence of early onset rectal cancer and analyze the short-term surgical outcomes of patients undergoing surgery.MethodsA 2-year review (2015–2016) of the ACS-NSQIP included patients with rectal cancer who underwent surgical management. Patients were stratified into early-onset RC (
Source: The American Journal of Surgery - February 17, 2020 Category: Surgery Source Type: research

Impact of general surgery rotation exposure on surgery clerkship performance
ConclusionsExposure to a GS rotation is not advantageous on the NBME examination. Students who completed the medicine clerkship prior to surgery demonstrated superior performance on the NBME examination. (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 17, 2020 Category: Surgery Source Type: research

Patient factors influence surgical options in gastroparesis
Publication date: Available online 16 February 2020Source: The American Journal of SurgeryAuthor(s): Jon S. Thompson, Alexander Hewlett, Elizabeth Lyden, James R. Scott, Corrigan McBrideAbstractBackgroundPatient selection for the diverse surgical procedures for gastroparesis remains poorly defined. Our aim was to evaluate how patient factors have determined our surgical approach to gastroparesis.Methods95 patients undergoing 105 surgical procedures for gastroparesis were reviewed. Patient factors were compared across six surgical procedures: gastric neurostimulator, pyloroplasty, neurostimulator plus pyloroplasty, sleeve g...
Source: The American Journal of Surgery - February 17, 2020 Category: Surgery Source Type: research

Surgical management of stomal prolapse – Is there a superior approach to repair?
ConclusionOperative repair of stomal prolapse, regardless of approach, is associated with high recurrence rates. No identifiable factors were associated with recurrence. (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 17, 2020 Category: Surgery Source Type: research

Performance advantages for grit and optimism
ConclusionsPassivity in response to negative events is the default human response, but the presence of control activates the prefrontal cortex—the brain region controlling executive function—promoting effort toward solutions. Challenges, failures, and traumatic events perceived as inescapable, permanent, pervasive, and irreparable lead to debility and attrition; grit and optimism shift the human response toward growth, strength, and improved performance. Methods for realizing these advantages include maintaining positivity, pursuing major challenges that match personal skills, engaging in deliberate practice to...
Source: The American Journal of Surgery - February 14, 2020 Category: Surgery Source Type: research

Editorial Board
Publication date: February 2020Source: The American Journal of Surgery, Volume 219, Issue 2Author(s): (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 12, 2020 Category: Surgery Source Type: research

Emeritus Editorial Board
Publication date: February 2020Source: The American Journal of Surgery, Volume 219, Issue 2Author(s): (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 12, 2020 Category: Surgery Source Type: research

Table of Contents
Publication date: February 2020Source: The American Journal of Surgery, Volume 219, Issue 2Author(s): (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 12, 2020 Category: Surgery Source Type: research

Editorial
Publication date: February 2020Source: The American Journal of Surgery, Volume 219, Issue 2Author(s): Dimitrios Stefanidis (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 12, 2020 Category: Surgery Source Type: research

Training with cognitive load improves performance under similar conditions in a real surgical task
Publication date: Available online 10 February 2020Source: The American Journal of SurgeryAuthor(s): Ganesh Sankaranarayanan, Coleman Odlozil, Katerina O. Wells, Steven G. Leeds, Sanket Chauhan, James W. Fleshman, Daniel B. Jones, Suvranu DeAbstractBackgroundEnhancing cognitive load while performing a bimanual surgical task affects performance. Whether repeated training under this condition could benefit performance in an operating room was tested using a virtual reality simulator with cognitive load applied through two-digit math multiplication questions.Method11 subjects were randomized to Control, VR and VR + ...
Source: The American Journal of Surgery - February 11, 2020 Category: Surgery Source Type: research

Evaluating how residents talk and what it means for surgical performance in the simulation lab
ConclusionParticipants with better hernia repair outcomes engaged in more operative management communication during the simulated procedure. This ability to integrate multiple operative steps and verbally communicate them significantly correlated with better operative outcomes. (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 9, 2020 Category: Surgery Source Type: research

Use of indocyanine green fluorescence compared to radioisotope for sentinel lymph node biopsy in early-stage breast cancer: Systematic review and meta-analysis
ConclusionICG-fluorescence could complement RI method or provide alternative in centers with poor accessibility to RI lymphoscintigraphy. (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 8, 2020 Category: Surgery Source Type: research

Early tracheostomy in patients with cervical spine injury reduces morbidity and improves resource utilization
ConclusionsEarly tracheostomy in patients with C-spine injuries was associated with lower rates of ventilator-associated-pneumonia, shorter duration of mechanical ventilation, and ICU and hospital stay. (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 8, 2020 Category: Surgery Source Type: research

Age is a predictor for mortality after blunt splenic injury
Publication date: Available online 6 February 2020Source: The American Journal of SurgeryAuthor(s): Elizabeth Warnack, Marko Bukur, Spiros Frangos, Charles DiMaggio, Rosemary Kozar, Michael Klein, Cherisse BerryAbstractBackgroundWhile the incidence of geriatric trauma continues to increase, the management of high-grade blunt splenic injury (BSI) in the elderly remains controversial. Among this population, data evaluating survival rates following non-operative and operative management are inconsistent. We analyzed mortality risk in geriatric patients with high-grade BSI based on operative vs. non-operative management.Method...
Source: The American Journal of Surgery - February 8, 2020 Category: Surgery Source Type: research

Predicting length of stay for trauma and emergency general surgery patients
ConclusionBoth the TEGS team and NSQIP are poor at predicting LOS for TEGS patients. Further work helping to guide LOS predictions for TEGS patients is warranted. (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 8, 2020 Category: Surgery Source Type: research

Nutritional risk screening score is associated with omission of adjuvant chemotherapy for stage III colon cancer
This study aimed to evaluate the association between nutritional risk screening (NRS) score and administration of adjuvant chemotherapy for stage III colon cancer.MethodsA total of 404 patients with stage III colon cancer who underwent curative resection between January 2012 and December 2015 were included. Patients with a preoperative high nutritional risk score (NRS ≥4) were compared with those with an NRS
Source: The American Journal of Surgery - February 8, 2020 Category: Surgery Source Type: research

Reoperative laparoscopic rectal surgery: Another potential tool for the expert’s toolbox
Publication date: Available online 22 January 2020Source: The American Journal of SurgeryAuthor(s): Marc D. Basson (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 6, 2020 Category: Surgery Source Type: research

Aeromedical retrieval of trauma patients: Impact of flight path model on estimates of population coverage
ConclusionWhile all three flight path models described have some validity and utility, simplistic circular flight time isochrones around trauma centers and helicopter bases provide overly optimistic estimates of population coverage. The elliptical model provides a more realistic evaluation. (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 5, 2020 Category: Surgery Source Type: research

Physician mistreatment in the clinical learning environment
The objective was to investigate the prevalence of mistreatment towards surgical housestaff and faculty and characterize such experiences.MethodsIn 2018, the Department of Surgery surveyed housestaff and faculty on incidents of mistreatment.ResultsClinical faculty (63%) and residents (72%) completed the mistreatment survey. Excluding public embarrassment, 48% of residents and 29% of clinical faculty experienced mistreatment. Residents experienced public embarrassment and public humiliation more frequently than faculty, however faculty were subjected to racially or ethnically offensive remarks/names more frequently than residents (p 
Source: The American Journal of Surgery - February 5, 2020 Category: Surgery Source Type: research

The evolving role of SBAS – We're getting in but we're not going on
Publication date: Available online 4 February 2020Source: The American Journal of SurgeryAuthor(s): Malcolm Brock (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 5, 2020 Category: Surgery Source Type: research

Impact of glucocorticoid supplementation on reducing perioperative complications in patients on long-term glucocorticoid: A propensity score analysis using a nationwide inpatient database
ConclusionsPerioperative glucocorticoid supplementation was not associated with decreased morbidity or mortality. (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 3, 2020 Category: Surgery Source Type: research

Does being in the hot seat matter? Effect of passive vs active learning in surgical simulation
ConclusionAnalyses confirmed the advantage of simulation-based training, but additionally suggest that the benefits for similar in both active participants and passive observers. This supports the idea of group based simulation training which can be more cost and time efficient. (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 2, 2020 Category: Surgery Source Type: research

Access to surgery following centralization of breast cancer surgical consultations
ConclusionCentralization of surgical referrals for breast cancer patients improved access to surgery. (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 2, 2020 Category: Surgery Source Type: research

Central pancreatectomy with pancreaticogastrostomy reconstruction: A brief report and video technique
We present a case of a patient with a well differentiated neuroendocrine tumor in the neck of the pancreas who underwent a central pancreatectomy with pancreaticogastrostomy reconstruction. Patient selection and technical aspects of the procedure are described. The decision to perform a central pancreatectomy should not be made lightly as complications are frequent. Careful patient selection is imperative. (Source: The American Journal of Surgery)
Source: The American Journal of Surgery - February 2, 2020 Category: Surgery Source Type: research

Risk factors for posttreatment recurrence in patients with intermediate-risk papillary thyroid carcinoma
This study involved 1,782 patients who underwent thyroidectomy for intermediate-risk PTC. Univariate and multivariate Cox proportional hazard regression analyses were used to identify the significant factors predictive of posttreatment recurrence-free survival (RFS).ResultsOf intermediate-risk factors, univariate analyses showed that clinical and pathological cervical lymph node (LN) positivity (cN1 and pN1), aggressive histology, and multifocality with microscopic extrathyroidal extension were significantly associated with RFS outcomes (all P 5 pN1, and posttreatment radioactive iodine (RAI)-avid metastatic foci of inte...
Source: The American Journal of Surgery - January 31, 2020 Category: Surgery Source Type: research