A Multicenter, 10-Year Experience With Hepatocellular Adenoma: Risk Factors and Disease Course
Am Surg. 2021 Apr 16:31348211011084. doi: 10.1177/00031348211011084. Online ahead of print.ABSTRACTBACKGROUND: Management of hepatocellular adenoma (HA) is marked by a paucity of recent studies. Long-term follow-up data from an equal access health care system may facilitate our understanding of the natural disease course of HA and identify modifiable risk factors.METHODS: A multi-institutional, retrospective review of patients with HA from 2008-2017 was performed. Patient demographics, disease characteristics, and clinical outcomes were analyzed.RESULTS: Of 124 patients identified, 94% were women with a mean age at diagnos...
Source: The American Surgeon - April 16, 2021 Category: Surgery Authors: Trevor S Silva Michael Sung Daniel W Nelson Andrew L DiFronzo Victoria V O'Connor Source Type: research

Predicting Surgical Margins in Patients With Borderline Resectable and Locally Advanced Pancreatic Cancer Undergoing Resection
Am Surg. 2021 Apr 16:31348211011129. doi: 10.1177/00031348211011129. Online ahead of print.ABSTRACTBACKGROUND: Many patients with borderline resectable/locally advanced pancreatic ductal adenocarcinoma (borderline resectable [BR]/locally advanced [LA] pancreatic ductal adenocarcinoma [PDAC]) undergoing resection will have positive resection margins (R1), which is associated with poor prognosis. It might be useful to preoperatively predict the margin (R) status.METHODS: Data from patients with BR/LA PDAC who underwent a pancreatectomy between 2008 and 2018 at Brigham and Women's Hospital were retrospectively reviewed. Logis...
Source: The American Surgeon - April 16, 2021 Category: Surgery Authors: Weizheng Ren Dimitrios Xourafas Stanley W Ashley Thomas E Clancy Source Type: research

No Difference in Morbidity or Mortality Between Octogenarians and Other Geriatric Burn Trauma Patients
DISCUSSION: Among burn trauma patients ≥65 years, age should not be a sole predictor for mortality risk. Continued research is necessary in order to determine more accurate approaches to prognosticate mortality in geriatric burn trauma patients, such as the validation and refinement of a burn-trauma-related frailty index.PMID:33861652 | DOI:10.1177/00031348211011122 (Source: The American Surgeon)
Source: The American Surgeon - April 16, 2021 Category: Surgery Authors: Miriam Alpert Areg Grigorian Victor Joe Theresa L Chin Nicole Bernal Michael Lekawa Shevonne Satahoo Jeffry Nahmias Source Type: research

Evaluating the Quality of Cost-Effectiveness Literature in Breast Surgery: What Do We Do Well and How Can We Do Better? A Systematic Review
In this study, we aimed to evaluate existing breast surgery cost-effectiveness literature against the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) validated scoring system.METHODS: A PRISMA search was performed for cost-effectiveness within breast surgery. Articles were scored with CHEERS criteria on a 0-24 scale and qualitative data were collected. Subgroup analysis was performed comparing pre-CHEERS (published in 2013 or earlier) and post-CHEERS (published in 2014 or later) cohorts. Chi-squared analysis was performed to compare where studies lost points between cohorts.RESULTS: Of 2279 articles sc...
Source: The American Surgeon - April 16, 2021 Category: Surgery Authors: Sydney N Char Joshua A Bloom Danielle DeMarco Abhishek Chatterjee Source Type: research

Cost-Benefit Analysis of Robotic vs. Laparoscopic Hepatectomy: A Propensity-Matched Retrospective Cohort Study of American College of Surgeons National Surgical Quality Improvement Program Database
This study compares the costs associated with robotic vs. laparoscopic liver resections, taking into account 30-day complications.METHODS: Using the American College of Surgeons National Surgical Quality Improvement Program database, a propensity-matched cohort of patients with laparoscopic or robotic liver resections between 2014 and 2017 was identified. Costs were assigned to perioperative variables, including operating room (OR) time, length of stay, blood transfusions, and 30-day complications. Cost estimates were obtained from the Centers for Medicare and Medicaid Services billing data (2017), American Hospital Associ...
Source: The American Surgeon - April 16, 2021 Category: Surgery Authors: Henry P Miller Abraham Hakim Alec Kellish Marisa Wozniak John Gaughan Richard Sensenig Umur M Atabek Francis R Spitz Young K Hong Source Type: research

Hospitalization Costs and Outcomes of Open, Laparoscopic, and Robotic Liver Resections
CONCLUSIONS: There is a financial benefit of using robotics in terms of cost, hospital length of stay, and readmission rates in patients undergoing liver resection, cost.PMID:33861658 | DOI:10.1177/00031348211011063 (Source: The American Surgeon)
Source: The American Surgeon - April 16, 2021 Category: Surgery Authors: Hassan Aziz Kamil Hanna Nassim Lashkari Noor-Us-Sabah Ahmad Yuri Genyk Mohd Raashid Sheikh Source Type: research

Duodenal Volvulus due to Duodenum Inversum
Am Surg. 2021 Apr 16:31348211011111. doi: 10.1177/00031348211011111. Online ahead of print.ABSTRACTDuodenum inversum, or inverted duodenum, is a rare congenital disorder resulting in an abnormal position of the third and/or fourth portions of the duodenum. Most patients are asymptomatic, but others can experience pain, nausea, vomiting, peptic ulcer disease, pancreatitis, and even intestinal obstruction. In this case, we report a patient who presented with acute abdominal pain and vomiting. He was diagnosed with duodenal volvulus and obstruction due to duodenum inversum. After failing nonoperative management, the patient w...
Source: The American Surgeon - April 16, 2021 Category: Surgery Authors: Mario P Zambito Erik J Teicher Source Type: research

Minimally Invasive Mastectomy Could Achieve Non-inferior Oncological Outcome in Appropriately Selected Patients: Propensity Matched Analysis of the National Cancer Database
DISCUSSION: MIM is associated with shorter LOS, and it is non-inferior to open mastectomy in terms of other short-term outcomes and long-term oncologic survival outcomes. These data suggest that MIM may be considered in appropriately selected breast cancer patients as an additional approach to the community.PMID:33861667 | DOI:10.1177/00031348211011152 (Source: The American Surgeon)
Source: The American Surgeon - April 16, 2021 Category: Surgery Authors: Lifen Cao Robert Shenk Megan E Miller Christopher Towe Source Type: research

"Prospective, Randomized, Controlled Trial of Ultra-modified Internal Sphincterotomy vs Closed Lateral Internal Sphincterotomy for Chronic Fissure-in-Ano"
Am Surg. 2021 Apr 16:31348211011104. doi: 10.1177/00031348211011104. Online ahead of print.ABSTRACTBACKGROUND: Currently, the lateral internal sphincterotomy is the treatment of choice for a chronic anal fissure (CAF). However, the length of the internal sphincter incision varies, due to lack of standardization. Insufficient length increases the risk of recurrence. To compare a new ultra-modified internal sphincterotomy (UMIS) to the closed lateral internal sphincterotomy (CLIS) for treating CAF, based on internal anal sphincter function and postoperative complications. The primary endpoint was continence after UMIS. The s...
Source: The American Surgeon - April 16, 2021 Category: Surgery Authors: Ugur Sungurtekin Utku Ozgen Hulya Sungurtekin Source Type: research

Evaluation of the Quality, Educational Value and Utility of the Videos on YouTube for Laparoscopic Low Anterior Resection
This study aims to test the efficacy for educational purposes by evaluating the videos published on YouTube (www.youtube.com) channel for low anterior resection procedure in rectum surgery.METHODS: We searched YouTube on October 17, 2020 to choose video clips that included relevant information about laparoscopic low anterior resection (LAR) for rectal cancer.RESULTS: We included 25 academics and 75 individual videos in this study. The teaching quality of the videos was evaluated according to academic and individual videos, and it was seen that the teaching quality scores of academic videos were higher and this result was s...
Source: The American Surgeon - April 16, 2021 Category: Surgery Authors: Erol Piskin Muhammet Kadri Çolakoğlu Ali Bal Volkan Oter Erdal Birol Bostanci Source Type: research

Impact of COVID-19 Governmental Restrictions on Emergency General Surgery Operative Volume and Severity
This study demonstrates a decrease of 65% in emergency general surgery operations during governmental restrictions secondary to the COVID-19 pandemic. This decrease in operations was not associated with worse disease severity, morbidity, or mortality.PMID:33861672 | DOI:10.1177/00031348211011113 (Source: The American Surgeon)
Source: The American Surgeon - April 16, 2021 Category: Surgery Authors: Sarah Lund Taleen MacArthur Marianna Martini Fischmann Justin Maroun Johnny Dang James R Markos Martin Zielinski Daniel Stephens Source Type: research

Ileal Pouch Excision can Be Performed With Similar Outcomes in Obese Patients Compared to Nonobese Counterparts: An Assessment From American College of Surgeons National Surgical Quality Improvement Program
Am Surg. 2021 Apr 15:31348211011121. doi: 10.1177/00031348211011121. Online ahead of print.ABSTRACTBACKGROUND: Failed pouches may tend to be managed with only a loop ileostomy in obese patients due to some safety concerns. The effect of obesity on ileal pouch excision outcomes is poorly studied. In our study, we aimed to assess the short-term outcomes after ileal pouch excision in obese patients compared to their nonobese counterparts.METHODS: The patients who underwent pouch excision between 2005 and 2017 were included using ACS-NSQIP participant user files. The operative outcomes were compared between obese (BMI ≥30 k...
Source: The American Surgeon - April 15, 2021 Category: Surgery Authors: Eren Esen Erman Aytac H Hande Aydinli Michael J Grieco Arman Erkan Hasan T Kirat David M Schwartzberg Bilgi Baca Tayfun Karahasanoglu Feza H Remzi Source Type: research

A Case Report of Breast Implant-Associated Anaplastic Large-Cell Lymphoma in a PALB2 Mutation-Positive Woman
This report describes a PALB2 mutation-positive woman with a strong family history of breast cancer who underwent prophylactic bilateral nipple-sparing mastectomy with textured silicone implant placement. She was diagnosed with BIA-ALCL less than 4 years later after seroma aspiration. She was treated with implant removal and capsulectomy; but, surprisingly, final surgical pathology did not show any malignancy.PMID:33856922 | DOI:10.1177/00031348211011056 (Source: The American Surgeon)
Source: The American Surgeon - April 15, 2021 Category: Surgery Authors: Valentina Bonev Source Type: research

A Single Institution Propensity Score Weighted Analysis of Time to Chemotherapy After Minimally Invasive Versus Open Colorectal Surgery
Am Surg. 2021 Apr 15:31348211011137. doi: 10.1177/00031348211011137. Online ahead of print.ABSTRACTBACKGROUND: Oncologic outcomes for colon cancer are optimal when chemotherapy is started within 6 to 8 weeks after surgery. The study objective was to investigate the impact of operative modality and urgency on the time interval from surgery to adjuvant chemotherapy.METHODS: This is a retrospective institutional tumor registry cohort study of open and laparoscopic/robotic colorectal resections for stage II-IV cancer between April 2010 and January 2018. Primary outcome was time from surgery to chemotherapy. Predictor variables...
Source: The American Surgeon - April 15, 2021 Category: Surgery Authors: Samik H Patel Michael A Battaglia Beth-Ann Shanker Robert K Cleary Source Type: research

The History of Hemorrhagic Shock and Damage Control Resuscitation
Am Surg. 2021 Apr 15:31348211011098. doi: 10.1177/00031348211011098. Online ahead of print.ABSTRACTThe understanding and management of hemorrhagic shock have evolved significantly over the last 400 years. Injured patients in shock mandate immediate surgeon involvement. Every graduating surgical resident and every surgeon taking trauma call should thoroughly understand the concepts of damage control resuscitation and be prepared to care for these patients. This review seeks to revisit the history of hemorrhagic shock and the evolution of damage control resuscitation.PMID:33856934 | DOI:10.1177/00031348211011098 (Source: The American Surgeon)
Source: The American Surgeon - April 15, 2021 Category: Surgery Authors: David R Velez Source Type: research

Gender Distribution of Current Surgical Critical Care Fellows, Faculty, and Program Directors
Am Surg. 2021 Apr 15:31348211011143. doi: 10.1177/00031348211011143. Online ahead of print.ABSTRACTAs women surgeons continue to represent a minority within the surgical field while also holding lower ranked positions, gaining a sub-specialized set of clinical skills through surgical fellowships, like surgical critical care (SCC), is one approach to advance within the surgical field. A cross-sectional analysis was performed investigating the websites of all 106 US-based SCC fellowships. A total of 116 SCC fellows were included in this analysis, comprising 67 (59.3%) men and 46 (40.7%) women. There were 977 SCC fellowship f...
Source: The American Surgeon - April 15, 2021 Category: Surgery Authors: Haley Ehrlich Jackie Nguyen Mason Sutherland Mark McKenney Adel Elkbuli Source Type: research

The Assessment of Regional Liver Function Before Major Hepatectomy Using Magnetic Resonance Imaging
Am Surg. 2021 Apr 15:31348211011095. doi: 10.1177/00031348211011095. Online ahead of print.ABSTRACTBACKGROUND: The liver-to-spleen signal intensity ratio (LSR) on magnetic resonance imaging with gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid has been used as a parameter to assess liver function. LSR of the future remnant liver region (FR-LSR) is included in preoperative assessment of regional liver function. The aim of this study was to investigate the predictability of post-hepatectomy liver failure (PHLF) by FR-LSR.METHODS: Between May 2013 and May 2019, 127 patients underwent standardized EOB-MRI for diagno...
Source: The American Surgeon - April 15, 2021 Category: Surgery Authors: Masashi Kudo Naoto Gotohda Motokazu Sugimoto Masaru Konishi Shinichiro Takahashi Shin Kobayashi Tatsushi Kobayashi Source Type: research

Does Localization Technique Matter for Non-palpable Breast Cancers?
Am Surg. 2021 Apr 15:31348211011135. doi: 10.1177/00031348211011135. Online ahead of print.ABSTRACTBACKGROUND: There are several techniques for localization of non-palpable breast tumors, but comparisons of these techniques in terms of margin positivity and volume of tissue resected are lacking.METHODS: Between 2011-2013 and 2016-2018, 2 randomized controlled trials involving 10 centers across the United States accrued 631 patients with stage 0-3 breast cancer, all of whom underwent breast conserving surgery. Of these, 522 had residual non-palpable tumors for which localization was required. The localization technique was ...
Source: The American Surgeon - April 15, 2021 Category: Surgery Authors: Anees B Chagpar Carlos Garcia-Cantu Marissa M Howard-McNatt Jennifer S Gass Edward A Levine Akiko Chiba Sharon Lum Ricardo Martinez Eric Brown Elisabeth Dupont SHAVE2 authors Source Type: research

The Impact of the COVID-19 Pandemic on an Israeli Acute Care Surgery Unit: Fewer Patients, More Disease
CONCLUSION: During the COVID-19 pandemic, despite a significantly less number of patients presenting to the hospital, there was a higher percentage of those admitted needing surgical intervention, and they were overall sicker than the previous year.PMID:33856956 | DOI:10.1177/00031348211011132 (Source: The American Surgeon)
Source: The American Surgeon - April 15, 2021 Category: Surgery Authors: Yossi Maman Adam Lee Goldstein Uri Neeman Yonatan Lessing Lior Orbach Saad Sirhan Ela Falk Guy Lahat Source Type: research

Ileal Pouch Excision can Be Performed With Similar Outcomes in Obese Patients Compared to Nonobese Counterparts: An Assessment From American College of Surgeons National Surgical Quality Improvement Program
Am Surg. 2021 Apr 15:31348211011121. doi: 10.1177/00031348211011121. Online ahead of print.ABSTRACTBACKGROUND: Failed pouches may tend to be managed with only a loop ileostomy in obese patients due to some safety concerns. The effect of obesity on ileal pouch excision outcomes is poorly studied. In our study, we aimed to assess the short-term outcomes after ileal pouch excision in obese patients compared to their nonobese counterparts.METHODS: The patients who underwent pouch excision between 2005 and 2017 were included using ACS-NSQIP participant user files. The operative outcomes were compared between obese (BMI ≥30 k...
Source: The American Surgeon - April 15, 2021 Category: Surgery Authors: Eren Esen Erman Aytac H Hande Aydinli Michael J Grieco Arman Erkan Hasan T Kirat David M Schwartzberg Bilgi Baca Tayfun Karahasanoglu Feza H Remzi Source Type: research

A Case Report of Breast Implant-Associated Anaplastic Large-Cell Lymphoma in a PALB2 Mutation-Positive Woman
This report describes a PALB2 mutation-positive woman with a strong family history of breast cancer who underwent prophylactic bilateral nipple-sparing mastectomy with textured silicone implant placement. She was diagnosed with BIA-ALCL less than 4 years later after seroma aspiration. She was treated with implant removal and capsulectomy; but, surprisingly, final surgical pathology did not show any malignancy.PMID:33856922 | DOI:10.1177/00031348211011056 (Source: The American Surgeon)
Source: The American Surgeon - April 15, 2021 Category: Surgery Authors: Valentina Bonev Source Type: research

A Single Institution Propensity Score Weighted Analysis of Time to Chemotherapy After Minimally Invasive Versus Open Colorectal Surgery
Am Surg. 2021 Apr 15:31348211011137. doi: 10.1177/00031348211011137. Online ahead of print.ABSTRACTBACKGROUND: Oncologic outcomes for colon cancer are optimal when chemotherapy is started within 6 to 8 weeks after surgery. The study objective was to investigate the impact of operative modality and urgency on the time interval from surgery to adjuvant chemotherapy.METHODS: This is a retrospective institutional tumor registry cohort study of open and laparoscopic/robotic colorectal resections for stage II-IV cancer between April 2010 and January 2018. Primary outcome was time from surgery to chemotherapy. Predictor variables...
Source: The American Surgeon - April 15, 2021 Category: Surgery Authors: Samik H Patel Michael A Battaglia Beth-Ann Shanker Robert K Cleary Source Type: research

The History of Hemorrhagic Shock and Damage Control Resuscitation
Am Surg. 2021 Apr 15:31348211011098. doi: 10.1177/00031348211011098. Online ahead of print.ABSTRACTThe understanding and management of hemorrhagic shock have evolved significantly over the last 400 years. Injured patients in shock mandate immediate surgeon involvement. Every graduating surgical resident and every surgeon taking trauma call should thoroughly understand the concepts of damage control resuscitation and be prepared to care for these patients. This review seeks to revisit the history of hemorrhagic shock and the evolution of damage control resuscitation.PMID:33856934 | DOI:10.1177/00031348211011098 (Source: The American Surgeon)
Source: The American Surgeon - April 15, 2021 Category: Surgery Authors: David R Velez Source Type: research

Gender Distribution of Current Surgical Critical Care Fellows, Faculty, and Program Directors
Am Surg. 2021 Apr 15:31348211011143. doi: 10.1177/00031348211011143. Online ahead of print.ABSTRACTAs women surgeons continue to represent a minority within the surgical field while also holding lower ranked positions, gaining a sub-specialized set of clinical skills through surgical fellowships, like surgical critical care (SCC), is one approach to advance within the surgical field. A cross-sectional analysis was performed investigating the websites of all 106 US-based SCC fellowships. A total of 116 SCC fellows were included in this analysis, comprising 67 (59.3%) men and 46 (40.7%) women. There were 977 SCC fellowship f...
Source: The American Surgeon - April 15, 2021 Category: Surgery Authors: Haley Ehrlich Jackie Nguyen Mason Sutherland Mark McKenney Adel Elkbuli Source Type: research

The Assessment of Regional Liver Function Before Major Hepatectomy Using Magnetic Resonance Imaging
Am Surg. 2021 Apr 15:31348211011095. doi: 10.1177/00031348211011095. Online ahead of print.ABSTRACTBACKGROUND: The liver-to-spleen signal intensity ratio (LSR) on magnetic resonance imaging with gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid has been used as a parameter to assess liver function. LSR of the future remnant liver region (FR-LSR) is included in preoperative assessment of regional liver function. The aim of this study was to investigate the predictability of post-hepatectomy liver failure (PHLF) by FR-LSR.METHODS: Between May 2013 and May 2019, 127 patients underwent standardized EOB-MRI for diagno...
Source: The American Surgeon - April 15, 2021 Category: Surgery Authors: Masashi Kudo Naoto Gotohda Motokazu Sugimoto Masaru Konishi Shinichiro Takahashi Shin Kobayashi Tatsushi Kobayashi Source Type: research

Does Localization Technique Matter for Non-palpable Breast Cancers?
Am Surg. 2021 Apr 15:31348211011135. doi: 10.1177/00031348211011135. Online ahead of print.ABSTRACTBACKGROUND: There are several techniques for localization of non-palpable breast tumors, but comparisons of these techniques in terms of margin positivity and volume of tissue resected are lacking.METHODS: Between 2011-2013 and 2016-2018, 2 randomized controlled trials involving 10 centers across the United States accrued 631 patients with stage 0-3 breast cancer, all of whom underwent breast conserving surgery. Of these, 522 had residual non-palpable tumors for which localization was required. The localization technique was ...
Source: The American Surgeon - April 15, 2021 Category: Surgery Authors: Anees B Chagpar Carlos Garcia-Cantu Marissa M Howard-McNatt Jennifer S Gass Edward A Levine Akiko Chiba Sharon Lum Ricardo Martinez Eric Brown Elisabeth Dupont SHAVE2 authors Source Type: research

The Impact of the COVID-19 Pandemic on an Israeli Acute Care Surgery Unit: Fewer Patients, More Disease
CONCLUSION: During the COVID-19 pandemic, despite a significantly less number of patients presenting to the hospital, there was a higher percentage of those admitted needing surgical intervention, and they were overall sicker than the previous year.PMID:33856956 | DOI:10.1177/00031348211011132 (Source: The American Surgeon)
Source: The American Surgeon - April 15, 2021 Category: Surgery Authors: Yossi Maman Adam Lee Goldstein Uri Neeman Yonatan Lessing Lior Orbach Saad Sirhan Ela Falk Guy Lahat Source Type: research

Severe Referred Shoulder Pain Following Revision Fundoplication From a Stich on the Diaphragm
Am Surg. 2021 Apr 13:31348211011110. doi: 10.1177/00031348211011110. Online ahead of print.ABSTRACTComplications following fundoplication surgery for hiatal hernias are rare. Herein, we present the case of a 61-year-old woman who underwent a Nissen fundoplication, complicated by dysphagia, and a revision modified Toupet fundoplication for a hiatal hernia, after which she began to experience severe prandial referred left shoulder pain that was refractory to medical management. We hypothesized that a diaphragmatic suture placed during the revision fundoplication could be the source of the pain, and we elected to remove the s...
Source: The American Surgeon - April 13, 2021 Category: Surgery Authors: Kevin J Gale Santana Sanchez Thomas J Sorenson Todd D Elftmann Source Type: research

Intercostal Hernia due to Forceful Coughing With Protrusion of the Lung
We report a male patient who presented with an intercostal herniation after vigorous coughing for over 2 weeks. Treatment of post-coughing intercostal hernias is either conservative management or surgical intervention, which is dictated by the signs, symptoms, site, and presence of strangulation.PMID:33847162 | DOI:10.1177/00031348211011087 (Source: The American Surgeon)
Source: The American Surgeon - April 13, 2021 Category: Surgery Authors: Mohamed H El-Farra Mir Wasif Ali Nahidh Hasaniya Source Type: research

The Efficacy of Transanal Opening of Intersphincteric Space Procedure in High Complex Anal Fistulas on Long-term Follow-up
Am Surg. 2021 Apr 13:31348211011092. doi: 10.1177/00031348211011092. Online ahead of print.NO ABSTRACTPMID:33847169 | DOI:10.1177/00031348211011092 (Source: The American Surgeon)
Source: The American Surgeon - April 13, 2021 Category: Surgery Authors: Pankaj Garg Vipul D Yagnik Source Type: research

Peritoneal Tuberculosis in a Middle-Aged Man
Am Surg. 2021 Apr 13:31348211011117. doi: 10.1177/00031348211011117. Online ahead of print.NO ABSTRACTPMID:33847174 | DOI:10.1177/00031348211011117 (Source: The American Surgeon)
Source: The American Surgeon - April 13, 2021 Category: Surgery Authors: Jacob H Frankovitz Kyle W Penny Danielle L Barnard Source Type: research

Management of a Drowned Person After Low-Voltage Electrocution While Attempting a Rescue on a River
Am Surg. 2021 Apr 13:31348211011147. doi: 10.1177/00031348211011147. Online ahead of print.NO ABSTRACTPMID:33847175 | DOI:10.1177/00031348211011147 (Source: The American Surgeon)
Source: The American Surgeon - April 13, 2021 Category: Surgery Authors: Ana Catarina Queiroga David Szpilman Justin Sempsrott Source Type: research

Complex Abdominal Wall Reconstruction in Neutropenic Patients
Am Surg. 2021 Apr 13:31348211011086. doi: 10.1177/00031348211011086. Online ahead of print.ABSTRACTThe aim of our study was to determine whether patients with neutropenia (absolute neutrophil count (ANC) ≤1,500 cells/µL) had higher rates of surgical site infection after elective abdominal wall reconstruction. This was a case series from a prospective complex abdominal wall reconstruction cohort describing the surgical outcomes of 4 neutropenic patients (ANC ≤1,500 cells/µL) within 48 hours of index operation. Median age was 55 years, 3 patients were female. All patients had liver cirrhosis as a comorbidit...
Source: The American Surgeon - April 13, 2021 Category: Surgery Authors: Kajmolli Agon Smiley Abbas McGuirk Matthew Gachabayov Mahir Bodin Roxana Latifi Rifat Source Type: research

The Surgeon's Risk of SARS-CoV-2 Infection During the Initial Peak of the COVID-19 Pandemic in New Orleans
The objective of this study was to examine SARS-CoV-2 seroprevalence among surgeons who cared for patients with active SARS-CoV-2 infection compared to other employees within our health care system and also the general public of New Orleans. 105 surgeons at our facilities provided direct surgical care to patients with active SARS-CoV-2 infection and underwent voluntary antibody testing. 2/105 (1.9% CI .2%-6.7%) tested positive for SARS-CoV-2 antibodies. 13 343 hospital employees underwent antibody testing and 1066/13 343 (8.0% CI 7.5%-8.5%) tested positive (1.9% vs. 8.0%; P = .03). We saw a significantly lower SARS-CoV-2 s...
Source: The American Surgeon - April 13, 2021 Category: Surgery Authors: Tung V Vu Ashlyn M Alongi Christopher Chow Clayton J Brinster Russell E Brown George Fuhrman Samuel R Money Source Type: research

Severe Referred Shoulder Pain Following Revision Fundoplication From a Stich on the Diaphragm
Am Surg. 2021 Apr 13:31348211011110. doi: 10.1177/00031348211011110. Online ahead of print.ABSTRACTComplications following fundoplication surgery for hiatal hernias are rare. Herein, we present the case of a 61-year-old woman who underwent a Nissen fundoplication, complicated by dysphagia, and a revision modified Toupet fundoplication for a hiatal hernia, after which she began to experience severe prandial referred left shoulder pain that was refractory to medical management. We hypothesized that a diaphragmatic suture placed during the revision fundoplication could be the source of the pain, and we elected to remove the s...
Source: The American Surgeon - April 13, 2021 Category: Surgery Authors: Kevin J Gale Santana Sanchez Thomas J Sorenson Todd D Elftmann Source Type: research

Intercostal Hernia due to Forceful Coughing With Protrusion of the Lung
We report a male patient who presented with an intercostal herniation after vigorous coughing for over 2 weeks. Treatment of post-coughing intercostal hernias is either conservative management or surgical intervention, which is dictated by the signs, symptoms, site, and presence of strangulation.PMID:33847162 | DOI:10.1177/00031348211011087 (Source: The American Surgeon)
Source: The American Surgeon - April 13, 2021 Category: Surgery Authors: Mohamed H El-Farra Mir Wasif Ali Nahidh Hasaniya Source Type: research

The Efficacy of Transanal Opening of Intersphincteric Space Procedure in High Complex Anal Fistulas on Long-term Follow-up
Am Surg. 2021 Apr 13:31348211011092. doi: 10.1177/00031348211011092. Online ahead of print.NO ABSTRACTPMID:33847169 | DOI:10.1177/00031348211011092 (Source: The American Surgeon)
Source: The American Surgeon - April 13, 2021 Category: Surgery Authors: Pankaj Garg Vipul D Yagnik Source Type: research

Peritoneal Tuberculosis in a Middle-Aged Man
Am Surg. 2021 Apr 13:31348211011117. doi: 10.1177/00031348211011117. Online ahead of print.NO ABSTRACTPMID:33847174 | DOI:10.1177/00031348211011117 (Source: The American Surgeon)
Source: The American Surgeon - April 13, 2021 Category: Surgery Authors: Jacob H Frankovitz Kyle W Penny Danielle L Barnard Source Type: research

Management of a Drowned Person After Low-Voltage Electrocution While Attempting a Rescue on a River
Am Surg. 2021 Apr 13:31348211011147. doi: 10.1177/00031348211011147. Online ahead of print.NO ABSTRACTPMID:33847175 | DOI:10.1177/00031348211011147 (Source: The American Surgeon)
Source: The American Surgeon - April 13, 2021 Category: Surgery Authors: Ana Catarina Queiroga David Szpilman Justin Sempsrott Source Type: research

Complex Abdominal Wall Reconstruction in Neutropenic Patients
Am Surg. 2021 Apr 13:31348211011086. doi: 10.1177/00031348211011086. Online ahead of print.ABSTRACTThe aim of our study was to determine whether patients with neutropenia (absolute neutrophil count (ANC) ≤1,500 cells/µL) had higher rates of surgical site infection after elective abdominal wall reconstruction. This was a case series from a prospective complex abdominal wall reconstruction cohort describing the surgical outcomes of 4 neutropenic patients (ANC ≤1,500 cells/µL) within 48 hours of index operation. Median age was 55 years, 3 patients were female. All patients had liver cirrhosis as a comorbidit...
Source: The American Surgeon - April 13, 2021 Category: Surgery Authors: Kajmolli Agon Smiley Abbas McGuirk Matthew Gachabayov Mahir Bodin Roxana Latifi Rifat Source Type: research

The Surgeon's Risk of SARS-CoV-2 Infection During the Initial Peak of the COVID-19 Pandemic in New Orleans
The objective of this study was to examine SARS-CoV-2 seroprevalence among surgeons who cared for patients with active SARS-CoV-2 infection compared to other employees within our health care system and also the general public of New Orleans. 105 surgeons at our facilities provided direct surgical care to patients with active SARS-CoV-2 infection and underwent voluntary antibody testing. 2/105 (1.9% CI .2%-6.7%) tested positive for SARS-CoV-2 antibodies. 13 343 hospital employees underwent antibody testing and 1066/13 343 (8.0% CI 7.5%-8.5%) tested positive (1.9% vs. 8.0%; P = .03). We saw a significantly lower SARS-CoV-2 s...
Source: The American Surgeon - April 13, 2021 Category: Surgery Authors: Tung V Vu Ashlyn M Alongi Christopher Chow Clayton J Brinster Russell E Brown George Fuhrman Samuel R Money Source Type: research

Severe Referred Shoulder Pain Following Revision Fundoplication From a Stich on the Diaphragm
Am Surg. 2021 Apr 13:31348211011110. doi: 10.1177/00031348211011110. Online ahead of print.ABSTRACTComplications following fundoplication surgery for hiatal hernias are rare. Herein, we present the case of a 61-year-old woman who underwent a Nissen fundoplication, complicated by dysphagia, and a revision modified Toupet fundoplication for a hiatal hernia, after which she began to experience severe prandial referred left shoulder pain that was refractory to medical management. We hypothesized that a diaphragmatic suture placed during the revision fundoplication could be the source of the pain, and we elected to remove the s...
Source: The American Surgeon - April 13, 2021 Category: Surgery Authors: Kevin J Gale Santana Sanchez Thomas J Sorenson Todd D Elftmann Source Type: research

Intercostal Hernia due to Forceful Coughing With Protrusion of the Lung
We report a male patient who presented with an intercostal herniation after vigorous coughing for over 2 weeks. Treatment of post-coughing intercostal hernias is either conservative management or surgical intervention, which is dictated by the signs, symptoms, site, and presence of strangulation.PMID:33847162 | DOI:10.1177/00031348211011087 (Source: The American Surgeon)
Source: The American Surgeon - April 13, 2021 Category: Surgery Authors: Mohamed H El-Farra Mir Wasif Ali Nahidh Hasaniya Source Type: research

The Efficacy of Transanal Opening of Intersphincteric Space Procedure in High Complex Anal Fistulas on Long-term Follow-up
Am Surg. 2021 Apr 13:31348211011092. doi: 10.1177/00031348211011092. Online ahead of print.NO ABSTRACTPMID:33847169 | DOI:10.1177/00031348211011092 (Source: The American Surgeon)
Source: The American Surgeon - April 13, 2021 Category: Surgery Authors: Pankaj Garg Vipul D Yagnik Source Type: research

Peritoneal Tuberculosis in a Middle-Aged Man
Am Surg. 2021 Apr 13:31348211011117. doi: 10.1177/00031348211011117. Online ahead of print.NO ABSTRACTPMID:33847174 | DOI:10.1177/00031348211011117 (Source: The American Surgeon)
Source: The American Surgeon - April 13, 2021 Category: Surgery Authors: Jacob H Frankovitz Kyle W Penny Danielle L Barnard Source Type: research

Management of a Drowned Person After Low-Voltage Electrocution While Attempting a Rescue on a River
Am Surg. 2021 Apr 13:31348211011147. doi: 10.1177/00031348211011147. Online ahead of print.NO ABSTRACTPMID:33847175 | DOI:10.1177/00031348211011147 (Source: The American Surgeon)
Source: The American Surgeon - April 13, 2021 Category: Surgery Authors: Ana Catarina Queiroga David Szpilman Justin Sempsrott Source Type: research

Complex Abdominal Wall Reconstruction in Neutropenic Patients
Am Surg. 2021 Apr 13:31348211011086. doi: 10.1177/00031348211011086. Online ahead of print.ABSTRACTThe aim of our study was to determine whether patients with neutropenia (absolute neutrophil count (ANC) ≤1,500 cells/µL) had higher rates of surgical site infection after elective abdominal wall reconstruction. This was a case series from a prospective complex abdominal wall reconstruction cohort describing the surgical outcomes of 4 neutropenic patients (ANC ≤1,500 cells/µL) within 48 hours of index operation. Median age was 55 years, 3 patients were female. All patients had liver cirrhosis as a comorbidit...
Source: The American Surgeon - April 13, 2021 Category: Surgery Authors: Kajmolli Agon Smiley Abbas McGuirk Matthew Gachabayov Mahir Bodin Roxana Latifi Rifat Source Type: research

The Surgeon's Risk of SARS-CoV-2 Infection During the Initial Peak of the COVID-19 Pandemic in New Orleans
The objective of this study was to examine SARS-CoV-2 seroprevalence among surgeons who cared for patients with active SARS-CoV-2 infection compared to other employees within our health care system and also the general public of New Orleans. 105 surgeons at our facilities provided direct surgical care to patients with active SARS-CoV-2 infection and underwent voluntary antibody testing. 2/105 (1.9% CI .2%-6.7%) tested positive for SARS-CoV-2 antibodies. 13 343 hospital employees underwent antibody testing and 1066/13 343 (8.0% CI 7.5%-8.5%) tested positive (1.9% vs. 8.0%; P = .03). We saw a significantly lower SARS-CoV-2 s...
Source: The American Surgeon - April 13, 2021 Category: Surgery Authors: Tung V Vu Ashlyn M Alongi Christopher Chow Clayton J Brinster Russell E Brown George Fuhrman Samuel R Money Source Type: research

Morbidity and Mortality in the Obese Trauma Intensive Care Unit Patient
DISCUSSION: The obesity paradox is observed in the obese critically ill trauma patient population.PMID:33830819 | DOI:10.1177/0003134820954824 (Source: The American Surgeon)
Source: The American Surgeon - April 8, 2021 Category: Surgery Authors: Hope L Conrad Robert A Hutchinson Jessica Pittman Joseph A Ewing John D Cull Source Type: research

Tissue Diagnosis Is Associated With Worse Survival in Hepatocellular Carcinoma: A National Cancer Database Analysis
Am Surg. 2021 Apr 8:3134821991983. doi: 10.1177/0003134821991983. Online ahead of print.ABSTRACTBACKGROUND: Biopsy to achieve tissue diagnosis (TD) of hepatocellular carcinoma (HCC) risks needle tract seeding. With chest wall and peritoneal recurrences reported, TD could worsen cancer outcomes. We investigated HCC outcomes after TD compared to clinical diagnosis (CD), hypothesizing that TD adversely affects overall survival (OS).METHODS: The National Cancer Database (NCDB) Participant User File for liver cancer was reviewed, including patients with nonmetastatic HCC treated with major hepatectomy or transplantation. Clinic...
Source: The American Surgeon - April 8, 2021 Category: Surgery Authors: Fadi S Dahdaleh Samer A Naffouje Scott K Sherman Sivesh K Kamarajah George I Salti Source Type: research