Video-Assisted Thoracoscopic Internal Rib Fixation
We present an observational experience at our level 1 trauma center with our first 10 cases of video-assisted thoracoscopic surgery (VATS) internal rib fixation. Video-assisted thoracoscopic surgery internal plates are especially helpful for rib fractures under the scapula, which are difficult to access traditionally. This technique is also excellent at reducing complex segmental fractures as the bridge can span across multiple fractures with a single post on either side. They also work well for posterior fractures where multiple screws cannot be placed. Video-assisted thoracoscopic surgery internal rib fixation is a viabl...
Source: The American Surgeon - December 3, 2021 Category: Surgery Authors: Christine Castater Ben Hazen Carolyn Davis Samuel Hoppe Caroline Butler April Grant Krystal Archer-Arroyo Michael Maceroli S Rob Todd Jonathan Nguyen Source Type: research

Do We Overdo Prophylactic Fasciotomy? In Response to Two Urgency Categories, Same Outcome: No Difference after "Therapeutic" vs. Prophylactic" Fasciotomy
Am Surg. 2021 Dec 2:31348211058624. doi: 10.1177/00031348211058624. Online ahead of print.NO ABSTRACTPMID:34854738 | DOI:10.1177/00031348211058624 (Source: The American Surgeon)
Source: The American Surgeon - December 2, 2021 Category: Surgery Authors: Amila S Ratnayake Tamara J Worlton Mark Bowyer Source Type: research

The Importance of the Institution of a Robotic Curriculum on Resident Training and Performance
Am Surg. 2021 Dec 2:31348211060460. doi: 10.1177/00031348211060460. Online ahead of print.ABSTRACTIn 2018, general surgery topped the number of robotic cases. Over 90% of residents participate, but only 65% of programs have a formal curriculum, and less than half track progress. Many are insufficient at training due to an observational role. This paper reviews Marshall University General Surgery Residency program's robotic curriculum, which started in 2018. The curriculum consists of a weekend course and simulations, enabling residents obtain certification. Residents participated in Intuitive's Resident Robotic Olympics wi...
Source: The American Surgeon - December 2, 2021 Category: Surgery Authors: Jenalee Corsello Darren B Nease Semeret Munie Paul Bown Farzad Amiri Source Type: research

Conservative Management of Large Tracheal Perforation due to Traumatic Intubation
Am Surg. 2021 Dec 2:31348211061099. doi: 10.1177/00031348211061099. Online ahead of print.ABSTRACTTracheal perforation is a rare complication of intubation and is associated with high mortality. Here we describe a case of large, full-thickness tracheal perforation from traumatic intubation after an elective procedure. The injury was managed with prolonged intubation that bypassed the site of injury, and the patient was successfully extubated after 11 days. Conservative management of tracheal perforation after traumatic intubation is an option in select patients that avoids need for surgery.PMID:34854781 | DOI:10.1177/00031...
Source: The American Surgeon - December 2, 2021 Category: Surgery Authors: Yasong Yu Justin T Sambol Huzaifa A Shakir Source Type: research

Zooming into Virtual Medical School
Am Surg. 2021 Dec 2:31348211058618. doi: 10.1177/00031348211058618. Online ahead of print.NO ABSTRACTPMID:34855518 | DOI:10.1177/00031348211058618 (Source: The American Surgeon)
Source: The American Surgeon - December 2, 2021 Category: Surgery Authors: Sean Drummond Nikhi P Singh Carter J Boyd Source Type: research

Femoral-Femoral Bypass for Limb Salvage to Correct Common Iliac Occlusion after Lower Extremity Trauma
We describe a unique presentation of chronic iliac artery occlusion in the setting of blunt trauma requiring extra-anatomic bypass for maximal limb salvage.RESULTS: A 50-year-old male presented after a pedestrian versus auto accident. He had mangled bilateral lower extremities and was taken emergently for lower extremity amputations. He was found to have chronic left common iliac occlusion and a femoral-femoral bypass was performed to assist with healing his left below-the-knee amputation.DISCUSSION: Lack of adequate perfusion can cause poor outcomes in limb salvage. This case demonstrated that lower extremity trauma can b...
Source: The American Surgeon - December 2, 2021 Category: Surgery Authors: Christine Castater Ben Hazen G Stewart Barrett Carolyn Davis Caroline Butler Christopher Ramos Randi N Smith Source Type: research

Laparoscopic Resection of Pediatric Solid Pseudopapillary Tumors of the Pancreas
DISCUSSION: Laparoscopic DP for pediatric SPT achieved similar oncologic goals to open resection. Splenic preservation was feasible with laparoscopy in most cases and was successfully supplemented with the Warshaw procedure, which has not been previously reported for SPT resection in children.PMID:34855532 | DOI:10.1177/00031348211060443 (Source: The American Surgeon)
Source: The American Surgeon - December 2, 2021 Category: Surgery Authors: Jan A Niec Muhammad O A Ghani Melissa A Hilmes Katlyn G McKay Hernan Correa Irving J Zamora Harold N Lovvorn Source Type: research

The Resource Costs of Maintaining Learner Utilization of a Simulation Center During the COVID-19 Pandemic
DISCUSSION: Despite an increase in costs and resources spent on surgical simulation during the pandemic, the utilization by academic entities has remained unaffected. Further studies are required to identify potential solutions to lower simulation resources without a negative impact on the quality of surgical simulation.PMID:34851174 | DOI:10.1177/00031348211058637 (Source: The American Surgeon)
Source: The American Surgeon - December 1, 2021 Category: Surgery Authors: Anastasios T Mitsakos Eftechios Xanthoudakis William Irish Walter C Robey Rebecca M Gilbird Jessica Cringan Carl E Haisch Source Type: research

Blunt Trauma to Brachiocephalic Artery: Presentation and Management
We report 2 cases of innominate artery injury post-blunt chest trauma. Both patients underwent thoracotomy and innominate artery Dacron graft repair and both had an uneventful postoperative course.PMID:34851196 | DOI:10.1177/00031348211056265 (Source: The American Surgeon)
Source: The American Surgeon - December 1, 2021 Category: Surgery Authors: Parvez M U Din Dar Supreet Kaur Vivek Kumar Soumya Ghoshal Junaid Alam Abhinav Kumar Subodh Kumar Sushma Sagar Source Type: research

The Resource Costs of Maintaining Learner Utilization of a Simulation Center During the COVID-19 Pandemic
DISCUSSION: Despite an increase in costs and resources spent on surgical simulation during the pandemic, the utilization by academic entities has remained unaffected. Further studies are required to identify potential solutions to lower simulation resources without a negative impact on the quality of surgical simulation.PMID:34851174 | DOI:10.1177/00031348211058637 (Source: The American Surgeon)
Source: The American Surgeon - December 1, 2021 Category: Surgery Authors: Anastasios T Mitsakos Eftechios Xanthoudakis William Irish Walter C Robey Rebecca M Gilbird Jessica Cringan Carl E Haisch Source Type: research

Blunt Trauma to Brachiocephalic Artery: Presentation and Management
We report 2 cases of innominate artery injury post-blunt chest trauma. Both patients underwent thoracotomy and innominate artery Dacron graft repair and both had an uneventful postoperative course.PMID:34851196 | DOI:10.1177/00031348211056265 (Source: The American Surgeon)
Source: The American Surgeon - December 1, 2021 Category: Surgery Authors: Parvez M U Din Dar Supreet Kaur Vivek Kumar Soumya Ghoshal Junaid Alam Abhinav Kumar Subodh Kumar Sushma Sagar Source Type: research

Safety and Clinical Value of Prophylactic Ureteral Stenting Before Cytoreductive Surgery With Hyperthermic Intraperitoneal Chemotherapy
CONCLUSION: Prophylactic ureteral stent placement in patients undergoing CRS-HIPEC may be useful, particularly in patients with predetermined extensive pelvic disease. However, PUS placement is not without potential morbidity and should be selectively considered in patients for whom benefits outweigh the risks.PMID:34844443 | DOI:10.1177/00031348211058622 (Source: The American Surgeon)
Source: The American Surgeon - November 30, 2021 Category: Surgery Authors: David N Hanna Andrew Hermina Emma Bradley Muhammad O Ghani Alexander Mina Christina E Bailey Kamran Idrees Deepa Magge Source Type: research

Feasibility of Umbilical Hernia Repair Under Local Anesthesia and Monitored Anesthesia Care at a Veteran Affairs Hospital
Am Surg. 2021 Nov 30:3134820951452. doi: 10.1177/0003134820951452. Online ahead of print.ABSTRACTBACKGROUND: Local anesthesia (LA) for open umbilical hernia tissue repair (OUHTR) is not widely utilized in academic centers in the United States. We hypothesize that LA for OUHTR is feasible in a veteran patient population.METHODS: From 2015 to 2019, 449 umbilical hernias were repaired at our institution utilizing a standardized technique in veteran patients. OUHTR was included in this analysis (n = 283). Since 2017, 18.7% (n = 53) UH were repaired under LA. We compared outcomes and operative times between general anesthesia a...
Source: The American Surgeon - November 30, 2021 Category: Surgery Authors: Lindsey Loss Jennie Meier Tri Phung Javier Ordonez Sergio Huerta Source Type: research

Safety and Clinical Value of Prophylactic Ureteral Stenting Before Cytoreductive Surgery With Hyperthermic Intraperitoneal Chemotherapy
CONCLUSION: Prophylactic ureteral stent placement in patients undergoing CRS-HIPEC may be useful, particularly in patients with predetermined extensive pelvic disease. However, PUS placement is not without potential morbidity and should be selectively considered in patients for whom benefits outweigh the risks.PMID:34844443 | DOI:10.1177/00031348211058622 (Source: The American Surgeon)
Source: The American Surgeon - November 30, 2021 Category: Surgery Authors: David N Hanna Andrew Hermina Emma Bradley Muhammad O Ghani Alexander Mina Christina E Bailey Kamran Idrees Deepa Magge Source Type: research

Feasibility of Umbilical Hernia Repair Under Local Anesthesia and Monitored Anesthesia Care at a Veteran Affairs Hospital
Am Surg. 2021 Nov 30:3134820951452. doi: 10.1177/0003134820951452. Online ahead of print.ABSTRACTBACKGROUND: Local anesthesia (LA) for open umbilical hernia tissue repair (OUHTR) is not widely utilized in academic centers in the United States. We hypothesize that LA for OUHTR is feasible in a veteran patient population.METHODS: From 2015 to 2019, 449 umbilical hernias were repaired at our institution utilizing a standardized technique in veteran patients. OUHTR was included in this analysis (n = 283). Since 2017, 18.7% (n = 53) UH were repaired under LA. We compared outcomes and operative times between general anesthesia a...
Source: The American Surgeon - November 30, 2021 Category: Surgery Authors: Lindsey Loss Jennie Meier Tri Phung Javier Ordonez Sergio Huerta Source Type: research

Unexpected Diaphragmatic Hernia Among Patients Undergoing Video-Assisted Thoracic Surgery for Internal Fixation of Rib Fractures
This study revealed that 20% of patients undergoing VATS for rib fracture fixation had a concomitant diaphragm injury. This higher-than-expected prevalence suggests that groups of patients sustaining blunt trauma may have occult diaphragmatic injuries that are otherwise unidentified. This raises the need for improved diagnostic modalities to identify these injuries.PMID:34839727 | DOI:10.1177/00031348211050574 (Source: The American Surgeon)
Source: The American Surgeon - November 29, 2021 Category: Surgery Authors: John R Murfee Kaitlin E Pardue Paige Farley Nathan M Polite Maryann I Mbaka Andrew C Bright Christopher M Kinnard Jon D Simmons C Caleb Butts Source Type: research

Whole Blood Versus Conventional Blood Component Massive Transfusion Protocol Therapy in Civilian Trauma Patients
Am Surg. 2021 Nov 27:31348211049752. doi: 10.1177/00031348211049752. Online ahead of print.ABSTRACTBACKGROUND: Military data demonstrating an improved survival rate with whole blood (WB) have led to a shift toward the use of WB in civilian trauma. The purpose of this study is to compare a low-titer group O WB (LTOWB) massive transfusion protocol (MTP) to conventional blood component therapy (BCT) MTP in civilian trauma patients.METHODS: Trauma patients 15 years or older who had MTP activations from February 2019 to December 2020 were included. Patients with a LTOWB MTP activation were compared to BCT MTP patients from a hi...
Source: The American Surgeon - November 29, 2021 Category: Surgery Authors: Janet S Lee Abid D Khan Franklin L Wright Robert C McIntyre Warren C Dorlac Chris Cribari Valerie Brockman Stephanie A Vega Jessica M Cofran Thomas J Schroeppel Source Type: research

Increased Mortality in Hip Fracture Patients With Aortic Stenosis and Pulmonary Hypertension Compared to Aortic Stenosis Alone
CONCLUSION: In patients with IHFs, PH and AS increase the likelihood of inpatient mortality by 2.5 times compared to AS alone. Pulmonary hypertension among IHF patients with AS is an important risk factor to identify in the preoperative period. Early identification may lead to better perioperative management and counseling of patients at higher risk of complications.PMID:34841906 | DOI:10.1177/00031348211054525 (Source: The American Surgeon)
Source: The American Surgeon - November 29, 2021 Category: Surgery Authors: Christian B Cignoni Steven K M Vuu Huazhi Liu Jason M Clark Carrie D Watson Laurence R Ferber Winston T Richards Darwin N Ang Source Type: research

Carotid-Subclavian Bypass to Treat Carotid Dissection From Blunt Cerebrovascular Injury Without Traumatic Brain Injury or Cervical Spine Fracture
Am Surg. 2021 Nov 29:31348211058612. doi: 10.1177/00031348211058612. Online ahead of print.NO ABSTRACTPMID:34841908 | DOI:10.1177/00031348211058612 (Source: The American Surgeon)
Source: The American Surgeon - November 29, 2021 Category: Surgery Authors: Kenji Okumura Jeffrey Baum Romeo Mateo Ilya Shnaydman Source Type: research

Angioembolization to Control Postoperative Bleeding From the Uterine Artery Two Weeks After Hysterectomy
Am Surg. 2021 Nov 29:31348211054069. doi: 10.1177/00031348211054069. Online ahead of print.NO ABSTRACTPMID:34841911 | DOI:10.1177/00031348211054069 (Source: The American Surgeon)
Source: The American Surgeon - November 29, 2021 Category: Surgery Authors: Stefan S Iverson Christina M Colosimo Cosmina Cristea Jeffrey N Harr John S Weaver Source Type: research

Improving Intraoperative Parathyroid Hormone Lab Efficiency
DISCUSSION: Utilizing a team-based approach to identify and expedite critical steps in the iPTH lab process can make a significant improvement in iPTH lab efficiency, improving patient care by decreasing total anesthesia time.PMID:34841912 | DOI:10.1177/00031348211054556 (Source: The American Surgeon)
Source: The American Surgeon - November 29, 2021 Category: Surgery Authors: John M Pickering Wesley H Giles Source Type: research

Loop Ileostomy for Management of Toxic < em > Clostridium difficile < /em > Enteritis and Bowel Obstruction After Restorative Proctocolectomy
Am Surg. 2021 Nov 27:31348211056255. doi: 10.1177/00031348211056255. Online ahead of print.NO ABSTRACTPMID:34841918 | DOI:10.1177/00031348211056255 (Source: The American Surgeon)
Source: The American Surgeon - November 29, 2021 Category: Surgery Authors: Nikhil C Reddy Robert D Bennett Source Type: research

The Impact of Flame Burn Injuries on Patients Who Sustain Mild Injuries From Motor Vehicle Crashes
Am Surg. 2021 Nov 29:31348211054712. doi: 10.1177/00031348211054712. Online ahead of print.ABSTRACTBACKGROUND: The purpose of this study was to determine the differences in patient outcomes between motor vehicle crash (MVC) victims with an ISS
Source: The American Surgeon - November 29, 2021 Category: Surgery Authors: Brady A Campbell Grace F Rozycki Elliott R Haut Raymond Fang Charles Scott Hultman Source Type: research

Endovascular Treatment of Innominate Artery Bifurcation Injury with Balloon-Expandable Covered Stents Utilizing Kissing Stent Technique
Am Surg. 2021 Nov 29:31348211048835. doi: 10.1177/00031348211048835. Online ahead of print.ABSTRACTMajor injury of the innominate artery is traditionally treated with an open repair which is technically challenging, associated with large volumes of blood loss and prolonged operative times. Endovascular treatment with covered stent placement across the injury is an attractive alternative. However, placement of a single covered stent across the innominate artery bifurcation into one of its distal branches will not prevent bleeding because of retrograde perfusion from the unstented branch distal to the bifurcation. Here, we r...
Source: The American Surgeon - November 29, 2021 Category: Surgery Authors: Anthony L Grzeda Marcus D Moseley Daisy Sangroula Erik J Wayne Amit J Dwivedi Abindra Sigdel Source Type: research

Unexpected Diaphragmatic Hernia Among Patients Undergoing Video-Assisted Thoracic Surgery for Internal Fixation of Rib Fractures
This study revealed that 20% of patients undergoing VATS for rib fracture fixation had a concomitant diaphragm injury. This higher-than-expected prevalence suggests that groups of patients sustaining blunt trauma may have occult diaphragmatic injuries that are otherwise unidentified. This raises the need for improved diagnostic modalities to identify these injuries.PMID:34839727 | DOI:10.1177/00031348211050574 (Source: The American Surgeon)
Source: The American Surgeon - November 29, 2021 Category: Surgery Authors: John R Murfee Kaitlin E Pardue Paige Farley Nathan M Polite Maryann I Mbaka Andrew C Bright Christopher M Kinnard Jon D Simmons C Caleb Butts Source Type: research

Whole Blood Versus Conventional Blood Component Massive Transfusion Protocol Therapy in Civilian Trauma Patients
Am Surg. 2021 Nov 27:31348211049752. doi: 10.1177/00031348211049752. Online ahead of print.ABSTRACTBACKGROUND: Military data demonstrating an improved survival rate with whole blood (WB) have led to a shift toward the use of WB in civilian trauma. The purpose of this study is to compare a low-titer group O WB (LTOWB) massive transfusion protocol (MTP) to conventional blood component therapy (BCT) MTP in civilian trauma patients.METHODS: Trauma patients 15 years or older who had MTP activations from February 2019 to December 2020 were included. Patients with a LTOWB MTP activation were compared to BCT MTP patients from a hi...
Source: The American Surgeon - November 29, 2021 Category: Surgery Authors: Janet S Lee Abid D Khan Franklin L Wright Robert C McIntyre Warren C Dorlac Chris Cribari Valerie Brockman Stephanie A Vega Jessica M Cofran Thomas J Schroeppel Source Type: research

Increased Mortality in Hip Fracture Patients With Aortic Stenosis and Pulmonary Hypertension Compared to Aortic Stenosis Alone
CONCLUSION: In patients with IHFs, PH and AS increase the likelihood of inpatient mortality by 2.5 times compared to AS alone. Pulmonary hypertension among IHF patients with AS is an important risk factor to identify in the preoperative period. Early identification may lead to better perioperative management and counseling of patients at higher risk of complications.PMID:34841906 | DOI:10.1177/00031348211054525 (Source: The American Surgeon)
Source: The American Surgeon - November 29, 2021 Category: Surgery Authors: Christian B Cignoni Steven K M Vuu Huazhi Liu Jason M Clark Carrie D Watson Laurence R Ferber Winston T Richards Darwin N Ang Source Type: research

Carotid-Subclavian Bypass to Treat Carotid Dissection From Blunt Cerebrovascular Injury Without Traumatic Brain Injury or Cervical Spine Fracture
Am Surg. 2021 Nov 29:31348211058612. doi: 10.1177/00031348211058612. Online ahead of print.NO ABSTRACTPMID:34841908 | DOI:10.1177/00031348211058612 (Source: The American Surgeon)
Source: The American Surgeon - November 29, 2021 Category: Surgery Authors: Kenji Okumura Jeffrey Baum Romeo Mateo Ilya Shnaydman Source Type: research

Angioembolization to Control Postoperative Bleeding From the Uterine Artery Two Weeks After Hysterectomy
Am Surg. 2021 Nov 29:31348211054069. doi: 10.1177/00031348211054069. Online ahead of print.NO ABSTRACTPMID:34841911 | DOI:10.1177/00031348211054069 (Source: The American Surgeon)
Source: The American Surgeon - November 29, 2021 Category: Surgery Authors: Stefan S Iverson Christina M Colosimo Cosmina Cristea Jeffrey N Harr John S Weaver Source Type: research

Improving Intraoperative Parathyroid Hormone Lab Efficiency
DISCUSSION: Utilizing a team-based approach to identify and expedite critical steps in the iPTH lab process can make a significant improvement in iPTH lab efficiency, improving patient care by decreasing total anesthesia time.PMID:34841912 | DOI:10.1177/00031348211054556 (Source: The American Surgeon)
Source: The American Surgeon - November 29, 2021 Category: Surgery Authors: John M Pickering Wesley H Giles Source Type: research

Loop Ileostomy for Management of Toxic < em > Clostridium difficile < /em > Enteritis and Bowel Obstruction After Restorative Proctocolectomy
Am Surg. 2021 Nov 27:31348211056255. doi: 10.1177/00031348211056255. Online ahead of print.NO ABSTRACTPMID:34841918 | DOI:10.1177/00031348211056255 (Source: The American Surgeon)
Source: The American Surgeon - November 29, 2021 Category: Surgery Authors: Nikhil C Reddy Robert D Bennett Source Type: research

The Impact of Flame Burn Injuries on Patients Who Sustain Mild Injuries From Motor Vehicle Crashes
Am Surg. 2021 Nov 29:31348211054712. doi: 10.1177/00031348211054712. Online ahead of print.ABSTRACTBACKGROUND: The purpose of this study was to determine the differences in patient outcomes between motor vehicle crash (MVC) victims with an ISS
Source: The American Surgeon - November 29, 2021 Category: Surgery Authors: Brady A Campbell Grace F Rozycki Elliott R Haut Raymond Fang Charles Scott Hultman Source Type: research

Endovascular Treatment of Innominate Artery Bifurcation Injury with Balloon-Expandable Covered Stents Utilizing Kissing Stent Technique
Am Surg. 2021 Nov 29:31348211048835. doi: 10.1177/00031348211048835. Online ahead of print.ABSTRACTMajor injury of the innominate artery is traditionally treated with an open repair which is technically challenging, associated with large volumes of blood loss and prolonged operative times. Endovascular treatment with covered stent placement across the injury is an attractive alternative. However, placement of a single covered stent across the innominate artery bifurcation into one of its distal branches will not prevent bleeding because of retrograde perfusion from the unstented branch distal to the bifurcation. Here, we r...
Source: The American Surgeon - November 29, 2021 Category: Surgery Authors: Anthony L Grzeda Marcus D Moseley Daisy Sangroula Erik J Wayne Amit J Dwivedi Abindra Sigdel Source Type: research

Elective Hernia Repair in Obese Patients
Am Surg. 2021 Nov 25:31348211058638. doi: 10.1177/00031348211058638. Online ahead of print.ABSTRACTNA this is a Letter to the Editor.PMID:34823404 | DOI:10.1177/00031348211058638 (Source: The American Surgeon)
Source: The American Surgeon - November 26, 2021 Category: Surgery Authors: Sergio Huerta Source Type: research

Short Observation Period and Aggressive Discharge of Patients With Head Injury and Serial CT Scans
Conclusions: In this retrospective review, most repeat CT scans had no new findings. A small percentage converted to positive, rarely altering clinical management. This study demonstrates the need for continued prospective research to update clinical guidelines that could reduce admission and serial CT scanning for mild TBI.PMID:34823406 | DOI:10.1177/00031348211063539 (Source: The American Surgeon)
Source: The American Surgeon - November 26, 2021 Category: Surgery Authors: Jordan Perkins Jacob Shreffler Danielle Kamenec Alexandra Bequer Corey Ziemba Dan O'Brien Hugh Shoff Jason Smith Nicholas Nash Martin Huecker Source Type: research

Elective Hernia Repair in Obese Patients
Am Surg. 2021 Nov 25:31348211058638. doi: 10.1177/00031348211058638. Online ahead of print.ABSTRACTNA this is a Letter to the Editor.PMID:34823404 | DOI:10.1177/00031348211058638 (Source: The American Surgeon)
Source: The American Surgeon - November 26, 2021 Category: Surgery Authors: Sergio Huerta Source Type: research

Short Observation Period and Aggressive Discharge of Patients With Head Injury and Serial CT Scans
Conclusions: In this retrospective review, most repeat CT scans had no new findings. A small percentage converted to positive, rarely altering clinical management. This study demonstrates the need for continued prospective research to update clinical guidelines that could reduce admission and serial CT scanning for mild TBI.PMID:34823406 | DOI:10.1177/00031348211063539 (Source: The American Surgeon)
Source: The American Surgeon - November 26, 2021 Category: Surgery Authors: Jordan Perkins Jacob Shreffler Danielle Kamenec Alexandra Bequer Corey Ziemba Dan O'Brien Hugh Shoff Jason Smith Nicholas Nash Martin Huecker Source Type: research

Elective Hernia Repair in Obese Patients
Am Surg. 2021 Nov 25:31348211058638. doi: 10.1177/00031348211058638. Online ahead of print.ABSTRACTNA this is a Letter to the Editor.PMID:34823404 | DOI:10.1177/00031348211058638 (Source: The American Surgeon)
Source: The American Surgeon - November 26, 2021 Category: Surgery Authors: Sergio Huerta Source Type: research

Short Observation Period and Aggressive Discharge of Patients With Head Injury and Serial CT Scans
Conclusions: In this retrospective review, most repeat CT scans had no new findings. A small percentage converted to positive, rarely altering clinical management. This study demonstrates the need for continued prospective research to update clinical guidelines that could reduce admission and serial CT scanning for mild TBI.PMID:34823406 | DOI:10.1177/00031348211063539 (Source: The American Surgeon)
Source: The American Surgeon - November 26, 2021 Category: Surgery Authors: Jordan Perkins Jacob Shreffler Danielle Kamenec Alexandra Bequer Corey Ziemba Dan O'Brien Hugh Shoff Jason Smith Nicholas Nash Martin Huecker Source Type: research

Delayed Hematogenous Metastasis Versus Second Primary Squamous Cell Carcinoma of the Neck in a Patient With Previous Cancer of the Cervix
We present here a 73-year-old female with a prior human papillomavirus (HPV) + SCC of the cervix that had metastasized to her peri-aortic lymph nodes. Eight years after diagnosis and treatment, she returned with a hypermetabolic supraclavicular lymph node and new left-sided neck mass. Biopsy of the neck mass revealed invasive SCC positive for high-risk HPV genotype. The presence of high-risk HPV genotypes in both the cervix and supraclavicular lymph node, without evidence of second primary tumor, implies that the neck mass is a delayed metastasis of the patient's previous cervical cancer. This marks the second recorded cas...
Source: The American Surgeon - November 25, 2021 Category: Surgery Authors: Peter Coriell Kevin Engledow Shailja Roy Glenda Smith Nadia Nashed Gus Slotman Source Type: research

Delayed Hematogenous Metastasis Versus Second Primary Squamous Cell Carcinoma of the Neck in a Patient With Previous Cancer of the Cervix
We present here a 73-year-old female with a prior human papillomavirus (HPV) + SCC of the cervix that had metastasized to her peri-aortic lymph nodes. Eight years after diagnosis and treatment, she returned with a hypermetabolic supraclavicular lymph node and new left-sided neck mass. Biopsy of the neck mass revealed invasive SCC positive for high-risk HPV genotype. The presence of high-risk HPV genotypes in both the cervix and supraclavicular lymph node, without evidence of second primary tumor, implies that the neck mass is a delayed metastasis of the patient's previous cervical cancer. This marks the second recorded cas...
Source: The American Surgeon - November 25, 2021 Category: Surgery Authors: Peter Coriell Kevin Engledow Shailja Roy Glenda Smith Nadia Nashed Gus Slotman Source Type: research

Risk Factors for Reoperation Following Radical Gastrectomy in Gastric Cancer Patients
This study investigated the potential risk factors associated with early reoperation after radical gastrectomy in gastric cancer patients and included an in-depth analysis of these risk factors.METHODS: This retrospective study reviewed 1568 patients with gastric cancer. Grade 3 or greater complications were defined as severe. Any factors related to reoperation after radical gastrectomy were analyzed in patients with severe local complications.RESULTS: Among 1537 patients undergoing radical gastrectomy, 115 (7.5%) patients had severe postoperative complications, 98 (6.38%) of whom experienced severe local complications. Th...
Source: The American Surgeon - November 24, 2021 Category: Surgery Authors: Dong-Hwan Kim Ji-Ho Park Tae Han Kim Eun-Jung Jung Chi-Young Jeong Young-Tae Ju Ju-Yeon Kim Tae-Jin Park Young-Joon Lee Sang-Ho Jeong Source Type: research

Nationwide Readmissions Analysis of Minimally Invasive Versus Open Ventral Hernia Repair: A Retrospective Population-Based Study
Am Surg. 2021 Nov 24:31348211050835. doi: 10.1177/00031348211050835. Online ahead of print.ABSTRACTINTRODUCTION: Minimally invasive ventral hernia repair (MISVHR) has been performed for almost 30 years; recently, there has been an accelerated adoption of the robotic platform leading to renewed comparisons to open ventral hernia repair (OVHR). The present study evaluates patterns and outcomes of readmissions for MISVHR and OVHR patients.METHODS: The Nationwide Readmissions Database (NRD) was queried for patients undergoing OVHR and MISVHR from 2016 to 2018. Demographic characteristics, complications, and 90-day readmissions...
Source: The American Surgeon - November 24, 2021 Category: Surgery Authors: Sullivan A Ayuso Michael M Katzen Bola G Aladegbami Raageswari B Nayak Vedra A Augenstein B Todd Heniford Paul D Colavita Source Type: research

Recurrent Nerve Injury After Total Thyroidectomy: Risk Factor Analysis of a Targeted NSQIP Data Set
Am Surg. 2021 Nov 23:31348211054701. doi: 10.1177/00031348211054701. Online ahead of print.ABSTRACTBACKGROUND: Recurrent laryngeal nerve (RLN) injury is a significant complication after thyroidectomy. Understanding risk factors for RLN injury and the associated postoperative complications may help inform quality improvement initiatives.METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) thyroidectomy-targeted database was utilized for patients undergoing total thyroidectomy between 2016 and 2017. Univariable and multivariable regression were used to identify factors associate...
Source: The American Surgeon - November 23, 2021 Category: Surgery Authors: David A Mahvi Lily V Saadat Jamie Knell Richard D Urman Edward E Whang Nancy L Cho Source Type: research

Assessing Content of Accredited Colon and Rectal Surgery Fellowship Websites: Is there Adequate Information for Applicants?
This study aimed to assess the completeness of colon and rectal surgery (CRS) fellowship program online information. Program information on the Association of Program Directors for Colon and Rectal Surgery (APDCRS) website as well as each institutional website was evaluated based on templated criteria. Sixty-eight accredited fellowship programs were identified. Six (9%) programs had complete profiles on the APDCRS platform, with an average of 3.5 details completed per program. Sixty-two (91%) websites were easily accessible. None of these contained all 28 criteria assessed and 47 (69%) contained less than half of assessed ...
Source: The American Surgeon - November 23, 2021 Category: Surgery Authors: Hossam Abdou Ace St John Andrea C Bafford Natalia S Kubicki Sarah Kidd-Romero Stephen M Kavic Rebecca F Brown Source Type: research

Recurrent Nerve Injury After Total Thyroidectomy: Risk Factor Analysis of a Targeted NSQIP Data Set
Am Surg. 2021 Nov 23:31348211054701. doi: 10.1177/00031348211054701. Online ahead of print.ABSTRACTBACKGROUND: Recurrent laryngeal nerve (RLN) injury is a significant complication after thyroidectomy. Understanding risk factors for RLN injury and the associated postoperative complications may help inform quality improvement initiatives.METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) thyroidectomy-targeted database was utilized for patients undergoing total thyroidectomy between 2016 and 2017. Univariable and multivariable regression were used to identify factors associate...
Source: The American Surgeon - November 23, 2021 Category: Surgery Authors: David A Mahvi Lily V Saadat Jamie Knell Richard D Urman Edward E Whang Nancy L Cho Source Type: research

Assessing Content of Accredited Colon and Rectal Surgery Fellowship Websites: Is there Adequate Information for Applicants?
This study aimed to assess the completeness of colon and rectal surgery (CRS) fellowship program online information. Program information on the Association of Program Directors for Colon and Rectal Surgery (APDCRS) website as well as each institutional website was evaluated based on templated criteria. Sixty-eight accredited fellowship programs were identified. Six (9%) programs had complete profiles on the APDCRS platform, with an average of 3.5 details completed per program. Sixty-two (91%) websites were easily accessible. None of these contained all 28 criteria assessed and 47 (69%) contained less than half of assessed ...
Source: The American Surgeon - November 23, 2021 Category: Surgery Authors: Hossam Abdou Ace St John Andrea C Bafford Natalia S Kubicki Sarah Kidd-Romero Stephen M Kavic Rebecca F Brown Source Type: research

Outcomes of Trauma Patients with Flail Chest and Surgical Rib Stabilization
Am Surg. 2021 Nov 21:31348211056260. doi: 10.1177/00031348211056260. Online ahead of print.ABSTRACTThe goal of this project was to describe the current practices of this institution and identify which patients benefit from surgical stabilization of rib fractures (SSRF). A total of 1429 trauma patients admitted to our Level 1 center with rib fractures between January 1, 2014 and June 22, 2020 were retrospectively reviewed. Flail chest was observed in 43 (3.01%) patients. Surgical stabilization of rib fractures was pursued in 27 of all patients (1.89%). Twenty-four flail chest patients required intubation (ETT). Nineteen wer...
Source: The American Surgeon - November 22, 2021 Category: Surgery Authors: Colten A Yahn Alexander P McNally Kyle Deivert Tyler Fraga Reem A Sharaf Alddin Michael T Martyak Jay N Collins Source Type: research

Response to Response to Telehealth Training for Surgeons to Empathetically Deliver Bad News via Video Mediated Communication
Am Surg. 2021 Nov 22:31348211056270. doi: 10.1177/00031348211056270. Online ahead of print.NO ABSTRACTPMID:34806907 | DOI:10.1177/00031348211056270 (Source: The American Surgeon)
Source: The American Surgeon - November 22, 2021 Category: Surgery Authors: Emily B Rivet Cherie Edwards Patricia Lange Susan Haynes Moshe Feldman Renee Cholyway Source Type: research

Radiologic Reporting of Simple Hepatic Cyst Versus Biliary Cystadenoma May Lead to Unnecessary Surgery
CONCLUSION: In summary, there is a growing trend of "ruling-out the diagnosis of biliary cystadenoma" in patients who present with liver cysts. Patients are appropriately more anxious after this preoperative diagnosis and the treating surgeons have medico-legal concerns regarding conservative management in asymptomatic patients diagnosed as BCA. This single center experience draws attention to the radiology criteria utilized for diagnosing a biliary cystadenoma and suggests that it is time to revisit the imaging interpretation and differential diagnosis.PMID:34806934 | DOI:10.1177/00031348211054077 (Source: The American Surgeon)
Source: The American Surgeon - November 22, 2021 Category: Surgery Authors: Aman Kumar Alex Zendel Michael Batres David A Gerber Chirag S Desai Source Type: research