Incidence of Complicated Appendicitis as a Metric of Health Care Delivery.
Abstract BACKGROUND: Complicated acute appendicitis (CAA) has been linked to extremes of age, racial and socioeconomic disparities, public insurance, and remote residency. CAA rate has been used from 2005 to 2018 as a health care quality metric, with the assumption that delay in treatment was a main cause of perforation. We studied factors that could contribute to CAA focusing on modifiable factors which could be altered as part of a health care delivery system. MATERIALS AND METHODS: All primary admissions for acute appendicitis (AA) from the 2010 Nationwide Inpatient Sample were linked to 2010 state-level p...
Source: The American Surgeon - November 27, 2020 Category: Surgery Authors: Araim F, Shmelev A, Kowdley GC Tags: Am Surg Source Type: research

Are NSAIDs Safe? Assessing the Risk-Benefit Profile of Nonsteroidal Anti-inflammatory Drug Use in Postoperative Pain Management.
Abstract In this article, we review controversies in assessing the risk of serious adverse effects caused by administration of nonsteroidal anti-inflammatory drugs (NSAIDs). Our focus is upon NSAIDs used in short courses for the management of acute postoperative pain. In our review of the literature, we found that the risks of short-term NSAID use may be overemphasized. Specifically, that the likelihood of renal dysfunction, bleeding, nonunion of bone, gastric complications, and finally, cardiac dysfunction do not appear to be significantly increased when NSAIDs are used appropriately after surgery. The importance...
Source: The American Surgeon - November 26, 2020 Category: Surgery Authors: Chang RW, Tompkins DM, Cohn SM Tags: Am Surg Source Type: research

Treatment and Outcomes of Women With Large Locally Advanced Breast Cancer.
Abstract Advances in breast cancer research have made breast cancer a treatable disease. However, there is a population of women who present with large, advanced, or sometimes neglected breast cancers who can prove difficult to treat. These women often require multiple modality treatment including chemotherapy, surgery, and radiation. The purpose of our study is to examine the treatment and outcomes on women with large, locally advanced breast cancers (LABCs). We identified 8 individuals who presented with LABCs requiring extensive treatment. Patients with inflammatory or metastatic cancer at the time of pres...
Source: The American Surgeon - November 24, 2020 Category: Surgery Authors: Mangieri CW, Ruffo J, Chiba A, Howard-McNatt M Tags: Am Surg Source Type: research

Initiation of an Intraoperative Radiotherapy Program at a Safety net Hospital: What Is the Impact of an Intraoperative Radiotherapy Program in Underserved Patients With Early Breast Cancer?
The objective of this study was to analyze the uptake and utilization of an IORT program in a safety-net hospital. MATERIALS AND METHODS: A retrospective review was conducted for all patients who underwent IORT from September 2014 to June 2018. Patient demographics, tumor characteristics, and IORT outcomes were analyzed. The proportion of patients undergoing IORT were determined to assess utilization and uptake. RESULTS: There were 27 female patients that received IORT, 23 (85.2%) of which required no further radiotherapy. Three (7.4%) patients had positive axillary lymph nodes and/or positive margins requiring s...
Source: The American Surgeon - November 24, 2020 Category: Surgery Authors: Lalchandani P, Sila C, Ozao-Choy J, Dauphine C Tags: Am Surg Source Type: research

Malignant Bowel Obstruction in the Time of the COVID-19 Pandemic.
Abstract Regardless of the anatomic site of malignant bowel obstruction leading to the need for palliative intervention, decisions must consider the natural history of the disease, the availability and success of nonsurgical treatments, the individual patient's symptom severity, goals, preferences, quality, and expectancy of life. Therapy for symptoms must remain flexible and individualized because the specific needs of the patient will change as disease progresses. Because strangulation is uncommon, malignant bowel obstruction is usually not a surgical emergency. There is usually time to proceed with deliberate a...
Source: The American Surgeon - November 24, 2020 Category: Surgery Authors: Fallon EA, Miner TJ Tags: Am Surg Source Type: research

Ketorolac Use for Pain Management in Trauma Patients With Rib Fractures Does not Increase of Acute Kidney Injury or Incidence of Bleeding.
Abstract INTRODUCTION: Ketorolac is useful in acute pain management to avoid opiate-related complications; however, some surgeons fear associated acute kidney injury (AKI) and bleeding despite a paucity of literature on ketorolac use in trauma patients. We hypothesized that our institution's use of intravenous ketorolac for rib fracture pain management did not increase the incidence of bleeding or AKI. METHODS: Rib fracture patients aged 15 years and above admitted between January 2016-June 2018 were identified in our trauma registry along with frequency of bleeding events. AKI was defined as ≥ 1.5x i...
Source: The American Surgeon - November 24, 2020 Category: Surgery Authors: Torabi J, Kaban JM, Lewis E, Laikhram D, Simon R, DeHaan S, Jureller M, Chao E, Reddy SH, Stone ME Tags: Am Surg Source Type: research

Surgical Palliative Care-Where are we in 2020?
Abstract The practice of surgical palliative care is not new. Dr Balfour M. M. Mount, a retired urologic surgeon is considered the father of North American Palliative Care and coined the term Palliative Care in 1975. Dr Geoffrey P. Dunn, a retired general surgeon and hospice and palliative medicine specialist along with other like minded surgical colleagues were instrumental in developing the field of surgical palliative care. Dr Olga Jonasson, championed the American Board of Surgery becoming one of the sponsoring boards of the Hospice and Palliative Medicine certifying exam. Dr Anne Mosenthal advocated for palli...
Source: The American Surgeon - November 24, 2020 Category: Surgery Authors: Miller P Tags: Am Surg Source Type: research

The Effects of the COVID-19 Pandemic on Trauma Presentations in a Level One Trauma Center.
Abstract BACKGROUND: Over 28 million confirmed cases of COVID-19 have been reported to date, resulting in over 900 000 deaths. With an increase in awareness regarding the virus, the behavior of general population has changed dramatically. As activities such as driving and hospital presentation patterns have changed, our study aimed to assess the differences in trauma case variables before and during the COVID-19 pandemic. METHODS: Trauma data for the period of March 1st-June 15th were compared for the years 2015-2019 (pre-COVID) and 2020 (COVID). The data were analyzed across the following categorie...
Source: The American Surgeon - November 24, 2020 Category: Surgery Authors: Devarakonda AK, Wehrle CJ, Chibane FL, Drevets PD, Fox ED, Lawson AG Tags: Am Surg Source Type: research

Biliary Clip Migration Causing Obstructive Jaundice in a Gastric Bypass Patient 28  Years After Cholecystectomy.
Biliary Clip Migration Causing Obstructive Jaundice in a Gastric Bypass Patient 28 Years After Cholecystectomy. Am Surg. 2020 Nov 24;:3134820972087 Authors: Sanin G, Fowler B, Bosley M, Powell M PMID: 33231484 [PubMed - as supplied by publisher] (Source: The American Surgeon)
Source: The American Surgeon - November 24, 2020 Category: Surgery Authors: Sanin G, Fowler B, Bosley M, Powell M Tags: Am Surg Source Type: research

Challenges to Understanding and Compliance Among Surgical Patients in Low-Income Urban Teaching Hospitals.
This study was designed to uncover the challenges to patient understanding and compliance with pre- and postsurgical clinical advice in low-income urban environments. The data for this study were collected in spoken survey with eighty patients in 9 surgery clinics at Temple University Hospital in Philadelphia. Survey responses were coded into various groups until categories emerged. Relationships among categories were identified to generate themes and subthemes. Key facilitators of patient understanding and compliance were physician likeability and communication. Eighty (100%) patients reported that the physician always tr...
Source: The American Surgeon - November 24, 2020 Category: Surgery Authors: Burgoon ML, Miller PA, Hoover-Hankerson B, Strand N, Ross H Tags: Am Surg Source Type: research

Acute Care Surgery Service Is Essential During a Nonsurgical Catastrophic Event, the COVID-19 Pandemic.
CONCLUSION: Acute care surgery is an "essential" service during the COVID-19 pandemic, capable of managing critically ill nonsurgical patients while maintaining the provision of trauma and emergent surgical services. PMID: 33231486 [PubMed - as supplied by publisher] (Source: The American Surgeon)
Source: The American Surgeon - November 24, 2020 Category: Surgery Authors: Bugaev N, Hojman HM, Breeze JL, Nasraway SA, Arabian SS, Holewinski S, Johnson BP Tags: Am Surg Source Type: research

Effect of Post-splenectomy Booster Vaccine Program on Vaccination Compliance in Trauma Patients.
The objective of this study was to evaluate our vaccination compliance rate and what sociodemographic factors were associated with noncompliance following this recommendation. MATERIALS AND METHODS: A retrospective review of a performance improvement database of trauma patients eligible for post-splenectomy vaccination (PSV) at a level I trauma center was carried out between 2009 and 2018. Overall and institutional compliance with PSV was compared before and after the addition of booster vaccine recommendation. Factors associated with booster noncompliance were also identified. RESULTS: A total of 257 patients we...
Source: The American Surgeon - November 24, 2020 Category: Surgery Authors: Gonzalez RA, Robbins JM, Garwe T, Stewart KE, Sarwar Z, Cross AM, Celii AM, Albrecht RM Tags: Am Surg Source Type: research

Disproportionate Impact of COVID-19 Pandemic on Racial and Ethnic Minorities.
CONCLUSION: COVID-19 has disproportionately impacted many racial/ethnic minority communities across the country, warranting further research and intervention. PMID: 33231496 [PubMed - as supplied by publisher] (Source: The American Surgeon)
Source: The American Surgeon - November 24, 2020 Category: Surgery Authors: Boserup B, McKenney M, Elkbuli A Tags: Am Surg Source Type: research

Predictors of Anastomotic Leak After Esophagectomy for Cancer: Not All Leaks Increase Mortality.
CONCLUSION: Preoperative chemotherapy/radiation does not contribute to risk for ALs after esophagectomy. There is a stepwise increased risk of 30-day mortality for ALs requiring increased invasiveness of treatment. PMID: 33233922 [PubMed - as supplied by publisher] (Source: The American Surgeon)
Source: The American Surgeon - November 24, 2020 Category: Surgery Authors: Krasnoff CC, Grigorian A, Smith BR, Jutric Z, Nguyen NT, Daly S, Lekawa ME, Nahmias J Tags: Am Surg Source Type: research

New York State and the Nation: Trends in Firearm Purchases and Firearm Violence During the COVID-19 Pandemic.
This study determined the impact of COVID-19 and shelter-in-place (SIP) orders on firearm purchases and incidents in the United States (US) and New York State (NYS). METHODS: Scatterplots reflected trends in firearm purchases, incidents, and deaths over a 16-month period (January 2019 to April 2020). Bivariate comparisons of SIP and non-SIP jurisdictions before and after SIP (February 2020 vs. April 2020) and April 2020 vs. April 2019 were performed with the Mann-Whitney U test. RESULTS: The incidence of COVID-19 in the US increased between February and April 2020 from 24 to 1 067 660 and in NYS from 0 ...
Source: The American Surgeon - November 24, 2020 Category: Surgery Authors: Donnelly MR, Barie PS, Grigorian A, Kuza CM, Schubl S, de Virgilio C, Lekawa M, Nahmias J Tags: Am Surg Source Type: research

Trends in Outcomes of Level 2 Volume Displacement in Oncoplastic Breast Surgery Between the United States and Western Europe.
PMID: 33228380 [PubMed - as supplied by publisher] (Source: The American Surgeon)
Source: The American Surgeon - November 23, 2020 Category: Surgery Authors: Erlichman Z, Bloom J, Char S, Foroutanjazi S, Nardello S, Chatterjee A Tags: Am Surg Source Type: research

Repurposing a Small Community Hospital Surgical Residency Program in an Epicenter of the COVID-19 Pandemic.
CONCLUSION: Repurposing the surgical department for the concerns of the pandemic has involved all surgical staff. We worked with other departments to allocate our team to areas of need and re-evaluated daily. The strengths of our team to deliver care and perform many bedside procedures allowed us to meet the demands posed by this disease while remaining as a cohesive unit. PMID: 33228383 [PubMed - as supplied by publisher] (Source: The American Surgeon)
Source: The American Surgeon - November 23, 2020 Category: Surgery Authors: Meghpara MK, Alapati A, Devanabanda B, Louis MA, Mandava N Tags: Am Surg Source Type: research

When Is It Safe to Proceed With Pancreaticoduodenectomy Without Biliary Decompression?
DISCUSSION: All patients presenting with bilirubin ≥15 mg/dL should undergo PBD, while those with bilirubin ≤10 mg/dL should forego stent placement to avoid stent-related complications. The decision to stent between 10.1 and 14.9 mg/dL should be made on a case-by-case basis keeping in mind timeliness to definitive cancer treatment. PMID: 33228390 [PubMed - as supplied by publisher] (Source: The American Surgeon)
Source: The American Surgeon - November 23, 2020 Category: Surgery Authors: Mosquera C, Mitsakos AT, Guyton RL, Fitzgerald TL, Zervos EE Tags: Am Surg Source Type: research

Clinical Score Predicting Overall Survival After Surgery for Synchronous Metastatic Adrenocortical Carcinoma: A Surveillance, Epidemiology, and End Result-Based Study.
Abstract Surgery remains the only potential option for prolonging survival in synchronous metastatic adrenocortical carcinoma (ACC). The purpose of this study is to identify patients who may benefit from adrenalectomy. Using the Surveillance, Epidemiology, and End Results (SEER) database (2010-2015), we identified synchronous metastatic ACC patients who underwent adrenalectomy. Cox regression analysis was performed to identify prognostic factors associated with overall survival. A clinical scoring system was created to predict survival after surgery. Sixty-two patients underwent adrenalectomy for synchronous metas...
Source: The American Surgeon - November 23, 2020 Category: Surgery Authors: Wu K, Liu Z, Li X, Lu Y Tags: Am Surg Source Type: research

D.N.R. in the O.R: Do Not Retain or Do Not Rescind? Use Your H.E.A.D.
PMID: 33222489 [PubMed - as supplied by publisher] (Source: The American Surgeon)
Source: The American Surgeon - November 23, 2020 Category: Surgery Authors: John PR Tags: Am Surg Source Type: research

FORTRESS: The Fluid and Organ Failure in Trauma Resuscitation Study.
PMID: 33225730 [PubMed - as supplied by publisher] (Source: The American Surgeon)
Source: The American Surgeon - November 22, 2020 Category: Surgery Authors: Braasch MC, Turco LM, Halimeh B, Wessel E, Winfield RD Tags: Am Surg Source Type: research

Chronic and Sudden Serious Illness, COVID-19, and Decision-Making Capacity: Integrating Advance Care Planning Into the Preoperative Checklist for Elective Surgery.
Abstract Advance Care Planning (ACP) includes anticipating future medical decisions and designating a medical decision maker in the event of losing the capacity to make one's own medical decisions. Many advantages can be seen to doing ACP before a crisis as well as revisiting these discussions over time as circumstances change. This case presentation is of a 74-year-old woman with multiple medical problems who had ACP discussions in the context of proposed surgery for colon cancer. These conversations highlight the elements of high-quality ACP and the importance of learning what patients mean when they employ phra...
Source: The American Surgeon - November 20, 2020 Category: Surgery Authors: Rivet EB, Blades CE, Hutson M, Noreika D Tags: Am Surg Source Type: research

All the World Is a Nail. Why Are Surgeons Resistant to Learn How to Place Cholecystostomy Drains in Seriously Ill Patients With Acute Acalculous Cholecystitis?
Abstract Surgeons routinely provide palliative care, but often the technical procedure needed for the palliative intervention is beyond our training and comfort zone. This case is an example of surgical palliative care that utilizes image-guided techniques to provide optimal care. A frail elderly patient with multiple comorbidities who had been hospitalized for other diseases was diagnosed with acute acalculous cholecystitis. General surgery and gastroenterology were initially consulted, and the patient was referred to interventional radiology for a percutaneous cholecystostomy. The procedure was technically succe...
Source: The American Surgeon - November 20, 2020 Category: Surgery Authors: Requarth J Tags: Am Surg Source Type: research

Surgical Peculiarities of the American Negro by Rudolph Matas (1896).
PMID: 33210936 [PubMed - as supplied by publisher] (Source: The American Surgeon)
Source: The American Surgeon - November 19, 2020 Category: Surgery Authors: Nakayama DK Tags: Am Surg Source Type: research

Nissen Fundoplication: An Operation Created in Exile.
PMID: 33210945 [PubMed - as supplied by publisher] (Source: The American Surgeon)
Source: The American Surgeon - November 19, 2020 Category: Surgery Authors: Nakayama DK Tags: Am Surg Source Type: research

Case Reports in Surgery.
PMID: 33210951 [PubMed - as supplied by publisher] (Source: The American Surgeon)
Source: The American Surgeon - November 19, 2020 Category: Surgery Authors: Nakayama DK Tags: Am Surg Source Type: research

The Slow Death of President Garfield, America's First Live Media Event.
PMID: 33210956 [PubMed - as supplied by publisher] (Source: The American Surgeon)
Source: The American Surgeon - November 19, 2020 Category: Surgery Authors: Nakayama DK Tags: Am Surg Source Type: research

Colorectal Cancer Presenting as a Presacral Mass.
PMID: 33196295 [PubMed - as supplied by publisher] (Source: The American Surgeon)
Source: The American Surgeon - November 16, 2020 Category: Surgery Authors: Lee CE, Honaker MD Tags: Am Surg Source Type: research

Zero Preventable Deaths by 2020: Analysis of Prehospital and Emergency Department Deaths Following Penetrating Trauma Stratified by Anatomic Location.
The objective of this study was to describe the location of death in patients with penetrating trauma, stratified by anatomic location of injury, in order to better tailor our approach to reducing preventable deaths from trauma. METHODS: This retrospective analysis of a prospectively maintained trauma registry included consecutive adult trauma activations with penetrating trauma at a level 1 trauma center between 07/2012 and 03/2018. Injuries were categorized as extremity, junctional, and torso. Head and neck injuries were excluded. Patients injured in>1 defined location were categorized as "multiple." Lo...
Source: The American Surgeon - November 15, 2020 Category: Surgery Authors: Houghton AC, Friedman JK, Smith AA, Toraih EA, Flanagan MR, Schroll RW, Guidry C, McGrew PR, Fakhry SM, Duchesne JC Tags: Am Surg Source Type: research

Traumatic Tracheal Injury and Pulmonary Contusions : Buying Time With ECMO.
PMID: 33174433 [PubMed - as supplied by publisher] (Source: The American Surgeon)
Source: The American Surgeon - November 11, 2020 Category: Surgery Authors: Grant AA, Lineen EB, Villamizar NR, Galbut D, Brozzi N, Loebe M, Ghodsizad A Tags: Am Surg Source Type: research

Appendicitis Within a Pseudocyst: Rare Presentation in a Child With a Ventriculoperitoneal Shunt.
PMID: 33174435 [PubMed - as supplied by publisher] (Source: The American Surgeon)
Source: The American Surgeon - November 11, 2020 Category: Surgery Authors: Klein JJ, Skertich NJ, Shah AN Tags: Am Surg Source Type: research

Identification of the Risk Factors of Postoperative Pulmonary Complications in Elderly Patients Undergoing Elective Colorectal Surgery.
This study was to identify the perioperative related risk factors of postoperative pulmonary complications (PPCs) in elderly patients undergoing elective colorectal surgery, which will provide new insight for better prevention and intervention of PPCs in elderly patients. METHODS: A retrospective study involving 445 patients (age ≥65), who registered in Shengjing Hospital affiliated to China Medical University for elective colorectal surgery from October 2014 to March 2017, was conducted. Clinical data, including demographic information, medical history, preoperative examination, and surgery-related factors, were a...
Source: The American Surgeon - November 11, 2020 Category: Surgery Authors: Chai J, Sang A, Tan M, Long B, Chen L Tags: Am Surg Source Type: research

Creating an Opioid Recommendation Card for Trainees: Methods, Use, and Impact.
DISCUSSION: An evidence-based guideline card for postoperative analgesia is highly valued and utilized by surgical trainees, especially those most junior in their training. PMID: 33174764 [PubMed - as supplied by publisher] (Source: The American Surgeon)
Source: The American Surgeon - November 11, 2020 Category: Surgery Authors: Freedman-Weiss MR, Chiu AS, White EM, Yoo PS Tags: Am Surg Source Type: research

A Nationwide Study of Intimate Partner Violence.
CONCLUSIONS: Young women are more likely to be victims of IPV, whereas men are more likely to be older and hospitalized with more severe injuries and worse outcomes. PMID: 33167696 [PubMed - as supplied by publisher] (Source: The American Surgeon)
Source: The American Surgeon - November 10, 2020 Category: Surgery Authors: Alfaro Quezada J, Mustafa Z, Zhang X, Zakhary B, Firek M, Coimbra R, Brenner M Tags: Am Surg Source Type: research

Rewarding On Time Start Times in Operating Rooms Improves Efficiency.
CONCLUSION: The significant increase in the number of cases that start on time after implementation of the star system leads us to believe that late start times are multifactorial, and that incentives are a positive way to encourage the OR team to start on time. PMID: 33167708 [PubMed - as supplied by publisher] (Source: The American Surgeon)
Source: The American Surgeon - November 10, 2020 Category: Surgery Authors: Jreije K, Sachdeva S, Cull M, Diaz G, Romero J, Schweitzer J Tags: Am Surg Source Type: research

Brachial Plexus Injury Significantly Increases Risk of Axillosubclavian Vessel Injury in Blunt Trauma Patients With Clavicle Fractures.
Abstract BACKGROUND: A national analysis of clavicle fractures is lacking and the risk of concomitant axillosubclavian vessel injury (ASVI) in patients with clavicle fractures is unknown. A minority of patients may have a combined brachial plexus injury (BPI). We sought to describe risk factors for concomitant ASVI in patients with a clavicle fracture; hypothesizing patients with combined clavicle fracture and BPI has a higher risk of ASVI. METHODS: The Trauma Quality Improvement Program (2010-2016) was queried for blunt trauma patients with a clavicle fracture. A multivariable logistic regression model was u...
Source: The American Surgeon - November 10, 2020 Category: Surgery Authors: Tay E, Grigorian A, Schubl SD, Lekawa M, de Virgilio C, Scolaro J, Kabutey NK, Nahmias J Tags: Am Surg Source Type: research

Community Hospital Experience With Bovine Tissue in Infected Vascular Fields.
The objective of this paper is to review the community hospital experience with bovine tissue repair in an infected vascular field. MATERIALS AND METHODS: A retrospective review of all cases performed by a single surgeon in a community hospital for infected prosthetic grafts was completed. Sixteen cases were included where bovine tissue was used for repair. Presentation, location of graft, and causative organism were reviewed, and outcomes including reoperation and mortality were recorded. RESULTS: Of the 16 patients, 15 (94%) had positive cultures of the graft. Methicillin-Resistant Staph Aureus was the most com...
Source: The American Surgeon - November 10, 2020 Category: Surgery Authors: Sowa P, Soult M, Blecha M Tags: Am Surg Source Type: research

Robotic Partial Hepatectomy With Temporary Vascular Inflow Control: A Simple Hemostatic Method in Liver Surgery.
PMID: 33169623 [PubMed - as supplied by publisher] (Source: The American Surgeon)
Source: The American Surgeon - November 10, 2020 Category: Surgery Authors: Sucandy I, Modasi A, Benzie AL, Ross S, Alva L, Spence J, Rosemurgy A Tags: Am Surg Source Type: research

Colon Resection With End Colostomy in a Patient With a History of Imperforate Anus.
PMID: 33169624 [PubMed - as supplied by publisher] (Source: The American Surgeon)
Source: The American Surgeon - November 10, 2020 Category: Surgery Authors: Misra A, Cook CH, Cataldo TE, Narula N Tags: Am Surg Source Type: research

Heineke, Mikulicz, Jaboulay, and Finney: Innovators of Surgical Pyloroplasty.
Abstract This historical retrospective explores the history of the gastric pyloroplasty through the lives of the 4 surgeons whose eponymous procedures have defined the operative management of pyloric strictures: Heineke, Mikulicz, Jaboulay, and Finney. Today's gastrointestinal surgeons employ a combination of techniques that highlight the rich and colorful history of their field. PMID: 33169625 [PubMed - as supplied by publisher] (Source: The American Surgeon)
Source: The American Surgeon - November 10, 2020 Category: Surgery Authors: Lovasik BP, Dodson TF, Srinivasan JK Tags: Am Surg Source Type: research

Total Neoadjuvant Treatment for Rectal Cancer: Preliminary Experience.
Conclusion: TNT is safe and efficient for patients with locally advanced rectal cancer. It increases complete pathological and clinical response rates and may more widely evolve to be the treatment of choice in this group of patients in the near future. PMID: 33169626 [PubMed - as supplied by publisher] (Source: The American Surgeon)
Source: The American Surgeon - November 10, 2020 Category: Surgery Authors: Gilshtein H, Ghuman A, Dawoud M, Yellinek S, Kent I, Sharp SP, Nagarajan A, Wexner SD Tags: Am Surg Source Type: research

Constructivist Grounded Theory to Establish the Relationship Between Technical Error and Adverse Patient Outcome: Modeling Technical Error and Adverse Outcomes.
DISCUSSION: Our conceptual model suggests that adverse patient outcomes can be related to minute technical deviations in surgical technique and provides a basis to study these preventable errors. Our model can also be used to develop intraoperative strategies to prevent these technical surgical errors. PMID: 33170022 [PubMed - as supplied by publisher] (Source: The American Surgeon)
Source: The American Surgeon - November 10, 2020 Category: Surgery Authors: Kanjilal D, Mahmud F, Sutkin G Tags: Am Surg Source Type: research

Prehabilitation for Hepatopancreatobiliary Surgical Patients: Interim Analysis Demonstrates a Protective Effect From Neoadjuvant Chemotherapy and Improvement in the Frailty Phenotype.
This study presents an interim analysis to demonstrate prehabilitation for hepatopancreatobiliary (HPB) surgical patients.Methods: In 2018, a structured prehabilitation pilot program was implemented. Eligibility required HPB malignancy, neoadjuvant chemotherapy, and residence within hour drive. Patients were enrolled into the 4-month program. The fitness component was composed of timed up and go test and grip strength with exercise recommendations. Nutrition involved evaluation of sarcopenic obesity, glucose management, and smoking and alcohol counseling. Psychological services included psychosocial assessments and advance...
Source: The American Surgeon - November 10, 2020 Category: Surgery Authors: Baimas-George M, Watson M, Thompson K, Shastry V, Iannitti D, Martinie JB, Baker E, Parala-Metz A, Vrochides D Tags: Am Surg Source Type: research

A Novel Radiological Predictor for Postoperative Pancreatic Fistula After Stapled Distal Pancreatectomy.
CONCLUSION: A PT/MPDD ratio greater than 8 (a wide pancreas with a narrow duct) is a significant predictive factor for CR-POPF following DP. PMID: 33170027 [PubMed - as supplied by publisher] (Source: The American Surgeon)
Source: The American Surgeon - November 10, 2020 Category: Surgery Authors: Bag YM, Topel C, Ozdemir E, Saglam K, Sumer F, Kayaalp C Tags: Am Surg Source Type: research

Catheter-Directed Thrombolysis for High- and Intermediate-Risk Pulmonary Thromboembolism: A Review of an Institution Protocol-Based Intervention Strategy.
PMID: 33170028 [PubMed - as supplied by publisher] (Source: The American Surgeon)
Source: The American Surgeon - November 10, 2020 Category: Surgery Authors: Philip S, Derbes H, Ren M, Hooks B, Nolan K Tags: Am Surg Source Type: research

Screening for Bacteremia in Trauma Patients: Traditional Markers Fall Short.
CONCLUSION: Current tools for identifying bacteremia in trauma patients result in overscreening. PCT may have a limited role as a negative predictor for bacteremia. Given that false-positive BCs have negative patient and economic consequences, future study should focus on development of alternative screening modalities. PMID: 33170029 [PubMed - as supplied by publisher] (Source: The American Surgeon)
Source: The American Surgeon - November 10, 2020 Category: Surgery Authors: Stutsrim AE, Griffin CM, Palavecino EL, Hildreth AN, Avery MD, Chang MC, Miller PR, Nunn AM Tags: Am Surg Source Type: research

Utilizing Change Management Theory to Optimize Resources and Reduce Supply Chain Costs.
PMID: 33170032 [PubMed - as supplied by publisher] (Source: The American Surgeon)
Source: The American Surgeon - November 10, 2020 Category: Surgery Authors: Purnell SM, Pei KY, Tilton J, Bloom A, Dickinson K, Zheng F Tags: Am Surg Source Type: research

Large Recurrent Retroperitoneal Cystic Lymphangioma in an Adult.
PMID: 33170033 [PubMed - as supplied by publisher] (Source: The American Surgeon)
Source: The American Surgeon - November 10, 2020 Category: Surgery Authors: Hardy KM, Richmond BK Tags: Am Surg Source Type: research

A Giant Hepatoid Carcinoma of the Perirenal Fat With Very High A-Fetoprotein and Vitamin B12 Levels.
PMID: 33170038 [PubMed - as supplied by publisher] (Source: The American Surgeon)
Source: The American Surgeon - November 10, 2020 Category: Surgery Authors: Kostakopoulos NA, Karakousis ND, Linardoutsos D, Argyropoulos V, Kouroupakis P, Kastora S, Kostakopoulos AN Tags: Am Surg Source Type: research

Closed Incision Negative Pressure Therapy: Indications and Adherence to Protocol.
Discussion: The most common indications for using CINPT according to the literature review and the NSQIP database are BMI> 30, smoking status, and diabetes mellitus. Besides identifying patients who potentially benefit the most from CINPT, the results of this study suggest clinical adherence to the practice guidelines reported in the literature regarding wound management using this treatment modality. PMID: 33170740 [PubMed - as supplied by publisher] (Source: The American Surgeon)
Source: The American Surgeon - November 10, 2020 Category: Surgery Authors: Foroutanjazi S, Jonczyk M, Chen L, Chatterjee A Tags: Am Surg Source Type: research