The Utilization of Laparoscopic Ventral Hernia Repair (LVHR) in Incarcerated and Strangulated Cases: A National Trend in Outcomes
CONCLUSION: Laparoscopic VHR has become a routine method for treating incarcerated and strangulated hernias, and its utilization continues to increase over time. Clinical outcomes have remained the same while hospital stays have decreased.PMID:38557282 | DOI:10.1177/00031348241241692 (Source: The American Surgeon)
Source: The American Surgeon - April 1, 2024 Category: Surgery Authors: Alexis M Holland William R Lorenz Brittany S Mead Gregory T Scarola Vedra A Augenstein Kent W Kercher B Todd Heniford Source Type: research
Chest Tube Size Selection: Evaluating Provider Practices, Treatment Efficacy, and Complications in Management of Thoracic Trauma
This study aimed to evaluate provider practice patterns, treatment efficacy, and complications related to the selection of chest tube sizes for patients with thoracic trauma.METHODS: A retrospective chart review was performed on adult patients who underwent tube thoracostomy for traumatic PTX, HTX, or HPTX at a Level 1 Trauma Center from January 2016 to December 2021. Comparison was made between SB and LB thoracostomy tubes. The primary outcome was indication for chest tube placement based on injury pattern. Secondary outcomes included retained hemothorax, insertion-related complications, and duration of chest tube placeme...
Source: The American Surgeon - April 1, 2024 Category: Surgery Authors: Genevieve E Messa Cameron J Fontenot Paige E Deville John P Hunt Alan B Marr Jonathan E Schoen Lance E Stuke Patrick P Greiffenstein Alison A Smith Source Type: research
Challenges, Preoperative Assessment, and Surgical Strategies for the Left-Sided Gallbladder
Am Surg. 2024 Apr 1:31348241241691. doi: 10.1177/00031348241241691. Online ahead of print.ABSTRACTLeft-sided gallbladder positioning, or sinistroposition, is a rare anatomical variation that poses challenges during surgical intervention due to associated vascular and biliary anomalies. While existing literature suggests an incidence of approximately 0.04-1.1%, it remains an underreported phenomenon that falls well outside the realm of "expected" anatomical variation and are rarely identified on preoperative imaging. Here, we present a case of acute cholecystitis in a patient with unexpected left-sided gallbladder, highligh...
Source: The American Surgeon - April 1, 2024 Category: Surgery Authors: Olivia A Starich Nicolas M Chanes Syed Shahyan Bakhtiyar Zain Aryanpour Magdalene A Brooke Source Type: research
Program Factors Associated With Improved American Board of Surgery Examination Pass Rates
CONCLUSION: Board certification serves as the capstone for surgeons after completing general surgery residency. Multiple program factors demonstrate a significant correlation to board performance.PMID:38557331 | DOI:10.1177/00031348241241655 (Source: The American Surgeon)
Source: The American Surgeon - April 1, 2024 Category: Surgery Authors: David Ray Velez Source Type: research
Overnight In-House Critical Care Resource Intensivist Improves General Surgery Resident Education
Am Surg. 2024 Apr 1:31348241241658. doi: 10.1177/00031348241241658. Online ahead of print.ABSTRACT24/7 critical care staffing has become more commonplace, and their impact on resident training must be carefully considered. At our institution, the Critical Care Resource Intensivist (CCRI) model was implemented to provide in-house dedicated faculty responsible solely for the provision of critical care overnight. An anonymous survey was distributed to all general surgery residents to evaluate CCRI's impact on education and autonomy. Descriptive statistics were completed for quantitative data. Qualitative analysis of free text...
Source: The American Surgeon - April 1, 2024 Category: Surgery Authors: Jeanette Zhang Rachel Warner Abby Sheffield Sarah Hodge Marie Crandall David Skarupa Source Type: research
Preoperative Nil Per Os Duration Predicts Mortality and Ambulation Following Below-Knee Amputation
CONCLUSION: While NPO duration does not appear to result in postoperative renal dysfunction, prolonged NPO duration predicts worse rates of follow-up, ambulation, and survival and is associated with increased stroke rates.PMID:38561237 | DOI:10.1177/00031348241244633 (Source: The American Surgeon)
Source: The American Surgeon - April 1, 2024 Category: Surgery Authors: Natalie T Chao Allison S Karwoski Luke T Pitsenbarger Maria N Som Eleanor Dunlap Khanjan H Nagarsheth Source Type: research
Complete Remission of Metastatic Melanoma of the Scalp Following Treatment With Nivolumab Plus Relatlimab
We describe the diagnosis and management of a patient with metastatic nodular melanoma treated with palliative resection of the primary tumor followed by immunotherapy with nivolumab and relatlimab. Four months after his first treatment, he had no evidence of disease on PET scan. He continued to show no evidence of disease at recent follow-up. Treatment of metastatic melanoma of the skin with nivolumab and relatlimab is an effective approach showing greater benefit to patients than nivolumab alone.PMID:38553440 | DOI:10.1177/00031348241241642 (Source: The American Surgeon)
Source: The American Surgeon - March 30, 2024 Category: Surgery Authors: Mary E McMinn Kelly A Brister W Shannon Orr Natale T Sheehan Wade O Christopher Source Type: research
The Impact of Pre-Trauma Steroid Use on Wound Healing and Outcomes
This study presents data on pre-trauma steroid use, a topic underrepresented in the trauma literature. Long-term steroid use has been linked to impaired wound healing, compromised immune responses, and hindrance of bone healing, alongside the potential for adrenal insufficiency during traumatic events. The aim of this study was to conduct a retrospective analysis of clinical outcomes for trauma patients with chronic steroid use. Examining adult trauma cases with pre-trauma steroid use at a level 1 trauma center (January 2016-September 2023), we identified 18 patients (58.6 ± 19.4 years, 55.6% males). All were on prednison...
Source: The American Surgeon - March 30, 2024 Category: Surgery Authors: Kaleb Derouen Sarah Aleman Harrison Travis John P Hunt Alan Marr Patrick Greiffenstein Lance Stuke Jonathan Schoen Alison Smith Source Type: research
Rib Fractures and Frailty in Geriatric Trauma Patients
Am Surg. 2024 Mar 29:31348241241660. doi: 10.1177/00031348241241660. Online ahead of print.ABSTRACTAs rib fractures are a common injury in the geriatric trauma population and can result in increased morbidity and mortality, we sought to understand predicting outcomes in this population. We hypothesized that frail geriatric rib fracture patients would have worse outcomes than their non-frail counterparts. This single-center retrospective study includes patients from July 2019 to June 2022 who were ≥65 years-old, had ≥ 2 rib fractures, and a documented Clinical Frailty Scale score. Univariate analysis was conducted compa...
Source: The American Surgeon - March 30, 2024 Category: Surgery Authors: Joan H Brown Samantha K LaRosa Katherine G Moore Lindsey L Perea Source Type: research
Healing Beyond the Knife: The Power of a Surgeon's Dialogue
Am Surg. 2024 Mar 29:31348241241724. doi: 10.1177/00031348241241724. Online ahead of print.NO ABSTRACTPMID:38553787 | DOI:10.1177/00031348241241724 (Source: The American Surgeon)
Source: The American Surgeon - March 30, 2024 Category: Surgery Authors: Joseph Abraham Kavian Source Type: research
Size of Splenic Subcapsular Hematoma Is Associated With Varying Outcomes of Nonoperative Management
Am Surg. 2024 Mar 29:31348241241734. doi: 10.1177/00031348241241734. Online ahead of print.ABSTRACTThe presence of a splenic subcapsular hematoma (SCH) has been associated with higher rates of failure of nonoperative management (FNOM) in patients with blunt splenic injury (BSI), with rates up to 80%. We hypothesized that contemporary rates are lower. A retrospective review was conducted of patients admitted with BSI to a level I trauma center (2016-2021). Patients with SCH who had FNOM were compared to those who did not. There were 661 BSI patients, of which 102 (15.4%) had SCH. Among the SCH patients, 8 (7.8%) had FNOM. F...
Source: The American Surgeon - March 30, 2024 Category: Surgery Authors: Navpreet K Dhillon Melike N Harfouche Joseph J DuBose Rosemary A Kozar Thomas M Scalea Source Type: research
A Daily Checklist Method Increases Documentation of Code Status in Trauma Patients
CONCLUSION: Including code status in a daily checklist involving key aspects of care for trauma patients is an effective method for improving code status documentation. Capturing code status for more patients in trauma allows us to provide patient-centered, goal-concordant care.PMID:38553854 | DOI:10.1177/00031348241241649 (Source: The American Surgeon)
Source: The American Surgeon - March 30, 2024 Category: Surgery Authors: Alexandria M Bontrager Sarah J Ouadah Malini Anand Michael C Smith Source Type: research
Geriatric Bariatric Surgery: Outcomes at a Single Institution
Am Surg. 2024 Mar 29:31348241241732. doi: 10.1177/00031348241241732. Online ahead of print.ABSTRACTObesity, especially in those over the age of 65, is associated with multiple comorbidities and decreased quality of life. Bariatric surgery is an effective method of weight loss and management of comorbidities and is increasingly utilized in younger and middle-aged populations. A retrospective review was performed of patients ≥65 years old who underwent bariatric surgery between 2018 and 2021 at a single institution to evaluate the safety and efficacy of bariatric surgery in older populations. A total of 11 patients were id...
Source: The American Surgeon - March 30, 2024 Category: Surgery Authors: Samantha Zhan-Moodie Brianna Stadsvold Elinor Mannon Madeleine Schlafly Taylor Lee Gabrielle Moore Kate Marino Viktoriya Sapkalova Hana Ghiathi Jack McClain Aaron Bolduc Lisa R Hilton Source Type: research
The Cost of Poverty: The Relationship Between Insurance Status, Length of Stay, and Discharge Disposition in Trauma Patients
CONCLUSIONS: Excess LOS and complications associated with ELOS were not associated with IS. Although UIPs were younger and had fewer baseline comorbidities, they had longer LOS after regression analysis. While discharge recommendations differed based on insurance status, UIPs had limited access to rehabilitation due to financial disparities. Despite initial treatment team recommendations, UIPs had to be sent home as their lack of insurance precluded inpatient rehabilitation placement.PMID:38554144 | DOI:10.1177/00031348241241656 (Source: The American Surgeon)
Source: The American Surgeon - March 30, 2024 Category: Surgery Authors: Alexandria M Bontrager Andrew J Medvecz Candice Smith Michael C Smith Source Type: research
Complete Remission of Metastatic Melanoma of the Scalp Following Treatment With Nivolumab Plus Relatlimab
We describe the diagnosis and management of a patient with metastatic nodular melanoma treated with palliative resection of the primary tumor followed by immunotherapy with nivolumab and relatlimab. Four months after his first treatment, he had no evidence of disease on PET scan. He continued to show no evidence of disease at recent follow-up. Treatment of metastatic melanoma of the skin with nivolumab and relatlimab is an effective approach showing greater benefit to patients than nivolumab alone.PMID:38553440 | DOI:10.1177/00031348241241642 (Source: The American Surgeon)
Source: The American Surgeon - March 30, 2024 Category: Surgery Authors: Mary E McMinn Kelly A Brister W Shannon Orr Natale T Sheehan Wade O Christopher Source Type: research
