A Supportive Culture Maintains General Surgery Wellness
Am Surg. 2024 Apr 3:31348241241700. doi: 10.1177/00031348241241700. Online ahead of print.ABSTRACTSocial restrictions during the pandemic required creative solutions for incorporating interns into a demanding residency, building relationships, and fostering resiliency. We hypothesized that resident-driven initiatives focused on inclusion would overcome a lack of in-person events. An anonymous survey was administered to all surgery residents to assess burnout pre- and post-wellness interventions. Assessment scores were analyzed with Mann-U Whitney and Kruskal-Wallis tests. The surveys were completed by 71.6% (n = 53) and 48...
Source: The American Surgeon - April 3, 2024 Category: Surgery Authors: Kristen M Quinn Julie B Siegel Andrea M Abbott Source Type: research
Management of Extraperitoneal Bladder Injuries in Patients With Pelvic Fractures
CONCLUSIONS: Patients with EBI and pelvic fractures who underwent cystorrhaphy had more bladder leaks on follow-up imaging, although there was no difference in composite complications, when compared to those who underwent non-operative management.PMID:38568507 | DOI:10.1177/00031348241244641 (Source: The American Surgeon)
Source: The American Surgeon - April 3, 2024 Category: Surgery Authors: Virginia H Byars Saskya E Byerly Caroline T Dong Emily K Lenart Cory R Evans Andrew J Kerwin Dina M Filiberto Source Type: research
Impact of Language Congruence on Patient Outcomes Following Gastrostomy Tube Insertion
This study explores outcomes in the setting of language congruence at the time of discharge for pediatric patients following laparoscopic gastrostomy tube insertion. We conducted a retrospective chart review from 2019 to 2022 at a community children's hospital, including 168 patients categorized based on language congruence. Although trends did suggest increased ER visits among Spanish-speaking patients, there were no statistically significant differences in health care utilization or patient outcomes identified. Further larger studies are needed for a comprehensive analysis of the relationship of language congruence at di...
Source: The American Surgeon - April 3, 2024 Category: Surgery Authors: Monique Motta Margaret Savage Nikitha Garapaty Shenae Samuels Joshua P Parreco Tamar Levene Source Type: research
Operative Management and Outcome of Idiopathic Rectal Necrosis in an Octogenarian
This report describes an 83-year-old man presenting with septic shock due to distal sigmoid and complete rectal necrosis with perforation. He underwent emergent exploratory laparotomy, sigmoid and proximal rectum resection, and end sigmoid colostomy creation with delayed distal rectal evaluation. Bedside proctoscopy revealed pale, viable-appearing distal rectal mucosa on postoperative day 3. The patient had a protracted, complicated hospital stay but required no further operative intervention. Subsequent colostomy reversal was done 8 months postoperatively, and the patient did well and has been discharged with normal gastr...
Source: The American Surgeon - April 3, 2024 Category: Surgery Authors: Vinila Baljepally Mary E McBride Lou Smith J Bracken Burns Source Type: research
The Effects of Pulmonary Risk Factors and Combination Thoracic Osseous Fractures on Mortality and Outcomes of Surgical Stabilization of Rib Fractures
DISCUSSION: Mortality from rib fractures with concomitant osseous thoracic fracture appears to be low. However, mortality is increased in patients with COPD regardless of rib fracture pattern. The number of patients who underwent SSRF was too small to make a statistical comparison.PMID:38569537 | DOI:10.1177/00031348241244627 (Source: The American Surgeon)
Source: The American Surgeon - April 3, 2024 Category: Surgery Authors: Jessica E Tullington Laura R Brown J Alford Flippin Chih-Yuan Fu Jasmine Patel Faran Bokhari Source Type: research
Implementing Resuscitative Endovascular Balloon Occlusion of the Aorta in a Rural Level II Trauma Center
This study's purpose is to develop a low-cost implementation of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in a rural level-2 trauma center. Literature and training to this point have involved urban level-1 trauma centers. This study examines the effectiveness of an in-house training program on trauma patient outcomes by comparing data from a matched historical control group of pre-REBOA patients (n = 32) to the REBOA intervention group (n = 17). The REBOA group had a similar ED to OR LOS (1.45 vs 1.79 hrs, P = .346) and similar ED LOS (1.36 vs 2.21 hrs, P = .01) as the historical control group. Alth...
Source: The American Surgeon - April 3, 2024 Category: Surgery Authors: Nathan Creel Jessica Mantooth Source Type: research
Efficacy of Landmark-Guided Transverse Abdominis Plane (LTAP) Block in Pediatric Patients Undergoing Laparoscopic Appendectomy
This study evaluates efficacy amongst pediatric patients undergoing landmark-guided transversus abdominis plane (LTAP) during laparoscopic appendectomy.METHODS: A retrospective chart review of patients, ages 0-18 years old, who underwent laparoscopic appendectomy for uncomplicated appendicitis at a single institution from January 2021 to December 2022 was conducted. Pearson's chi-square test or Fisher's exact test and Welch's t test were used to assess differences between the two cohorts for categorical and continuous variables, respectively. Results are statistically significant at P < .05.RESULTS: Of the 90 patients w...
Source: The American Surgeon - April 3, 2024 Category: Surgery Authors: Monique Motta Rachel Siretskiy Azalia Avila Shenae Samuels Tamar Levene Source Type: research
Interhospital Transfer for Emergency General Surgery: A Contemporary National Analysis
DISCUSSION: While incidence of interhospital transfer for EGS is increasing, transfer patients face greater morbidity and resource utilization. Novel interventions are needed to optimize patient selection and improve post-transfer outcomes.PMID:38570318 | DOI:10.1177/00031348241244642 (Source: The American Surgeon)
Source: The American Surgeon - April 3, 2024 Category: Surgery Authors: Sara Sakowitz Syed Shahyan Bakhtiyar Zihan Gao Saad Mallick Amulya Vadlakonda Troy Coaston Jeffrey Balian Nikhil Chervu Peyman Benharash Source Type: research
Time to Mobility Is Associated With Pulmonary Complications in Patients With Spine Fractures
CONCLUSION: Time to mobility is independently associated with pulmonary complications in patients with spine fractures.PMID:38566605 | DOI:10.1177/00031348241241702 (Source: The American Surgeon)
Source: The American Surgeon - April 3, 2024 Category: Surgery Authors: Michael L Jackson Samuel C Thomas Matthew R Joyner Mengjie Hu Yann-Leei Larry Lee Thomas Capasso Nathan M Polite Christopher M Kinnard Maryann I Mbaka Ashley Williams Jon D Simmons Charles C Butts Source Type: research
Rarely Seen Compartment Syndrome of the Shoulder and Back: Diagnosis and Management
We present a patient who fell off his bicycle and sustained cervical spine fractures causing near complete quadriplegia. He was found by the road over 12 hours later, so his creatine phosphokinase (CPK) was trended and serial examinations were performed. We identified tight deltoid, trapezius, and latissimus compartments and brought him to the operating room for fasciotomies. Although lab values and compartment pressures can be helpful, they should not guide treatment. It is important to consider atypical sites for CS and complete a head to toe physical examination. Patients should proceed to the operating room if clinical...
Source: The American Surgeon - April 3, 2024 Category: Surgery Authors: Jamesa Fabien Ciara Burgess Douglas Taylor Raven Hill Andreya Antoine Samantha Woolery Archibald Agyekum-Yamoah Courtney Meyer Stacy Dougherty Jonathan Nguyen Randi Smith Jason Sciarretta S Rob Todd Christine Castater Source Type: research
Vitamin C and Thiamin Deficiencies in Patients Undergoing Laparoscopic and Robotic Gastric Band Removal
Am Surg. 2024 Apr 3:31348241244630. doi: 10.1177/00031348241244630. Online ahead of print.ABSTRACTOutcomes after adjustable gastric banding (AGB) were unsatisfactory and many devices need to be removed for dysphagia. Vitamin C and thiamin deficiency are rare conditions in industrialized countries. Patients undergoing AGB removal (90% for dysphagia) from 2021 to 2023 (laparoscopic 15 and robotic 5) were tested for vitamin C and thiamin levels. Twenty patients (8 m/12 f median aged 56 (range 33.6-79.4) were included. BMI at AGB removal was 39.7 (range 24.4-50.1) kg/m2. Only 20% of patients had normal thiamin levels, 30% had ...
Source: The American Surgeon - April 3, 2024 Category: Surgery Authors: Hugo Jr Bonatti Cheryl Frushour Aaron George Source Type: research
The Role of Procalcitonin in Predicting Failure of Non-operative Management in Bowel Obstructions
This study examined the role of procalcitonin in predicting failure of non-operative management (NOM) in bowel obstructions. Patients with bowel obstructions at a single center from August 2022 to January 2023 were prospectively enrolled (n = 79). Lactic acid (LA) and procalcitonin were collected after surgical consultation. The primary outcome was success or failure of NOM. Univariate analysis, multivariable logistic regression, and performance measures of procalcitonin and LA in predicting bowel ischemia was performed. Of 79 patients included, 48 (61%) required operative intervention during index admission. There were no...
Source: The American Surgeon - April 3, 2024 Category: Surgery Authors: Kaylan N Gee Devin J Clegg Brett J Salomon Anthony Shaun Rowe Lindsay C McKnight Source Type: research
Outcomes of Simultaneous Versus Staged Resection for Stage IV Colorectal Cancer with Synchronous Liver Metastases
CONCLUSIONS: Practice patterns within Southern California KP hospitals favor minor colorectal and liver resections. However, there were no significant differences in demographics, treatment rates, or outcomes between simultaneous and staged resection. While not statistically significant, our findings of a 11.9% higher major liver resection rate and 7.5-month longer median disease-free survival in the staged resection group may benefit from further study with higher power datasets.PMID:38567700 | DOI:10.1177/00031348241244632 (Source: The American Surgeon)
Source: The American Surgeon - April 3, 2024 Category: Surgery Authors: Harry H Kim Nghiem H Nguyen Claire J Yang Michael S Tam Anna M Leung Vikram Attaluri Source Type: research
A Supportive Culture Maintains General Surgery Wellness
Am Surg. 2024 Apr 3:31348241241700. doi: 10.1177/00031348241241700. Online ahead of print.ABSTRACTSocial restrictions during the pandemic required creative solutions for incorporating interns into a demanding residency, building relationships, and fostering resiliency. We hypothesized that resident-driven initiatives focused on inclusion would overcome a lack of in-person events. An anonymous survey was administered to all surgery residents to assess burnout pre- and post-wellness interventions. Assessment scores were analyzed with Mann-U Whitney and Kruskal-Wallis tests. The surveys were completed by 71.6% (n = 53) and 48...
Source: The American Surgeon - April 3, 2024 Category: Surgery Authors: Kristen M Quinn Julie B Siegel Andrea M Abbott Source Type: research
Management of Extraperitoneal Bladder Injuries in Patients With Pelvic Fractures
CONCLUSIONS: Patients with EBI and pelvic fractures who underwent cystorrhaphy had more bladder leaks on follow-up imaging, although there was no difference in composite complications, when compared to those who underwent non-operative management.PMID:38568507 | DOI:10.1177/00031348241244641 (Source: The American Surgeon)
Source: The American Surgeon - April 3, 2024 Category: Surgery Authors: Virginia H Byars Saskya E Byerly Caroline T Dong Emily K Lenart Cory R Evans Andrew J Kerwin Dina M Filiberto Source Type: research
