Journal of Surgical Research最新文献_第9页

Evaluating the Association Between Social Vulnerability and Outcomes of Heart Transplantation in the United States 评估美国社会脆弱性与心脏移植结果之间的关联。

IF 1.8 3区医学 Q2 SURGERY

Journal of Surgical Research

Pub Date : 2024-10-04 DOI: 10.1016/j.jss.2024.09.012

Khaled Shorbaji MD, MPH, Brett Welch MBA, MHA, Arman Kilic MD

Introduction

The Social Vulnerability Index (SVI) is a tool that was developed by the Centers for Disease Control and Prevention to help identify communities that are at risk of harm from social, economic, or environmental factors. This study evaluates the association between SVI and outcomes of adult heart transplantation (HT) in the United States.

Methods

The United Network for Organ Sharing registry was used to identify all isolated adult (≥18 y) HT recipients and their home address zip codes between 2010 and 2021. Recipients were classified into three SVI risk groups: low risk (SVI: <0.33), intermediate risk (SVI: 0.33-0.65), and high risk (SVI: ≥0.66). Kaplan–Meier analysis was used to estimate recipient survival probability based on SVI risk. Multivariable Cox proportional hazard models were built to evaluate the association of SVI with 1- and 5-y mortality.

Results

A total of 22,400 recipients distributed over 9753 zip codes were included. Unadjusted 1-y survival rates in the three risk groups were as follows: low risk: 90.5%, intermediate risk: 91.1%, high risk 90.9%, and Log-rank P = 0.550 and 5-y survival rates were as follows: low risk: 80.8%, intermediate risk: 78.6%, high risk: 76.1%, and Log-rank P < 0.001. Compared to low-risk recipients, risk-adjusted 1-y mortality hazard ratio was 1.02 (0.92-1.14, P = 0.657) for intermediate risk and 1.09 (0.95-1.24, P = 0.222) for high-risk recipients. Risk-adjusted 5-y mortality hazard ratio was 1.07 (0.99-1.16, P = 0.095) for intermediate-risk recipients and 1.17 (1.06-1.28, P = 0.002) for high-risk recipients.

Conclusions

Social vulnerability is associated with HT outcomes. The Centers for Disease Control and Prevention SVI may be a useful tool in identifying at-risk geographic areas where targeted efforts may be prudent for reducing disparities in HT outcomes.

导言：社会脆弱性指数（SVI）是由美国疾病控制和预防中心开发的一种工具，用于帮助识别因社会、经济或环境因素而面临伤害风险的社区。本研究评估了 SVI 与美国成人心脏移植（HT）结果之间的关联：方法：使用器官共享联合网络登记册识别 2010 年至 2021 年间所有孤立的成人（≥18 岁）心脏移植受者及其家庭住址邮编。受者被分为三个 SVI 风险组：低风险组（SVI.A）、高风险组（SVI.B）和高风险组（SVI.C）：结果：共纳入了分布在 9753 个邮政编码中的 22,400 名受试者。三个风险组未经调整的 1 年生存率如下：低风险：90.5%，中度风险：91.1%，高度风险：90.9%，Log-rank P = 0.550；5 年生存率如下：低风险：80.8%，中度风险：78.6%，高度风险：76.1%，Log-rank P 结论：社会脆弱性与高血压结果相关：社会脆弱性与高血压结果相关。美国疾病控制和预防中心的 SVI 可能是一个有用的工具，可用于识别高风险地区，在这些地区开展有针对性的工作可能会有助于减少高血压预后的差异。

{"title":"Evaluating the Association Between Social Vulnerability and Outcomes of Heart Transplantation in the United States","authors":"Khaled Shorbaji MD, MPH, Brett Welch MBA, MHA, Arman Kilic MD","doi":"10.1016/j.jss.2024.09.012","DOIUrl":"10.1016/j.jss.2024.09.012","url":null,"abstract":"<div><h3>Introduction</h3><div>The Social Vulnerability Index (SVI) is a tool that was developed by the Centers for Disease Control and Prevention to help identify communities that are at risk of harm from social, economic, or environmental factors. This study evaluates the association between SVI and outcomes of adult heart transplantation (HT) in the United States.</div></div><div><h3>Methods</h3><div>The United Network for Organ Sharing registry was used to identify all isolated adult (≥18 y) HT recipients and their home address zip codes between 2010 and 2021. Recipients were classified into three SVI risk groups: low risk (SVI: <0.33), intermediate risk (SVI: 0.33-0.65), and high risk (SVI: ≥0.66). Kaplan–Meier analysis was used to estimate recipient survival probability based on SVI risk. Multivariable Cox proportional hazard models were built to evaluate the association of SVI with 1- and 5-y mortality.</div></div><div><h3>Results</h3><div>A total of 22,400 recipients distributed over 9753 zip codes were included. Unadjusted 1-y survival rates in the three risk groups were as follows: low risk: 90.5%, intermediate risk: 91.1%, high risk 90.9%, and Log-rank <em>P</em> = 0.550 and 5-y survival rates were as follows: low risk: 80.8%, intermediate risk: 78.6%, high risk: 76.1%, and Log-rank <em>P</em> < 0.001. Compared to low-risk recipients, risk-adjusted 1-y mortality hazard ratio was 1.02 (0.92-1.14, <em>P</em> = 0.657) for intermediate risk and 1.09 (0.95-1.24, <em>P</em> = 0.222) for high-risk recipients. Risk-adjusted 5-y mortality hazard ratio was 1.07 (0.99-1.16, <em>P</em> = 0.095) for intermediate-risk recipients and 1.17 (1.06-1.28, <em>P</em> = 0.002) for high-risk recipients.</div></div><div><h3>Conclusions</h3><div>Social vulnerability is associated with HT outcomes. The Centers for Disease Control and Prevention SVI may be a useful tool in identifying at-risk geographic areas where targeted efforts may be prudent for reducing disparities in HT outcomes.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Postoperative Wound Infection After Primary Closure in Pediatric Dog Bite Injuries 小儿被狗咬伤初次缝合后的术后伤口感染。

IF 1.8 3区医学 Q2 SURGERY

Journal of Surgical Research

Pub Date : 2024-10-04 DOI: 10.1016/j.jss.2024.09.007

Brielle Ochoa MD , R. Scott Eldredge MD , Megan Gilbert CPNP-AC , Benjamin Padilla MD , David M. Notrica MD , Christian Armstrong PharmD , Wassim Ballan MD , Justin Lee MD

Introduction

Guidelines recommend three to 5 d of antibiotic prophylaxis after dog bite injury, but variation exists in clinical practice after primary closure of wounds. The purpose of this study was to analyze antibiotic duration and incidence of infection during a study period in which an institutional protocol limiting postrepair antibiotics to a maximum of 3 d was implemented.

Methods

Dog bite injuries that underwent primary closure in patients ≤18 y were retrospectively identified from 2018 to 2022 at a level 1 pediatric trauma center. Demographic and clinical data were collected. Protocol compliance and short course of antibiotics were defined as ≤3 d of antibiotics. Multivariable regression analysis for variables associated with wound infection was performed.

Results

455 injuries were included for analysis. After protocol implementation, the mean antibiotic duration decreased from 6.8 to 4.4 d (P < 0.001). Postrepair follow-up data were available for 235 (51.6%) cases in the cohort. Multivariable logistic regression identified superficial wounds and anatomic injury location to be significantly associated with wound infection. Shorter antibiotic duration was not associated with increased risk of wound infection on regression analysis, and there was no difference in postoperative wound infection rate between short-course and long-course groups (7.5% versus 7.1%, P = 0.912).

Conclusions

Standardization of postoperative antibiotic duration was associated with a decrease antibiotic duration without an increase in the incidence of wound infections after closure of dog bite wounds. This study highlights the feasibility of multidisciplinary standardization of pediatric trauma care across specialties and the safety of minimizing antibiotic duration after pediatric dog bite repairs.

导言：指南建议在被狗咬伤后使用三到五天的抗生素进行预防，但在伤口初次闭合后的临床实践中存在差异。本研究的目的是分析在研究期间抗生素的使用时间和感染发生率，在此期间，医院实施了修复后抗生素最多使用 3 天的规定：方法：回顾性地确定了2018年至2022年在1级儿科创伤中心接受初次闭合术的18岁以下患者的狗咬伤情况。收集了人口统计学和临床数据。协议合规性和抗生素短疗程定义为使用抗生素≤3 d。对与伤口感染相关的变量进行了多变量回归分析：共有 455 例伤口纳入分析。协议实施后，平均抗生素使用时间从 6.8 天减少到 4.4 天（P 结论：术后抗生素使用时间的标准化有助于减少伤口感染：术后抗生素使用时间的标准化与狗咬伤伤口缝合后抗生素使用时间的缩短有关，但伤口感染的发生率并未增加。这项研究强调了跨专业小儿创伤护理多学科标准化的可行性，以及在小儿狗咬伤修复术后尽量缩短抗生素使用时间的安全性。

{"title":"Postoperative Wound Infection After Primary Closure in Pediatric Dog Bite Injuries","authors":"Brielle Ochoa MD , R. Scott Eldredge MD , Megan Gilbert CPNP-AC , Benjamin Padilla MD , David M. Notrica MD , Christian Armstrong PharmD , Wassim Ballan MD , Justin Lee MD","doi":"10.1016/j.jss.2024.09.007","DOIUrl":"10.1016/j.jss.2024.09.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Guidelines recommend three to 5 d of antibiotic prophylaxis after dog bite injury, but variation exists in clinical practice after primary closure of wounds. The purpose of this study was to analyze antibiotic duration and incidence of infection during a study period in which an institutional protocol limiting postrepair antibiotics to a maximum of 3 d was implemented.</div></div><div><h3>Methods</h3><div>Dog bite injuries that underwent primary closure in patients ≤18 y were retrospectively identified from 2018 to 2022 at a level 1 pediatric trauma center. Demographic and clinical data were collected. Protocol compliance and short course of antibiotics were defined as ≤3 d of antibiotics. Multivariable regression analysis for variables associated with wound infection was performed.</div></div><div><h3>Results</h3><div>455 injuries were included for analysis. After protocol implementation, the mean antibiotic duration decreased from 6.8 to 4.4 d (<em>P</em> < 0.001). Postrepair follow-up data were available for 235 (51.6%) cases in the cohort. Multivariable logistic regression identified superficial wounds and anatomic injury location to be significantly associated with wound infection. Shorter antibiotic duration was not associated with increased risk of wound infection on regression analysis, and there was no difference in postoperative wound infection rate between short-course and long-course groups (7.5% <em>versus</em> 7.1%, <em>P</em> = 0.912).</div></div><div><h3>Conclusions</h3><div>Standardization of postoperative antibiotic duration was associated with a decrease antibiotic duration without an increase in the incidence of wound infections after closure of dog bite wounds. This study highlights the feasibility of multidisciplinary standardization of pediatric trauma care across specialties and the safety of minimizing antibiotic duration after pediatric dog bite repairs.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Breaking Barriers: Ensuring Gender Neutral Care on Short Term Surgical Missions 打破障碍：确保短期手术任务中的性别中立护理。

IF 1.8 3区医学 Q2 SURGERY

Journal of Surgical Research

Pub Date : 2024-10-03 DOI: 10.1016/j.jss.2024.09.004

Julia Riccardi MD , Ryan Benson MD , Fatemeh Parvin-Nejad MD , Vennila Padmanaban MD , Samba Jalloh MD , Mawuli Gyakobo MD , Ziad Sifri MD

Introduction

Gender discrimination is prevalent worldwide in medical and surgical care. In the setting of short-term surgical missions (STSMs) conducted to address the global burden of surgical disease, patient selection raises ethical considerations regarding equitable distribution of limited clinical resources. The goal of this study was to examine if equitable distribution of operative care between male and female patients occurs in STSMs.

Methods

The International Surgical Health Initiative (ISHI) is a US based nonprofit, nongovernmental organization. Records from surgical missions to Ghana (2014-2023) and Sierra Leone (2013-2023) were analyzed to evaluate for gender equity in inguinal hernia repairs, the most common procedure performed. A control group was created from a literature review inclusive of all studies of inguinal hernia repairs that included over 500 patients and patient gender.

Results

The review of 26 studies, representing 3,239,043 patients, demonstrated a gender distribution of 13% female. In Sierra Leone 246 inguinal hernia repairs were performed between 2013 and 2023. 28 (11.4%) of the hernia repairs were in females, which was not significantly different from the control group (P = 0.45). In Ghana 150 inguinal hernia repairs were performed between 2014 and 2023. 12 (8%) of the hernia repairs were in females. This was not significantly different from the control group (P = 0.07).

Conclusions

This is the first study investigating the gender equity conducted within the context of humanitarian surgical outreach. Equitable patient selection is a paramount consideration in STSMs, particularly to address gender-related disparities in surgical care.

导言：在世界范围内，医疗和外科护理中普遍存在性别歧视。在为解决全球外科疾病负担而开展的短期外科任务（STSM）中，患者的选择引发了对有限临床资源公平分配的伦理考虑。本研究的目的是探讨在短期外科手术中，男性患者和女性患者的手术护理是否公平分配：国际外科健康倡议组织（ISHI）是一家总部设在美国的非营利性非政府组织。我们对加纳（2014-2023 年）和塞拉利昂（2013-2023 年）的手术任务记录进行了分析，以评估腹股沟疝修补术（最常见的手术）中的性别平等情况。对照组是通过文献综述创建的，包括所有关于腹股沟疝修补术的研究，其中包括 500 多名患者和患者性别：结果：对代表 3,239,043 名患者的 26 项研究进行了审查，结果显示女性患者占 13%。2013年至2023年期间，塞拉利昂共进行了246例腹股沟疝修补术。其中28例（11.4%）为女性，与对照组无显著差异（P = 0.45）。加纳在2014年至2023年间进行了150例腹股沟疝修补术。其中 12 例（8%）为女性。这与对照组无明显差异（P = 0.07）：这是第一项在人道主义外科外展活动中进行的性别平等调查研究。公平选择患者是 STSMs 的首要考虑因素，尤其是为了解决外科护理中与性别相关的差异。

{"title":"Breaking Barriers: Ensuring Gender Neutral Care on Short Term Surgical Missions","authors":"Julia Riccardi MD , Ryan Benson MD , Fatemeh Parvin-Nejad MD , Vennila Padmanaban MD , Samba Jalloh MD , Mawuli Gyakobo MD , Ziad Sifri MD","doi":"10.1016/j.jss.2024.09.004","DOIUrl":"10.1016/j.jss.2024.09.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Gender discrimination is prevalent worldwide in medical and surgical care. In the setting of short-term surgical missions (STSMs) conducted to address the global burden of surgical disease, patient selection raises ethical considerations regarding equitable distribution of limited clinical resources. The goal of this study was to examine if equitable distribution of operative care between male and female patients occurs in STSMs.</div></div><div><h3>Methods</h3><div>The International Surgical Health Initiative (ISHI) is a US based nonprofit, nongovernmental organization. Records from surgical missions to Ghana (2014-2023) and Sierra Leone (2013-2023) were analyzed to evaluate for gender equity in inguinal hernia repairs, the most common procedure performed. A control group was created from a literature review inclusive of all studies of inguinal hernia repairs that included over 500 patients and patient gender.</div></div><div><h3>Results</h3><div>The review of 26 studies, representing 3,239,043 patients, demonstrated a gender distribution of 13% female. In Sierra Leone 246 inguinal hernia repairs were performed between 2013 and 2023. 28 (11.4%) of the hernia repairs were in females, which was not significantly different from the control group (<em>P</em> = 0.45). In Ghana 150 inguinal hernia repairs were performed between 2014 and 2023. 12 (8%) of the hernia repairs were in females. This was not significantly different from the control group (<em>P</em> = 0.07).</div></div><div><h3>Conclusions</h3><div>This is the first study investigating the gender equity conducted within the context of humanitarian surgical outreach. Equitable patient selection is a paramount consideration in STSMs, particularly to address gender-related disparities in surgical care.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cover 1: Update 封面 1：更新

IF 1.8 3区医学 Q2 SURGERY

Journal of Surgical Research

Pub Date : 2024-10-01 DOI: 10.1016/S0022-4804(24)00619-X

引用次数: 0

Wound Healing and Scar Patterning After Addition of Autologous Skin Cell Suspension to Meshed Grafts. 在网状移植物中加入自体皮肤细胞悬浮液后的伤口愈合和疤痕形态。

IF 1.8 3区医学 Q2 SURGERY

Journal of Surgical Research

Pub Date : 2024-10-01 Epub Date: 2024-09-13 DOI: 10.1016/j.jss.2024.08.006

Monica L Collins, Dillon Williams, Brooke E Pierson, Cameron S D'Orio, Mary A Oliver, Lauren T Moffatt, Jeffrey W Shupp, Taryn E Travis, Bonnie C Carney

Introduction: A common treatment for large deep-to-full-thickness burns is excision and grafting with a widely meshed split-thickness skin graft (mSTSG). Due to the differential healing of the interstices and adhered split-thickness skin graft, wound patterning and delayed wound healing are common outcomes of this treatment. Delayed healing may increase infection rates and wound care requirements, while wound patterning may be psychologically and aesthetically consequential for patients. Autologous skin cell suspension (ASCS) can be used to "over spray" a meshed autograft. It was hypothesized that the use of ASCS combined with mSTSG would increase the rate of wound healing and decrease patterning in healed burn wounds.

Methods: Full-thickness burns or excisional wounds (n = 8 each) were created in red Duroc pigs and received 4:1 mSTSGs after wound bed preparation. Half of the wounds received ASCS and half did not at the time of grafting. Percent re-epithelialization, patterning, rete ridge ratio, cellularity, dermal and epidermal thickness, immunofluorescent S100β staining, and melanin index were assessed for each scar.

Results: Wounds that received ASCS exhibited increased rates of re-epithelialization (burn +ACSC versus burn-ASCS; day 3 (53.9 ± 3.1 versus 34.3 ± 3.3, P = 0.009): day 5 (68.1 ± 1.6 versus 40.8 ± 3.2, P < 0.001)). Excision +ASCS versus excision-ASCS; day 7 (98.1 ± 1.2 versus 86.4 ± 2.0, day 7 P = 0.022) compared to wounds not treated with ASCS. There was no difference in rete ridge ratio, cellularity, dermal thickness, epidermal thickness, S100β staining, melanin index, or patterning was measured between wounds that received ASCS and those that did not.

Conclusions: The addition of ASCS to 4:1 mSTSGs leads to increased rate of wound healing but does not impact the degree of patterning in this model, suggesting that ASCS application likely robustly transfers keratinocytes but not functioning melanocytes at acute timepoints.

导言：大面积深层至全层烧伤的常见治疗方法是切除并用大网膜分层植皮（mSTSG）。由于间隙和粘连的分层厚皮移植的愈合情况不同，这种治疗方法常见的结果是伤口花纹和伤口延迟愈合。延迟愈合可能会增加感染率和伤口护理要求，而伤口花纹可能会对患者的心理和美观造成影响。自体皮肤细胞悬浮液（ASCS）可用于 "过度喷洒 "网状自体移植物。我们假设 ASCS 与 mSTSG 结合使用可提高伤口愈合率，减少愈合烧伤创面的花纹：方法：在红色杜洛克猪身上创建全厚烧伤或切除伤口（各为 8 个），并在伤口床准备后接受 4:1 mSTSG。一半的伤口在移植时接受了 ASCS，一半没有。对每个疤痕的再上皮化百分比、形态、齿嵴比率、细胞度、真皮和表皮厚度、免疫荧光 S100β 染色和黑色素指数进行了评估：结果：接受 ASCS 治疗的创面再上皮率增加（烧伤 +ACSC 与烧伤-ASCS 相比；第 3 天（53.9 ± 3.1 与 34.3 ± 3.3，P = 0.009）：第 5 天（68.1 ± 1.6 与 40.8 ± 3.2，P 结论：ASCS 与烧伤-ASCS 相比，创面再上皮率增加：在 4:1 mSTSGs 中添加 ASCS 可提高伤口愈合率，但不会影响该模型的图案化程度。

{"title":"Wound Healing and Scar Patterning After Addition of Autologous Skin Cell Suspension to Meshed Grafts.","authors":"Monica L Collins, Dillon Williams, Brooke E Pierson, Cameron S D'Orio, Mary A Oliver, Lauren T Moffatt, Jeffrey W Shupp, Taryn E Travis, Bonnie C Carney","doi":"10.1016/j.jss.2024.08.006","DOIUrl":"10.1016/j.jss.2024.08.006","url":null,"abstract":"<p><strong>Introduction: </strong>A common treatment for large deep-to-full-thickness burns is excision and grafting with a widely meshed split-thickness skin graft (mSTSG). Due to the differential healing of the interstices and adhered split-thickness skin graft, wound patterning and delayed wound healing are common outcomes of this treatment. Delayed healing may increase infection rates and wound care requirements, while wound patterning may be psychologically and aesthetically consequential for patients. Autologous skin cell suspension (ASCS) can be used to \"over spray\" a meshed autograft. It was hypothesized that the use of ASCS combined with mSTSG would increase the rate of wound healing and decrease patterning in healed burn wounds.</p><p><strong>Methods: </strong>Full-thickness burns or excisional wounds (n = 8 each) were created in red Duroc pigs and received 4:1 mSTSGs after wound bed preparation. Half of the wounds received ASCS and half did not at the time of grafting. Percent re-epithelialization, patterning, rete ridge ratio, cellularity, dermal and epidermal thickness, immunofluorescent S100β staining, and melanin index were assessed for each scar.</p><p><strong>Results: </strong>Wounds that received ASCS exhibited increased rates of re-epithelialization (burn +ACSC versus burn-ASCS; day 3 (53.9 ± 3.1 versus 34.3 ± 3.3, P = 0.009): day 5 (68.1 ± 1.6 versus 40.8 ± 3.2, P < 0.001)). Excision +ASCS versus excision-ASCS; day 7 (98.1 ± 1.2 versus 86.4 ± 2.0, day 7 P = 0.022) compared to wounds not treated with ASCS. There was no difference in rete ridge ratio, cellularity, dermal thickness, epidermal thickness, S100β staining, melanin index, or patterning was measured between wounds that received ASCS and those that did not.</p><p><strong>Conclusions: </strong>The addition of ASCS to 4:1 mSTSGs leads to increased rate of wound healing but does not impact the degree of patterning in this model, suggesting that ASCS application likely robustly transfers keratinocytes but not functioning melanocytes at acute timepoints.</p>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Analyzing the Social Vulnerability Index With Metabolic Surgery 分析代谢外科手术的社会脆弱性指数。

IF 1.8 3区医学 Q2 SURGERY

Journal of Surgical Research

Pub Date : 2024-10-01 DOI: 10.1016/j.jss.2024.09.002

Samuel K. Mathai BA , Denise M. Garofalo MD , Quintin W. Myers PhD , Charlotte H. Heron MD , Victoria S. Clair BS , India Bonner BS , Adam R. Dyas MD , Catherine G. Velopulos MD, FACS , Kweku Hazel MD

Introduction

The social vulnerability index (SVI) is a census tract-level population-based measure generated from 16 socioeconomic and demographic variables on a scale from 1 (least) to 100 (most) vulnerable. This study has three objectives as follows: 1) to analyze multiple ways of utilizing SVI, 2) compare SVI as a group measure of marginalization to individual markers, and 3) to understand how SVI is associated with choice of surgery in metabolic surgery.

Methods

We retrospectively identified adults undergoing Roux-en-Y gastric bypass and gastric sleeve in 2013-2018 National Surgical Quality Improvement Program data from a single academic center. High SVI was defined as >75^th percentile. Low SVI was coded as <75^th percentile in measure 1 and < 25^th percentile in measure 2. Chi-square and Mann–Whitney U tests were utilized for categorical and continuous variables, respectively. Multivariable regression models were performed comparing SVI to marginalized status as a predictor for type of metabolic surgery.

Results

We identified 436 patients undergoing metabolic surgery, with a low overall morbidity (6.1%). Complication and readmission rates were similar across comparator groups. The logistic regression models had similar area under the curve, supporting SVI as a proxy for individual measures of marginalization.

Conclusions

SVI performed as well as marginalized status in predicting preoperative risk. This suggests the validity of using SVI to identify high risk patients. By providing a single, quantitative score encompassing many social determinants of health, SVI is a useful tool in identifying patients facing the greatest health disparities.

导言：社会脆弱程度指数（SVI）是一个基于人口普查区的衡量标准，由 16 个社会经济和人口变量组成，脆弱程度从 1（最不脆弱）到 100（最脆弱）不等。本研究有以下三个目标1）分析利用 SVI 的多种方法；2）将 SVI 作为边缘化的群体衡量标准与个体标记进行比较；3）了解 SVI 如何与代谢外科手术的选择相关联：我们回顾性地从一个学术中心 2013-2018 年国家外科质量改进计划的数据中识别了接受 Roux-en-Y 胃旁路术和胃袖状手术的成人。高 SVI 被定义为大于第 75 百分位数。低 SVI 在衡量标准 1 中编码为第 th 百分位数，在衡量标准 2 中编码为第 th 百分位数。对分类变量和连续变量分别采用卡方检验（Chi-square）和曼惠特尼U检验（Mann-Whitney U）。将 SVI 与边缘化状态作为代谢手术类型的预测因素进行了多变量回归模型比较：我们发现有 436 名患者接受了代谢手术，总发病率较低（6.1%）。各对比组的并发症和再入院率相似。逻辑回归模型的曲线下面积相似，支持将 SVI 作为边缘化个体措施的替代指标：结论：在预测术前风险方面，SVI 和边缘化状态一样有效。结论：在预测术前风险方面，SVI 的表现与边缘化状况相当，这表明使用 SVI 识别高风险患者是有效的。SVI 提供了一个单一的量化评分，涵盖了许多健康的社会决定因素，是识别面临最大健康差异的患者的有用工具。

{"title":"Analyzing the Social Vulnerability Index With Metabolic Surgery","authors":"Samuel K. Mathai BA , Denise M. Garofalo MD , Quintin W. Myers PhD , Charlotte H. Heron MD , Victoria S. Clair BS , India Bonner BS , Adam R. Dyas MD , Catherine G. Velopulos MD, FACS , Kweku Hazel MD","doi":"10.1016/j.jss.2024.09.002","DOIUrl":"10.1016/j.jss.2024.09.002","url":null,"abstract":"<div><h3>Introduction</h3><div>The social vulnerability index (SVI) is a census tract-level population-based measure generated from 16 socioeconomic and demographic variables on a scale from 1 (least) to 100 (most) vulnerable. This study has three objectives as follows: 1) to analyze multiple ways of utilizing SVI, 2) compare SVI as a group measure of marginalization to individual markers, and 3) to understand how SVI is associated with choice of surgery in metabolic surgery.</div></div><div><h3>Methods</h3><div>We retrospectively identified adults undergoing Roux-en-Y gastric bypass and gastric sleeve in 2013-2018 National Surgical Quality Improvement Program data from a single academic center. High SVI was defined as >75<sup>th</sup> percentile. Low SVI was coded as <75<sup>th</sup> percentile in measure 1 and < 25<sup>th</sup> percentile in measure 2. Chi-square and Mann–Whitney U tests were utilized for categorical and continuous variables, respectively. Multivariable regression models were performed comparing SVI to marginalized status as a predictor for type of metabolic surgery.</div></div><div><h3>Results</h3><div>We identified 436 patients undergoing metabolic surgery, with a low overall morbidity (6.1%). Complication and readmission rates were similar across comparator groups. The logistic regression models had similar area under the curve, supporting SVI as a proxy for individual measures of marginalization.</div></div><div><h3>Conclusions</h3><div>SVI performed as well as marginalized status in predicting preoperative risk. This suggests the validity of using SVI to identify high risk patients. By providing a single, quantitative score encompassing many social determinants of health, SVI is a useful tool in identifying patients facing the greatest health disparities.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Are We Enhancing Recovery After Neonatal Surgery? Assessment of Enhanced Recovery After Surgery Principles for Ostomy Takedown 我们是否加强了新生儿手术后的恢复？评估手术后促进恢复的原则：造口取下。

IF 1.8 3区医学 Q2 SURGERY

Journal of Surgical Research

Pub Date : 2024-10-01 DOI: 10.1016/j.jss.2024.07.092

Shaige L. Werth BS , Nutan B. Hebballi BDS, MPH, PhD , Rachel C. Bordelon MD , Eric W. Reynolds MD , Kuojen Tsao MD , Allison L. Speer MD

Introduction

Enhanced Recovery After Surgery (ERAS) guidelines in adults have demonstrated reduced complications, length of stay, and cost. However, neonatal ERAS studies are limited and translation of adult ERAS guidelines to neonates is challenging. Furthermore, the knowledge, perception, and practice of neonatal ERAS guidelines is largely unknown. Our aim is to address this practice gap by determining current practice of the 2020 neonatal intestinal surgery ERAS guidelines at our institution and evaluating postoperative outcomes.

Methods

A retrospective study was conducted of patients <1 y who underwent elective ostomy takedown at a single-center tertiary children's hospital between 2013 and 2023. A 13-point ERAS score was developed. Demographics, clinical course, pain management, nutrition, ERAS scores, and outcomes were analyzed using descriptive statistics, logistic and negative binomial regression.

Results

One hundred eighty-six patients met the inclusion criteria. At surgery, the median age was 124 d (interquartile range [IQR] 81-220) and median weight was 4360 g (IQR 2920-7200). The median ERAS score was 6 (IQR 5-7). The highest scores were for appropriate (97.9%) and timely (91.9%) prophylactic antibiotics, and the lowest for preventing intraoperative hypothermia (14.5%), limiting opioids (9.1%), and early enteral feeding postoperatively (24.7%). Surgical site infection occurred in 14.5% and median length of stay was 28 (IQR 5-127) d.

Conclusions

Our institution's current practice of the 2020 neonatal intestinal surgery ERAS guidelines was poor. We identified opportunities for improvement including postoperative antibiotic administration, prevention of intraoperative hypothermia, nutrition, and pain management. Future studies will focus on implementation of neonatal ERAS guidelines at our institution and evaluation of adherence and outcomes.

导言：成人术后加强恢复（ERAS）指南已证明可减少并发症、住院时间和费用。然而，新生儿ERAS研究有限，将成人ERAS指南应用于新生儿具有挑战性。此外，新生儿ERAS指南的知识、认知和实践在很大程度上还不为人所知。我们的目的是通过确定本院目前对2020年新生儿肠道手术ERAS指南的实践情况并评估术后结果来弥补这一实践空白：方法：对患者进行回顾性研究：186例患者符合纳入标准。手术时的中位年龄为124天（四分位距[IQR] 81-220），中位体重为4360克（IQR 2920-7200）。ERAS 评分中位数为 6（IQR 5-7）。得分最高的是适当（97.9%）和及时（91.9%）的预防性抗生素，得分最低的是防止术中低体温（14.5%）、限制阿片类药物（9.1%）和术后早期肠内喂养（24.7%）。手术部位感染发生率为 14.5%，中位住院时间为 28 天（IQR 5-127 天）：结论：我院目前对2020年新生儿肠道手术ERAS指南的执行情况不佳。我们发现了需要改进的地方，包括术后抗生素管理、术中低体温的预防、营养和疼痛管理。未来的研究将重点关注新生儿ERAS指南在我院的实施情况，并对遵守情况和结果进行评估。

{"title":"Are We Enhancing Recovery After Neonatal Surgery? Assessment of Enhanced Recovery After Surgery Principles for Ostomy Takedown","authors":"Shaige L. Werth BS , Nutan B. Hebballi BDS, MPH, PhD , Rachel C. Bordelon MD , Eric W. Reynolds MD , Kuojen Tsao MD , Allison L. Speer MD","doi":"10.1016/j.jss.2024.07.092","DOIUrl":"10.1016/j.jss.2024.07.092","url":null,"abstract":"<div><h3>Introduction</h3><div>Enhanced Recovery After Surgery (ERAS) guidelines in adults have demonstrated reduced complications, length of stay, and cost. However, neonatal ERAS studies are limited and translation of adult ERAS guidelines to neonates is challenging. Furthermore, the knowledge, perception, and practice of neonatal ERAS guidelines is largely unknown. Our aim is to address this practice gap by determining current practice of the 2020 neonatal intestinal surgery ERAS guidelines at our institution and evaluating postoperative outcomes.</div></div><div><h3>Methods</h3><div>A retrospective study was conducted of patients <1 y who underwent elective ostomy takedown at a single-center tertiary children's hospital between 2013 and 2023. A 13-point ERAS score was developed. Demographics, clinical course, pain management, nutrition, ERAS scores, and outcomes were analyzed using descriptive statistics, logistic and negative binomial regression.</div></div><div><h3>Results</h3><div>One hundred eighty-six patients met the inclusion criteria. At surgery, the median age was 124 d (interquartile range [IQR] 81-220) and median weight was 4360 g (IQR 2920-7200). The median ERAS score was 6 (IQR 5-7). The highest scores were for appropriate (97.9%) and timely (91.9%) prophylactic antibiotics, and the lowest for preventing intraoperative hypothermia (14.5%), limiting opioids (9.1%), and early enteral feeding postoperatively (24.7%). Surgical site infection occurred in 14.5% and median length of stay was 28 (IQR 5-127) d.</div></div><div><h3>Conclusions</h3><div>Our institution's current practice of the 2020 neonatal intestinal surgery ERAS guidelines was poor. We identified opportunities for improvement including postoperative antibiotic administration, prevention of intraoperative hypothermia, nutrition, and pain management. Future studies will focus on implementation of neonatal ERAS guidelines at our institution and evaluation of adherence and outcomes.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Story of Dr. Asa G. Yancey and Surgical Innovation in the Face of Discrimination Asa G. Yancey 博士的故事和面对歧视的外科创新。

IF 1.8 3区医学 Q2 SURGERY

Journal of Surgical Research

Pub Date : 2024-10-01 DOI: 10.1016/j.jss.2024.08.002

Rodrigo G. Gerardo MD , Naomi-Liza Denning MD, PhD , Carolyn L. Yancey MD , Asa G. Yancey Jr. MD , Arthur H. Yancey II MD, MPH , Erika A. Newman MD , Ankush Gosain MD, PhD, MBA , Henri R. Ford MD , Jason S. Frischer MD , Marc A. Levitt MD

Introduction

Dr. Asa G. Yancey published a surgical technique describing a pull – through of normal colon through a cuff of aganglionic colon to treat Hirschsprung disease in 1952, 12 y before Dr. Franco Soave whose name is attached to the procedure. Yancey and his pioneering operation went unrecognized for over half a century because of discriminatory segregation in the publishing practices of academic medicine dating back to the 1950s.

Materials and methods

We performed a literature review on the surgical therapies for Hirschsprung disease. This history was supplemented with first-hand accounts provided by Yancey's children. Further information by leaders of the American Pediatric Surgical Association Hirschsprung interest group regarding the future of surgical nomenclature for the endorectal pull-through procedure was acquired through interviews.

Results

A review of the literature revealed that Yancey's description of the pull-through technique for Hirschsprung disease was published 12 y prior to Soave's publication and yet, Yancey received little to no recognition for his work. Yancey's children describe a surgeon who was persistent in his endeavor to create a more inclusive field of academic surgery as well as a man who prioritized his family and the education of future surgeons. Conversations with the American Pediatric Surgical Association Hirschsprung interest group suggest active changes to give posthumous credit to Yancey, including renaming the procedure to the Yancey – Soave pull-through technique.

Conclusions

Here, we provide a historical review of Yancey's career as well as insights on the man behind the surgery and how he persevered in academic surgery despite experiencing discrimination during the civil rights movement.

简介Asa G. Yancey 博士于 1952 年发表了一项外科技术，描述了通过无痛结肠袖带拉通正常结肠以治疗赫氏病的方法，比与该手术齐名的 Franco Soave 博士早 12 年。由于早在 20 世纪 50 年代学术医学出版实践中的歧视性隔离，Yancey 和他的开创性手术在长达半个多世纪的时间里一直不为人知：我们查阅了有关赫氏胃肠病手术疗法的文献。杨斯的孩子们提供的第一手资料对这段历史进行了补充。此外，我们还通过访谈获得了美国小儿外科协会赫氏胃肠病兴趣小组负责人提供的有关肛门直肠内拉通术未来手术术语的更多信息：结果：文献回顾显示，Yancey关于Hirschsprung病拉通术的描述是在Soave发表之前12年发表的，然而Yancey的工作几乎没有得到任何认可。扬西的子女描述说，扬西是一位坚持不懈地努力创造一个更具包容性的外科学术领域的外科医生，同时也是一位将家庭和未来外科医生的教育放在首位的人。与美国小儿外科协会赫氏脓肿兴趣小组的对话表明，他们正在积极改变，以追记Yancey的功劳，包括将手术重新命名为Yancey-Soave拉通技术：在此，我们对杨斯的职业生涯进行了历史回顾，并对手术背后的人物以及他如何在民权运动期间遭受歧视的情况下仍坚持学术外科工作进行了深入探讨。

{"title":"The Story of Dr. Asa G. Yancey and Surgical Innovation in the Face of Discrimination","authors":"Rodrigo G. Gerardo MD , Naomi-Liza Denning MD, PhD , Carolyn L. Yancey MD , Asa G. Yancey Jr. MD , Arthur H. Yancey II MD, MPH , Erika A. Newman MD , Ankush Gosain MD, PhD, MBA , Henri R. Ford MD , Jason S. Frischer MD , Marc A. Levitt MD","doi":"10.1016/j.jss.2024.08.002","DOIUrl":"10.1016/j.jss.2024.08.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Dr. Asa G. Yancey published a surgical technique describing a pull – through of normal colon through a cuff of aganglionic colon to treat Hirschsprung disease in 1952, 12 y before Dr. Franco Soave whose name is attached to the procedure. Yancey and his pioneering operation went unrecognized for over half a century because of discriminatory segregation in the publishing practices of academic medicine dating back to the 1950s.</div></div><div><h3>Materials and methods</h3><div>We performed a literature review on the surgical therapies for Hirschsprung disease. This history was supplemented with first-hand accounts provided by Yancey's children. Further information by leaders of the American Pediatric Surgical Association Hirschsprung interest group regarding the future of surgical nomenclature for the endorectal pull-through procedure was acquired through interviews.</div></div><div><h3>Results</h3><div>A review of the literature revealed that Yancey's description of the pull-through technique for Hirschsprung disease was published 12 y prior to Soave's publication and yet, Yancey received little to no recognition for his work. Yancey's children describe a surgeon who was persistent in his endeavor to create a more inclusive field of academic surgery as well as a man who prioritized his family and the education of future surgeons. Conversations with the American Pediatric Surgical Association Hirschsprung interest group suggest active changes to give posthumous credit to Yancey, including renaming the procedure to the Yancey – Soave pull-through technique.</div></div><div><h3>Conclusions</h3><div>Here, we provide a historical review of Yancey's career as well as insights on the man behind the surgery and how he persevered in academic surgery despite experiencing discrimination during the civil rights movement.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Letter Regarding: Modern Trends for Primary Hyperparathyroidism: Intervening on Less Biochemically Severe Disease. 有关信件原发性甲状旁腺功能亢进症的现代趋势：干预生化程度较轻的疾病

IF 1.8 3区医学 Q2 SURGERY

Journal of Surgical Research

Pub Date : 2024-10-01 Epub Date: 2024-06-25 DOI: 10.1016/j.jss.2024.04.039

Elena Castellano, Roberto Attanasio, Giorgio Borretta

引用次数: 0

Access to Laparoscopic Pediatric Surgery: Do Ethnic and Racial Disparities Exist? 腹腔镜小儿外科手术的可及性：是否存在民族和种族差异？

IF 1.8 3区医学 Q2 SURGERY

Journal of Surgical Research

Pub Date : 2024-10-01 DOI: 10.1016/j.jss.2024.08.009

Charbel Chidiac MD, Paul Phan BS, Daniel S. Rhee MD, MPH, Alejandro V. Garcia MD

Introduction

Disparate access to laparoscopic surgery may contribute to poorer health outcomes among racial and ethnic minorities, especially among children. We investigated whether racial and ethnic disparities in laparoscopic procedures existed among four common surgical operations in the pediatric population in the United States.

Methods

Using the American College of Surgeons National Surgical Quality Improvement Program–Pediatrics, we conducted a retrospective review of pediatric patients, aged less than 18 y old, undergoing appendectomy, fundoplication, cholecystectomy, and colectomy from 2012 to 2021. To compare the surgical approach (laparoscopy or open), a propensity score matching algorithm was used to compare laparoscopic and open procedures between non-Hispanic Black with non-Hispanic White children and Hispanic with non-Hispanic White children.

Results

143,205, 9,907, 4,581, and 26,064 children underwent appendectomy, fundoplication, colectomy, and cholecystectomy, respectively. After propensity score matching, non-Hispanic Black children undergoing appendectomy were found to be treated laparoscopically less than non-Hispanic White children (93.5% versus 94.4%, P = 0.007). With fundoplication, Hispanic children were more likely to be treated laparoscopically than White ones (86.7% versus 80.9%, P < 0.0001). There were no statistically significant differences between Black or Hispanic children and White children in rates of laparoscopy for other procedures.

Conclusions

Though some racial and ethnic disparities exist with appendectomies and fundoplications, there is limited evidence to indicate that widespread inequities among common laparoscopic procedures exist in the pediatric population.

导言：接受腹腔镜手术的机会不均等可能会导致少数种族和少数族裔的健康状况较差，尤其是儿童。我们调查了美国儿科四种常见外科手术中是否存在腹腔镜手术的种族和民族差异：利用美国外科学院国家外科质量改进计划-儿科，我们对2012年至2021年期间接受阑尾切除术、胃底折叠术、胆囊切除术和结肠切除术的18岁以下儿科患者进行了回顾性研究。为了比较手术方法（腹腔镜或开腹），使用倾向得分匹配算法比较了非西班牙裔黑人儿童和非西班牙裔白人儿童以及西班牙裔儿童和非西班牙裔白人儿童的腹腔镜手术和开腹手术：接受阑尾切除术、胃底折叠术、结肠切除术和胆囊切除术的儿童人数分别为 143,205 人、9,907 人、4,581 人和 26,064 人。经过倾向得分匹配后发现，接受阑尾切除术的非西班牙裔黑人儿童接受腹腔镜治疗的比例低于非西班牙裔白人儿童（93.5% 对 94.4%，P = 0.007）。在胃底折叠术中，西语裔儿童比白人儿童更有可能接受腹腔镜治疗（86.7% 对 80.9%，P=0.007）：虽然阑尾切除术和胃底折叠术存在一些种族和民族差异，但只有有限的证据表明在儿科常见腹腔镜手术中存在广泛的不平等。

{"title":"Access to Laparoscopic Pediatric Surgery: Do Ethnic and Racial Disparities Exist?","authors":"Charbel Chidiac MD, Paul Phan BS, Daniel S. Rhee MD, MPH, Alejandro V. Garcia MD","doi":"10.1016/j.jss.2024.08.009","DOIUrl":"10.1016/j.jss.2024.08.009","url":null,"abstract":"<div><h3>Introduction</h3><div>Disparate access to laparoscopic surgery may contribute to poorer health outcomes among racial and ethnic minorities, especially among children. We investigated whether racial and ethnic disparities in laparoscopic procedures existed among four common surgical operations in the pediatric population in the United States.</div></div><div><h3>Methods</h3><div>Using the American College of Surgeons National Surgical Quality Improvement Program–Pediatrics, we conducted a retrospective review of pediatric patients, aged less than 18 y old, undergoing appendectomy, fundoplication, cholecystectomy, and colectomy from 2012 to 2021. To compare the surgical approach (laparoscopy or open), a propensity score matching algorithm was used to compare laparoscopic and open procedures between non-Hispanic Black with non-Hispanic White children and Hispanic with non-Hispanic White children.</div></div><div><h3>Results</h3><div>143,205, 9,907, 4,581, and 26,064 children underwent appendectomy, fundoplication, colectomy, and cholecystectomy, respectively. After propensity score matching, non-Hispanic Black children undergoing appendectomy were found to be treated laparoscopically less than non-Hispanic White children (93.5% <em>versus</em> 94.4%, <em>P</em> = 0.007). With fundoplication, Hispanic children were more likely to be treated laparoscopically than White ones (86.7% <em>versus</em> 80.9%, <em>P</em> < 0.0001). There were no statistically significant differences between Black or Hispanic children and White children in rates of laparoscopy for other procedures.</div></div><div><h3>Conclusions</h3><div>Though some racial and ethnic disparities exist with appendectomies and fundoplications, there is limited evidence to indicate that widespread inequities among common laparoscopic procedures exist in the pediatric population.</div></div>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142093580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0