Kayla K. Umemoto, Shahini Ananth, Anthony Ma, Anvay Ullal, P. Ramdass, P. Lo, D. Vyas
INTRODUCTION Laparoscopic cholecystectomy (LC) for gangrenous gallbladders (GGBs) can be challenging and represent a significant number of LC cases, necessitating more efficacious surgical techniques. Currently, the standard treatment for GGBs is blunt dissection which can have high iatrogenic complication rates. To our knowledge, this is the first large retrospective study conducted on the novel application of hydrodissection (HD) in LCs for GGBs. METHODS In this retrospective study of 386 LCs, data were collected for patient demographics, medical comorbidities, operating time (OT), anesthesia time (AT), length of stay (LOS), estimated blood loss, conversion to open procedures, 30-day readmissions, and mortality. Patients were categorized into four groups: (1) Vyas employing HD for GGBs (VHG), (2) non-Vyas group of five surgeons not employing HD for GGBs (NVG), (3) Vyas treating non-GGBs, and (4) non-Vyas group of five surgeons treating non-GGBs. Control groups were age-matched and sex-matched. Statistical analysis used descriptive statistics, Mann-Whitney U testing, and chi-squared testing (α = 0.05). RESULTS This study demonstrated significantly decreased (P < 0.05) OT (P = 0.001), AT (P < 0.001), LOS (P = 0.015), and conversion to open procedures (P = 0.047) between the VHG and NVG groups, with HD reducing OT by 35.5% compared to blunt dissection. This study did not demonstrate significantly decreased (P > 0.05) estimated blood loss (P = 0.185) and 30-day readmissions (P = 0.531) between the VHG and NVG groups, but they were trending toward significant. There were no mortalities in this study. CONCLUSIONS HD is associated with improved surgical outcomes of LCs for GGBs demonstrated by reduced OT, AT, LOS, and conversion to open procedures. Further multi-institutional studies are needed to validate HD implementation and further dissemination.
{"title":"Novel Application of Hydrodissection in Laparoscopic Cholecystectomy for Gangrenous Gallbladders.","authors":"Kayla K. Umemoto, Shahini Ananth, Anthony Ma, Anvay Ullal, P. Ramdass, P. Lo, D. Vyas","doi":"10.2139/ssrn.4065017","DOIUrl":"https://doi.org/10.2139/ssrn.4065017","url":null,"abstract":"INTRODUCTION\u0000Laparoscopic cholecystectomy (LC) for gangrenous gallbladders (GGBs) can be challenging and represent a significant number of LC cases, necessitating more efficacious surgical techniques. Currently, the standard treatment for GGBs is blunt dissection which can have high iatrogenic complication rates. To our knowledge, this is the first large retrospective study conducted on the novel application of hydrodissection (HD) in LCs for GGBs.\u0000\u0000\u0000METHODS\u0000In this retrospective study of 386 LCs, data were collected for patient demographics, medical comorbidities, operating time (OT), anesthesia time (AT), length of stay (LOS), estimated blood loss, conversion to open procedures, 30-day readmissions, and mortality. Patients were categorized into four groups: (1) Vyas employing HD for GGBs (VHG), (2) non-Vyas group of five surgeons not employing HD for GGBs (NVG), (3) Vyas treating non-GGBs, and (4) non-Vyas group of five surgeons treating non-GGBs. Control groups were age-matched and sex-matched. Statistical analysis used descriptive statistics, Mann-Whitney U testing, and chi-squared testing (α = 0.05).\u0000\u0000\u0000RESULTS\u0000This study demonstrated significantly decreased (P < 0.05) OT (P = 0.001), AT (P < 0.001), LOS (P = 0.015), and conversion to open procedures (P = 0.047) between the VHG and NVG groups, with HD reducing OT by 35.5% compared to blunt dissection. This study did not demonstrate significantly decreased (P > 0.05) estimated blood loss (P = 0.185) and 30-day readmissions (P = 0.531) between the VHG and NVG groups, but they were trending toward significant. There were no mortalities in this study.\u0000\u0000\u0000CONCLUSIONS\u0000HD is associated with improved surgical outcomes of LCs for GGBs demonstrated by reduced OT, AT, LOS, and conversion to open procedures. Further multi-institutional studies are needed to validate HD implementation and further dissemination.","PeriodicalId":191568,"journal":{"name":"The Journal of surgical research","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117225006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-01DOI: 10.1016/j.jss.2022.02.052
Tracy S. Wang
{"title":"A is for American. Asian. Ally.","authors":"Tracy S. Wang","doi":"10.1016/j.jss.2022.02.052","DOIUrl":"https://doi.org/10.1016/j.jss.2022.02.052","url":null,"abstract":"","PeriodicalId":191568,"journal":{"name":"The Journal of surgical research","volume":"3 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"118319253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-01Epub Date: 2021-08-21DOI: 10.1016/j.jss.2021.05.033
KuoJen Tsao
{"title":"Response Regarding: Standardized Care and Oral Antibiotics on Discharge for Pediatric Perforated Appendicitis.","authors":"KuoJen Tsao","doi":"10.1016/j.jss.2021.05.033","DOIUrl":"https://doi.org/10.1016/j.jss.2021.05.033","url":null,"abstract":"","PeriodicalId":191568,"journal":{"name":"The Journal of surgical research","volume":" ","pages":"728"},"PeriodicalIF":2.2,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jss.2021.05.033","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39725034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-01Epub Date: 2021-07-14DOI: 10.1016/j.jss.2021.05.049
Sandra Tomita, Jason Fisher, Howard Ginsburg, Keith Kuenzler, Jee-Hye Choi, Alex Gordon
{"title":"Response Regarding: Standardized Care and Oral Antibioics on Discharge for Pediatric Perforated Appendicitis.","authors":"Sandra Tomita, Jason Fisher, Howard Ginsburg, Keith Kuenzler, Jee-Hye Choi, Alex Gordon","doi":"10.1016/j.jss.2021.05.049","DOIUrl":"https://doi.org/10.1016/j.jss.2021.05.049","url":null,"abstract":"","PeriodicalId":191568,"journal":{"name":"The Journal of surgical research","volume":" ","pages":"729"},"PeriodicalIF":2.2,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jss.2021.05.049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39197034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-01Epub Date: 2021-07-12DOI: 10.1016/j.jss.2021.06.039
Soundappan S V Soundappan, Lawrence Lam, Daniel T Cass, Jonathan Karpelowsky
{"title":"Corrigendum to \"Open vs Ultrasound Guided Tunneled Central Venous Access in Children: A Randomised Controlled Study\": Journal of Surgical Research April 2021 (260) 284-292.","authors":"Soundappan S V Soundappan, Lawrence Lam, Daniel T Cass, Jonathan Karpelowsky","doi":"10.1016/j.jss.2021.06.039","DOIUrl":"https://doi.org/10.1016/j.jss.2021.06.039","url":null,"abstract":"","PeriodicalId":191568,"journal":{"name":"The Journal of surgical research","volume":" ","pages":"568"},"PeriodicalIF":2.2,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jss.2021.06.039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39187112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-01Epub Date: 2021-08-21DOI: 10.1016/j.jss.2021.02.059
Sherif Emil
{"title":"Standardized Care and Oral Antibiotics on Discharge for Pediatric Perforated Appendicitis.","authors":"Sherif Emil","doi":"10.1016/j.jss.2021.02.059","DOIUrl":"https://doi.org/10.1016/j.jss.2021.02.059","url":null,"abstract":"","PeriodicalId":191568,"journal":{"name":"The Journal of surgical research","volume":" ","pages":"717-718"},"PeriodicalIF":2.2,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jss.2021.02.059","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39725032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-01Epub Date: 2021-07-25DOI: 10.1016/j.jss.2021.06.053
Soundappan S V Soundappan
{"title":"Response Regarding: Open Versus Ultrasound Guided Tunnelled Central Venous Access in Children: A Randomized Controlled Study.","authors":"Soundappan S V Soundappan","doi":"10.1016/j.jss.2021.06.053","DOIUrl":"https://doi.org/10.1016/j.jss.2021.06.053","url":null,"abstract":"","PeriodicalId":191568,"journal":{"name":"The Journal of surgical research","volume":" ","pages":"715-716"},"PeriodicalIF":2.2,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jss.2021.06.053","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39253316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-18DOI: 10.1101/2021.10.14.21265033
Irene Y. Zhang, Danielle Norwitz, A. Drewnowski, Nidhi Agrawal, D. Flum, J. Liao
Introduction: The Mediterranean diet is being studied as an alternative to surgery for common gastrointestinal conditions. However, dietary change can be challenging. "Nudges" - behavioral science strategies seeking to influence cognitive processes to promote good behaviors - may help. We conducted a pilot study evaluating the acceptability of the MediDiet, a behaviorally designed dietary intervention incorporating nudges and recommendations based on the Mediterranean Diet. Methods: We conducted a three-phase pilot study involving parallel randomized surveys of U.S. adults. After completing a validated questionnaire assessing dietary consistency with a Mediterranean diet, participants were randomized to feedback containing no nudge versus nudge: peer comparison; peer comparison + positive affect induction; or default. Participants then rated their positive and negative emotions, motivation for dietary change, and interest in recipes. Responses were analyzed using baseline covariate-adjusted regression. Results: Among 1,709 participants, 56% were men, 73% were White, and the mean age was 38. In response to dietary feedback, participants reported low negative emotions, high positive emotions, moderate motivation for dietary change and high interest in recipes. Nudges did not affect the extent of negative (p=0.104) or positive (p=0.34) emotions, motivation (p=0.139), or interest (p=0.86). In exploratory analyses, those with moderate and high consistency with the Mediterranean diet, with or without nudges, reported lower negative affect, greater positive affect, greater motivation, and greater interest in recipes, than the minimally consistent, no nudge group. Conclusion: Delivering dietary feedback based on the Mediterranean diet using behavioral nudges was acceptable among U.S. adults, rousing positive reactions without triggering negative ones. As early evidence, this pilot study provides the basis for testing nudge-based dietary guidance among individuals with symptomatic gallstones, diverticulitis, and other gastrointestinal diseases.
{"title":"Applying Behavioral Nudges in a Dietary Comparator for Surgical Trials: Developing the MediDiet","authors":"Irene Y. Zhang, Danielle Norwitz, A. Drewnowski, Nidhi Agrawal, D. Flum, J. Liao","doi":"10.1101/2021.10.14.21265033","DOIUrl":"https://doi.org/10.1101/2021.10.14.21265033","url":null,"abstract":"Introduction: The Mediterranean diet is being studied as an alternative to surgery for common gastrointestinal conditions. However, dietary change can be challenging. \"Nudges\" - behavioral science strategies seeking to influence cognitive processes to promote good behaviors - may help. We conducted a pilot study evaluating the acceptability of the MediDiet, a behaviorally designed dietary intervention incorporating nudges and recommendations based on the Mediterranean Diet. Methods: We conducted a three-phase pilot study involving parallel randomized surveys of U.S. adults. After completing a validated questionnaire assessing dietary consistency with a Mediterranean diet, participants were randomized to feedback containing no nudge versus nudge: peer comparison; peer comparison + positive affect induction; or default. Participants then rated their positive and negative emotions, motivation for dietary change, and interest in recipes. Responses were analyzed using baseline covariate-adjusted regression. Results: Among 1,709 participants, 56% were men, 73% were White, and the mean age was 38. In response to dietary feedback, participants reported low negative emotions, high positive emotions, moderate motivation for dietary change and high interest in recipes. Nudges did not affect the extent of negative (p=0.104) or positive (p=0.34) emotions, motivation (p=0.139), or interest (p=0.86). In exploratory analyses, those with moderate and high consistency with the Mediterranean diet, with or without nudges, reported lower negative affect, greater positive affect, greater motivation, and greater interest in recipes, than the minimally consistent, no nudge group. Conclusion: Delivering dietary feedback based on the Mediterranean diet using behavioral nudges was acceptable among U.S. adults, rousing positive reactions without triggering negative ones. As early evidence, this pilot study provides the basis for testing nudge-based dietary guidance among individuals with symptomatic gallstones, diverticulitis, and other gastrointestinal diseases.","PeriodicalId":191568,"journal":{"name":"The Journal of surgical research","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133889609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-01DOI: 10.1016/j.jvs.2021.07.082
C. DeCarlo, J. Mohebali, A. Dua, M. Conrad, A. Mohapatra
{"title":"Preoperative Anemia is Associated With Postoperative Renal Failure After Elective Open Aortic Repair.","authors":"C. DeCarlo, J. Mohebali, A. Dua, M. Conrad, A. Mohapatra","doi":"10.1016/j.jvs.2021.07.082","DOIUrl":"https://doi.org/10.1016/j.jvs.2021.07.082","url":null,"abstract":"","PeriodicalId":191568,"journal":{"name":"The Journal of surgical research","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124897274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-01DOI: 10.1200/jco.2020.39.28_suppl.316
S. Hopkins, R. Vidri, M. Hill, Namrata Vijayvergia, J. Farma
INTRODUCTION Multidisciplinary tumor boards (TBs) are crucial for decision-making and management of patients diagnosed with complex malignancies. The social distancing conditions imposed by coronavirus disease 2019 presented an opportunity to compare virtual versus in-person TBs. METHODS A retrospective analysis of attendance data from an National Cancer Institute-designated cancer center's gastrointestinal (GI) TB participant data from September 2019 to October 2020. In addition, an online survey assessing the virtual TB experience was sent to participants of all TBs. Interrupted time series analyses were performed to evaluate preintervention and postintervention GI TB attendance only. RESULTS The overall mean attendance for GI TB was 30 participants; turnout was higher for virtual format compared to in-person (32 versus 23 attendees, P < 0.001). This increase was seen across all participant categories: attending physicians (15 versus 11 attendees, P < 0.001), trainees (11 versus 8, P < 0.001), and support staff (6 versus 3, P < 0.001). There was no significant difference in the mean number of cases discussed between TB formats. The majority of the 141 survey respondents (across all TB) were attending physicians with >20-year experience. Most supported a permanent virtual or hybrid TB format, 72.5% found this format to be more time efficient and with similar productivity, and 85.8% found it easier to attend. The majority (89.9%) felt confident that the decision-making process was not affected by virtual interactions. CONCLUSIONS A virtual platform for multispecialty TBs allows for greater attendance without sacrificing the decision-making process. This survey supports continuing with a virtual or hybrid format, which may increase attendance and facilitate access to multidisciplinary discussions leading to improved patient care.
{"title":"A Virtual Tumor Board Platform: A Way to Enhance Decision-Making for Complex Malignancies.","authors":"S. Hopkins, R. Vidri, M. Hill, Namrata Vijayvergia, J. Farma","doi":"10.1200/jco.2020.39.28_suppl.316","DOIUrl":"https://doi.org/10.1200/jco.2020.39.28_suppl.316","url":null,"abstract":"INTRODUCTION\u0000Multidisciplinary tumor boards (TBs) are crucial for decision-making and management of patients diagnosed with complex malignancies. The social distancing conditions imposed by coronavirus disease 2019 presented an opportunity to compare virtual versus in-person TBs.\u0000\u0000\u0000METHODS\u0000A retrospective analysis of attendance data from an National Cancer Institute-designated cancer center's gastrointestinal (GI) TB participant data from September 2019 to October 2020. In addition, an online survey assessing the virtual TB experience was sent to participants of all TBs. Interrupted time series analyses were performed to evaluate preintervention and postintervention GI TB attendance only.\u0000\u0000\u0000RESULTS\u0000The overall mean attendance for GI TB was 30 participants; turnout was higher for virtual format compared to in-person (32 versus 23 attendees, P < 0.001). This increase was seen across all participant categories: attending physicians (15 versus 11 attendees, P < 0.001), trainees (11 versus 8, P < 0.001), and support staff (6 versus 3, P < 0.001). There was no significant difference in the mean number of cases discussed between TB formats. The majority of the 141 survey respondents (across all TB) were attending physicians with >20-year experience. Most supported a permanent virtual or hybrid TB format, 72.5% found this format to be more time efficient and with similar productivity, and 85.8% found it easier to attend. The majority (89.9%) felt confident that the decision-making process was not affected by virtual interactions.\u0000\u0000\u0000CONCLUSIONS\u0000A virtual platform for multispecialty TBs allows for greater attendance without sacrificing the decision-making process. This survey supports continuing with a virtual or hybrid format, which may increase attendance and facilitate access to multidisciplinary discussions leading to improved patient care.","PeriodicalId":191568,"journal":{"name":"The Journal of surgical research","volume":"192 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129239377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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