Global Surgery has gained prominence in global health but suffers from persistent data gaps. Current research is either overly generalized, lacking local relevance, or narrowly interventionist, missing context. These "misfit" approaches stem from power imbalances and limited local involvement. Mixed-methods research, combining quantitative and qualitative approaches, offers a balanced solution, uncovering not just "what" but also "how" and "why." Despite its potential, mixed-methods research remains underutilized in Global Surgery. A shift toward this approach is essential to generate actionable, context-sensitive insights and close critical data gaps.
{"title":"Rethinking Global Surgery research: Role of mixed-methods studies.","authors":"Nikita Manish Shah, Aiman Perween Afsar, Siddhesh Zadey","doi":"10.1016/j.amjsurg.2026.116831","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2026.116831","url":null,"abstract":"<p><p>Global Surgery has gained prominence in global health but suffers from persistent data gaps. Current research is either overly generalized, lacking local relevance, or narrowly interventionist, missing context. These \"misfit\" approaches stem from power imbalances and limited local involvement. Mixed-methods research, combining quantitative and qualitative approaches, offers a balanced solution, uncovering not just \"what\" but also \"how\" and \"why.\" Despite its potential, mixed-methods research remains underutilized in Global Surgery. A shift toward this approach is essential to generate actionable, context-sensitive insights and close critical data gaps.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116831"},"PeriodicalIF":2.7,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146096677","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}
Pub Date : 2026-01-18DOI: 10.1016/j.amjsurg.2026.116824
Jaspinder Sanghera , Ioannis Liapis , Nritya Nair , Michelle Holland , Manish Tripathi , Larry Hearld , Krista Mehari , Smita Bhatia , Annabelle L. Fonseca
Purpose
Many patients with foregut cancers fail to receive guideline-concordant treatment. The perspectives of health system stakeholders who care for these patients, and their insights into feasible solutions, remain underexplored.
Methods
Using grounded theory methodology, 12 semi-structured interviews were conducted to identify multilevel barriers, and health system stakeholders proposed solutions to overcome these barriers.
Results
Participants described barriers across four levels. Individual-level barriers included financial toxicity, transportation challenges, and psychosocial distress. Provider-level barriers included inadequate physician-patient communication and insufficient inter-provider communication. Institutional barriers included delays in accessing specialty care, scheduling inefficiencies, and institutional resource limitations. Policy-level barriers included care fragmentation, inadequate sub-specialty care in rural areas, and inadequate reimbursement. Proposed solutions included strengthening institutional psychiatric support programs, increasing inter-provider engagement, streamlining referral pathways, targeted rural physician recruitment, and reimbursement reform.
Conclusion
Health system stakeholders proposed interventions emphasizing communication, navigation, and system-level integration that may improve the delivery of foregut cancer care in resource-constrained environments.
{"title":"Examining health system stakeholder-reported barriers and solutions to foregut cancer care","authors":"Jaspinder Sanghera , Ioannis Liapis , Nritya Nair , Michelle Holland , Manish Tripathi , Larry Hearld , Krista Mehari , Smita Bhatia , Annabelle L. Fonseca","doi":"10.1016/j.amjsurg.2026.116824","DOIUrl":"10.1016/j.amjsurg.2026.116824","url":null,"abstract":"<div><h3>Purpose</h3><div>Many patients with foregut cancers fail to receive guideline-concordant treatment. The perspectives of health system stakeholders who care for these patients, and their insights into feasible solutions, remain underexplored.</div></div><div><h3>Methods</h3><div>Using grounded theory methodology, 12 semi-structured interviews were conducted to identify multilevel barriers, and health system stakeholders proposed solutions to overcome these barriers.</div></div><div><h3>Results</h3><div>Participants described barriers across four levels. Individual-level barriers included financial toxicity, transportation challenges, and psychosocial distress. Provider-level barriers included inadequate physician-patient communication and insufficient inter-provider communication. Institutional barriers included delays in accessing specialty care, scheduling inefficiencies, and institutional resource limitations. Policy-level barriers included care fragmentation, inadequate sub-specialty care in rural areas, and inadequate reimbursement. Proposed solutions included strengthening institutional psychiatric support programs, increasing inter-provider engagement, streamlining referral pathways, targeted rural physician recruitment, and reimbursement reform.</div></div><div><h3>Conclusion</h3><div>Health system stakeholders proposed interventions emphasizing communication, navigation, and system-level integration that may improve the delivery of foregut cancer care in resource-constrained environments.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"254 ","pages":"Article 116824"},"PeriodicalIF":2.7,"publicationDate":"2026-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146074920","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}
Pub Date : 2026-01-17DOI: 10.1016/j.amjsurg.2026.116828
Stephanie Delos Santos , Marta Invernizzi , Cindy Liu , Xin Tong , Jodi Rosen , Lihong V. Wang , Lily L. Lai
Objective
Current breast imaging has limitations. Mammography uses radiation and compression; ultrasound depends on user expertise; MRI requires time and intravenous contrast. Development of novel technologies for breast imaging may be improved with patient surveys.
Methods
Breast cancer patients scheduled for breast operations or undergoing neoadjuvant therapy were enrolled in studies to evaluate photoacoustic computed tomography (PACT) at a single institution. After each imaging session, the patients were surveyed. The survey included Likert scale, multiple choice, and open-ended questions.
Results
Of 49 patients, 86 % completed at least one survey with 42 % completing three. Survey completion took <10 min. Features assessed specific to the imaging technology included water bath, duration, positioning, and environment. Patients overwhelmingly reported ease of PACT over mammography and MRI. Suggestions included better cushioning, improved head support, well-fitting laser safety glasses.
Conclusion
Photoacoustic breast imaging is feasible to breast cancer patients. User feedback informs on clinical technology improvement.
{"title":"Utilizing post-imaging surveys to guide development of photoacoustic computed technology for breast imaging","authors":"Stephanie Delos Santos , Marta Invernizzi , Cindy Liu , Xin Tong , Jodi Rosen , Lihong V. Wang , Lily L. Lai","doi":"10.1016/j.amjsurg.2026.116828","DOIUrl":"10.1016/j.amjsurg.2026.116828","url":null,"abstract":"<div><h3>Objective</h3><div>Current breast imaging has limitations. Mammography uses radiation and compression; ultrasound depends on user expertise; MRI requires time and intravenous contrast. Development of novel technologies for breast imaging may be improved with patient surveys.</div></div><div><h3>Methods</h3><div>Breast cancer patients scheduled for breast operations or undergoing neoadjuvant therapy were enrolled in studies to evaluate photoacoustic computed tomography (PACT) at a single institution. After each imaging session, the patients were surveyed. The survey included Likert scale, multiple choice, and open-ended questions.</div></div><div><h3>Results</h3><div>Of 49 patients, 86 % completed at least one survey with 42 % completing three. Survey completion took <10 min. Features assessed specific to the imaging technology included water bath, duration, positioning, and environment. Patients overwhelmingly reported ease of PACT over mammography and MRI. Suggestions included better cushioning, improved head support, well-fitting laser safety glasses.</div></div><div><h3>Conclusion</h3><div>Photoacoustic breast imaging is feasible to breast cancer patients. User feedback informs on clinical technology improvement.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"254 ","pages":"Article 116828"},"PeriodicalIF":2.7,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146036385","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}
Pub Date : 2026-01-17DOI: 10.1016/j.amjsurg.2026.116830
Herbert Chen (Editor-in-Chief)
{"title":"From the Editor – in – Chief","authors":"Herbert Chen (Editor-in-Chief)","doi":"10.1016/j.amjsurg.2026.116830","DOIUrl":"10.1016/j.amjsurg.2026.116830","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"253 ","pages":"Article 116830"},"PeriodicalIF":2.7,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146008653","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}
Pub Date : 2026-01-17DOI: 10.1016/j.amjsurg.2026.116819
Angel Rosario, Catherine Gbekie, Brianna M Peet, Daniel P Pacella, Grace B Simmons, Viemma Nwigwe, Catherine McManus
{"title":"Integrating cultural humility into surgical training: A case-based workshop utilizing AI and experiential learning.","authors":"Angel Rosario, Catherine Gbekie, Brianna M Peet, Daniel P Pacella, Grace B Simmons, Viemma Nwigwe, Catherine McManus","doi":"10.1016/j.amjsurg.2026.116819","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2026.116819","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116819"},"PeriodicalIF":2.7,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146040299","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}
Pub Date : 2026-01-16DOI: 10.1016/j.amjsurg.2026.116829
Stefanie J Soelling, Lily V Saadat, Joshua S Jolissaint, Jamie Hillas, Stephanie L Nitzschke, Douglas S Smink
{"title":"Surgeon peer coaching to optimize intraoperative performance: How to adapt for residents.","authors":"Stefanie J Soelling, Lily V Saadat, Joshua S Jolissaint, Jamie Hillas, Stephanie L Nitzschke, Douglas S Smink","doi":"10.1016/j.amjsurg.2026.116829","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2026.116829","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116829"},"PeriodicalIF":2.7,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146040383","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}
Pub Date : 2026-01-16DOI: 10.1016/j.amjsurg.2026.116827
Priyanka V Chugh
{"title":"Intersectionality and advancement in academic surgery.","authors":"Priyanka V Chugh","doi":"10.1016/j.amjsurg.2026.116827","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2026.116827","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116827"},"PeriodicalIF":2.7,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146027847","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}
Pub Date : 2026-01-13DOI: 10.1016/j.amjsurg.2026.116826
Angela Renne, Francis Deng, Jenny X Chen
Background: Gender-based salary differences persist in surgery. This study evaluated pay differences among U.S. academic surgeons over time across ranks.
Methods: A retrospective analysis of AAMC Faculty Salary Survey data (2014-2024) was conducted across 14 surgical specialties. Salaries were compared by gender and rank. Primary outcomes included salary differences and female-to-male pay ratios; secondary outcomes included trends and variability.
Results: At the assistant professor level, women earned 73% of male salaries (mean difference: $122,690); at associate professor, 71% ($158,048); and at professor, 74% ($152,550). Differences were largest in orthopedic and neurosurgery. Salary variability was consistently higher among males. Over the study period, modest gains were seen in pay equity at the assistant (annual improvement in pay ratio, β = 0.16%, P = .01) and associate (β = 0.41%, P = .01) professor levels but not among full professors (β = -0.01%, P = .89).
Conclusion: Gender pay differences are narrowing but remain pervasive in academic surgery, particularly at senior ranks.
Level of evidence: 4:
背景：性别工资差异在外科手术中持续存在。这项研究评估了美国学术外科医生在不同时期的薪酬差异。方法：对2014-2024年我院14个外科专业的教师薪酬调查数据进行回顾性分析。工资按性别和级别进行比较。主要结果包括工资差异和男女薪酬比率；次要结局包括趋势和变异性。结果：在助理教授级别，女性的工资是男性的73%（平均差值：122,690美元）；副教授：71%（158048美元）；教授则是74%（152550美元）。骨科和神经外科的差异最大。男性的薪酬变异性一直较高。在研究期间，助理教授（薪酬比率每年改善，β = 0.16%, P = 0.01）和助理教授（β = 0.41%, P = 0.01）的薪酬平等略有改善，但正教授则没有（β = -0.01%, P = 0.89）。结论：性别薪酬差异正在缩小，但在学术外科领域仍然普遍存在，尤其是在高级职位。证据等级：4；
{"title":"Gender-based salary differences among academic surgeons from 2014 to 2024.","authors":"Angela Renne, Francis Deng, Jenny X Chen","doi":"10.1016/j.amjsurg.2026.116826","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2026.116826","url":null,"abstract":"<p><strong>Background: </strong>Gender-based salary differences persist in surgery. This study evaluated pay differences among U.S. academic surgeons over time across ranks.</p><p><strong>Methods: </strong>A retrospective analysis of AAMC Faculty Salary Survey data (2014-2024) was conducted across 14 surgical specialties. Salaries were compared by gender and rank. Primary outcomes included salary differences and female-to-male pay ratios; secondary outcomes included trends and variability.</p><p><strong>Results: </strong>At the assistant professor level, women earned 73% of male salaries (mean difference: $122,690); at associate professor, 71% ($158,048); and at professor, 74% ($152,550). Differences were largest in orthopedic and neurosurgery. Salary variability was consistently higher among males. Over the study period, modest gains were seen in pay equity at the assistant (annual improvement in pay ratio, β = 0.16%, P = .01) and associate (β = 0.41%, P = .01) professor levels but not among full professors (β = -0.01%, P = .89).</p><p><strong>Conclusion: </strong>Gender pay differences are narrowing but remain pervasive in academic surgery, particularly at senior ranks.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116826"},"PeriodicalIF":2.7,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146008668","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}
Pub Date : 2026-01-13DOI: 10.1016/j.amjsurg.2026.116825
Almunthir Alyahya , Yousef Albegamy , Mansour Ahmed Albalawi , Ali Elkarouri , Shroog Alanazi , Lamis Alshehri , Rakan Almokhlef , Jenan Fayez Almutairi , Abdulaziz Alqarni , Najd Alanazi , Abdullah Altamimi , Laksh Kumar , Adarsh Raja
Background
Surgery remains a major contributor to healthcare costs and mortality from perioperative complications, yet long term national mortality trends are poorly defined.
Methods
A population based analysis of U.S. mortality data (1999–2024) was conducted using the CDC WONDER database. High risk surgical deaths were identified by ICD-10 code Y83. Age adjusted mortality rates (AAMRs) were calculated, and Joinpoint regression estimated annual percentage changes (APCs).
Results
Among 470,098 deaths, men comprised 54.7 %, with 76.0 % occurring in medical facilities. National AAMR declined from 8.1 (1999) to 3.4 (2015), rose to 7.9 (2021), then fell to 3.2 (2024). Mortality was highest among men, non Hispanic Black and American Indian/Alaska Native groups, and in non-metropolitan areas; Marked state level variation was observed, with the highest AAMRs in Mississippi, New Mexico, Wyoming, North Dakota, and West Virginia.
Conclusions
U.S. surgical mortality showed a three phase pattern of decline, rise, and reduction, with persistent demographic and state/regional disparities requiring targeted policy action.
{"title":"Trends in mortality from High-Risk surgical procedures: National burden of Transplants, Implants, and Organ removal from 1999 to 2024 in United States","authors":"Almunthir Alyahya , Yousef Albegamy , Mansour Ahmed Albalawi , Ali Elkarouri , Shroog Alanazi , Lamis Alshehri , Rakan Almokhlef , Jenan Fayez Almutairi , Abdulaziz Alqarni , Najd Alanazi , Abdullah Altamimi , Laksh Kumar , Adarsh Raja","doi":"10.1016/j.amjsurg.2026.116825","DOIUrl":"10.1016/j.amjsurg.2026.116825","url":null,"abstract":"<div><h3>Background</h3><div>Surgery remains a major contributor to healthcare costs and mortality from perioperative complications, yet long term national mortality trends are poorly defined.</div></div><div><h3>Methods</h3><div>A population based analysis of U.S. mortality data (1999–2024) was conducted using the CDC WONDER database. High risk surgical deaths were identified by ICD-10 code Y83. Age adjusted mortality rates (AAMRs) were calculated, and Joinpoint regression estimated annual percentage changes (APCs).</div></div><div><h3>Results</h3><div>Among 470,098 deaths, men comprised 54.7 %, with 76.0 % occurring in medical facilities. National AAMR declined from 8.1 (1999) to 3.4 (2015), rose to 7.9 (2021), then fell to 3.2 (2024). Mortality was highest among men, non Hispanic Black and American Indian/Alaska Native groups, and in non-metropolitan areas; Marked state level variation was observed, with the highest AAMRs in Mississippi, New Mexico, Wyoming, North Dakota, and West Virginia.</div></div><div><h3>Conclusions</h3><div>U.S. surgical mortality showed a three phase pattern of decline, rise, and reduction, with persistent demographic and state/regional disparities requiring targeted policy action.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"254 ","pages":"Article 116825"},"PeriodicalIF":2.7,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145986689","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}
Pub Date : 2026-01-13DOI: 10.1016/j.amjsurg.2026.116823
Arkadii Sipok , Sophia Dort , Saima Shafique , Jonathan M. Dort
Background
Opioids are often prescribed after outpatient inguinal hernia repair despite limited evidence of benefit and well-documented risks. We evaluated their impact on complications and patient-reported outcomes.
Methods
This prospective observational study enrolled adults undergoing outpatient inguinal hernia repair (June 2022–October 2024) at a single institution. Pain, satisfaction, hernia-related quality of life (HerQLes), and early (≤1 week) and late (12 weeks) complications were assessed. Opioid use was quantified in morphine milligram equivalents. Logistic regression adjusted for age and comorbidity estimated complication risk.
Results
Among 110 patients, 16 (14.5 %) used opioids. Opioid use was associated with higher early (50 % vs 43.6 %) and late (43.8 % vs 40 %) complications (AOR 1.12, p = .018), with no improvement in pain, medication satisfaction, or quality of life over time.
Conclusions
Even after low-risk surgery, opioids may add harm without benefit. Opioid-sparing regimens should be prioritized for outpatient inguinal hernia repair.
背景：阿片类药物经常在门诊腹股沟疝修补后开处方，尽管有有限的证据表明其有益且有充分的风险。我们评估了它们对并发症和患者报告结果的影响。方法：这项前瞻性观察性研究招募了在单一机构接受门诊腹股沟疝修补术的成年人（2022年6月至2024年10月）。评估疼痛、满意度、疝相关生活质量（HerQLes）以及早期（≤1周）和晚期（12周）并发症。阿片类药物的使用以吗啡毫克当量量化。经年龄和合并症调整后的Logistic回归估计了并发症的风险。结果：110例患者中有16例（14.5%）使用阿片类药物。阿片类药物的使用与较高的早期（50%对43.6%）和晚期（43.8%对40%）并发症相关（AOR 1.12, p = 0.018），随着时间的推移，疼痛、药物满意度或生活质量没有改善。结论：即使在低风险手术后，阿片类药物也可能增加伤害而没有益处。保留阿片类药物的方案应优先用于门诊腹股沟疝修补。
{"title":"Opioids add risk without improving outcomes after outpatient inguinal hernia surgery: A prospective cohort study","authors":"Arkadii Sipok , Sophia Dort , Saima Shafique , Jonathan M. Dort","doi":"10.1016/j.amjsurg.2026.116823","DOIUrl":"10.1016/j.amjsurg.2026.116823","url":null,"abstract":"<div><h3>Background</h3><div>Opioids are often prescribed after outpatient inguinal hernia repair despite limited evidence of benefit and well-documented risks. We evaluated their impact on complications and patient-reported outcomes.</div></div><div><h3>Methods</h3><div>This prospective observational study enrolled adults undergoing outpatient inguinal hernia repair (June 2022–October 2024) at a single institution. Pain, satisfaction, hernia-related quality of life (HerQLes), and early (≤1 week) and late (12 weeks) complications were assessed. Opioid use was quantified in morphine milligram equivalents. Logistic regression adjusted for age and comorbidity estimated complication risk.</div></div><div><h3>Results</h3><div>Among 110 patients, 16 (14.5 %) used opioids. Opioid use was associated with higher early (50 % vs 43.6 %) and late (43.8 % vs 40 %) complications (AOR 1.12, p = .018), with no improvement in pain, medication satisfaction, or quality of life over time.</div></div><div><h3>Conclusions</h3><div>Even after low-risk surgery, opioids may add harm without benefit. Opioid-sparing regimens should be prioritized for outpatient inguinal hernia repair.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"254 ","pages":"Article 116823"},"PeriodicalIF":2.7,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146027820","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}
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