Pub Date : 2025-12-22DOI: 10.1016/j.amjsurg.2025.116793
Frank Bevacqua
The Good Shift' follows a day on surgical placement as an MD student, exploring the motivations and moments of inspiration that soften the fears and challenges along the path to a future in operative practise.
{"title":"The good shift.","authors":"Frank Bevacqua","doi":"10.1016/j.amjsurg.2025.116793","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116793","url":null,"abstract":"<p><p>The Good Shift' follows a day on surgical placement as an MD student, exploring the motivations and moments of inspiration that soften the fears and challenges along the path to a future in operative practise.</p>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116793"},"PeriodicalIF":2.7,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145909848","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 : 2025-12-20DOI: 10.1016/j.amjsurg.2025.116779
Shawn Tejiram
{"title":"Invited commentary: Global inequities in surgical oncology editorial leadership: Comparing high-income and lower-income countries.","authors":"Shawn Tejiram","doi":"10.1016/j.amjsurg.2025.116779","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116779","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116779"},"PeriodicalIF":2.7,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145877431","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 : 2025-12-19DOI: 10.1016/j.amjsurg.2025.116786
Annie Tang, Katherine Schulz-Costello, Veronica Jones, Jennifer Tseng
Introduction
In 2024, the American Cancer Society reported that Asian American/Pacific Islander (AAPI) women have a rising breast cancer incidence that has surpassed other ethnicities. We aimed to identify the prevalence of pathogenic variants (PV) in the AAPI population with breast cancer and the implications for treatment.
Methods
We conducted a prospective cohort study of AAPI women diagnosed with breast cancer between 2020 and 2024 who underwent germline testing.
Results
Of the 797 AAPI women with breast cancer underwent germline testing, 21.6 % were found to have PVs. Patients with PVs had more aggressive luminal B or triple negative breast cancers (45.3 % vs 16.8 %, p = 0.002) and were more likely to choose contralateral risk-reducing mastectomy (30.2 % vs 15.8 %, p < 0.001). AAPI women with breast cancer and PVs often have dense breast tissue but less frequently personal risk factors for breast cancer.
Conclusions
As one in five AAPI women with breast cancer can be found to have a germline pathogenic variant, genetic testing is an influential aspect of surgical and oncologic care. Efforts should be made to improve patient access.
{"title":"Germline pathogenic variants in Asian American/Pacific Islander women with breast cancer","authors":"Annie Tang, Katherine Schulz-Costello, Veronica Jones, Jennifer Tseng","doi":"10.1016/j.amjsurg.2025.116786","DOIUrl":"10.1016/j.amjsurg.2025.116786","url":null,"abstract":"<div><h3>Introduction</h3><div>In 2024, the American Cancer Society reported that Asian American/Pacific Islander (AAPI) women have a rising breast cancer incidence that has surpassed other ethnicities. We aimed to identify the prevalence of pathogenic variants (PV) in the AAPI population with breast cancer and the implications for treatment.</div></div><div><h3>Methods</h3><div>We conducted a prospective cohort study of AAPI women diagnosed with breast cancer between 2020 and 2024 who underwent germline testing.</div></div><div><h3>Results</h3><div>Of the 797 AAPI women with breast cancer underwent germline testing, 21.6 % were found to have PVs. Patients with PVs had more aggressive luminal B or triple negative breast cancers (45.3 % vs 16.8 %, p = 0.002) and were more likely to choose contralateral risk-reducing mastectomy (30.2 % vs 15.8 %, p < 0.001). AAPI women with breast cancer and PVs often have dense breast tissue but less frequently personal risk factors for breast cancer.</div></div><div><h3>Conclusions</h3><div>As one in five AAPI women with breast cancer can be found to have a germline pathogenic variant, genetic testing is an influential aspect of surgical and oncologic care. Efforts should be made to improve patient access.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"253 ","pages":"Article 116786"},"PeriodicalIF":2.7,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145882039","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 : 2025-12-18DOI: 10.1016/j.amjsurg.2025.116783
Riley Brian , Alyssa Murillo , Ivori White , Laura Sterponi , Hueylan Chern , Daniel Oh , Patricia S. O'Sullivan
Introduction
When communication breaks down, misunderstandings ensue and may result in a communication process called repair. We aimed to characterize misunderstandings in robotic surgical instruction by appraising repairs.
Methods
We recorded learners and instructors working through simulated robotic surgical procedures. Using tools from discourse analysis, we categorized different aspects of repair: the trouble source (cause of confusion), initiation of repair (marker of the trouble source as confusing), repair proper (attempted resolution of confusion), and response to repair (signal of repair proper as adequate or inadequate).
Results
We reviewed 2596 min of video and audio data from 33 simulated cases. Using transcripts, we defined categories of trouble source, initiation of repair, repair proper, and response to repair.
Conclusions
Our findings suggest methods by which instructors can avoid common trouble sources to reduce reasons for misunderstanding and through which both learners and instructors can more effectively address misunderstandings when they do occur.
{"title":"Misunderstandings in robotic surgical instruction: An exploratory discourse analysis","authors":"Riley Brian , Alyssa Murillo , Ivori White , Laura Sterponi , Hueylan Chern , Daniel Oh , Patricia S. O'Sullivan","doi":"10.1016/j.amjsurg.2025.116783","DOIUrl":"10.1016/j.amjsurg.2025.116783","url":null,"abstract":"<div><h3>Introduction</h3><div>When communication breaks down, misunderstandings ensue and may result in a communication process called repair. We aimed to characterize misunderstandings in robotic surgical instruction by appraising repairs.</div></div><div><h3>Methods</h3><div>We recorded learners and instructors working through simulated robotic surgical procedures. Using tools from discourse analysis, we categorized different aspects of repair: the trouble source (cause of confusion), initiation of repair (marker of the trouble source as confusing), repair proper (attempted resolution of confusion), and response to repair (signal of repair proper as adequate or inadequate).</div></div><div><h3>Results</h3><div>We reviewed 2596 min of video and audio data from 33 simulated cases. Using transcripts, we defined categories of trouble source, initiation of repair, repair proper, and response to repair.</div></div><div><h3>Conclusions</h3><div>Our findings suggest methods by which instructors can avoid common trouble sources to reduce reasons for misunderstanding and through which both learners and instructors can more effectively address misunderstandings when they do occur.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"253 ","pages":"Article 116783"},"PeriodicalIF":2.7,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145838746","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 : 2025-12-17DOI: 10.1016/j.amjsurg.2025.116781
Ghassan Chakhtoura , Charbel Dargham , Farid Abi Habib , Richard Saade , Christopher El Hadi , Christian Mouawad , Michael Osseis , Joseph Gharios , Roger Noun
Background
Lebanon's overlapping economic collapse, COVID-19 pandemic, and Beirut port explosion have profoundly strained healthcare delivery. We assessed their impact on the severity and surgical management of acute cholecystitis.
Methods
We conducted a retrospective cohort study of 554 patients who underwent cholecystectomy between 2018 and 2024, comparing a pre-crisis period (2018–January 2020) with a crisis period (February 2020–2024). Monthly interrupted time series analyses and multivariable logistic regression models adjusting for age, ASA class, and inflammatory markers were performed.
Results
Crisis-period patients presented later (median 2 vs 1 day) with higher WBC counts. The proportion of Tokyo Grade II-III cholecystitis increased from 22.5 % to 44.9 %, and the crisis period independently predicted higher severity (adjusted OR 3.27; 95 % CI 2.10–5.10). Postoperative complication and readmission rates remained stable.
Conclusion
Lebanon's crises were associated with delayed presentation and more severe acute cholecystitis, without worsening adjusted postoperative outcomes.
黎巴嫩的经济崩溃、COVID-19大流行和贝鲁特港口爆炸叠加在一起，给医疗服务带来了严重压力。我们评估了它们对急性胆囊炎的严重程度和手术治疗的影响。方法：我们对2018年至2024年间接受胆囊切除术的554例患者进行回顾性队列研究，比较危机前（2018年至2020年1月）和危机期（2020年2月至2024年）。每月进行中断时间序列分析和多变量逻辑回归模型，调整年龄、ASA类别和炎症标志物。结果危机期患者出现较晚（中位2天vs 1天），白细胞计数较高。东京II-III级胆囊炎的比例从22.5%增加到44.9%，危机期独立预测更高的严重程度（调整OR 3.27; 95% CI 2.10-5.10）。术后并发症和再入院率保持稳定。结论黎巴嫩危机与延迟出现和更严重的急性胆囊炎有关，但没有恶化调整后的术后预后。
{"title":"Multidimensional impacts of the Lebanese economic crisis on the management of acute cholecystitis","authors":"Ghassan Chakhtoura , Charbel Dargham , Farid Abi Habib , Richard Saade , Christopher El Hadi , Christian Mouawad , Michael Osseis , Joseph Gharios , Roger Noun","doi":"10.1016/j.amjsurg.2025.116781","DOIUrl":"10.1016/j.amjsurg.2025.116781","url":null,"abstract":"<div><h3>Background</h3><div>Lebanon's overlapping economic collapse, COVID-19 pandemic, and Beirut port explosion have profoundly strained healthcare delivery. We assessed their impact on the severity and surgical management of acute cholecystitis.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of 554 patients who underwent cholecystectomy between 2018 and 2024, comparing a pre-crisis period (2018–January 2020) with a crisis period (February 2020–2024). Monthly interrupted time series analyses and multivariable logistic regression models adjusting for age, ASA class, and inflammatory markers were performed.</div></div><div><h3>Results</h3><div>Crisis-period patients presented later (median 2 vs 1 day) with higher WBC counts. The proportion of Tokyo Grade II-III cholecystitis increased from 22.5 % to 44.9 %, and the crisis period independently predicted higher severity (adjusted OR 3.27; 95 % CI 2.10–5.10). Postoperative complication and readmission rates remained stable.</div></div><div><h3>Conclusion</h3><div>Lebanon's crises were associated with delayed presentation and more severe acute cholecystitis, without worsening adjusted postoperative outcomes.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"253 ","pages":"Article 116781"},"PeriodicalIF":2.7,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145799289","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 : 2025-12-17DOI: 10.1016/j.amjsurg.2025.116788
Charles Adams, Polina Zmijewski
{"title":"Proper use of the recurrent laryngeal nerve monitor.","authors":"Charles Adams, Polina Zmijewski","doi":"10.1016/j.amjsurg.2025.116788","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116788","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116788"},"PeriodicalIF":2.7,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800358","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 : 2025-12-17DOI: 10.1016/j.amjsurg.2025.116782
Young Hae Choi, Jung Wook Huh, Woo Yong Lee, Seong Hyeon Yun, Hee Cheol Kim, Yong Beom Cho, Yoonah Park, Jung Kyong Shin
Background
This study aimed to identify and compare risk factors for lymph node metastasis in rectal cancer patients with and without neoadjuvant chemoradiotherapy.
Methods
We retrospectively analyzed 1354 patients who underwent curative surgery, categorized into a Non-CRT group (pT1–2, n = 921) and a CRT group (ypT1–2, n = 433).
Results
Lymph node metastasis occurred in 20.4 % of Non-CRT and 17.6 % of CRT patients. Independent predictors were lymphatic invasion (p < 0.001), tumor budding (p < 0.001), and pT2 stage (p = 0.002) in Non-CRT, and lymphatic invasion (p = 0.001) and venous invasion (p < 0.001) in CRT. Venous invasion showed a markedly stronger association in the CRT group (OR 12.102). Lymph node metastasis rates increased up to 64.3 % and 87.5 % with all risk factors, respectively.
Conclusion
Risk factors for lymph node metastasis differed by CRT status, with venous invasion emerging as the key determinant in the CRT group.
背景：本研究旨在确定和比较接受和未接受新辅助放化疗的直肠癌患者淋巴结转移的危险因素。方法：回顾性分析1354例根治性手术患者，分为非CRT组（pT1-2, n = 921）和CRT组（ypT1-2, n = 433）。结果：非CRT患者发生淋巴结转移20.4%，CRT患者发生淋巴结转移17.6%。非CRT的独立预测因子为淋巴浸润（p < 0.001）、肿瘤出芽（p < 0.001）和pT2分期（p = 0.002）， CRT的独立预测因子为淋巴浸润（p = 0.001）和静脉浸润（p < 0.001）。静脉侵犯与CRT组的相关性更强（OR 12.102）。在所有危险因素的影响下，淋巴结转移率分别增加了64.3%和87.5%。结论：淋巴结转移的危险因素因CRT状态而异，其中静脉浸润是CRT组的关键决定因素。
{"title":"Risk factors for lymph node metastasis in p/ypT1-2 rectal cancer","authors":"Young Hae Choi, Jung Wook Huh, Woo Yong Lee, Seong Hyeon Yun, Hee Cheol Kim, Yong Beom Cho, Yoonah Park, Jung Kyong Shin","doi":"10.1016/j.amjsurg.2025.116782","DOIUrl":"10.1016/j.amjsurg.2025.116782","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to identify and compare risk factors for lymph node metastasis in rectal cancer patients with and without neoadjuvant chemoradiotherapy.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 1354 patients who underwent curative surgery, categorized into a Non-CRT group (pT1–2, n = 921) and a CRT group (ypT1–2, n = 433).</div></div><div><h3>Results</h3><div>Lymph node metastasis occurred in 20.4 % of Non-CRT and 17.6 % of CRT patients. Independent predictors were lymphatic invasion (p < 0.001), tumor budding (p < 0.001), and pT2 stage (p = 0.002) in Non-CRT, and lymphatic invasion (p = 0.001) and venous invasion (p < 0.001) in CRT. Venous invasion showed a markedly stronger association in the CRT group (OR 12.102). Lymph node metastasis rates increased up to 64.3 % and 87.5 % with all risk factors, respectively.</div></div><div><h3>Conclusion</h3><div>Risk factors for lymph node metastasis differed by CRT status, with venous invasion emerging as the key determinant in the CRT group.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"253 ","pages":"Article 116782"},"PeriodicalIF":2.7,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145817404","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 : 2025-12-17DOI: 10.1016/j.amjsurg.2025.116787
Sarah M Cheney, Haley Anderson Feltracco, Juan M Sarmiento
{"title":"Liver cyst resection using maximal diameter concept.","authors":"Sarah M Cheney, Haley Anderson Feltracco, Juan M Sarmiento","doi":"10.1016/j.amjsurg.2025.116787","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116787","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116787"},"PeriodicalIF":2.7,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145817421","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 : 2025-12-16DOI: 10.1016/j.amjsurg.2025.116784
Erin Risotto-Urbanowicz, Tiffany Emery, Richard J Miskimins, Sarah A Moore
{"title":"Beware of big data - A lesson from data collection of unhoused populations in trauma.","authors":"Erin Risotto-Urbanowicz, Tiffany Emery, Richard J Miskimins, Sarah A Moore","doi":"10.1016/j.amjsurg.2025.116784","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116784","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116784"},"PeriodicalIF":2.7,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145888770","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 : 2025-12-15DOI: 10.1016/j.amjsurg.2025.116780
Peter Abraham, Sophie Dream
{"title":"Pushing the Envelope: Expanding the use of thermal ablative techniques for small papillary thyroid carcinomas.","authors":"Peter Abraham, Sophie Dream","doi":"10.1016/j.amjsurg.2025.116780","DOIUrl":"https://doi.org/10.1016/j.amjsurg.2025.116780","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":" ","pages":"116780"},"PeriodicalIF":2.7,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145792794","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：