Pub Date : 2025-02-01DOI: 10.1016/j.amjsurg.2024.115995
Eleanor A. Fallon MD, Sarah B. Fisher MD, MS (Assistant Professor)
{"title":"A chance to cut is a chance to cure","authors":"Eleanor A. Fallon MD, Sarah B. Fisher MD, MS (Assistant Professor)","doi":"10.1016/j.amjsurg.2024.115995","DOIUrl":"10.1016/j.amjsurg.2024.115995","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"240 ","pages":"Article 115995"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456224","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 : 2025-02-01DOI: 10.1016/j.amjsurg.2024.115906
Valentine S. Alia , Toluwani Akinpelu , Aaron Dadzie , Shuaibahmed Arab , Robert Sanchez , Aaron Silva , Christian D. Cerecedo Lopez , Daniel Albo
Background
South Texas and the Rio Grande Valley (RGV) are medically underserved-communities near the Texas-Mexico border with the highest incidence of end-stage renal disease (ESRD) in the nation, and a shortage of available full-time equivalent (FTE) specialty-physicians.
Methods
Data on the incidence/prevalence of ESRD and workforce projections on vascular-surgeons and nephrologists were collected from the United States Renal Data System and Texas Department of State Health Services. We then merged data from both datasets to identify population-specific healthcare-trends.
Results
Texas had the highest rates of ESRD from 2016 to 2020, with its border regions leading the state. By 2032, vascular-surgery and nephrology are projected to have the 1st and 4th worst physician-shortages in the state respectively, with the percentage of these FTE specialty-physicians available to meet the need of the RGV ranging from 42.3 to 58.4 %.
Conclusions
The RGV is experiencing increased rates of ESRD, while having a paradoxical-decline in specialty-physicians available to provide adequate care.
{"title":"When physician supply does not meet patient demand: A looming epidemic in vascular and renal care for a community with the highest incidence of end-stage renal disease in the United States","authors":"Valentine S. Alia , Toluwani Akinpelu , Aaron Dadzie , Shuaibahmed Arab , Robert Sanchez , Aaron Silva , Christian D. Cerecedo Lopez , Daniel Albo","doi":"10.1016/j.amjsurg.2024.115906","DOIUrl":"10.1016/j.amjsurg.2024.115906","url":null,"abstract":"<div><h3>Background</h3><div>South Texas and the Rio Grande Valley (RGV) are medically underserved-communities near the Texas-Mexico border with the highest incidence of end-stage renal disease (ESRD) in the nation, and a shortage of available full-time equivalent (FTE) specialty-physicians.</div></div><div><h3>Methods</h3><div>Data on the incidence/prevalence of ESRD and workforce projections on vascular-surgeons and nephrologists were collected from the United States Renal Data System and Texas Department of State Health Services. We then merged data from both datasets to identify population-specific healthcare-trends.</div></div><div><h3>Results</h3><div>Texas had the highest rates of ESRD from 2016 to 2020, with its border regions leading the state. By 2032, vascular-surgery and nephrology are projected to have the 1st and 4th worst physician-shortages in the state respectively, with the percentage of these FTE specialty-physicians available to meet the need of the RGV ranging from 42.3 to 58.4 %.</div></div><div><h3>Conclusions</h3><div>The RGV is experiencing increased rates of ESRD, while having a paradoxical-decline in specialty-physicians available to provide adequate care.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"240 ","pages":"Article 115906"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142046126","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 : 2025-02-01DOI: 10.1016/j.amjsurg.2024.116046
Alison A. Smith MD, PhD, FACS
{"title":"Trust issues in the operating room: What does sex have to do with it?","authors":"Alison A. Smith MD, PhD, FACS","doi":"10.1016/j.amjsurg.2024.116046","DOIUrl":"10.1016/j.amjsurg.2024.116046","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"240 ","pages":"Article 116046"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543177","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 : 2025-02-01DOI: 10.1016/j.amjsurg.2024.116116
Ahmer Irfan , Katherine E. McElroy , Rui Zheng-Pywell , Andrea Gillis , Sushanth Reddy , Clayton Yates , Herbert Chen , J. Bart Rose
Introduction
Pancreatic neuroendocrine tumors (pNETs) are slow growing, malignant tumors that show different survival outcomes by race. Current size-based guidelines were largely developed in White patients. Our aim was to investigate tumor size and incidence of lymph node metastasis (LNM) between White and Asian pNET patients to evaluate generalizability of established guidelines.
Methods
Using the National Cancer Database (NCDB), we conducted a multi-institutional analysis of patients with low grade, resected, nonfunctional, sporadic, non-metastatic pNETs. Chi-squared tests were implemented to determine correlation between PTS and LMN incidence as well as race and LMN incidence. A logistic regression model was utilized to determine correlation between LMN, tumor size, and race. Overall survival was assessed using the Kaplan-Meier method.
Results
A total of 4977 pNET patients (205 Asian and 4772 White) were included in our analysis. Asian patients presented with smaller tumors (3.0 cm vs 3.9 cm, p = 0.029) but when grouped by size, there was no difference in the distribution (p = 0.77). White patients demonstrated a higher incidence of lymph node metastasis at presentation compared to Asian patients (27 % vs 19 %, p = 0.013), a higher likelihood of an R0 resection (95.3 % vs. 89.3 %, p < 0.0001).
Within both populations, tumor size (<2 cm, 2–3 cm, and ≥3 cm) positively correlated with incidence of LNM (11.5 %, 24.6 %, and 39.1 %). No difference of LNM was seen between racial cohorts at PTS <3 cm, however, Asian patients were less likely to exhibit LNM at PTS ≥3 cm (28.2 % and 39.5 %, p = 0.04). Overall survival was not significantly different between racial groups (p = 0.92).
Conclusion
Size based surgical resection guidelines for pancreatic neuroendocrine tumors based on a predominantly White patient population may not be generalizable to the Asian population. Within this population, we found the risk of lymph node metastasis did not increase at similar rates with increasing primary tumor size.
胰腺神经内分泌肿瘤（pNETs）是一种生长缓慢的恶性肿瘤，其生存结局因种族而异。目前基于尺寸的指南主要是针对白人患者制定的。我们的目的是研究白人和亚裔pNET患者的肿瘤大小和淋巴结转移（LNM）发生率，以评估既定指南的普遍性。方法：使用国家癌症数据库（NCDB），我们对低级别，切除，无功能，散发性，非转移性pNETs患者进行了多机构分析。采用卡方检验确定PTS与LMN发病率以及种族与LMN发病率之间的相关性。采用logistic回归模型确定LMN、肿瘤大小和种族之间的相关性。采用Kaplan-Meier法评估总生存率。结果：我们的分析共纳入4977例pNET患者（205例亚洲人，4772例白人）。亚洲患者肿瘤较小（3.0 cm vs 3.9 cm, p = 0.029），但按大小分组时，分布无差异（p = 0.77）。与亚洲患者相比，白人患者在发病时表现出更高的淋巴结转移发生率（27%对19%，p = 0.013）， R0切除的可能性更高（95.3%对89.3%,p）结论：以白人患者为主的胰腺神经内分泌肿瘤手术切除指南可能无法推广到亚洲人群。在这一人群中，我们发现淋巴结转移的风险并没有随着原发肿瘤大小的增加而增加。
{"title":"NET guidelines for white patients may not fit Asian patients","authors":"Ahmer Irfan , Katherine E. McElroy , Rui Zheng-Pywell , Andrea Gillis , Sushanth Reddy , Clayton Yates , Herbert Chen , J. Bart Rose","doi":"10.1016/j.amjsurg.2024.116116","DOIUrl":"10.1016/j.amjsurg.2024.116116","url":null,"abstract":"<div><h3>Introduction</h3><div>Pancreatic neuroendocrine tumors (pNETs) are slow growing, malignant tumors that show different survival outcomes by race. Current size-based guidelines were largely developed in White patients. Our aim was to investigate tumor size and incidence of lymph node metastasis (LNM) between White and Asian pNET patients to evaluate generalizability of established guidelines.</div></div><div><h3>Methods</h3><div>Using the National Cancer Database (NCDB), we conducted a multi-institutional analysis of patients with low grade, resected, nonfunctional, sporadic, non-metastatic pNETs. Chi-squared tests were implemented to determine correlation between PTS and LMN incidence as well as race and LMN incidence. A logistic regression model was utilized to determine correlation between LMN, tumor size, and race. Overall survival was assessed using the Kaplan-Meier method.</div></div><div><h3>Results</h3><div>A total of 4977 pNET patients (205 Asian and 4772 White) were included in our analysis. Asian patients presented with smaller tumors (3.0 cm vs 3.9 cm, p = 0.029) but when grouped by size, there was no difference in the distribution (p = 0.77). White patients demonstrated a higher incidence of lymph node metastasis at presentation compared to Asian patients (27 % vs 19 %, p = 0.013), a higher likelihood of an R0 resection (95.3 % vs. 89.3 %, p < 0.0001).</div><div>Within both populations, tumor size (<2 cm, 2–3 cm, and ≥3 cm) positively correlated with incidence of LNM (11.5 %, 24.6 %, and 39.1 %). No difference of LNM was seen between racial cohorts at PTS <3 cm, however, Asian patients were less likely to exhibit LNM at PTS ≥3 cm (28.2 % and 39.5 %, p = 0.04). Overall survival was not significantly different between racial groups (p = 0.92).</div></div><div><h3>Conclusion</h3><div>Size based surgical resection guidelines for pancreatic neuroendocrine tumors based on a predominantly White patient population may not be generalizable to the Asian population. Within this population, we found the risk of lymph node metastasis did not increase at similar rates with increasing primary tumor size.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"240 ","pages":"Article 116116"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142790989","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 : 2025-02-01DOI: 10.1016/j.amjsurg.2024.116134
Francesco Abboretti , Laura Didisheim , Hugo Teixeira Farinha , Markus Schäfer , Styliani Mantziari
Background
Although laparoscopy is widely used in oncologic digestive surgery, many centers are still reluctant to replace open surgery for gastric cancer treatment, especially in advanced disease. The aim of this study was to assess long-term survival and recurrence in patients after laparoscopic (LG) versus open (OG) oncological gastrectomy, in a tertiary reference center.
Methods
All consecutive patients with gastric adenocarcinoma undergoing curative gastrectomy between December 2007 and December 2021 were retrospectively analyzed. Clinico-pathological characteristics, survival and recurrence were compared among LG, OG or converted (CoG) patients. The ×2 test was used for categorical variables and the Mann-Whitney U test for continuous ones. Survival was assessed with the Kaplan-Meier method and log-rank test, as well as a multivariable Cox regression analysis.
Results
Among 156 included patients, 49 (31.4 %) were in the LG group, 93 (59.6 %) in the OG group, and 14 (9 %) in the CoG group. Baseline demographics were similar among the groups. R0 resection rates were 75.5 % in LG, 80.6 % in OG, and 64.3 % in CoG (p = 0.489). Open surgery was associated with a higher mean lymph node yield (28.4 ± 11.6) compared to LG (22.8 ± 9.7) and CoG (26.5 ± 12.3, p = 0.036). Severe postoperative complications were higher in the CoG group (64.3 % CoG versus 29 % OG, 32.7 % LG, p = 0.035). The CoG group had a significantly inferior disease-free survival (p = 0.012 vs OG, p = 0.003 vs LG; 53.3 % OG, 62.7 % LG and 28.1 % CoG) although overall survival was similar (57.1 % OG, 62.7 % LG and 32.7 % CoG, all p > 0.005).
Conclusions
Laparoscopic gastrectomy, while associated with a lower lymph node yield, provides similar overall survival rates compared to open surgery. Conversion to open surgery was associated with higher major postoperative morbidity and inferior disease-free survival.
{"title":"Long-term oncological outcomes of minimally invasive versus open gastrectomy for cancer","authors":"Francesco Abboretti , Laura Didisheim , Hugo Teixeira Farinha , Markus Schäfer , Styliani Mantziari","doi":"10.1016/j.amjsurg.2024.116134","DOIUrl":"10.1016/j.amjsurg.2024.116134","url":null,"abstract":"<div><h3>Background</h3><div>Although laparoscopy is widely used in oncologic digestive surgery, many centers are still reluctant to replace open surgery for gastric cancer treatment, especially in advanced disease. The aim of this study was to assess long-term survival and recurrence in patients after laparoscopic (LG) versus open (OG) oncological gastrectomy, in a tertiary reference center.</div></div><div><h3>Methods</h3><div>All consecutive patients with gastric adenocarcinoma undergoing curative gastrectomy between December 2007 and December 2021 were retrospectively analyzed. Clinico-pathological characteristics, survival and recurrence were compared among LG, OG or converted (CoG) patients. The ×2 test was used for categorical variables and the Mann-Whitney <em>U</em> test for continuous ones. Survival was assessed with the Kaplan-Meier method and log-rank test, as well as a multivariable Cox regression analysis.</div></div><div><h3>Results</h3><div>Among 156 included patients, 49 (31.4 %) were in the LG group, 93 (59.6 %) in the OG group, and 14 (9 %) in the CoG group. Baseline demographics were similar among the groups. R0 resection rates were 75.5 % in LG, 80.6 % in OG, and 64.3 % in CoG (p = 0.489). Open surgery was associated with a higher mean lymph node yield (28.4 ± 11.6) compared to LG (22.8 ± 9.7) and CoG (26.5 ± 12.3, p = 0.036). Severe postoperative complications were higher in the CoG group (64.3 % CoG versus 29 % OG, 32.7 % LG, p = 0.035). The CoG group had a significantly inferior disease-free survival (p = 0.012 vs OG, p = 0.003 vs LG; 53.3 % OG, 62.7 % LG and 28.1 % CoG) although overall survival was similar (57.1 % OG, 62.7 % LG and 32.7 % CoG, all p > 0.005).</div></div><div><h3>Conclusions</h3><div>Laparoscopic gastrectomy, while associated with a lower lymph node yield, provides similar overall survival rates compared to open surgery. Conversion to open surgery was associated with higher major postoperative morbidity and inferior disease-free survival.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"240 ","pages":"Article 116134"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794295","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}
Pub Date : 2025-02-01DOI: 10.1016/j.amjsurg.2024.116132
Min Wang , Bin Wang , Xianyan Chen , Ting Mei , Xuexi Yang , Qiang Luo , Feifei Na , Youling Gong
Background
Treatments for invasive T4 non-small cell lung cancer (NSCLC) tumors have been traditionally individualized and often require multidisciplinary team (MDT) evaluation. Advances in precision medicine may open up new opportunities for these patients.
Methods
This retrospective cohort study, using the Surveillance, Epidemiology, and End Results (SEER) database, identified T4N0-3M0 NSCLC patients with central structure invasion from 2010 to 2020. Precision medicine has progressed in three periods: 2010–2014 (targeted therapy), 2015–2017 (initial immunotherapy), and 2018–2020 (latest immunotherapy). We utilized Propensity Score Matching (PSM) to control confounding factors and competing risk regression models to evaluate cancer-specific survival (CSS).
Results
A total of 9,106 cases were matched after PSM. For all populations, the median overall survival (OS) significantly increased with the advancement of precision medicine: 23.0 months in Period I (95 % CI: 22.0–25.0), 28.0 months in Period II (95 % CI: 26.0–31.0), and not reached (NR) in Period III (95 % CI: 30.0 – NR). Multivariate analysis also revealed a sequential survival improvement from Period I to III (p < 0.001). Surgery-based treatment yielded the longest median OS at 46.0 months (95 % CI: 43.0–49.0, p < 0.001), compared with chemoradiotherapy, chemotherapy alone and radiation alone. Surgery-based treatment has also yielded the best survival in three precision medicine eras, in both N0-1 and N2-3 categories. After analyzing CSS, the results above remained consistent. The survival following chemoradiotherapy and chemotherapy alone has seen significant and progressive enhancements across the three eras of precision medicine. There were no significant survival differences between Periods I and II among surgery-based patients, but a slight improvement trend was noted in Period III.
Conclusion
This retrospective study indicated that as precision medicine for NSCLC evolved, personalized treatment strategies supported by effective MDT led to survival improvement. Notably, for invasive stage III patients, surgery-based strategies have consistently shown substantial benefits across all the periods, irrespective of the N stage. The integration of perioperative therapies to enhance surgical feasibility, especially the latest immunotherapy, holds particular promise for further survival benefits.
{"title":"Surgery/non-surgery-based strategies for invasive locally-advanced non-small cell lung cancer in the era of precision medicine","authors":"Min Wang , Bin Wang , Xianyan Chen , Ting Mei , Xuexi Yang , Qiang Luo , Feifei Na , Youling Gong","doi":"10.1016/j.amjsurg.2024.116132","DOIUrl":"10.1016/j.amjsurg.2024.116132","url":null,"abstract":"<div><h3>Background</h3><div>Treatments for invasive T<sub>4</sub> non-small cell lung cancer (NSCLC) tumors have been traditionally individualized and often require multidisciplinary team (MDT) evaluation. Advances in precision medicine may open up new opportunities for these patients.</div></div><div><h3>Methods</h3><div>This retrospective cohort study, using the Surveillance, Epidemiology, and End Results (SEER) database, identified T<sub>4</sub>N<sub>0-3</sub>M<sub>0</sub> NSCLC patients with central structure invasion from 2010 to 2020. Precision medicine has progressed in three periods: 2010–2014 (targeted therapy), 2015–2017 (initial immunotherapy), and 2018–2020 (latest immunotherapy). We utilized Propensity Score Matching (PSM) to control confounding factors and competing risk regression models to evaluate cancer-specific survival (CSS).</div></div><div><h3>Results</h3><div>A total of 9,106 cases were matched after PSM. For all populations, the median overall survival (OS) significantly increased with the advancement of precision medicine: 23.0 months in Period I (95 % CI: 22.0–25.0), 28.0 months in Period II (95 % CI: 26.0–31.0), and not reached (NR) in Period III (95 % CI: 30.0 – NR). Multivariate analysis also revealed a sequential survival improvement from Period I to III (<em>p</em> <em><</em> 0.001). Surgery-based treatment yielded the longest median OS at 46.0 months (95 % CI: 43.0–49.0, <em>p</em> <em><</em> 0.001), compared with chemoradiotherapy, chemotherapy alone and radiation alone. Surgery-based treatment has also yielded the best survival in three precision medicine eras, in both N<sub>0-1</sub> and N<sub>2-3</sub> categories. After analyzing CSS, the results above remained consistent. The survival following chemoradiotherapy and chemotherapy alone has seen significant and progressive enhancements across the three eras of precision medicine. There were no significant survival differences between Periods I and II among surgery-based patients, but a slight improvement trend was noted in Period III.</div></div><div><h3>Conclusion</h3><div>This retrospective study indicated that as precision medicine for NSCLC evolved, personalized treatment strategies supported by effective <span>MDT</span> led to survival improvement. Notably, for invasive stage III patients, surgery-based strategies have consistently shown substantial benefits across all the periods, irrespective of the N stage. The integration of perioperative therapies to enhance surgical feasibility, especially the latest immunotherapy, holds particular promise for further survival benefits.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"240 ","pages":"Article 116132"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142816991","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 : 2025-02-01DOI: 10.1016/j.amjsurg.2024.115905
Raul Castañeda-Vozmediano , Bárbara Areces Carrasco , Alejandra López Marsella , Carmen Ahenke Francisco , Joaquín Munoz-Rodriguez , Luis Alberto Blazquez Hernando , Alvaro Robin Valle de Lersundi , Javier Lopez-Monclus , Miguel Angel Garcia-Urena
Introduction
This study aimed to analyze the European Hernia Society Quality of Life (EHS-QoL) in abdominal wall reconstruction by comparing preoperative scores with those at 1 and 2 postoperative years.
Methods
Data from 105 patients with complex incisional hernias were collected preoperatively and at 1 and 2 years postoperatively. Statistical analyses included three ART ANOVA models to compare scores among the three time points and within each time point's items.
Results
The EHS score significantly decreased from preoperative (Mdn = 57) to 1 year (Mdn = 10.5) and 2 years postoperative (Mdn = 8). The most significant changes occurred between preoperative and 1-year measurements, particularly in pain levels during activities and limitations in heavy labor and activities outside the home.
Conclusion
Patients' quality of life notably improved at 1 year post-surgery, with some reaching near-maximum levels, and this improvement was generally sustained or increased at 2 years post-surgery.
{"title":"Comprehensive retrospective analysis of the European hernia Society quality of life in patients undergoing abdominal wall reconstruction","authors":"Raul Castañeda-Vozmediano , Bárbara Areces Carrasco , Alejandra López Marsella , Carmen Ahenke Francisco , Joaquín Munoz-Rodriguez , Luis Alberto Blazquez Hernando , Alvaro Robin Valle de Lersundi , Javier Lopez-Monclus , Miguel Angel Garcia-Urena","doi":"10.1016/j.amjsurg.2024.115905","DOIUrl":"10.1016/j.amjsurg.2024.115905","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aimed to analyze the European Hernia Society Quality of Life (EHS-QoL) in abdominal wall reconstruction by comparing preoperative scores with those at 1 and 2 postoperative years.</div></div><div><h3>Methods</h3><div>Data from 105 patients with complex incisional hernias were collected preoperatively and at 1 and 2 years postoperatively. Statistical analyses included three ART ANOVA models to compare scores among the three time points and within each time point's items.</div></div><div><h3>Results</h3><div>The EHS score significantly decreased from preoperative (Mdn = 57) to 1 year (Mdn = 10.5) and 2 years postoperative (Mdn = 8). The most significant changes occurred between preoperative and 1-year measurements, particularly in pain levels during activities and limitations in heavy labor and activities outside the home.</div></div><div><h3>Conclusion</h3><div>Patients' quality of life notably improved at 1 year post-surgery, with some reaching near-maximum levels, and this improvement was generally sustained or increased at 2 years post-surgery.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"240 ","pages":"Article 115905"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142046123","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 : 2025-02-01DOI: 10.1016/j.amjsurg.2024.115928
Yuan-Hsin Chen , Ya-Wen Chen , David C. Chang , Tawakalitu O. Oseni
Background
We investigated the likelihood of timely surgery for breast cancer patients among diverse Asian subgroups.
Methods
We analyzed the National Cancer Database from 2010 to 2019 and included White and Asian women diagnosed with stage I-III breast cancer. Patients with multiple cancers, patients who received chemotherapy, and those diagnosed and treated at different hospitals were excluded. The primary outcome was timely surgery within 8 weeks of diagnosis. Race was the primary independent variable. Asian Americans were stratified by geography.
Results
A total of 716,701 women were analyzed, with 3.5% Asians. Delayed surgery was experienced by 13.2% of women. Adjusted analysis indicated no difference in receiving timely surgery between all Asians and Whites. However, Southeast Asians were less likely to undergo timely surgery compared to Whites (OR 0.75, 95% CI 0.67–0.84).
Conclusions
Variations among Asian ethnicities emphasize the need to explore treatment patterns to address disparities in breast cancer care.
{"title":"Disparities in timely surgery among Asian American women with breast cancer","authors":"Yuan-Hsin Chen , Ya-Wen Chen , David C. Chang , Tawakalitu O. Oseni","doi":"10.1016/j.amjsurg.2024.115928","DOIUrl":"10.1016/j.amjsurg.2024.115928","url":null,"abstract":"<div><h3>Background</h3><div>We investigated the likelihood of timely surgery for breast cancer patients among diverse Asian subgroups.</div></div><div><h3>Methods</h3><div>We analyzed the National Cancer Database from 2010 to 2019 and included White and Asian women diagnosed with stage I-III breast cancer. Patients with multiple cancers, patients who received chemotherapy, and those diagnosed and treated at different hospitals were excluded. The primary outcome was timely surgery within 8 weeks of diagnosis. Race was the primary independent variable. Asian Americans were stratified by geography.</div></div><div><h3>Results</h3><div>A total of 716,701 women were analyzed, with 3.5% Asians. Delayed surgery was experienced by 13.2% of women. Adjusted analysis indicated no difference in receiving timely surgery between all Asians and Whites. However, Southeast Asians were less likely to undergo timely surgery compared to Whites (OR 0.75, 95% CI 0.67–0.84).</div></div><div><h3>Conclusions</h3><div>Variations among Asian ethnicities emphasize the need to explore treatment patterns to address disparities in breast cancer care.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"240 ","pages":"Article 115928"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139050","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 : 2025-02-01DOI: 10.1016/j.amjsurg.2024.115992
Aimee N. Di Marco
{"title":"Thyroidectomy outcomes in admitted patients are indeed worse than for outpatents: Providers must now acknowledge and respond","authors":"Aimee N. Di Marco","doi":"10.1016/j.amjsurg.2024.115992","DOIUrl":"10.1016/j.amjsurg.2024.115992","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"240 ","pages":"Article 115992"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493095","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 : 2025-02-01DOI: 10.1016/j.amjsurg.2024.116013
Angelena Crown, Amanda L. Kong
{"title":"Unveiling the disparities within: Why we need to disaggregate data for Asian women with breast cancer","authors":"Angelena Crown, Amanda L. Kong","doi":"10.1016/j.amjsurg.2024.116013","DOIUrl":"10.1016/j.amjsurg.2024.116013","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"240 ","pages":"Article 116013"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493096","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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