Pub Date : 2026-03-01Epub Date: 2025-10-30DOI: 10.1016/j.amjsurg.2025.116706
Niranjna Swaminathan, Raj Roy, Rachael Caretti, Andrea Gillis, Sophie Dream, Brenessa Lindeman, Herbert Chen
{"title":"Defining cure in patients with normocalcemic primary hyperparathyroidism: Should calcium or PTH be used?","authors":"Niranjna Swaminathan, Raj Roy, Rachael Caretti, Andrea Gillis, Sophie Dream, Brenessa Lindeman, Herbert Chen","doi":"10.1016/j.amjsurg.2025.116706","DOIUrl":"10.1016/j.amjsurg.2025.116706","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"253 ","pages":"Article 116706"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145450402","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}
We sought to investigate racial/ethnic disparities in opioid prescribing patterns among patients undergoing gastrointestinal (GI) cancer surgery.
Methods
Patients who underwent surgery for GI cancer (2016–2023) were identified using the EPIC Cosmos database. Multivariate analyses were conducted to assess differences in opioid prescription patterns postoperatively.
Results
168,220 individuals underwent GI cancer surgery (esophagus: 2.5 %; stomach: 4.1 %, pancreas: 9.7 %; hepatobiliary: 6.4 %; colorectal: 77.3 %); 52.9 % were male, 86.0 % were White with median age of 72 years (IQR: 62–80). Black patients were younger (68 years [IQR: 60–76] vs. 72 years [IQR: 63–81]) and had a lower Charlson Comorbidity Index score (>2) (66.2 % vs. 68.5 %) compared with White patients (both p < 0.001). On multivariable analysis, Black patients had similar odds of receiving opioids as White patients (OR: 1.01, 95 % CI: 0.95–1.08).
Conclusion
No race-based differences were noted in the use of opioid prescriptions, duration of prescriptions, or mode of opioid administration following GI surgery.
{"title":"Investigating racial/ethnic disparities in opioid use among patients undergoing gastrointestinal cancer surgery","authors":"Shahzaib Zindani , Zayed Rashid , Selamawit Woldesenbet , Mujtaba Khalil , Timothy M. Pawlik","doi":"10.1016/j.amjsurg.2025.116799","DOIUrl":"10.1016/j.amjsurg.2025.116799","url":null,"abstract":"<div><h3>Introduction</h3><div>We sought to investigate racial/ethnic disparities in opioid prescribing patterns among patients undergoing gastrointestinal (GI) cancer surgery.</div></div><div><h3>Methods</h3><div>Patients who underwent surgery for GI cancer (2016–2023) were identified using the EPIC Cosmos database. Multivariate analyses were conducted to assess differences in opioid prescription patterns postoperatively.</div></div><div><h3>Results</h3><div>168,220 individuals underwent GI cancer surgery (esophagus: 2.5 %; stomach: 4.1 %, pancreas: 9.7 %; hepatobiliary: 6.4 %; colorectal: 77.3 %); 52.9 % were male, 86.0 % were White with median age of 72 years (IQR: 62–80). Black patients were younger (68 years [IQR: 60–76] vs. 72 years [IQR: 63–81]) and had a lower Charlson Comorbidity Index score (>2) (66.2 % vs. 68.5 %) compared with White patients (both p < 0.001). On multivariable analysis, Black patients had similar odds of receiving opioids as White patients (OR: 1.01, 95 % CI: 0.95–1.08).</div></div><div><h3>Conclusion</h3><div>No race-based differences were noted in the use of opioid prescriptions, duration of prescriptions, or mode of opioid administration following GI surgery.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"253 ","pages":"Article 116799"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145916607","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 : 2026-03-01Epub Date: 2025-09-21DOI: 10.1016/j.amjsurg.2025.116625
Lamario Williams PhD , Toluwani Akinpelu BS , Ariana Naaseh MD, MPHS , Cameron Comrie MD , Alizeh Abbas MD , American Journal of Surgery Students and Residents Scholars (STARS) Delegation
{"title":"A call to action to formally incorporate SDOH training in surgery residency curricula","authors":"Lamario Williams PhD , Toluwani Akinpelu BS , Ariana Naaseh MD, MPHS , Cameron Comrie MD , Alizeh Abbas MD , American Journal of Surgery Students and Residents Scholars (STARS) Delegation","doi":"10.1016/j.amjsurg.2025.116625","DOIUrl":"10.1016/j.amjsurg.2025.116625","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"253 ","pages":"Article 116625"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197958","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 : 2026-03-01Epub Date: 2025-12-09DOI: 10.1016/j.amjsurg.2025.116773
Phillip J. Hsu , Katherine Khosrovaneh , Nick Kunnath , Cody L. Mullens , Andrew M. Ibrahim , Samir K. Gadepalli
Background
Neighborhood deprivation begets care delays and complications after children's surgery in single center studies. We aimed to better understand these associations through generalizable data.
Methods
We identified children undergoing six common operations using State Inpatient Databases, defining neighborhood deprivation using Child Opportunity Index. Risk-adjusted length of stay (LOS) and complication rates were compared using multivariable regression.
Results
Among 102,399 children, neighborhood deprivation was associated with race, public insurance, and transfer. On risk-adjusted analysis, children with greater neighborhood deprivation had longer LOS for appendectomy (4.36 vs 4.21 days), skin graft (10.80 vs 8.55 days), and skin excision/debridement (10.45 vs 9.51 days). Risk-adjusted complication rates were not different, and LOS differences persisted in children without complications.
Conclusions
Children from deprived neighborhoods stay longer post-operatively, despite similar complication rates. Factors beyond clinical care are thus associated with utilization, and should inform how payment models and quality metrics account for these non-clinical factors.
{"title":"Neighborhood deprivation is associated with longer hospital stay for common pediatric surgical procedures independent of complication rates","authors":"Phillip J. Hsu , Katherine Khosrovaneh , Nick Kunnath , Cody L. Mullens , Andrew M. Ibrahim , Samir K. Gadepalli","doi":"10.1016/j.amjsurg.2025.116773","DOIUrl":"10.1016/j.amjsurg.2025.116773","url":null,"abstract":"<div><h3>Background</h3><div>Neighborhood deprivation begets care delays and complications after children's surgery in single center studies. We aimed to better understand these associations through generalizable data.</div></div><div><h3>Methods</h3><div>We identified children undergoing six common operations using State Inpatient Databases, defining neighborhood deprivation using Child Opportunity Index. Risk-adjusted length of stay (LOS) and complication rates were compared using multivariable regression.</div></div><div><h3>Results</h3><div>Among 102,399 children, neighborhood deprivation was associated with race, public insurance, and transfer. On risk-adjusted analysis, children with greater neighborhood deprivation had longer LOS for appendectomy (4.36 vs 4.21 days), skin graft (10.80 vs 8.55 days), and skin excision/debridement (10.45 vs 9.51 days). Risk-adjusted complication rates were not different, and LOS differences persisted in children without complications.</div></div><div><h3>Conclusions</h3><div>Children from deprived neighborhoods stay longer post-operatively, despite similar complication rates. Factors beyond clinical care are thus associated with utilization, and should inform how payment models and quality metrics account for these non-clinical factors.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"253 ","pages":"Article 116773"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145882037","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 : 2026-03-01Epub Date: 2025-12-24DOI: 10.1016/j.amjsurg.2025.116797
Nicholas Stevens, Raisa Gao-Gibbons, Clayton Wyland, Kayla Flewelling, Theresa McGoff, Austin Brubaker, Laurence E. McCahill
Introduction
For perforated sigmoid diverticulitis, the “gold standard” has traditionally been the Hartmann's Procedure (HP). The LADIES trial published in 2019 suggested that primary anastomosis (PA) is safe. Our study aims to evaluate whether the LADIES trial has influenced the surgical management of perforated diverticulitis at our institution.
Methods
Retrospective cohort study of patients undergoing urgent or emergent colectomy for perforated diverticulitis, divided into Group 1 (2013–2019) and Group 2 (post LADIES Trial, 2020–2024). Inclusion criteria was similar to the LADIES trial and included patients 85 years or younger, not immunocompromised, and without preoperative vasopressor requirements.
Results
There were 88 patients total, 41 patients in Group 1 and 47 in Group 2. No significant difference was noted in procedure performed, though there was an upwards trend for performing PA (19.5 % vs 36.2 %, p = 0.084) and creation of protective ileostomy (7.3 % vs 19.2 %, p = 0.129) in Group2.
Conclusion
After publication in 2019, our institution demonstrated limited adoption of the LADIES trial for surgical management of perforated diverticulitis. Further study is required to better delineate surgeon continued reluctance for PA in this setting.
对于乙状结肠穿孔性憩室炎，传统的“金标准”是哈特曼手术（HP）。2019年发表的LADIES试验表明，初级吻合（PA）是安全的。我们的研究旨在评估LADIES试验是否影响了我们机构穿孔性憩室炎的手术治疗。方法回顾性队列研究，对穿孔性憩室炎患者进行紧急或急诊结肠切除术，分为1组（2013-2019）和2组（LADIES试验后，2020-2024）。纳入标准与LADIES试验相似，纳入年龄在85岁或以下、无免疫功能低下、术前无血管加压药物需求的患者。结果共88例患者，其中1组41例，2组47例。虽然在第二组中进行PA （19.5% vs 36.2%, p = 0.084）和建立保护性回肠造口（7.3% vs 19.2%, p = 0.129）的比例呈上升趋势，但所执行的手术没有显著差异。在2019年发表后，我们的机构证明了在穿孔性憩室炎的手术治疗中有限地采用了LADIES试验。需要进一步的研究来更好地描述外科医生在这种情况下对PA的持续不情愿。
{"title":"Current urgent and emergent management of acute sigmoid diverticulitis … has the LADIES trial impacted change in surgical management at a single institution?","authors":"Nicholas Stevens, Raisa Gao-Gibbons, Clayton Wyland, Kayla Flewelling, Theresa McGoff, Austin Brubaker, Laurence E. McCahill","doi":"10.1016/j.amjsurg.2025.116797","DOIUrl":"10.1016/j.amjsurg.2025.116797","url":null,"abstract":"<div><h3>Introduction</h3><div>For perforated sigmoid diverticulitis, the “gold standard” has traditionally been the Hartmann's Procedure (HP). The LADIES trial published in 2019 suggested that primary anastomosis (PA) is safe. Our study aims to evaluate whether the LADIES trial has influenced the surgical management of perforated diverticulitis at our institution.</div></div><div><h3>Methods</h3><div>Retrospective cohort study of patients undergoing urgent or emergent colectomy for perforated diverticulitis, divided into Group 1 (2013–2019) and Group 2 (post LADIES Trial, 2020–2024). Inclusion criteria was similar to the LADIES trial and included patients 85 years or younger, not immunocompromised, and without preoperative vasopressor requirements.</div></div><div><h3>Results</h3><div>There were 88 patients total, 41 patients in Group 1 and 47 in Group 2. No significant difference was noted in procedure performed, though there was an upwards trend for performing PA (19.5 % vs 36.2 %, p = 0.084) and creation of protective ileostomy (7.3 % vs 19.2 %, p = 0.129) in Group2.</div></div><div><h3>Conclusion</h3><div>After publication in 2019, our institution demonstrated limited adoption of the LADIES trial for surgical management of perforated diverticulitis. Further study is required to better delineate surgeon continued reluctance for PA in this setting.</div></div>","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"253 ","pages":"Article 116797"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145882038","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 : 2026-03-01Epub Date: 2025-10-01DOI: 10.1016/j.amjsurg.2025.116648
Adan Z. Becerra PhD , Christopher T. Aquina MD, MPH , Steven D. Schwaitzberg MD, FACS, MAMSE , Katia Noyes PhD, MPH
{"title":"A new era of surgical intelligence: Analyzing disruption in general surgery from 2015 to 2021","authors":"Adan Z. Becerra PhD , Christopher T. Aquina MD, MPH , Steven D. Schwaitzberg MD, FACS, MAMSE , Katia Noyes PhD, MPH","doi":"10.1016/j.amjsurg.2025.116648","DOIUrl":"10.1016/j.amjsurg.2025.116648","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"253 ","pages":"Article 116648"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145547734","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 : 2026-03-01Epub 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":"2026-03-01","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 : 2026-03-01Epub Date: 2025-10-10DOI: 10.1016/j.amjsurg.2025.116656
Kala T. Pham BS , Youmna A. Sherif MD , Melany C. Hughes MD , Sudha Jayaraman MD, MSc, FACS , Rachel W. Davis MD , Dr. Host MD
{"title":"Bridging surgical education gaps in times of conflict: Experience with virtual and remote platforms for enhancing surgical workforce","authors":"Kala T. Pham BS , Youmna A. Sherif MD , Melany C. Hughes MD , Sudha Jayaraman MD, MSc, FACS , Rachel W. Davis MD , Dr. Host MD","doi":"10.1016/j.amjsurg.2025.116656","DOIUrl":"10.1016/j.amjsurg.2025.116656","url":null,"abstract":"","PeriodicalId":7771,"journal":{"name":"American journal of surgery","volume":"253 ","pages":"Article 116656"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318042","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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