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Addressing the high rates of pregnancy complications and infertility among female surgeons: What should we do about it? 解决女性外科医生妊娠并发症和不孕症的高发率:我们应该做些什么?
IF 2.7 3区 医学 Q1 SURGERY Pub Date : 2026-03-01 Epub Date: 2025-10-28 DOI: 10.1016/j.amjsurg.2025.116699
Gopika SenthilKumar , Umut Sarpel , Tiffany A. Glazer
Although nearly half of current surgical trainees identify as women, significant reproductive health disparities persist in our field. Female surgeons experience infertility rates nearly three times that of the general U.S. population, alongside substantially higher rates of pregnancy complications—even when compared to other demanding professions. These disparities are compounded by modifiable occupational hazards and the absence of standardized accommodations during pregnancy. In this article, we synthesize current evidence, identify the specific occupational factors contributing to these disparities, and propose practical, evidence-based workplace modification and policy recommendations. We also present a reproducible institutional model for pregnancy accommodations that can be adapted across institutions.
The surgical profession is at an inflection point; just as duty-hour limits reshaped the culture of surgical training in the name of safety, so too must we advance comprehensive, enforceable accommodations that protect reproductive health.
尽管目前近一半的外科受训者认为自己是妇女,但在我们的领域中仍然存在重大的生殖健康差距。女性外科医生的不孕率几乎是普通美国人的三倍,而且怀孕并发症的发生率也高得多——即使与其他要求很高的职业相比也是如此。这些差异由于可改变的职业危害和怀孕期间缺乏标准化的住宿而加剧。在本文中,我们综合了现有的证据,确定了导致这些差异的具体职业因素,并提出了实用的、基于证据的工作场所修改和政策建议。我们还提出了一个可重复的怀孕住宿制度模式,可以跨机构适应。外科行业正处于一个拐点;正如值班时间限制以安全的名义重塑了外科培训文化一样,我们也必须推进保护生殖健康的全面、可执行的便利措施。
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引用次数: 0
Statewide trends in routine pre-operative testing before low-risk surgery 低风险手术前常规术前检查的全州趋势
IF 2.7 3区 医学 Q1 SURGERY Pub Date : 2026-03-01 Epub Date: 2025-12-29 DOI: 10.1016/j.amjsurg.2025.116815
Nicole M. Mott , Erin Kim , Faelan Jacobson-Davies , Michael J. Englesbe , Hari Nathan , Lesly A. Dossett

Background

Routine pre-operative testing before low-risk surgery remains common despite guidelines against it.

Methods

We conducted a retrospective cohort study of adults undergoing low-risk surgery (cholecystectomy, hernia repair, lumpectomy, thyroidectomy, mastectomy) in Michigan from 2015 to 2024. The primary outcome was testing performed within 30 days of surgery. Linear mixed models identified predictors of testing, and the results of a pilot quality improvement (QI) initiative to reduce testing at 31 hospitals were examined.

Results

Among 99,501 patients, testing rates declined from 44 % to 39 % from 2019 to 2024. Older age, comorbidity burden, and undergoing a pre-operative history and physical were associated with testing. Hospital testing rates varied from 13 % to 93 %. In the QI-participating hospitals, testing declined from 38 % to 33 % in the measurement period compared to the baseline period (p = 0.035).

Conclusions

Pre-operative testing remains common and variable. QI initiatives help reduce testing, but broader de-implementation strategies may promote sustained improvement.
背景:尽管指南反对在低风险手术前进行常规术前检查,但这种做法仍然很普遍。方法对2015年至2024年在密歇根州接受低风险手术(胆囊切除术、疝修补术、乳房肿瘤切除术、甲状腺切除术、乳房切除术)的成年人进行回顾性队列研究。主要结果是手术后30天内进行的测试。线性混合模型确定了检测的预测因素,并检查了31家医院减少检测的试点质量改进(QI)倡议的结果。结果在99501例患者中,检测率从2019年的44%下降到2024年的39%。年龄较大、合并症负担、术前病史和体格检查与检测有关。医院检测率从13%到93%不等。在参与qi的医院中,与基线期相比,检测率从38%下降到33% (p = 0.035)。结论术前检测普遍存在,且存在差异。QI计划有助于减少测试,但是更广泛的去实现策略可能促进持续的改进。
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引用次数: 0
Socioecological model and designing interventions for surgical patients with non-English preferred language 非英语优先语言外科患者的社会生态模型及干预设计。
IF 2.7 3区 医学 Q1 SURGERY Pub Date : 2026-03-01 Epub Date: 2025-08-28 DOI: 10.1016/j.amjsurg.2025.116597
Jesus Mejia BS , Brittany M. Dacier MD, MPH , Jenny Ventura MD, MPH , Emily E. Witt MD, MSc , Regan W. Bergmark MD, MPH , Gezzer Ortega MD, MPH
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引用次数: 0
Spaced repetition in surgical education: Understanding the barriers and opportunities for broader adoption through a plastic surgery lens 外科教育中的间隔重复:通过整形外科镜头了解更广泛采用的障碍和机会。
IF 2.7 3区 医学 Q1 SURGERY Pub Date : 2026-03-01 Epub Date: 2025-10-10 DOI: 10.1016/j.amjsurg.2025.116655
Zachary A. Koenig MD , Joshua T. Henderson MD , Iraj Hasan BS , Sebastian M. Brooke MD
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引用次数: 0
The rise of women in pediatric surgery training: Have we reached equity? 女性在儿科外科培训中的崛起:我们达到平等了吗?
IF 2.7 3区 医学 Q1 SURGERY Pub Date : 2026-03-01 Epub Date: 2025-09-22 DOI: 10.1016/j.amjsurg.2025.116624
Lisa Marie Jackson , James Petrancosta , Nina Kosciuszek , Sophia Liu , Tawny Kim , Erin E. Perrone , Claudia N. Emami , Kristen A. Calabro , Kenneth W. Gow

Background

Women have long been underrepresented in surgical fields, including pediatric general surgery (PGS), one of the most competitive subspecialties. This study examined trends in gender representation in PGS.

Methods

We identified all PGS graduates from U.S. and Canadian programs between 1919 and 2025 using validated sources. Gender was determined, and male-to-female ratios were analyzed by year. National leadership roles were reviewed for their representation of females. Chi-square tests were used to assess statistical significance (p ​< ​0.05).

Results

Seventy-nine programs produced 2235 graduates: 1675 (75 ​%) men and 560 (25 ​%) women. Female representation increased steadily, with gender parity emerging around 2020. Although women entered leadership roles in PGS earlier than in General Surgery, they still lag behind men in overall leadership representation.

Conclusions

PGS has made significant progress toward gender equity in training, with recent parity among graduates. However, leadership remains an area for continued improvement to ensure equitable representation at all levels.
背景:长期以来,女性在外科领域的代表性不足,包括儿科普外科(PGS),这是最具竞争力的专科之一。这项研究调查了PGS中性别代表性的趋势。方法:我们使用经过验证的来源确定了1919年至2025年间所有来自美国和加拿大项目的PGS毕业生。确定了性别,并按年分析了男女比例。审查了国家领导角色中女性的代表性。采用卡方检验评价差异有统计学意义(p < 0.05)。结果:79个项目培养了2235名毕业生:1675名(75%)男性和560名(25%)女性。女性代表比例稳步上升,到2020年左右实现性别平等。尽管女性在PGS中担任领导角色比在普外科中更早,但她们在整体领导代表性方面仍落后于男性。结论:PGS在培训中的性别平等方面取得了重大进展,最近毕业生之间的性别平等。但是,领导仍然是一个需要继续改进的领域,以确保各级的公平代表性。
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引用次数: 0
Lessons for the surgeon from the early history of the Zollinger Ellison syndrome 从佐林格·埃里森综合征的早期历史给外科医生的教训:第六届亚历山大·沃尔特历史讲座在中西部外科协会第68届年会上提出,威斯康星州德拉万,2025年7月27日。
IF 2.7 3区 医学 Q1 SURGERY Pub Date : 2026-03-01 Epub Date: 2025-10-09 DOI: 10.1016/j.amjsurg.2025.116654
E. Christopher Ellison MD
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引用次数: 0
The long-lasting effects of redlining: Editorial to the paper “Strong laws aren't enough: Historic Redlining, state firearm laws, and urban firearm violence in the United States” 警戒线的长期影响:《强有力的法律是不够的:历史性的警戒线、州枪支法和美国城市枪支暴力》一文的社论。
IF 2.7 3区 医学 Q1 SURGERY Pub Date : 2026-03-01 Epub Date: 2025-09-12 DOI: 10.1016/j.amjsurg.2025.116611
Denzel R. Woode MD, Andre R. Campbell MD
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引用次数: 0
The people left behind 留下来的人。
IF 2.7 3区 医学 Q1 SURGERY Pub Date : 2026-03-01 Epub Date: 2025-12-08 DOI: 10.1016/j.amjsurg.2025.116770
Lyen C. Huang MD, MPH, FACS, FASCRS , Kevin D. Helling MD, FACS
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引用次数: 0
Multidisciplinary prehabilitation in rectal cancer: Implications for recovery. 直肠癌的多学科康复:对康复的影响。
IF 2.7 3区 医学 Q1 SURGERY Pub Date : 2026-02-26 DOI: 10.1016/j.amjsurg.2026.116892
Lauren Theiss Gleason
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引用次数: 0
Cultural humility training in surgery-Innovation in format, not yet in outcomes. 手术中的文化谦逊训练——形式上的创新,而不是结果上的创新。
IF 2.7 3区 医学 Q1 SURGERY Pub Date : 2026-02-20 DOI: 10.1016/j.amjsurg.2026.116876
Sasha A Still
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引用次数: 0
期刊
American journal of surgery
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