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 Showing 1-20 of 73 Articles
Viewpoint 
Eduardo de Santibañes, MD, PhD; Victoria Ardiles, MD; Fernando A. Alvarez, MD

This Viewpoint discusses the benefits of the associating liver partition and portal vein ligation for staged hepatectomy approach for treating liver tumors.

This Viewpoint discusses the associating liver partition and portal vein ligation (ALPPS) procedure vs portal vein embolization for safe and effective generation of future liver remnant hypertrophy for hepatectomy.

Original Investigation 
Thomas A. Pham, MD; Amy M. Gallo, MD; Waldo Concepcion, MD; Carlos O. Esquivel, MD, PhD; C. Andrew Bonham, MD

Introduction  Hepatoblastoma (HBL) and hepatocellular cancer (HCC) are the most common primary hepatic malignant neoplasms in childhood. Given the rarity of these childhood tumors and their propensity to present at advanced stages, updated long-term data are needed.

Objective  To determine the efficacy of liver transplant in ...

Invited Commentary: Liver Transplant for Hepatoblastoma and Hepatocellular Carcinoma; Elaine Y. Cheng, MD; Ronald W. Busuttil, MD, PhD
Original Investigation 
Joseph DiNorcia, MD; Minna K. Lee, MD; Michael P. Harlander-Locke, BS; Victor Xia, MD; Fady M. Kaldas, MD; Ali Zarrinpar, MD, PhD; Douglas G. Farmer, MD; Hasan Yersiz, MD; Jonathan R. Hiatt, MD; Ronald W. Busuttil, MD, PhD; Vatche G. Agopian, MD
Includes: Supplemental Content

Importance  Damage control (DC) with intra-abdominal packing and delayed reconstruction is an accepted strategy in trauma and acute care surgery but has not been evaluated in liver transplant.

Objective  To evaluate the incidence, effect on survival, and predictors of the need for DC using intra-abdominal packing ...

Invited Commentary: Supersick Patients Undergoing Liver Transplant; Marc L. Melcher, MD, PhD
Original Investigation  FREE
Charles E. Edmiston Jr, PhD; Cheong J. Lee, MD; Candace J. Krepel, MS; Maureen Spencer, MEd; David Leaper, MD; Kellie R. Brown, MD; Brian D. Lewis, MD; Peter J. Rossi, MD; Michael J. Malinowski, MD; Gary R. Seabrook, MD

Importance  To reduce the amount of skin surface bacteria for patients undergoing elective surgery, selective health care facilities have instituted a preadmission antiseptic skin cleansing protocol using chlorhexidine gluconate. A Cochrane Collaborative review suggests that existing data do not justify preoperative skin cleansing as a strategy to ...

Invited Commentary: Chlorhexidine Gluconate, 4%, Showers and Surgical Site Infection ; Zeinab M. Alawadi, MD, MS; Lillian S. Kao, MD, MS
Invited Commentary 
Elaine Y. Cheng, MD; Ronald W. Busuttil, MD, PhD

With advances in chemotherapy, surgical treatment, and postoperative care, the prognosis for children with hepatoblastoma (HBL) has improved significantly during the past 3 decades. The combined use of liver transplantation and chemotherapy is now the preferred treatment option for unresectable HBL.1 In pediatric patients with hepatocellular carcinoma ...

Invited Commentary 
Marc L. Melcher, MD, PhD

In this issue of JAMA Surgery, DiNorcia et al1 suggest that damage control (DC) strategies adopted from the trauma experience can also be applied to hypothermic, coagulopathic, and/or hemodynamically unstable patients undergoing liver transplant. In this single-center, 10-year experience, 150 liver transplant recipients (8.3%) underwent intra-abdominal ...

Invited Commentary 
Zeinab M. Alawadi, MD, MS; Lillian S. Kao, MD, MS

Surgical site infections (SSIs) are a focus of many quality improvement programs owing to increased morbidity, resource utilization, and costs. Although national programs have demonstrated a gradual reduction in SSIs over time, the optimal strategy for achieving and sustaining further improvements is unknown. Given that SSIs are a ...

Research Letter 
Jennifer A. Kaplan, MD; Samuel Schecter, MBBS; Matthew Y. C. Lin, MD; Stanley J. Rogers, MD; Jonathan T. Carter, MD

This study reports on the morbidity and mortality rates among patients who undergo an elective or emergency paraesophageal hernia repair.

Original Investigation 
Adam Hart, MSc, MD; Stephane G. Bergeron, MD, MPH; Laura Epure, MSc; Olga Huk, MSc, MD; David Zukor, MD; John Antoniou, PhD, MD
Includes: Supplemental Content

Importance  The combination of an aging population, growing number of medical interventions, and surging economic burden of health care has renewed interest in reevaluating and exploring new health care models.

Objectives  To compare the performance of the US and Canadian health care systems by assessing major ...

Invited Commentary: Evaluating Total Joint Arthroplasty in the US and Canada; Andrew J. Schoenfeld, MD, MSc
Original Investigation  FREE
Sandrine Colas, MSc, MPH; Cédric Collin, PharmD, PhD; Philippe Piriou, MD, PhD; Mahmoud Zureik, MD, PhD
Includes: Supplemental Content

Importance  Total hip replacement (THR) is successful in treating hip arthritis. Prosthetic survivorship may depend on characteristics of the implant, notably THR fixation technique and bearing surface type.

Objective  To compare THR short-term survivorship according to cement type and bearing surface.

Design, Setting, and Participants  ...

Invited Commentary: Total Hip Replacement Survivorship; Constance R. Chu, MD
Original Investigation 
Andrea T. Obi, MD; Christopher J. Pannucci, MD, MS; Andrew Nackashi, BS; Newaj Abdullah, BS; Rafael Alvarez, MD; Vinita Bahl, DMD, MPP; Thomas W. Wakefield, MD; Peter K. Henke, MD
Includes: Supplemental Content

Importance  Appropriate risk stratification for venous thromboembolism (VTE) is essential to providing appropriate thromboprophylaxis and avoiding morbidity and mortality.

Objective  To validate the Caprini VTE risk assessment model in a previously unstudied high-risk cohort: critically ill surgical patients.

Design, Setting, and Participants  We performed a ...

In their study published in this issue of JAMA Surgery, Hart and colleagues1 sought to use National Surgical Quality Improvement Program (NSQIP) data to compare performance between hospitals in the United States and Canada. Although the authors hypothesized that arthroplasty procedures performed in both countries would ...

Invited Commentary 
Constance R. Chu, MD

Total hip replacement (THR) predictably relieves pain and restores mobility to people with hip arthritis and is considered one of the most significant medical advances of the 20th century. Large population and long-term studies1,2 show 85% or better revision-free 10-year survival. Because of the high ...

JAMA Surgery Clinical Challenge 
Guillermo J. Ares, MD; Dustin Y. Yoon, MD; William H. Pearce, MD

An elderly man presented to the emergency department with a 1-month history of new-onset, persistent lower abdominal and flank pain that was sharp and constant with intermittent radiation to the back and associated anorexia with a 10-kg weight loss. What is your diagnosis?

Comment & Response 
Jeffrey Freed, MD, MPH; Sar Medoff, MD, MPP

To the Editor The Viewpoint by Ginwalla and Rickard1 was of particular interest to us and our colleagues who have completed more than 30 missions of the type described by them. Before commenting, we would like to acknowledge and congratulate the authors for the exceptional work they ...

Comment & Response 
Joel T. Adler, MD, MPH; Heidi Yeh, MD

To the Editor The recently published retrospective analysis by Zarkowsky et al1 not only describes an observed racial/ethnic disparity in the care of patients with end-stage renal disease but also calls attention to an important issue regarding race and ethnicity as reported in large databases. Race and ...

Comment & Response 
Devin S. Zarkowsky, MD; Joseph K. Canner, MHS; Mahmoud B. Malas, MD, MHS

In Reply Adler and Yeh are to be commended for their culturally aware, close reading of our recent article1; we sincerely appreciate their thoughtfulness. Simply, patients self-identifying as racially white and ethnically “Hispanic or Latino” were categorized as Hispanic. This is not explicitly stated in the ...

Original Investigation 
Maeve O’Neill Trudeau, MD; Emmanuel Baron, MD; Patrick Hérard, MD; Amy S. Labar, MS; Xavier Lassalle, CRNA; Carrie Lee Teicher, MD, MPH; David H. Rothstein, MD, MS
Includes: Supplemental Content

Importance  Little is known about the scope of practice and outcomes in pediatric surgery performed by humanitarian organizations in resource-poor settings and conflict zones. This study provides the largest report to date detailing such data for a major nongovernmental organization providing humanitarian surgical relief support in these ...

Invited Commentary: Building Evidence for Global Surgery One Experience at a Time; Haile T. Debas, MD
Original Investigation  FREE
Tyler R. Grenda, MD; Sha’Shonda L. Revels, MD, MS, MA; Huiying Yin, MS; John D. Birkmeyer, MD; Sandra L. Wong, MD, MS

Importance  Wide variations in mortality rates exist across hospitals following lung cancer resection; however, the factors underlying these differences remain unclear.

Objective  To evaluate perioperative outcomes in patients who underwent lung cancer resection at hospitals with very high and very low mortality rates (high-mortality hospitals [HMHs] ...

Invited Commentary: Failure to Rescue Metric in Lung Surgery; Thomas K. Varghese Jr, MD, MS

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