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 Showing 1-20 of 136 Articles
Original Investigation  FREE
Vlad V. Simianu, MD, MPH; Alessandro Fichera, MD; Amir L. Bastawrous, MD, MBA; Giana H. Davidson, MD, MPH; Michael G. Florence, MD; Richard C. Thirlby, MD; David R. Flum, MD, MPH
Includes: Supplemental Content

Importance  Despite professional recommendations to delay elective colon resection for patients with uncomplicated diverticulitis, early surgery (after <3 preceding episodes) appears to be common. Several factors have been suggested to contribute to early surgery, including increasing numbers of younger patients, a lower threshold to operate laparoscopically, and ...

Invited Commentary: Improving Treatment of Uncomplicated Diverticulitis; James Fleshman, MD
Original Investigation 
Lance E. Davidson, PhD; Ted D. Adams, PhD, MPH; Jaewhan Kim, PhD; Jessica L. Jones, MD, MSPH; Mia Hashibe, PhD; David Taylor, PhD; Tapan Mehta, PhD; Rodrick McKinlay, MD; Steven C. Simper, MD; Sherman C. Smith, MD; Steven C. Hunt, PhD
Includes: Supplemental Content

Importance  Bariatric surgery is effective in reducing all-cause and cause-specific long-term mortality. Whether the long-term mortality benefit of surgery applies to all ages at which surgery is performed is not known.

Objective  To examine whether gastric bypass surgery is equally effective in reducing mortality in groups ...

Invited Commentary: Age-Related Mortality After Gastric Bypass Surgery; Malcolm K. Robinson, MD
Invited Commentary 
James Fleshman, MD

We continue to struggle with the perfect definition of the indication for an elective operation in the patient with diverticulitis. Simianu et al,1 in their review of the MarketScan Commercial Claims and Encounters Database, have attempted to determine the influences that drive early and late operation on ...

Invited Commentary 
Malcolm K. Robinson, MD

Young adults are generally thought to be the least risky operative candidates for elective surgery, whereas older individuals may be considered too risky. In this issue of JAMA Surgery, Davidson et al1 challenge these notions for patients undergoing gastric bypass surgery.

Research Letter 
Peter C. Minneci, MD, MHSc; Kristine M. Nacion, MPH; Daniel L. Lodwick, MD, MS; Jennifer N. Cooper, MS, PhD; Katherine J. Deans, MD, MHSc

This study discusses the effect of stakeholder involvement in an ongoing randomized clinical trial of pediatric appendicitis.

Comment & Response 
Vakhtang Tchantchaleishvili, MD; William Hallinan, RN, MS; H. Todd Massey, MD

In Reply In their comments on our recent Viewpoint,1 Garan et al and Fiedler et al have highlighted the institutional commitment needed to provide timely and comprehensive care for patients with acute myocardial infarction with cardiogenic shock (AMICS). Indeed, a 24/7 multidisciplinary “Shock Team” should be an ...

Comment & Response 
Arthur Reshad Garan, MD; Ajay Kirtane, MD, SM; Hiroo Takayama, MD, PhD

To the Editor We read with great interest the Viewpoint by Tchantchaleishvili et al1 calling for organized statewide networks for the management of acute myocardial infarction–related cardiogenic shock. We applaud the authors’ insights into one of the major current challenges in cardiovascular care. Despite advances in the ...

Comment & Response 
Amy G. Fiedler, MD; Tae H. Song, MD; David A. D’Alessandro, MD

To the Editor The Viewpoint by Tchantchaleishvili et al1 calling for organized statewide networks for the management of acute myocardial infarction–related cardiogenic shock brings to attention the critical need for multidisciplinary, multicenter, coordinated efforts to treat and manage patients presenting with cardiogenic shock. This is a timely ...

Todd A. Jaffe, BBA; Steven J. Hasday, BS; Justin B. Dimick, MD, MPH

This Viewpoint explores the limits of the methods used in the Surgeon Scorecard, uses laparoscopic cholecystectomy data to illustrate the inherent statistical challenges the Scorecard faces, and suggests improvements for future surgical performance assessments.

Original Investigation 
Lynne Moore, PhD; François Lauzier, MD, MSc, FRCPC; Henry T. Stelfox, MD, PhD, FRCPC; John Kortbeek, MD, FRCSC; Richard Simons, MA, FRCSC; Simon Berthelot, MD, MSc, FRPCP; Julien Clément, MD, FRCSC; Gilles Bourgeois, MD; Alexis F. Turgeon, MD, MSc, FRCPC
Includes: Supplemental Content

Importance  The rate of complications among injury admissions has been estimated to be more than 3 times that observed for general admissions, and complications have been targeted as an important quality-of-care metric. Despite the negative effect of complications on resource use and patient mortality and morbidity, there ...

Original Investigation 
Matthias Bock, MD, Priv Doz; Antonio Fanolla, MS; Isabelle Segur-Cabanac, MD; Franco Auricchio, MD; Carla Melani, MS; Flavio Girardi, MD; Horand Meier, MD; Armin Pycha, MD
Includes: Supplemental Content

Importance  The appropriately coached implementation of surgical safety checklists (SSCs) reduces the incidence of perioperative complications and 30-day mortality of patients undergoing surgery. The association of the introduction of SSCs with 90-day mortality remains unclear.

Objective  To assess the association between the implementation of SSCs and ...

Invited Commentary: The Surgical Checklist; William Berry, MD, MPH; Alex Haynes, MD, MPH; Janaka Lagoo, MD
Invited Commentary 
William Berry, MD, MPH; Alex Haynes, MD, MPH; Janaka Lagoo, MD

Surgical safety checklists (SSCs) are associated with reductions in postoperative morbidity and mortality and have now achieved widespread implementation, although the quality of implementation remains unclear in many settings.1,2 In this issue of JAMA Surgery, Bock and colleagues3 evaluate the effect of introducing ...

JAMA Surgery Clinical Challenge 
Daniel J. Gross, MD; Gainosuke Sugiyama, MD; Antonio Alfonso, MD

An asymptomatic 47-year-old woman with a mediastinal mass complained of mild but worsening orthopnea that was exacerbated when she would lie down. What is your diagnosis?

Comment & Response 
Simon Erridge; Swathikan Chidambaram

To the Editor We would first like to thank Hatoum et al1 for their contribution to the discussion on identifying improved predictors of the response of comorbidities to bariatric surgery. In their study,1 they determined remission of comorbidities via records of diagnosis and prescription drug fills. ...

Original Investigation 
Marco Milone, MD; Loredana Maria Sosa Fernandez, MD; Mario Musella, MD; Francesco Milone, MD
Includes: Supplemental Content

Importance  Video-assisted ablation of pilonidal sinus (VAAPS) is a new minimally invasive treatment based on the complete removal of the sinus cavity with a minimal surgical wound.

Objective  To validate the safety and efficacy of VAAPS.

Design, Setting, and Participants  From January 1, 2012, through ...

Invited Commentary 
Benjamin K. Poulose, MD, MPH; Brent D. Matthews, MD; Michael J. Rosen, MD

The work by Heurta et al1 in this issue of JAMA Surgery highlights a fundamental problem in surgery: balancing the need for innovation with the practicalities of demonstrating clinical benefit for novel ideas. This issue is particularly timely given an unsustainable trajectory of health care spending in ...

Sergio Huerta, MD; Anubodh Varshney, MD; Prachi M. Patel, BS; Helen G. Mayo, MLS; Edward H. Livingston, MD
Includes: Supplemental Content

Importance  Expensive biological mesh materials are increasingly used to reinforce abdominal wall hernia repairs. The clinical and cost benefit of these materials are unknown.

Objectives  To review the published evidence on the use of biological mesh materials and to examine the US Food and Drug Administration ...

Invited Commentary: Biological Meshes in Hernia; Benjamin K. Poulose, MD, MPH; Brent D. Matthews, MD; Michael J. Rosen, MD
Research Letter 
Breanne V. Britton, BA; Neeraja Nagarajan, MD, MPH; Cheryl K. Zogg, MSPH, MHS; Shalini Selvarajah, MD, MPH; Maya J. Torain, BS; Ali Salim, MD; Adil H. Haider, MD, MPH

This pilot study assesses US surgeons’ awareness of racial/ethnic disparities in surgical outcomes and processes of surgical care.

Comment & Response 
David N. Blitzer, BA; Rajan Gupta, MD; Gregory L. Peck, DO

To the Editor We read the insightful Viewpoint by Debas1 describing the “emergence and future of global surgery.” Indeed, we agree with the need for competency standards, societal involvement, and resource support as means to sustainability, but we suggest the following additional points: (1) encouraging surgeons early ...

Comment & Response 
Kathleen M. Casey, MD; Alexander A. Hannenberg, MD

To the Editor We applaud the recent Viewpoint by Debas1 calling for the formation of a “Consortium for Global Surgery” composed of academic institutions and surgical associations and organizations. Coordination and collaboration will be essential in effectively mobilizing assets from the United States and beyond to address ...

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