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 Showing 1-20 of 60 Articles
Original Investigation 
Ingo Stoffels, MD; Joachim Dissemond, MD; Thorsten Pöppel, MD; Dirk Schadendorf, MD; Joachim Klode, MD

Importance  The metastatic status of regional lymph nodes is the most relevant prognostic factor in breast cancer, melanoma, and other solid organ tumors with a lymphatic spread. The current gold standard for detection and targeted excision of the sentinel lymph node is preoperative lymphoscintigraphy with technetium Tc ...

Invited Commentary: Lymphatic Mapping and Sentinel Node Biopsy in Melanoma; Charles M. Balch, MD; Merrick I. Ross, MD
Original Investigation 
William C. Huang, MD; Coral L. Atoria, MPH; Marc Bjurlin, MsC, DO; Laura C. Pinheiro, MPH; Paul Russo, MD; William T. Lowrance, MD, MPH; Elena B. Elkin, PhD
Includes: Supplemental Content

Importance  With the significant downward size and stage migration of localized kidney cancers, the management options for small kidney cancers have expanded and evolved.

Objective  To describe trends and outcomes in the management of small kidney cancers in the first decade of the new millennium.

Design, ...

Invited Commentary: Standard of Care for Small Renal Masses in the 21st Century; Joshua J. Meeks, MD, PhD; Chris M. Gonzalez, MD, MBA
Original Investigation  FREE
Mark L. Friedell, MD; Charles W. Van Way III, MD; Ron W. Freyberg, MS; Peter L. Almenoff, MD

Importance  The use of perioperative pharmacologic β-blockade in patients at low risk of myocardial ischemic events undergoing noncardiac surgery (NCS) is controversial because of the risk of stroke and hypotension. Published studies have not found a consistent benefit in this cohort.

Objective  To determine the effect ...

Invited Commentary 
Joshua J. Meeks, MD, PhD; Chris M. Gonzalez, MD, MBA

The cornerstone of treatment of small renal masses (SRMs), which are renal cancers of less than 4 cm, is surgical removal; metastatic renal cancer is largely incurable with limited response to chemotherapy and radiotherapy. Thus, most patients with SRMs elect surgery, either partial or radical nephrectomy by open ...

Invited Commentary 
Charles M. Balch, MD; Merrick I. Ross, MD

Lymphatic mapping is essential in performing sentinel lymph node biopsy (SLNB) procedures accurately because it allows for the complete visualization of nodal groups at risk for metastases.1 While the use of Tc 99–labeled agents has been the gold standard method for lymphatic mapping in patients with melanoma, ...

Research Letter 
Alice Chung, MD; Alexandra Gangi, MD; Farin Amersi, MD; Xiao Zhang, PhD; Armando Giuliano, MD

This study evaluates the safety of not performing a sentinel node biopsy for patients 70 years of age or older with clinically node-negative breast cancer.

Viewpoint 
Arghavan Salles, MD, PhD; Cara A. Liebert, MD; Ralph S. Greco, MD

This Viewpoints report on a program to help residents cope with daily stress, provide tools to manage challenges after completing residency, and reduce the risk of burnout, depression, and suicide.

Original Investigation  FREE
Junun Bae, MHS; Jaime Shade; Amanda Abraham; Brianna Abraham; Leigh Peterson, MHS; Eric B. Schneider, PhD; Thomas H. Magnuson, MD; Michael A. Schweitzer, MD; Kimberly E. Steele, MD, PhD

Importance  From February 21, 2006, through September 24, 2013, the Centers for Medicare & Medicaid Services (CMS) required, via the National Coverage Determination manual, that bariatric surgery be performed only in hospitals that had been designated as a Center of Excellence (COE). The effect of this certification ...

Invited Commentary: Evaluating Changes in Health Care Policy; Lauren Hersch Nicholas, PhD, MPP; Justin B. Dimick, MD, MPH
Original Investigation 
Christina L. Jacovides, MD; Gregory Nadolski, MD; Steven R. Allen, MD; Niels D. Martin, MD; Daniel N. Holena, MD; Patrick M. Reilly, MD; Scott Trerotola, MD; Benjamin M. Braslow, MD; Lewis J. Kaplan, MD; Jose L. Pascual, MD, PhD, FRCPS(C)
Includes: Supplemental Content

Importance  Optimizing the nature and sequence of diagnostic imaging when managing lower gastrointestinal hemorrhage may reduce subsequent morbidity and mortality.

Objectives  To determine if preceding visceral arteriography with computed tomographic angiography (CTA) in acute lower gastrointestinal hemorrhage increases hemorrhage identification and localization and to determine if ...

Invited Commentary: Computed Tomographic Angiography for Lower Gastrointestinal Hemorrhage; Amy L. Lightner, MD; Marcia M. Russell, MD
Invited Commentary 
Amy L. Lightner, MD; Marcia M. Russell, MD

This Invited Commentary discusses the increasing use of computed tomographic angiography prior to visceral angiography for lower gastrointestinal hemorrhage and raises questions about clinical outcomes and costs to be considered before it is used routinely.

Invited Commentary 
Lauren Hersch Nicholas, PhD, MPP; Justin B. Dimick, MD, MPH

The cost-benefit trade-offs of regionalizing elective surgery remain an important policy issue.1,2 In this issue, Bae and colleagues3 examine patient demographics following a 2006 Medicare National Coverage Decision (NCD) regarding bariatric surgery. The NCD simultaneously extended bariatric surgery coverage to all Medicare patients (previously ...

JAMA Surgery Clinical Challenge 
Matthew M. Boelig, MD; Pablo Laje, MD; William H. Peranteau, MD
Comment & Response 
Neeraja Nagarajan, MD, MPH; Varshini Varadaraj, MBBS, MS

To the Editor We commend the timely article by Kotagal and Horvath1 that discusses the challenges of providing surgical care in under-resourced settings, and we look forward to more articles that address this important issue. As the authors point out, low- and middle-income countries have complex health ...

Comment & Response 
Richard Vander Burg, RN, BSN; Charles Kabetu, MD; Ruben Ayala, MD

To the Editor We commend Ginwalla and Rickard on their recent publication “Surgical Missions: The View From the Other Side”1 in JAMA Surgery. At Operation Smile, we wholeheartedly support and agree with the comments put forward by the authors regarding the duty of mission-based organizations to ...

Original Investigation  FREE
Caitlin W. Hicks, MD, MS; Elizabeth C. Wick, MD; Joseph K. Canner, MHS; James H. Black III, MD; Isibor Arhuidese, MD, MPH; Umair Qazi, MD, MPH; Tammam Obeid, MD; Julie A. Freischlag, MD; Mahmoud B. Malas, MD, MHS

Importance  Endovascular technology has become ubiquitous in the modern care of abdominal aortic aneurysm (AAA), yet broad estimates of its efficacy among variable hospital and regional settings is not known.

Objective  To perform a preliminary analysis of hospital effects on mortality following open AAA repair (OAR) ...

Invited Commentary: Improving the Quality of Data in Surgical Registries; Philip P. Goodney, MD, MS
Original Investigation 
Hunter B. Moore, MD; Elizabeth Juarez-Colunga, PhD; Michael Bronsert, PhD, MS; Karl E. Hammermeister, MD; William G. Henderson, MPH, PhD; Ernest E. Moore, MD; Robert A. Meguid, MD, MPH
Includes: Supplemental Content

Importance  The literature regarding the occurrence of adverse outcomes following nonobstetric surgery in pregnant compared with nonpregnant women has conflicting findings. Those differing conclusions may be the result of inadequate adjustment for differences between pregnant and nonpregnant women. It remains unclear whether pregnancy is a risk factor ...

Invited Commentary 
Philip P. Goodney, MD, MS

This Invited Commentary discusses the need for better data to assess mortality in abdominal aortic aneurysm repair and improve practice patterns in vascular surgery.

Surgical Innovation 
Audrey E. Ertel, MD; Tiffany Kaiser, PharmD; Shimul A. Shah, MD, MHCM

A telehealth intervention is described in patients following liver transplantation.

Research Letter 
Judson B. Williams, MD, MHS; Ralf E. Harskamp, MD; Saideep Bose, MD, MPH; Jeffrey H. Lawson, MD, PhD; John H. Alexander, MD, MHS; Peter K. Smith, MD; Renato D. Lopes, MD, PhD

This anonymous, voluntary, electronic survey sought to characterize the techniques of vein graft preservation and handling among a large cohort of high-performing US cardiovascular hospitals.

Viewpoint 
William P. Schecter, MD

This Viewpoint discusses global surgery initiatives in low- and middle-income countries.

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