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Editor's Audio Summary

February 25, 2014

JAMA Surgery, 2014-02-19 Online First articles, Editor's Audio Summary

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 Showing 1-20 of 38 Articles
Original Investigation  FREE
Timo W. Hakkarainen, MD, MS; Scott R. Steele, MD; Amir Bastaworous, MD, MBA; E. Patchen Dellinger, MD; Ellen Farrokhi, MD, MPH; Farhood Farjah, MD, MPH; Michael Florence, MD; Scott Helton, MD; Marc Horton, MD; Michael Pietro, MD; Thomas K. Varghese, MD; David R. Flum, MD, MPH

Importance  Nonsteroidal anti-inflammatory drugs (NSAIDs) have many physiologic effects and are being used more commonly to treat postoperative pain, but recent small studies have suggested that NSAIDs may impair anastomotic healing in the gastrointestinal tract.

Objective  To evaluate the relationship between postoperative NSAID administration and anastomotic ...

Original Investigation 
Emily Vaughan, BMedSc; Frances Sesay, MBChB; Adaora Chima, MBBS, MPH; Mira Mehes, BScH, MES; Benjamin Lee, MD; Dzifa Dordunoo, RN, MSN; Alice Sitch, MSc, BSc; Gilles de Wildt, MD, MSc; Thaim B. Kamara, MBBS, FWACS; Bailah Leigh, MBBS; Fizan Abdullah, MD, PhD; John Sampson, MD

Importance  Strengthening workforce capacity to deliver essential surgical and anesthesia care has been identified as a strategy for addressing the unmet burden of morbidity and mortality in under-resourced countries. Sierra Leone is one of the poorest countries in the world and faces the challenge of stretching limited ...

Original Investigation 
Anna F. Tyson, MD; Claire E. Kendig, BS; Charles Mabedi, MB, BS; Bruce A. Cairns, MD; Anthony G. Charles, MD, MPH

Importance  Changes in pulmonary dynamics following laparotomy are well documented. Deep breathing exercises, with or without incentive spirometry, may help counteract postoperative decreased vital capacity; however, the evidence for the role of incentive spirometry in the prevention of postoperative atelectasis is inconclusive. Furthermore, data are scarce regarding ...

JAMA Surgery Clinical Challenge 
Tafadzwa P. Makarawo, MD, MRCS; Jessica Bartock, DO; Marc L. Cullen, MD, MPH
Research Letter 
Robert E. Noll Jr, MD; B. Zane Atkins, MD; John Carson, MD; James Sampson, MD; David Dawson, MD; Scott Hundahl, MD; W. Darrin Clouse, MD
Vascular surgery is critical to military management of wartime casualties and, at the same time, to aging veterans with chronic vascular disorders.1,2 A federal system of collaboration in a restrictive health care environment can expand and enhance the provision of vascular care. We report our experience in developing and sustaining ...
Research Letter 
Monique Boudreaux-Kelly, PhD; Mark Wilson, MD, PhD; Malak Bokhari, MD, MPH
Risk-adjusted cumulative summation is an iterative statistical process control chart centered on 0 that allows for local and individualized risk adjustment.1- 3 Risk-adjusted cumulative summation scores signal special-cause variation if data points cross predefined control limits. We used cumulative summation charts and individual patient-level data at the Veterans Affairs (VA) ...
Viewpoint 
Ravinder S. Vohra, MD, PhD; Michael T. Hallissey, MD
This Viewpoint discusses how social networks and social media are revolutionizing the field of surgery, particularly surgical education.
Original Investigation 
Kendrick A. Shunk, MD, PhD; Jeffrey Zimmet, MD, PhD; Brian Cason, MD; Bernadette Speiser, MSN, CCRN, RCIS; Elaine E. Tseng, MD

Importance  Transcatheter aortic valve replacement (TAVR) revolutionized the treatment of aortic stenosis. Developing a TAVR program with a custom-built hybrid operating room (HOR) outside the surgical operating room area poses unique challenges in Veterans Affairs (VA) institutions.

Objective  To present the process by which the San ...

Original Investigation 
Chung-Yuan Hu, MPH, PhD; Christina E. Bailey, MD, MS; Y. Nancy You, MD, MHSc; John M. Skibber, MD; Miguel A. Rodriguez-Bigas, MD; Barry W. Feig, MD; George J. Chang, MD, MS

Importance  With the advent of effective modern chemotherapeutic and biologic agents, primary tumor resection for patients with stage IV colorectal cancer (CRC) may not be routinely necessary.

Objective  To evaluate the secular patterns of primary tumor resection use in stage IV CRC in the United States....

Original Investigation 
Bradley N. Reames, MD, MS; Robert W. Krell, MD; Darrell A. Campbell Jr, MD; Justin B. Dimick, MD, MPH

Importance  Previous studies of checklist-based quality improvement interventions have reported mixed results.

Objective  To evaluate whether implementation of a checklist-based quality improvement intervention—Keystone Surgery—was associated with improved outcomes in patients in a large statewide population undergoing general surgery.

Design, Setting, and Exposures  A retrospective longitudinal ...

Invited Commentary 
David R. Urbach, MD, MSc
The story of surgical quality improvement has become a saga of high hopes followed by dashed expectations. Eminently sensible quality and safety interventions—promoted by opinion leaders, endorsed by health quality organizations, and supported by impressive results in promising early studies—too frequently fail to perform as expected when they are introduced ...
Editorial 
Meera Kotagal, MD, MPH; Karen Horvath, MD
Service to patient and community has always been the sacred vow of every physician. Certainly for those marginalized in society—by poverty, plague, isolation, or disaster—our obligation takes on renewed importance. As the physician Francis Weld Peabody wrote in his classic essay “The Care of the Patient,” “One of the essential ...
Original Investigation 
Christopher A. Beadles, MD, PhD; Ashley D. Meagher, MD; Anthony G. Charles, MD, MPH
Includes: Supplemental Content

Importance  Abdominal wall hernia is one of the most common conditions encountered by general surgeons. Rising rates of abdominal wall hernia repair have been described; however, population-based evidence concerning incidence rates of emergent hernia repair and changes with time are unknown.

Objective  To examine trends in ...

Original Investigation 
Grace A. Nicksa, MD; Cristan Anderson, MD; Richard Fidler, CRNA; Lygia Stewart, MD

Importance  The Accreditation Council for Graduate Medical Education core competencies stress nontechnical skills that can be difficult to evaluate and teach to surgical residents. During emergencies, surgeons work in interprofessional teams and are required to perform certain procedures. To obtain proficiency in these skills, residents must be ...

Invited Commentary 
Diana L. Farmer, MD
General surgery education research is an important topic as work-hour restrictions continue to change. Most of the literature has focused on how simulation affects trainees’ procedural skills. The article by Nicksa and colleagues1 focuses on the nontechnical skills that the Accreditation Council for Graduate Medical Education requires that general training ...
JAMA Surgery Clinical Challenge 
Stéphanie Truant, MD, PhD; Charbel Chater, MD; François-René Pruvot, MD, PhD
Original Investigation 
Mohamed Elshaer, MD; Gianpiero Gravante, MD, PhD; Katie Thomas, MD, PhD; Roberto Sorge, PhD; Salem Al-Hamali, MD; Hamdi Ebdewi, MD
Includes: Supplemental Content

Importance  Subtotal cholecystectomy (SC) is a procedure that removes portions of the gallbladder when structures of the Calot triangle cannot be safely identified in “difficult gallbladders.”

Objective  To conduct a systematic review and meta-analysis to evaluate current studies and present an evidence-based assessment of the outcomes ...

Original Investigation 
Morgan K. Richards, MD; Jarod P. McAteer, MD, MPH; F. Thurston Drake, MD, MPH; Adam B. Goldin, MD, MPH; Saurabh Khandelwal, MD; Kenneth W. Gow, MD
Includes: Supplemental Content

Importance  Minimally invasive surgery (MIS) has created a shift in how many surgical diseases are treated. Examining the effect on resident operative experience provides valuable insight into trends that may be useful for restructuring the requirements of resident training.

Objective  To evaluate changes in general surgery ...

JAMA Surgery Clinical Challenge 
Ibrahim Nassour, MD; Sandy H. Fang, MD
Comment & Response 
Kevin Koo, MD, MPH, MPhil
To the Editor Hicks and colleagues1 highlight several ways in which operating room briefings improve patient safety and surgical quality, citing 4 categories of outcomes in their Table 2 that are aligned with Medicare incentives to reduce 30-day readmission rates. The concept of quality, however, has grown increasingly multifactorial in ...
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