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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 47 Articles
Invited Commentary 
Juan I. Arcelus, MD, PhD
Splenectomy remains a common procedure for the management of certain benign and malignant hematologic diseases. Laparoscopic splenectomy is associated with better outcomes than open splenectomy and has become the standard approach for these conditions.1- 3
Invited Commentary 
Simon P. Kim, MD, MPH; Marc C. Smaldone, MD, MSHP
During the past decade, performance of minimally invasive surgery (MIS) has rapidly disseminated into clinical practice for commonly performed procedures in the United States owing to lowering of the risk for complications, shortening of the length of stay, and improving convalescence compared with open surgery.1,2 Assessing the effect of MIS ...
Invited Commentary 
L. D. Britt, MD
Notwithstanding the several inherent limitations of any retrospective review (including omissions, miscodings or other inaccuracies, potential for selection bias), the study by Richman et al1 in this issue of JAMA Surgery reflects an enormous effort by the authors to analyze a large patient database to assess and measure the adherence ...
Original Investigation 
Naina Bagrodia, MD; Anna M. Button, MS; Philip M. Spanheimer, MD; Mary E. Belding-Schmitt, MS; Lori J. Rosenstein, MD; James J. Mezhir, MD

Importance  Splenectomy is a commonly performed operation; however, data from large series regarding operative outcomes to help guide decision making and informed consent are lacking.

Objective  To evaluate clinical and pathologic variables associated with morbidity and mortality following elective splenectomy for benign and malignant hematologic conditions ...

Original Investigation 
Giorgio Gandaglia, MD; Khurshid R. Ghani, MD; Akshay Sood, MD; Jessica R. Meyers, MD; Jesse D. Sammon, MD; Marianne Schmid, MD; Briony Varda, MD; Alberto Briganti, MD; Francesco Montorsi, MD; Maxine Sun, BSc; Mani Menon, MD; Adam S. Kibel, MD; Quoc-Dien Trinh, MD
Includes: Supplemental Content

Importance  Surgical site infection (SSI) represents the second most common cause of hospital-acquired infection and the most common type of infection in patients undergoing surgery. However, evidence is scarce regarding the effect of the surgical approach (open surgery vs minimally invasive surgery [MIS]) on the risk for ...

Original Investigation 
Joshua S. Richman, MD, PhD; Kamal M. F. Itani, MD; Rhiannon J. Deierhoi, MPH; William G. Henderson, MPH, PhD; Mary T. Hawn, MD, MPH
Includes: Supplemental Content

Importance  The Surgical Care Improvement Project perioperative β-blocker (BB) (SCIP-BB) continuation measure was revised in 2012 to incorporate inpatient BB continuation after discharge from the postanesthesia care unit.

Objective  To determine whether adherence to the original or revised SCIP-BB measure is associated with decreased adverse events....

Original Investigation 
Joseph Miller, MD, MS; Janice Cho, BA; Meina Joseph Michael, BS; Rola Saouaf, MD; Shirin Towfigh, MD

Importance  Occult hernias are symptomatic but not palpable on physical examination. This is more commonly seen with inguinal hernias. Early diagnosis and treatment of occult hernias are essential in relieving symptoms and improving patients’ quality of life.

Objective  To determine the effectiveness of imaging—ultrasonography (US), computed ...

Original Investigation 
Monica Morrow, MD; Yun Li, PhD; Amy K. Alderman, MD; Reshma Jagsi, MD, DPhil; Ann S. Hamilton, PhD; John J. Graff, PhD; Sarah T. Hawley, PhD; Steven J. Katz, MD, MPH

Importance  Most women undergoing mastectomy for breast cancer do not undergo breast reconstruction.

Objective  To examine correlates of breast reconstruction after mastectomy and to determine if a significant unmet need for reconstruction exists.

Design, Setting, and Participants  We used Surveillance, Epidemiology, and End Results registries ...

JAMA Surgery Clinical Challenge 
Alessandra Landmann, MD; Juan L. Calisto, MD; Russell G. Postier, MD
Invited Commentary 
Paul Montero, MD; Richard D. Schulick, MD, MBA
Möller et al1 report on common bile duct stone (CBDS) incidence, management, and outcomes in a large retrospective cohort analysis. They find a higher rate of unfavorable outcomes when stones are encountered and no measures are taken to address them. Limitations, including the heterogenous metric of unfavorable outcome and the ...
Original Investigation 
Mats Möller, MD; Ulf Gustafsson, MD, PhD; Finn Rasmussen, MD, PhD; Gunnar Persson, MD, PhD; Anders Thorell, MD, PhD

Importance  The optimal strategy for common bile duct stones (CBDSs) encountered during cholecystectomy is yet to be determined.

Objective  To evaluate the outcomes after various interventional techniques to clear the bile ducts and the natural course of CBDSs found during intraoperative cholangiography.

Design, Setting, and Participants...

Original Investigation  FREE
John O. Hwabejire, MD, MPH; Haytham M. A. Kaafarani, MD, MPH; Jarone Lee, MD, MPH; Daniel D. Yeh, MD; Peter Fagenholz, MD; David R. King, MD; Marc A. de Moya, MD; George C. Velmahos, MD, PhD

Importance  With the dramatic growth in the very old population and their concomitant heightened exposure to traumatic injury, the trauma burden among this patient population is estimated to be exponentially increasing.

Objective  To determine the clinical outcomes and predictors of in-hospital and 1-year mortality in nonagenarian ...

Original Investigation 
Nicholas B. Abt, BS; José M. Flores, MPH; Pablo A. Baltodano, MD; Karim A. Sarhane, MD, MSc; Francis M. Abreu, BS; Carisa M. Cooney, MPH; Michele A. Manahan, MD; Vered Stearns, MD; Martin A. Makary, MD, MPH; Gedge D. Rosson, MD
Includes: Supplemental Content

Importance  Neoadjuvant chemotherapy (NC) is increasingly being used in patients with breast cancer, and evidence-based reports related to its independent effects on morbidity after mastectomy with immediate breast reconstruction are limited.

Objective  To determine the effect of NC on 30-day postoperative morbidity in women undergoing mastectomy ...

Peter W. Dillon, MD, MSc; Harold L. Paz, MD, MS
It is an inescapable fact that the expectations for the delivery of high-value, safe, and effective patient care in the hospital setting have changed dramatically over the last few years, and nowhere is this evolution more evident than in acute surgical care. The increasing number of process and outcome measures, ...
Invited Commentary 
Darren Malinoski, MD
The need for an increase in the number of organs available to patients on the transplant waiting list has clearly been established. In this issue, Salim and colleagues1 describe their efforts to address this shortage by increasing consent rates for organ donation among Hispanic Americans. There is also an emerging ...
Invited Commentary 
Stephen Kaminski, MD
Using financial incentives to improve efficiency is not new. The business world routinely uses this. A quotation often attributed to Peter Drucker1 comes to mind: “What’s measured improves.” I prefer to think of this as “people will work faster if you pay them to work faster.” This is an effective ...
Original Investigation 
Ali Salim, MD; Eric J. Ley, MD; Cherisse Berry, MD; Danielle Schulman, MPH; Sonia Navarro, BA; Ling Zheng, MD, PhD; Linda S. Chan, PhD

Importance  The need for suitable organs for transplantation is especially pronounced in minority populations such as Hispanic Americans owing to disproportionately high rates of diabetes mellitus and kidney disease. Considerable barriers exist for Hispanic Americans consent to donation, resulting in significantly lower donation rates compared with white ...

Original Investigation 
Ken Catchpole, PhD; Eric Ley, MD; Doug Wiegmann, PhD; Jennifer Blaha, MBA; Daniel Shouhed, MD; Alexandra Gangi, MD; Renaldo Blocker, PhD; Richard Karl, MD; Cathy Karl, MBA; Bill Taggart, BS; Benjamin Starnes, MD; Bruce Gewertz, MD
Includes: Supplemental Content

Importance  A physician-centered approach to systems design is fundamental to ameliorating the causes of many errors, inefficiencies, and reliability problems.

Objective  To use human factors engineering to redesign the trauma process based on previously identified impediments to care related to coordination problems, communication failures, and equipment ...

Original Investigation 
Thomas M. Scalea, MD; Darlene Carco, RN; Melissa Reece, RN; Yvette L. Fouche, MD; Andrew N. Pollak, MD; Sushruta S. Nagarkatti, MD

Importance  Operating room (OR) turnaround times (TATs) and on-time first-case starts (FCSs) are commonly used measures of OR efficiency. Prolonged TATs and late FCSs occur frequently at academic medical centers.

Objective  To test the hypothesis that establishing a financial incentive program (FIP) for OR teams would ...

Special Communication 
Steven C. Stain, MD; David B. Hoyt, MD; John G. Hunter, MD; Geoffrey Joyce, PhD; Jonathan R. Hiatt, MD

The Affordable Care Act (ACA) attempts to change the way we finance and deliver health care by coordinating the delivery of primary, specialty, and hospital services in accountable care organizations. The ways in which accountable care organizations will develop and evolve is unclear; however, the effects on surgeons ...

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