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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 21-40 of 43 Articles
Invited Commentary 
Ira L. Leeds, MD, MBA; Elizabeth C. Wick, MD
The aviation and other industries with low-frequency but catastrophic events have embraced the model of high-reliability organizations. First described by editor Todd LaPorte1 and later popularized by Weick and Sutcliffe,2 high-reliability organizations are characterized by operational sensitivity, resilience mechanisms, experience with deference, recognition of complexity, and a preoccupation with failure. ...
Invited Commentary 
J. Michael Millis, MD
The article by Gerlach et al1 published in this issue of JAMA Surgery has the promise to usher in an era in which the time to cease traditional medical and surgical therapies and initiate transplantation care is defined. The role of intestinal transplantation, although proven to be of value in ...
Original Investigation 
Jeffrey E. Keenan, MD; Paul J. Speicher, MD; Julie K. M. Thacker, MD; Monica Walter, DNP; Maragatha Kuchibhatla, PhD; Christopher R. Mantyh, MD

Importance  Surgical site infections (SSIs) in colorectal surgery are associated with increased morbidity and health care costs.

Objective  To determine the effect of a preventive SSI bundle (hereafter bundle) on SSI rates and costs in colorectal surgery.

Design  Retrospective study of institutional clinical and cost ...

Original Investigation 
Undine A. Gerlach, MD; Georgios Vrakas, MD; Srikanth Reddy, MD, PhD, MBBS, FRCS; Daniel C. Baumgar, MD, PhD; Peter Neuhaus, MD, PhD; Peter J. Friend, MD, MA, MB, BChir, FRCS; Andreas Pascher, MD, PhD, MBA; Anil Vaidya, MD

Importance  Because of the severity of disease and additional surgery, Crohn disease (CD) may result in intestinal failure (IF) and dependency on home parenteral nutrition (HPN). Defining the indication and timing for intestinal transplantation (ITx) is challenging.

Objectives  To determine the limitations of conventional surgery and ...

Original Investigation 
Ryan A. Helmick, MD; Meredith L. Knofsky, DO; Carla C. Braxton, MD; Anuradha Subramanian, MD; Patricia Byers, RM, M(ASCP), CIC; Charlie K. W. Lan, DO; Samir S. Awad, MD

Importance  As quality measures increasingly become tied to payment, evaluating the most effective ways to provide high-quality care becomes more important.

Objectives  To determine whether mandated reporting for ventilator and catheter bundle compliance is correlated with decreased infection rates, and to determine whether labor-intensive audits are ...

Michael R. Rose, MD
Health care hasn’t held such hope and possibility for patients since the explosion of technological advances that began 3 decades ago. To be sure, this is an era of disruptive, wrenching change in the health care delivery system. It has been made especially unsettling because the course forward in the ...
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 
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, ...

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