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 Showing 61-80 of 128 Articles

This Viewpoint proposes a strategy to reduce general surgery resident attrition, focusing on the creation of formal mentorship programs.

This Viewpoint discusses specialty fellowships within general surgery and emphasizes the importance of striking a balance between specialty fellowships and residential training.

This Viewpoint discusses training of general surgery subspecialists through postresidency fellowships.

Surgical Innovation 
Caprice C. Greenberg, MD, MPH; Janet Dombrowski, BSN, MHSA; Justin B. Dimick, MD, MPH

This article discusses the potential of video-based peer coaching to improve the quality and safety of surgical care.

Original Investigation 
Christina L. Roland, MD; Genevieve M. Boland, MD, PhD; Elizabeth G. Demicco, MD; Kristelle Lusby, MD; Davis Ingram, BS; Caitlin D. May, PhD; Christine M. Kivlin, BS; Kelsey Watson, BS; Ghadah A. Al Sannaa, MD; Wei-Lien Wang, MD; Vinod Ravi, MD; Raphael E. Pollock, MD, PhD; Dina Lev, MD; Janice N. Cormier, MD; Kelly K. Hunt, MD; Barry W. Feig, MD; Alexander J. Lazar, MD, PhD; Keila E. Torres, MD, PhD
Includes: Supplemental Content

Importance  Vascular leiomyosarcomas are a rare subtype of leiomyosarcomas that most commonly affect the inferior vena cava and account for 5% of all leiomyosarcomas. These tumors are aggressive malignant tumors for which adjuvant modalities have not shown increased efficacy compared with surgery.

Objectives  To evaluate the ...

Invited Commentary: Finding the Common Thread in Rare Diseases; Eric K. Nakakura, MD, PhD
Original Investigation 
Alexandra Thomas, MD; Seema A. Khan, MD; Elizabeth A. Chrischilles, PhD; Mary C. Schroeder, PhD
Includes: Supplemental Content

Importance  Management of the primary tumor site in patients with metastatic breast cancer remains controversial.

Objective  To evaluate the patterns of receipt of initial breast surgery for female patients with stage IV breast cancer in the United States, with particular attention to women who survived at ...

Invited Commentary: Surgery for Stage IV Breast Cancer; Lisa A. Newman, MD, MPH
Invited Commentary 
Eric K. Nakakura, MD, PhD

Soft-tissue sarcomas are extremely rare, with an estimated 11 930 new cases in the United States in 2015, representing less than 1% of all new cancer cases.1 They are a heterogeneous group of diseases with more than 80 different histologic types and subtypes that have widely different clinical ...

Invited Commentary 
Lisa A. Newman, MD, MPH

Advances in systemic therapy have improved survival of women with metastatic breast cancer. The Thomas et al1 analysis of Surveillance, Epidemiology, and End Results (SEER) data supports the concept that surgery may contribute to an outcome advantage by reducing the total body burden of disease. While this ...

JAMA Surgery Clinical Challenge 
Steve M. Niemiec, BA; Joseph M. Vinetz, MD; Jason K. Sicklick, MD

A 64-year-old man from the Philippines presented with 5 months of progressive fatigue, worsening jaundice, and a 13-kg weight loss and no fever, chills, or abdominal pain. What is your diagnosis?

Comment & Response 
Daniela Calderaro, MD, PhD; Danielle Menosi Gualandro, MD, PhD; Bruno Caramelli, MD, PhD

To the Editor We read with great interest the study by Spolverato and colleagues1 recently published in JAMA Surgery. They elegantly explore the effect of acute anemia on the perioperative period of major abdominal surgery, showing that a lower nadir hemoglobin (Hb) level and a higher ...

Original Investigation 
Xinli Li, PhD; Mark Wilson, MD, PhD; William Nylander, MD, MBA; Tracy Smith, MS; Marilyn Lynn, NP, MSN, CPHQ; William Gunnar, MD, JD

Importance  This study analyzes and reports Clostridium difficile infection (CDI) rates, risk factors, and associations with postoperative outcomes in the Veterans Health Administration (VHA).

Objective  To report 30-day postoperative CDI rates and outcomes and identify associated risks by surgical procedures and preoperative patient demographics in a ...

Invited Commentary: The High Stakes of Postoperative Clostridium difficile Infection; Paul K. Waltz, MD; Brian S. Zuckerbraun, MD
Invited Commentary 
Paul K. Waltz, MD; Brian S. Zuckerbraun, MD

Clostridium difficile is a major cause of hospital-acquired infections. Attention has been focused over the past 2 decades to the increasing incidence of C difficile infection (CDI), the high recurrence rates, and the associated morbidity and mortality. Patients undergoing surgical procedures are at relatively high risk for ...

Elizabeth J. Lilley, MD, MPH; Kashif T. Khan, MD; Fabian M. Johnston, MD, MHS; Ana Berlin, MD, MPH; Angela M. Bader, MD, MPH; Anne C. Mosenthal, MD; Zara Cooper, MD, MSc
Includes: Supplemental Content

Importance  Inpatient palliative care improves symptom management and patient satisfaction with care and reduces hospital costs in seriously ill patients. However, the role of palliative care in the treatment of patients undergoing surgery (surgical patients) remains poorly defined.

Objective  To characterize the content, design, and results ...

Research Letter 
Katharine Yao, MD; Jeff Belkora, PhD; Mark Sisco, MD; Shoshana Rosenberg, ScD, MPH; Isabelle Bedrosian, MD; Erik Liederbach, BS; Chihsiung Wang, PhD

This survey examines surgeons’ knowledge of contralateral prophylactic mastectomy.

Comment & Response 
Dipesh P. Gopal, BMBS; Charlotte Lee, MBChB

To the Editor We commend Salles and colleagues1 on their comprehensive well-being program, which is laudable in its scope. The issue of physicians’ well-being is one shared across the Atlantic.2 Increasing strain on health care organizations increases the risk of physician burnout. We provide evidence for ...

Steven J. Hasday, BS; Karan R. Chhabra, AB; Justin B. Dimick, MD, MPH

This Viewpoint reviews the study results of and reactions to the Salminen et al acute appendicitis trial and provides recommendations for surgeons who will be confronted by patients questioning whether they need surgery.

Original Investigation 
Charles C. van Rossem, MD; Marc H. F. Schreinemacher, MD, PhD; Anna A. W. van Geloven, MD, PhD; Willem A. Bemelman, MD, PhD; for the Snapshot Appendicitis Collaborative Study Group

Importance  Optimal duration of antibiotic treatment to reduce infectious complications after an appendectomy for acute complicated appendicitis remains unclear.

Objective  To investigate the effect of antibiotic duration on infectious complications after laparoscopic appendectomy for acute complicated appendicitis.

Design, Setting, and Participants  National multicenter prospective, observational, ...

Original Investigation 
Mia Shapiro, MD; Qi Chen, MD, PhD; Qin Huang, MD, PhD; Valia A. Boosalis, MD; Charles H. Yoon, MD, PhD; Mandeep S. Saund, MD; Edward E. Whang, MD; Jason S. Gold, MD

Importance  Socioeconomic variables including sex, race, ethnicity, marital status, and insurance status are associated with survival in pancreatic cancer. It remains unknown exactly how these variables influence survival, including whether they affect stage at presentation or receipt of treatment or are independently associated with outcomes.

Objectives  ...

Invited Commentary: Outcome Disparities in Pancreatic Cancer; Daniel A. Anaya, MD; Mokenge Malafa, MD
Original Investigation 
Zhengqing Lei, MD; Jun Li, MD; Dong Wu, MD; Yong Xia, MD; Qing Wang, MD; Anfeng Si, MD; Kui Wang, MD; Xuying Wan, MD; Wan Yee Lau, MD, FRCS; Mengchao Wu, MD; Feng Shen, MD, PhD
Includes: Supplemental Content

Importance  The presence of microvascular invasion (MVI) decreases surgical outcomes of hepatocellular carcinoma (HCC). An accurate preoperative prediction of MVI can help surgeons to better choose surgical procedures, but accuracy is still difficult to achieve.

Objective  To develop a nomogram to predict MVI presence before liver ...

Invited Commentary: Evaluation of Microvascular Invasion in Hepatocellular Carcinoma; Ernesto Sparrelid, MD; Marco Del Chiaro, MD, PhD
Invited Commentary 
Daniel A. Anaya, MD; Mokenge Malafa, MD

The study published in this issue of JAMA Surgery by Shapiro et al1 sought to understand differences in outcomes observed in early-stage pancreatic cancer. The authors used a population-level cancer registry (Surveillance, Epidemiology, and End Results Program) and included patients with localized disease only, for whom surgery ...

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