Journal of the American College of Surgeons (JACS)

The November issue of JACS is live. Explore the latest research on advances in surgical care, postoperative risk assessment, and the changing demands on healthcare systems. Full issue at: ovid.com/jnls/journalacs/toc…

Higher technical skill scores did not translate into more accurate predictions of surgical outcomes. In a study of 19 experienced surgeons reviewing robotic sleeve gastrectomy videos, perceived technical performance differed from actual postoperative outcomes. Read the full study by @mattiaballo and colleagues at: doi.org/10.1097/XCS.00000000…

ERAS implementation alone does not guarantee improved outcome. In a province-wide study of 3,292 colorectal surgery patients, each 10-percentage-point increase in ERAS adherence was associated with a 5.5% reduction in postoperative complication. Read the full study by Puterman-Salzman at: doi.org/10.1097/XCS.00000000…

A 60-day threshold emerged for emergency general surgery after acute pulmonary embolism. In a national study of 3,785 patients, operation ≥60 days after pulmonary embolism was associated with 79% lower adjusted odds of thromboembolic complication. Read the full study by Mehta and colleagues at: doi.org/10.1097/XCS.00000000…

Does more delirium screening mean better detection or simply more documented cases? In nearly 98,000 surgical patients, screening rate was 94% at geriatric surgery–verified hospitals vs 52% at nonverified hospitals. Host @TomVargheseJr is joined by Drs Remer and Russell to discuss their recently published article, on the latest episode of the #OperativeWord theoperativeword.podbean.com…

A humanized monoclonal antibody improved arterial oxygenation by 33% and reduced neutrophil infiltration by 83% following smoke inhalation injury in rats. Targeting citrullinated histone H3 may offer a therapeutic approach to acute lung injury. Read the full study by Aziz and colleagues at: doi.org/10.1097/XCS.00000000…

Postoperative delirium screening was nearly twice as common at Geriatric Surgery Verification hospitals compared with nonverified hospitals, yet delirium screen positivity remained similar in a national @AmCollSurgeons NSQIP analysis of 97,886 patients. Read the full study by Remer and colleagues at: ovid.com/10.1097/XCS.0000000…

After 2 failed peripheral IV attempts, a 3rd succeeded in only 39% of hypotensive trauma patients. A multicenter study of 929 attempts across 479 patients found diminishing returns with repeated attempts, supporting earlier consideration of alternative vascular access. Find the full study by Dumas and colleagues at: doi.org/10.1097/XCS.00000000…

88% of US surgeons viewed surgery as a calling, a perception independently associated with higher flourishing. A national survey of 283 surgeons found high overall flourishing (7.98/10), but social relationships scored lowest (7.41/10). Read the full study by Ig-Izevbekhai and colleagues at: ovid.com/10.1097/XCS.0000000… @MayoClinic @DukeMedSchool @DukeSurgery

Missed radiotherapy appointments decreased by nearly 40% across 194 US cancer programs. An @AmCollSurgeons national quality improvement collaborative included 99,057 patients and reduced rates of missing ≥3 treatments from 8.3% to 5.0%. Read the full study by Chan and colleagues at: ovid.com/10.1097/XCS.0000000…

A humanized anti-CitH3 monoclonal antibody improved arterial oxygenation by 33% following smoke inhalation injury (77.5 vs 58.2 mmHg). In a preclinical rat model, treatment also reduced neutrophil infiltration, NET formation, and NLRP3 expression. Find the full study by Aziz and colleagues at: ovid.com/10.1097/XCS.0000000… @kibbemr

Congratulations to the JACS Author of the Month, Lena K Egbert, MD! In this video, Dr Egbert highlights findings from her recently published article, Longitudinal Incidence and Outcomes of Remnant Cholecystitis after Subtotal Cholecystectomy: An Analysis of 2,682 Patients. Read the full study by Egbert and colleagues out of @MayoAZSurg at: ovid.com/10.1097/XCS.0000000…

Indocyanine green fluorescence identified 83% of malignant hepatic specimens but was not significantly associated with negative surgical margins. A prospective, 13-center study of 43 pediatric oncologic operations highlights the tumor-specific performance of fluorescence-guided operation. Read the full study by Schermerhorn and colleagues at: doi.org/10.1097/XCS.00000000…

Despite guideline recommendations, post-discharge venous thromboembolism prophylaxis remains uncommon after thoracic cancer operation. Among 157,619 patients, only 1.5% received prophylaxis after lung resection and 11.2% after esophagectomy. Substantial variation persists across providers and health systems. Read the full study by @ElioBitar and colleagues at: doi.org/10.1097/XCS.00000000…

Endoscopic sleeve gastroplasty was associated with more than twice the 30-day readmission rate of sleeve gastrectomy (3.8% vs 1.6%). In a national cohort of 3,753 matched patients, reoperation rate was also higher after endoscopic sleeve gastroplasty (1.0% vs 0.3%). Read the full study by Leslie and colleagues at: doi.org/10.1097/XCS.00000000…

An updated surgical palliative care research agenda identifies 11 gaps across patient selection, care delivery, and outcome measurement, including intervention timing, surgical communication, and patient-centered outcomes. Read the full study by Wong and colleagues at: doi.org/10.1097/XCS.00000000…