Does Management of Postoperative Nausea and Vomiting Differ by Patient Demographics? An Evaluation of Perioperative Anesthetic Management - An Observational Study.

Background: Disparities in postoperative nausea and vomiting (PONV) and its prophylaxis may exist based on race, ethnicity, and socioeconomic status (SES). Our objective was to evaluate whether patients from racial and ethnic minority groups and patients from lower SES backgrounds received less appropriate PONV prophylaxis and experienced higher rates of PONV and post-discharge nausea and vomiting (PDNV).

Methods: This retrospective cohort study included 23,333 adults who underwent major surgeries (total knee arthroplasty, cholecystectomy, hysterectomy, and prostatectomy) from 2017-2022 in a single, multi-state hospital system.

Quality of Cancer Recurrence Data in the National Cancer Database: A Reappraisal of Reporting Readiness.

Background: This study evaluated the quality of cancer recurrence data in the National Cancer Database (NCDB) to determine if missingness and reporting consistency have improved enough to support national research.

Methods: This multi-methods study included NCDB analyses and a cancer registry staff survey. Trends in recurrence data missingness from 2004 to 2021 and multivariable analyses of factors associated with missingness from 2017 to 2021 were evaluated for 4,568,927 patients with non-metastatic cancer.

National Trends and Benchmarks for Operative Time and Hospital Length of Stay in Parotidectomies.

Objective: The extent of parotidectomy for benign tumors has de-escalated in the United States. We aim to define modern benchmarks for operative time and hospital length of stay (LOS) in parotidectomy and identify risk factors that may prolong these benchmarks.

Study Design: This is a retrospective cross-sectional study of all adults who underwent parotidectomy for a primary parotid neoplasm between January 2011 and December 2021 using the American College of Surgeons National Surgical Quality Improvement Program database.

American College of Surgeons Cancer Program Annual Report from 2021 Participant User File.

The National Cancer Database (NCDB) collects data from approximately 1,500 Commission on Cancer (CoC) facilities and represent 73.7% of newly diagnosed cancers nationwide. The American College of Surgeons Cancer Program developed it first annual report from the NCDB 2021 participant user file reporting new observations and recent trends of cancer diagnoses, patient demographics, and treatments as well as an in-depth report on treatment and outcomes in breast, pancreas, and colon cancers.

American College of Surgeons survival calculator for biliary tract cancers: using machine learning to individualize predictions.

Background: Although cancer prognosis is most commonly estimated by tumor stage, survival is multifactorial. Our objective was to develop an American College of Surgeons "Biliary Tract Cancer Survival Calculator" prototype using machine learning to generate personalized survival estimates based on patient, tumor, and treatment factors.

Methods: The National Cancer Database was used to identify all patients with biliary tract malignancies between 2010 and 2017 including intrahepatic bile duct, extrahepatic bile duct, and gallbladder cancers.

Oncocytic Adrenal Neoplasms: Clinical Profiles and Long-Term Outcomes.

Oncocytic adrenal neoplasms, defined by ≥90 % of oncocytic cells, are rare. The significance of oncocytic changes within an adrenal neoplasm remains unclear. A retrospective study of adults who underwent adrenalectomy at a large center identified pure oncocytic neoplasms on final pathology (1997-2022).

When Is Diversion Indicated After Right-Sided Colon Resections?

Introduction: Ileocolonic anastomoses have a low anastomotic leak (AL) risk, resulting in infrequent diverting loop ileostomy use. Identifying patients who warrant diverting loop ileostomy with right-sided resection is challenging due to this low incidence of AL. Therefore, a multicenter database was used to develop an AL risk score to help inform when diversion should be strongly considered after right-sided resections.

Reproductive Experiences of Physicians in Medical and Surgical Subspecialties.

To evaluate the reproductive experiences of physicians across gender and specialty. Between November and December 2021, we surveyed nontrainee physicians of all genders at a single quaternary institution using a modified version of an existing survey instrument. Experiences with family planning, fertility, pregnancy, and parental leave were assessed.

Perioperative outcomes of robotic versus laparoscopic paraesophageal hernia repair: a NSQIP analysis.

Background: Studies comparing outcomes between robotic and laparoscopic paraesophageal hernia repairs have yielded conflicting results. We sought to analyze early postoperative complications between these approaches using a newly available NSQIP variable indicating robot use.

Methods: We queried the 2022 ACS NSQIP database for adult patients undergoing elective minimally invasive hiatal hernia repair.

Rurality and patients' hospital experience: A multisite analysis from a US healthcare system.

Background: The association between rurality of patients' residence and hospital experience is incompletely described. The objective of the study was to compare hospital experience by rurality of patients' residence.

Methods: From a US Midwest institution's 17 hospitals, we included 56,685 patients who returned a post-hospital Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey.

Trends and Distribution of IPAAs in the United States: Becoming Harder to Find in Colon and Rectal Surgery Residency Training?

Background: There has been concern among colon and rectal surgery residency programs in the United States that IPAA procedures have been decreasing, but evidence is limited.

Objective: The study aimed to evaluate the number of IPAAs performed by colon and rectal surgery residents in the United States and analyze the distribution of these cases on a national level.

Design: Retrospective.

Prophylactic antibodies inhibit spike-specific T and B cell responses after COVID-19 vaccination.

Active and passive immunization is used in high-risk patients to prevent severe courses of COVID-19, but the impact of prophylactic neutralizing antibodies on the immune reaction to the mRNA vaccines has remained enigmatic. Here we show that CD4 T and B cell responses to Spikevax booster immunization are suppressed by the therapeutic antibodies Casirivimab and Imdevimab. B cell and T cell responses were significantly induced in controls but not in antibody-treated patients.

Thrombotic and Hemorrhagic Outcomes After Elective Surgery in Preoperatively Anticoagulated Patients.

Objective: To better understand the incidence and timing of thrombotic and hemorrhagic complications in anticoagulated patients undergoing elective surgery.

Methods: Using institutional American College of Surgeons National Surgical Quality Improvement Program data, we identified patients receiving preoperative anticoagulation undergoing elective surgery between 2011 and 2021. Medical records review supplemented National Surgical Quality Improvement Program data to detail complication and anticoagulation type and timing.

Neuroendocrine Tumors of Unknown Primary in the Setting of Cytoreductive Hepatectomy.

Background: Surgical cytoreduction for neuroendocrine tumor liver metastasis (NETLM) consistently shows positive long-term outcomes. Despite reservations in guidelines for surgery when the primary tumor is unidentified (UP-NET), this study compared the surgical and oncologic long-term outcomes between patients with these rare cases undergoing cytoreductive surgery and patients who had liver resection for known primaries.

Methods: The study identified 32 unknown primary liver metastases (UP-NETLM) in 522 retrospectively evaluated patients who underwent resection of well-differentiated NETLM between January 2000 and December 2020.

Outpatient surgery benchmarks and practice variation patterns: case controlled study.

Background: Despite numerous potential benefits of outpatient surgery, there is currently a lack of national benchmarking data available for hospitals and surgeons to compare their own outcomes as they transition toward outpatient surgery.

Materials And Methods: Patients who underwent 14 common general surgery operations from 2016 to 2020 were identified in the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. Operations were selected based on frequency and the ability to be performed both inpatient and outpatient.

Is the Rise of Medicare Advantage Impacting the Fidelity of Traditional Medicare Claims Data? Implications for Reporting of Long-Term Total Hip Arthroplasty Survivorship.

Background: Arthroplasty registries often use traditional Medicare (TM) claims data to report long-term total hip arthroplasty (THA) survivorship. The purpose of this study was to determine whether the large number of patients leaving TM for Medicare Advantage (MA) has compromised the fidelity of TM data.

Methods: We identified 10,962 THAs in 9,333 Medicare-eligible patients who underwent primary THA from 2000 to 2020 at a single institution.

The Impact of an Overactive Bladder Care Pathway on Longitudinal Patient Management.

Importance: Implementation of an overactive bladder (OAB) care pathway may affect treatment patterns and progression.

Objectives: This study aimed to assess the effect of OAB care pathway implementation on treatment patterns for women with OAB.

Study Design: This retrospective cohort study evaluated women with OAB, before (January 1, 2015-December 31, 2017) and after (January 1, 2019-December 31, 2021) care pathway initiation.

Postoperative Complications After Sling Operations for Incontinence: Is Race a Factor?

Importance: Racial and ethnic disparities exist in urogynecologic surgery; however, literature identifying specific disparities after sling operations for stress incontinence are limited.

Objective: The objective of this study was to evaluate racial and ethnic disparities in surgical complications within 30 days of midurethral sling operations.

Study Design: This retrospective cohort study identified women who underwent an isolated midurethral sling operation between 2014 and 2021 using the American College of Surgeons National Surgical Quality Improvement Program database.

Impact of pharmacogenomic profiles on post-surgical pain following laparotomy for gynecologic pathology.

Objectives: The aim of this prospective study was to compare perioperative opioid use in women by status of CYP2D6, a highly polymorphic pharmacogene relevant to opioid metabolism.

Methods: Patients undergoing laparotomy were prospectively recruited and provided a preoperative saliva swab for a pharmacogenomic (PGx) gene panel. Postoperative opioid usage and pain scores were evaluated via chart review and a phone survey.

Distinct presentation of melanoma in Black patients may inform strategies to improve outcomes.

Introduction: Melanoma guidelines stem largely from data on non-Hispanic White (NHW) patients. We aimed to identify features of melanoma within non-Hispanic Black (NHB) patients to inform strategies for earlier detection and treatment.

Methods: From 2004 to 2019 Surveillance, Epidemiology, and End Results (SEER) data, we identified nonmetastatic melanoma patients with known TN category and race.

Balancing trade-offs: Enhanced carbon assimilation and productivity with reduced nutritional value in a well-watered C pasture under a warmer CO-enriched atmosphere.

The concentration of atmospheric CO and temperature are pivotal components of ecosystem productivity, carbon balance, and food security. In this study, we investigated the impacts of a warmer climate (+2 °C above ambient temperature) and an atmosphere enriched with CO (600 ppm) on gas exchange, antioxidant enzymatic system, growth, nutritive value, and digestibility of a well-watered, managed pasture of Megathyrsus maximus, a tropical C forage grass, under field conditions. Elevated [CO] (eC) improved photosynthesis and reduced stomatal conductance, resulting in increased water use efficiency and plant C content.