High barriers to treatment are associated with stereotactic radiation instead of surgery for patients with operable stage I non-small cell lung cancer†.

Objectives: Although surgery is considered the standard of care for early-stage lung cancer, there has been increased use of stereotactic radiotherapy for operable patients in recent years. Given that this modality may be perceived as a more practical treatment, we hypothesized that it might be more often delivered to patients who experience barriers to care.

Methods: The National Cancer Database (2018-2020) was queried for patients with clinical stage IA non-small cell lung cancer treated with surgery or stereotactic radiotherapy (48-60 Gy, 3-5 fractions), excluding patients with contraindications to surgery.

Single-dock Robotic Bilateral Transversus Abdominis Release: Technique Description and Preliminary Outcomes.

Background: Posterior component separation with transversus abdominis release (TAR) is a valuable adjunct to address incisional hernia defects. Currently, bilateral docking is a standard technique for robotic TAR. The aim of this study is to describe our technique for extended totally extraperitoneal (eTEP) repair with bilateral TAR through a bottom single-dock robotic approach for hernias at the level of the umbilicus or higher.

Elective complex ventral hernia repair in contaminated fields: A propensity score-matched analysis of long-term quality of life and outcomes between different prostheses.

Background: Randomized studies have endorsed nonabsorbable prosthetics for contaminated ventral hernia surgery, yet the broader applicability and impact on patient-reported outcomes are still questioned. Here, we evaluated the long-term outcomes of elective contaminated ventral hernia repairs (based on Centers of Disease Control and Prevention [CDC] wound classification) using real-world data from a multicenter US cohort, focusing on quality of life and postoperative pain.

Methods: The Abdominal Core Health Quality Collaborative database was queried for patients undergoing elective contaminated (CDC class II-IV) ventral hernia repair (2013-2023).

Trends and Disparities in Robotic Surgery Utilization for Non-Small Cell Lung Cancer.

Introduction: Robotic surgery has become an increasingly utilized approach for resectable lung cancer. However, availability may be limited for certain patient populations, underscoring inequity in access to innovative surgical techniques. We hypothesize that there is an association between social determinants of health and robotic surgery utilization for resectable non-small cell lung cancer (NSCLC).

The Representation of Women Moderators at The Society of Thoracic Surgeons Annual Meeting.

Background: Recently, there has been an increase in the representation of women within the cardiothoracic surgery workforce, with discussions about gender equity garnering interest. We sought to identify whether this increase is accompanied by commensurate selection for representation at national meetings.

Methods: Online archives of The Society of Thoracic Surgeons (STS) Annual Meetings were reviewed from 2015 to 2024.

Pneumonectomy for non-small cell lung cancer. A National Cancer Database analysis of geographic and temporal trends, outcomes, and associated factors.

Background: The circumstances under which pneumonectomy should be performed are controversial. This study aims to investigate national trends in pneumonectomy use to determine which patients, in what geographic areas, and under what clinical circumstances pneumonectomy is performed in the United States.

Methods: We queried the National Cancer Database and included all patients undergoing anatomic surgical resection for non-small cell lung cancer (2015-2020).

Gastric bypass revisional surgery: percentage total body weight loss differences among three different techniques.

Introduction: Suboptimal weight loss or weight regain may occur after Roux-en-Y gastric bypass (RYGB). For this reason, revisional surgery has gained increasing interest. We aimed to compare the percentage of total body weight loss (%TBWL) at one-year follow-up among three different techniques: Jejuno-jejunostomy distalization (JJD), Sleeve resection of the gastrojejunostomy and gastric pouch (SRGJP), and the combination of both (JJD + SRGJP).

Resection of the Primary Tumor and Survival in Patients with Single-Site Synchronous Oligometastatic Non-Small Cell Lung Cancer: Propensity-Matched Analysis of the National Cancer Database.

Background: Local therapy for the primary tumor is postulated to remove resistant cancer cells as well as immunosuppressive cells from the tumor microenvironment, potentially improving response to systemic therapy (ST). We sought to determine whether resection of the primary tumor was associated with overall survival (OS) in a multicentric cohort of patients with single-site synchronous oligometastatic non-small cell lung cancer.

Study Design: Using the National Cancer Database (2018 to 2020), we evaluated patients with clinical stage IVA disease who received ST and stratified the cohort based on receipt of surgery for the primary tumor (S).

Elevated glycosylated hemoglobin levels are associated with severe acute kidney injury following coronary artery bypass surgery.

Background: Diabetic patients are at increased risk of acute kidney injury (AKI) following surgery. The significance of uncontrolled diabetes on kidney function after coronary artery bypass grafting (CABG) remains controversial. Our aim was to study the association between pre-operative hemoglobin A1c (HbA1c) and severe cardiac surgery-associated AKI (CSA-AKI) following CABG.

Is underutilization of adjuvant therapy in resected non-small-cell lung cancer associated with socioeconomic disparities?

Objectives: Although adjuvant systemic therapy (AT) has demonstrated improved survival in patients with resected non-small-cell lung cancer (NSCLC), it remains underutilized. Recent trials demonstrating improved outcomes with adjuvant immunotherapy and targeted treatment imply that low uptake of systemic therapy in at-risk populations may widen existing outcome gaps. We, therefore, sought to determine factors associated with the underutilization of AT.

Slowly absorbable mesh in sublay ventral hernia repair in contaminated fields.

Background: In the past years, there has been increasing evidence that supports the use of permanent mesh in contaminated wounds. Given this increased evidence, the indications to opt for slowly absorbable "biosynthetic" prostheses have been questioned. To address this, we compared the outcomes of slowly absorbable mesh in contaminated cases in a well-matched multicentric cohort.

Underutilization of Systemic Therapy in Patients With NSCLC Undergoing Pneumonectomy: A Missed Opportunity for Survival.

Introduction: Recent trials have reported promising results with the addition of immunotherapy to chemotherapy for patients with locally advanced NSCLC, but in practice, the proportion of patients who receive systemic therapy (ST) has historically been low. Underutilization of ST may be particularly apparent in patients undergoing pneumonectomy, in whom the physiologic insult and surgical complications may preclude adjuvant therapy (ADJ). We, therefore, evaluated the use of ST for patients with NSCLC undergoing pneumonectomy.

Preoperative frailty assessment in older patients with colorectal cancer: use of clinical and radiological tool.

Purpose: The Memorial Sloan Kattering Frailty Index (MSK-FI) and the Skeletal Muscle Index (SMI) have recently gained attention as markers of frailty and decreased physiologic reserve, and are promising as predictors of adverse postoperative outcomes in patients undergoing oncologic surgery. The objective of this study was to establish the prognostic accuracy of these indexes in a cohort of patients with colorectal cancer subjected to surgical intervention.

Methods: We performed an observational study including all patients older than 60 years, subjected to colorectal cancer surgery between January 2010 and May 2020, and stratified our cohort based on the presence of frailty, as defined by MSK-FI ≥ 3.

Permanent vs Absorbable Mesh for Ventral Hernia Repair in Contaminated Fields: Multicenter Propensity-Matched Analysis of 1-Year Outcomes Using the Abdominal Core Health Quality Collaborative Database.

Background: Traditionally, the use of absorbable mesh in contaminated fields aimed to reduce postoperative morbidity at the expense of increased hernia recurrence. This dogma has recently been challenged in randomized trials that demonstrate the advantages of permanent mesh in this setting. Although these studies are of high quality, their reproducibility across institutions is limited.

Exploring the Challenges for International Medical Graduates Pursuing Minimally Invasive Surgery Training in the United States and Canada: A Cross-Sectional Analysis.

Background: International Medical Graduates (IMGs) are an important component of the US healthcare workforce. Prior studies have investigated bias against IMGs during the general surgery residency application in the United States. Minimally invasive surgery (MIS) is a growing field; The MIS fellowship match was established in 2004 and is a competitive process with a match rate of 47%.

Predictors of anastomotic leak after total gastrectomy in patients with adenocarcinoma.

Background: Esophagojejunal anastomotic leakage (EJAL) is among the most feared complications after gastric cancer surgery; they entail an uncertain prognosis and relate with increased morbidity and mortality. Factors associated with their development are not well determined, and their diagnosis and treatment vary between institutions.

Material And Methods: Retrospective case-control study of patients operated of total gastrectomy with Roux-en-Y esophagojejunostomy from January 2002 to December 2018.

The COVID-19 Pandemic Did Not Affect Target Weight Loss 1 Year Post Bariatric Surgery.

Background: Bariatric surgery is one of the most effective treatments for patients with severe and complex obesity. Lifestyle modifications in diet and exercise habits have long been important adjunct to the long-term success after bariatric surgery. The effect of the COVID-19 pandemic on the postoperative bariatric patient is not well understood.