No Difference in Perioperative Outcomes Following Colorectal Cancer Resection Between Flagship and Non-Flagship Hospitals in New York State.

Background: Hospitals are rapidly consolidating to create large healthcare systems. Whether outcomes following colorectal cancer resection at flagship hospitals differ from those at non-flagship hospitals is unknown.

Methods: A 6-year retrospective analysis of an all-payor New York State (NYS) hospital database was conducted.

The always evolving diagnosis and management of Clostridioides difficile colitis: What you need to know.

The diagnosis, pharmacologic management, and surgical options for Clostridioides difficile infection (CDI) are rapidly evolving, which presents a challenge for the busy surgeon to remain up to date on the latest clinical guidelines. This review provides an evidence-based practical guide for CDI management tailored to the needs of surgeons and surgical intensivists. Historically, the diagnosis of CDI relied on slow cell culture cytotoxicity neutralization assays, but now, the rapidly resulting nucleic acid amplification tests and enzyme immunoassays have become mainstream.

Enhancing Hospital Reimbursement Through a Pediatric Surgery Resident Orientation Program: A Focus on Accurate Diagnosis Code Documentation for Acute Appendicitis.

Background: The usage of specific ICD-10 diagnosis codes significantly influences hospital reimbursement compared to non-specific codes. This study hypothesized that a formal orientation program for pediatric surgery residents would enhance the selection of accurate and specific diagnosis codes for acute appendicitis such as K35.30 for "Acute appendicitis with localized peritonitis" rather than K35.

Filter Out the Noise: How to Narrow Your Search for the Perfect Match by the Collaboration of Surgical Education Fellows (CoSEF).

The residency match process can be overwhelming. We are the Collaboration of Surgical Education Fellows (CoSEF), a multi-institutional group of surgical residents. Our perspectives represent our current experiences as residents at academic programs, but all authors recently underwent the general surgery resident interview and match process, during which they interviewed at programs of all kinds.

Is it gossip or feedback? Surgical attendings' perceptions of gossip within residency.

Objective: Gossip-evaluative talk about an absent third party-exists in surgical residency programs. Attending surgeons may engage in gossip to provide residents with feedback on performance, which may contribute to bias. Nevertheless, the perspectives of attending surgeons on gossip has not been studied.

Plain Chest Film Versus Computed Tomography of the Chest as the Initial Imaging Modality for Blunt Thoracic Injury.

Background: While chest X-ray (CXR) is an efficient tool for expeditious detection of life-threatening injury, chest computed tomography (CCT) is more sensitive albeit with added time, cost, and radiation. Thus far, there is limited evidence and lack of consensus on the best imaging practices. We sought to determine the association between imaging modality and outcomes in isolated blunt thoracic trauma.

Geographic and demographic trends with the initiation of virtual interviews in general surgery: A 7-program evaluation.

Background: Although most general surgery residency interviews remain virtual, the effect of this format remains understudied. Single-institution data have shown an increase in the number of applications received and interviews conducted with virtual interviewing but no change in the geographic backgrounds of interviewed or matched applicants. This study sought to compare national trends in geographic characteristics of general surgery applicants, interviewed applicants, and matched applicants between in-person and virtual application cycles.

The Magic Number 63 - Redefining the Geriatric Age for Massive Transfusion in Trauma.

Introduction: The arbitrary geriatric age cutoff of 65 may not accurately define older adults at higher risk of mortality following massive transfusion (MT). We sought to redefine a new geriatric age threshold for MT and understand its association with outcomes.

Material And Methods: The 2013-2018 Trauma Quality Improvement Program database was queried for all adults who received ≥10 units of packed red blood cells (pRBCs) within 24 h of admission.

Gun violence revictimization in New York State: What increases the risk of being shot again?

Background: While gun injuries are more likely to occur in urban settings and affect people of color, factors associated with gun violence revictimization-suffering multiple incidents of gun violence-are unknown. We examined victim demographics and environmental factors associated with gun violence revictimization in New York State (NYS).

Methods: The 2005 to 2020 NYS hospital discharge database was queried for patients aged 12 years to 65 years with firearm-related hospital encounters.

How I GPT It: Development of Custom Artificial Intelligence (AI) Chatbots for Surgical Education.

Artificial Intelligence (AI) chatbots provide a novel format for individuals to interact with large language models (LLMs). Recently released tools allow nontechnical users to develop chatbots using natural language. Surgical education is an exciting area in which chatbots developed in this manner may be rapidly deployed, though additional work will be required to ensure their accuracy and safety.

Challenging Dogma by Skipping the Emergency Department Thoracotomy: A Propensity Score Matched Analysis of the Trauma Quality Improvement Database.

Introduction: Survival following emergency department thoracotomy (EDT) for patients in extremis is poor. Whether intervention in the operating room instead of EDT in select patients could lead to improved outcomes is unknown. We hypothesized that patients who underwent intervention in the operating room would have improved outcomes compared to those who underwent EDT.

Perceptions of Competition-Based Learning After a Brief Experience at a National Surgical Meeting.

Background: Competition-based learning (CBL) facilitates learning through competitions. At the 2022 & 2023 Annual SAGES meetings, we evaluated a CBL experience (TOP GUN Shootout) developed from a modified version of the previously validated TOP GUN Laparoscopic Skills and Suturing Program. The project sought to evaluate the TOP GUN Shootout's (TGS) ability to enhance participant engagement in pursuit of laparoscopic surgical skills.

Thriving as a Surgical Intern: Three Tips From the Collaboration of Surgical Education Fellows (CoSEF).

We are the multi-institutional organization known as the Collaboration of Surgical Education Fellows (CoSEF). We've collectively reflected on our range of experiences across the country and identified 3 principles which promote a successful intern experience: (1) Own your patients; (2) Treat people like people; and (3) Take care of yourself.

Transfusion futility thresholds and mortality in geriatric trauma: Does frailty matter?

Background: Data on massive transfusion (MT) in geriatric trauma patients is lacking. This study aims to determine geriatric transfusion futility thresholds (TT) and TT variations based on frailty.

Methods: Patients from 2013 to 2018 TQIP database receiving MT were stratified by age and frailty.

Utility of intracranial pressure monitoring in patients with traumatic brain injuries: a propensity score matching analysis of TQIP data.

Purpose: Intracranial pressure monitoring (ICPM) is central to traumatic brain injury (TBI) management, but its utility is controversial.

Methods: The 2016-2017 TQIP database was queried for isolated TBI. Patients with ICPM [(ICPM (+)] were propensity-score matched (PSM) to those without ICPM [ICPM (-)] and divided into three age groups by years (< 18, 18-54, ≥  55).

Simulation-Based Medical Education: Development of an Assessment Tool for Novice Use.

Background: Simulation-based medical education, an educational model in which students engage in simulated patient scenarios, improves performance. However, assessment tools including the Oxford Non-Technical Skills (NOTECHS) scale require expert assessors. We modified this tool for novice use.

Syringomatous Tumor of the Nipple.

Syringomatous tumor of the nipple (SyT), previously known as syringomatous adenoma of the nipple (SAN) was originally described in 1983 as a rare benign tumor of the sweat duct. It is a rare benign tumor arising from the skin adnexal eccrine glands that can be misdiagnosed as invasive carcinoma due to its infiltrative nature, resulting in overtreatment. We report clinical, histopathologic, and surgical findings of a case of infiltrating syringomatous adenoma in a 40-year-old female as well as a literature review of previous cases.

Severe Pancreatitis Multidisciplinary Working Group: Exploratory Analysis to Optimize Care and Cost.

Introduction: The minimally invasive step-up approach to pancreatitis improves outcomes. Multidisciplinary working groups may best facilitate this approach. However, support for these working groups requires funding.

Surgery Acting Internship Individual Learning Plans: Fostering Mentorship in the COVID-19 Era.

Objective: Mentorship facilitates successful matching for surgical specialties. A formal mentorship plan may counteract restricted mentorship opportunities due to the COVID-19 pandemic.

Design: We surveyed medical students applying to surgery specialties who participated in our formalized mentorship program (M) and those of a prior cohort who were informally mentored (M).

Strategies for appropriate positioning and repositioning the Avalon ECMO cannula in a 17-year-old with left hepatic vein malposition.

Introduction: Extracorporeal membrane oxygenation (ECMO) is a well-recognized therapy in children with refractory hypoxia. Different cannulas have been used with reported complications with placement, such as cardiac perforation, and multiple reports focusing on avoiding this. However, strategies to avoid hepatic vein cannulation and reposition when it occurs are not well described.