Characterizing patterns of opioid prescribing after outpatient ventral hernia repair with mesh.

Purpose: Despite efforts to minimize opioid prescribing, outpatient ventral hernia repair (VHR) with mesh remains notoriously painful, often requiring postoperative opioid analgesia. Here, we aim to characterize patterns of opioid prescribing for the heterogenous group of patients and procedures that comprise mesh-based, outpatient VHR.

Methods: The Abdominal Core Health Quality Collaborative registry was queried for patients undergoing VHR with mesh who were discharged the same or next day between January 2019 to October 2023.

Mature effectiveness and toxicity outcomes associated with three treatment schedules of high-dose-rate brachytherapy monotherapy for favorable-risk prostate cancer.

Purpose: To present long-term toxicity and effectiveness outcomes of three prostate high-dose-rate (HDR) brachytherapy schedules: 38 Gy in 4 fractions, 24 Gy in 2 fractions, and 27 Gy in 2 fractions for men with low- or intermediate-risk prostate cancer.

Methods And Materials: Patients treated with HDR brachytherapy monotherapy for prostate cancer were identified in a prospectively maintained, single institution database. Patients with AJCC T-stage ≤ T2b, Gleason score ≤ 7, prostate-specific antigen level ≤ 20 ng/mL, and ≥2 years of follow-up were included.

Hospitals Infrequently Receive EMS Patient Care Reports in the Era of Electronic Medical Records: A Preliminary Report.

Objectives: Emergency Medical Services (EMS) patient care reports (PCRs) are an important component for the transfer of patient care from EMS systems to hospitals and a foundational element of EMS quality improvement (QI). The PCR may serve as the only objective source of information for EMS patient presentation. Surprisingly little data, either objective or anecdotal, exists regarding the reliability of this process.

"The Ultrathin Parascapular Flap: Proof of Concept and Use in Plantar Foot Reconstruction".

Optimal reconstruction of weight-bearing plantar foot defects is challenging due to the need for relatively thin coverage with simultaneous durability. The medial plantar flap provides an excellent tissue match but is not always available or appropriate (Figure 1, 2). Microsurgical free flap reconstruction provides many options for coverage.

Optimum anastomosis angle of end-to-side microsurgical anastomosis for preventing future shear-related risk of thrombosis by computationalmodeling.

End-to-side (ETS) microsurgical anastomosis is a powerful technique in microsurgery. It can overcome vessel's diameter discrepancy and preserve the distal blood flow. Optimal angle of the ETS anastomosis has been debated and studied, and is currently limited to animal models.

Assessing Public-Reported Perceptions of Low-Risk Hand Surgery Provided in the Office Versus an Ambulatory Surgery Center: Survey Study.

Purpose: There is growing evidence for the safety of wide-awake, office-based, low-risk hand surgery. However, there is limited insight into patient receptiveness to these procedures. Here, we evaluate the public perceptions and degree of tolerance of low-risk, office-based hand surgery.

Managing Soft Tissue Defects in Parry-Romberg Syndrome: An Individualized Approach.

Background: Parry-Romberg syndrome (PRS) is a rare condition characterized by a progressive shrinkage and degeneration of the tissues beneath the skin, usually on one side of the face. Managing this disease presents numerous challenges due to its heterogeneity and unpredictable outcomes. The existing literature is primarily composed of case reports and series, leading to a lack of comprehensive guidelines on surgical intervention for the various manifestations of PRS.

Aesthetic and Functional Reconstruction of Periorbital Region Using Radial Forearm Free Flap.

Background: This study describes the utilization of the radial forearm free flap (RFFF) for the restoration of severe soft tissue deficiency involving the upper and lower eyelids in three patients.

Methods: This study is a retrospective review of the senior authors' clinical records for patients who presented with periorbital defect and underwent reconstruction with RFFF between 2018 and 2022.

Results: As a part of a comprehensive reconstructive surgery, we used the RFFF to deliver an ample amount of well-vascularized soft tissue.

An approach to achieve tension-free closure and mitigate recurrence in the management of recurrent cervical keloids.

Keloid is a burdensome condition that negatively affects patient's quality of life. It is influenced by a spectrum of risk factors, including tension. We propose an approach to address the tension-free closure and optimize surgical outcomes in neck keloid.

Long-term survival in patients with brain-only metastatic non-small cell lung cancer undergoing upfront intracranial stereotactic radiosurgery and definitive treatment to the thoracic primary site.

Background And Purpose: To evaluate modern clinical outcomes for patients with brain-only metastatic non-small cell lung cancer (NSCLC) treated with intracranial stereotactic radiosurgery (SRS) with or without definitive treatment of the primary site.

Materials And Methods: Patients with synchronously diagnosed NSCLC and brain-only metastatic disease treated with intracranial SRS at a single institution were retrospectively identified. Patients were stratified based on whether they did (A) or did not (B) receive definitive primary site treatment.

Laparoscopic Repair of Pediatric Femoral Hernias.

Current rates of reported pediatric femoral hernias remain exceedingly low, with their incidence reported to be <1%. The mainstay of repair has traditionally been through an open approach, and pediatric surgeons remain reluctant to repair otherwise. Owing to its rarity, consensus regarding management remains absent.

Clinical Outcomes of Breast-Conserving Surgery with Synchronous 50-kV X-ray Intraoperative Partial Breast Irradiation in Patients Aged 64 Years or Older with Low-Risk Breast Cancer.

Background: Breast-conserving surgery with synchronous 50-kV X-ray intraoperative radiation therapy (TARGIT-IORT) is a convenient form of partial breast irradiation; however, the existing literature supports a wide range of local control rates.

Objectives: We investigated the treatment effectiveness and toxic effects of TARGIT-IORT in a patient cohort aged 64 years or older with low-risk breast cancer.

Design: Retrospective analysis.

Cervical disc arthroplasty versus anterior cervical discectomy and fusion: an analysis of the Michigan Spine Surgery Improvement Collaborative Database.

Background Context: Anterior cervical discectomy and fusion (ACDF) and cervical disc arthroplasty (CDA) are established surgical options for the treatment of cervical radiculopathy, myelopathy, and cervical degenerative disc disease. However, current literature does not demonstrate a clear superiority between ACDF and CDA.

Purpose: To investigate procedural and patient-reported outcomes of ACDF and CDA among patients included in the Michigan Spine Surgery Improvement Collaborative (MSSIC) database.

Identifying barriers to resident robotic console time in a general surgery residency through a targeted needs assessment.

Robotic-assisted general surgery is experiencing exponential growth. Despite our institution's high volume, residents often graduate with inadequate console experience. Our aim was to identify the educational needs of residents and perceived barriers to residents' console time from both attendings and residents.

Ulnar Nerve Translocation Following a Routine Distal Radius Fracture.

A 35-year-old right hand dominant male sustained a high energy closed right distal radius fracture with associated generalized paresthesias. Following closed reduction, the patient was found to have an atypical low ulnar nerve palsy upon outpatient follow-up. After continued symptoms and an equivocal wrist MRI the patient underwent surgical exploration.