December 1, 2016 Issue of JAMA Surgery

December 2016, Vol 151, No. 12, Pages 1097-1193

In This Issue of JAMA Surgery

Highlights

Abstract Full Text

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JAMA Surg. 2016;151(12):1097. doi:10.1001/jamasurg.2015.2958

Viewpoint

The Need for Postdischarge, Patient-Centered Data in Trauma

Arturo J. Rios-Diaz, MD; Jimmy Lam, BS; Cheryl K. Zogg, MSPH, MHS

Abstract Full Text

JAMA Surg. 2016;151(12):1101-1102. doi:10.1001/jamasurg.2016.2343

This Viewpoint assesses the current status of postdischarge data collection in US trauma registries.

A Call to Action to Develop Programs for Bystanders to Control Severe Bleeding

Matthew J. Levy, DO, MSc; Lenworth M. Jacobs, MD, MPH

Abstract Full Text

JAMA Surg. 2016;151(12):1103-1104. doi:10.1001/jamasurg.2016.2789

This Viewpoint discusses the importance of recommendations for all responders, including bystanders, to have the education and necessary equipment to stop severe bleeding, similar to use of cardiopulmonary resuscitation and automated external defibrillators.

Editorial

Announcing the New JAMASurgery.com

Paul Gee; Colleen Kelly; Michael Berkwits, MD, MSCE

Abstract Full Text

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JAMA Surg. 2016;151(12):1105-1106. doi:10.1001/jamasurg.2016.4155

Original Investigation

Association of VA Surgeons

Efficacy of Local Anesthetic With Dexamethasone on the Quality of Recovery Following Total Extraperitoneal Bilateral Inguinal Hernia Repair: A Randomized Clinical Trial

Bryan Sakamoto, MD, PhD; Gene Harker, MD, PhD; Andrew C. Eppstein, MD; et al.

Abstract Full Text

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JAMA Surg. 2016;151(12):1108-1114. doi:10.1001/jamasurg.2016.2905

This randomized clinical trial compares the efficacy of a transversus abdominis plane block with dexamethasone and preperitoneal instillation of local anesthetic with dexamethasone vs control on postoperative quality of recovery following a bilateral total extraperitoneal inguinal hernia repair.

Invited Commentary
Improved Recovery After Laparoscopic Bilateral Inguinal Hernia Repair: Perception vs Function Improvement?
Robert V. Rege, MD

JAMA Surg

Combined Epidural-General Anesthesia vs General Anesthesia Alone for Elective Abdominal Aortic Aneurysm Repair

Amit Bardia, MBBS; Akshay Sood, MD; Feroze Mahmood, MD; et al.

Abstract Full Text

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JAMA Surg. 2016;151(12):1116-1123. doi:10.1001/jamasurg.2016.2733

This study uses data from the Vascular Study Group of New England data registry to compare postoperative complication and long-term survival rates in patients who received general anesthesia with those who received combined epidural and general anesthesia for elective abdominal aortic aneurysm repair.

Invited Commentary
Increased Survival Secondary to Decreased Perioperative Complications in Open Aortic Aneurysm Repair Using Epidural Anesthesia : The Long and the Short of It
Gale L. Tang, MD

JAMA Surg

Pacific Coast Surgical Association

Nationwide Assessment of Trends in Choledocholithiasis Management in the United States From 1998 to 2013

Michael W. Wandling, MD, MS; Eric S. Hungness, MD; Emily S. Pavey, MA; et al.

Abstract Full Text

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JAMA Surg. 2016;151(12):1125-1130. doi:10.1001/jamasurg.2016.2059

This cohort study evaluates secular trends in the management of choledocholithiasis in the United States and compares hospital length of stay between patients with choledocholithiasis treated with endoscopic retrograde cholangiopancreatography with laparoscopic cholecystectomy vs laparoscopic common bile duct exploration with laparoscopic cholecystectomy.

Invited Commentary
Surgical Management of Choledocholithiasis: A Disappearing Skill
Feng Shen, MD; Timothy M. Pawlik, MD, MPH, PhD

JAMA Surg

External Validation of the Estimation of Physiologic Ability and Surgical Stress (E-PASS) Risk Model to Predict Operative Risk in Perihilar Cholangiocarcinoma

Robert J. S. Coelen, MD; Pim B. Olthof, MD; Susan van Dieren, PhD; et al.

Abstract Full Text

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JAMA Surg. 2016;151(12):1132-1138. doi:10.1001/jamasurg.2016.2305

This cohort study investigates the ability of the original and modified Estimation of Physiologic Ability and Surgical Stress (E-PASS) risk models to discriminate mortality risk after resection for suspected perihilar cholangiocarcinoma.

Long-term Cost-effectiveness in the Veterans Affairs Open vs Endovascular Repair Study of Aortic Abdominal Aneurysm: A Randomized Clinical Trial

Frank A. Lederle, MD; Kevin T. Stroupe, PhD; Tassos C. Kyriakides, PhD; et al.

Abstract Full Text

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JAMA Surg. 2016;151(12):1139-1144. doi:10.1001/jamasurg.2016.2783

This randomized clinical trial compares the use of health care services, costs, and cost-effectiveness between patients undergoing open and endovascular repair of abdominal aortic aneurysm.

Invited Commentary
The Balance of Open vs Endovascular Aneurysm Repair: Cost Equipoise
Gilbert R. Upchurch Jr, MD

JAMA Surg

Standard vs Distal Roux-en-Y Gastric Bypass in Patients With Body Mass Index 50 to 60: A Double-blind, Randomized Clinical Trial

Hilde Risstad, MD; Marius Svanevik, MD; Jon A. Kristinsson, MD, PhD; et al.

Abstract Full Text

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JAMA Surg. 2016;151(12):1146-1155. doi:10.1001/jamasurg.2016.2798

This randomized clinical trial assesses the efficacy and safety of standard gastric bypass vs distal gastric bypass in patients with a BMI of 50 to 60.

Invited Commentary
Bariatric Surgery in Patients With Body Mass Index Greater Than 50 : Technique or Timing?
Oliver A. Varban, MD; Justin B. Dimick, MD, MPH

JAMA Surg

Association of VA Surgeons

Complications and Failure to Rescue After Inpatient Noncardiac Surgery in the Veterans Affairs Health System

Nader N. Massarweh, MD, MPH; Panagiotis Kougias, MD, MSc; Mark A. Wilson, MD, PhD

Abstract Full Text

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JAMA Surg. 2016;151(12):1157-1165. doi:10.1001/jamasurg.2016.2920

This national cohort study uses data from the Veterans Affairs National Surgical Quality Improvement Program to report noncardiac postoperative outcomes in the Veterans Affairs health system for the past 15 years.

Invited Commentary
Codman, Hawthorne, and End Results of a Watched System
Jason M. Johanning, MD, MS; Shipra Arya, MD, SM

JAMA Surg

Variation in Medicare Expenditures for Treating Perioperative Complications: The Cost of Rescue

Jason C. Pradarelli, MD, MS; Mark A. Healy, MD, MS; Nicholas H. Osborne, MD, MS; et al.

Abstract Full Text

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JAMA Surg. 2016;151(12):e163340. doi:10.1001/jamasurg.2016.3340

This retrospective cohort study evaluates differences across hospitals in the costs of care for patients surviving perioperative complications after major inpatient surgery.

Implications of the Patient Protection and Affordable Care Act on Insurance Coverage and Rehabilitation Use Among Young Adult Trauma Patients

Cheryl K. Zogg, MSPH, MHS; Fernando Payró Chew, BS; John W. Scott, MD, MPH; et al.

Abstract Full Text

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JAMA Surg. 2016;151(12):e163609. doi:10.1001/jamasurg.2016.3609

This population-based study evaluates insurance coverage and rehabilitation use among young adult trauma patients since implementation of the Patient Protection and Affordable Care Act, as well as the Dependent Coverage Provision and Medicaid expansion/open enrollment.

Invited Commentary
Assessing the Effect of the Affordable Care Act on Surgical Populations
Hari Nathan, MD, PhD; Justin B. Dimick, MD, MPH

JAMA Surg

Invited Commentary

Improved Recovery After Laparoscopic Bilateral Inguinal Hernia Repair: Perception vs Function Improvement?

Robert V. Rege, MD

Abstract Full Text

JAMA Surg. 2016;151(12):1114-1115. doi:10.1001/jamasurg.2016.2906

Increased Survival Secondary to Decreased Perioperative Complications in Open Aortic Aneurysm Repair Using Epidural Anesthesia : The Long and the Short of It

Gale L. Tang, MD

Abstract Full Text

JAMA Surg. 2016;151(12):1123-1124. doi:10.1001/jamasurg.2016.2753

Surgical Management of Choledocholithiasis: A Disappearing Skill

Feng Shen, MD; Timothy M. Pawlik, MD, MPH, PhD

Abstract Full Text

JAMA Surg. 2016;151(12):1130-1131. doi:10.1001/jamasurg.2016.2087

The Balance of Open vs Endovascular Aneurysm Repair: Cost Equipoise

Gilbert R. Upchurch Jr, MD

Abstract Full Text

JAMA Surg. 2016;151(12):1145. doi:10.1001/jamasurg.2016.2831

Bariatric Surgery in Patients With Body Mass Index Greater Than 50 : Technique or Timing?

Oliver A. Varban, MD; Justin B. Dimick, MD, MPH

Abstract Full Text

JAMA Surg. 2016;151(12):1156. doi:10.1001/jamasurg.2016.2828

Codman, Hawthorne, and End Results of a Watched System

Jason M. Johanning, MD, MS; Shipra Arya, MD, SM

Abstract Full Text

JAMA Surg. 2016;151(12):1165. doi:10.1001/jamasurg.2016.2901

Sometimes Wrong, Always In Doubt: Is There a Crisis of Confidence in General Surgery Residents?

Steven Yule, PhD; Stanley W. Ashley, MD

Abstract Full Text

JAMA Surg. 2016;151(12):1176. doi:10.1001/jamasurg.2016.2825

Assessing the Effect of the Affordable Care Act on Surgical Populations

Hari Nathan, MD, PhD; Justin B. Dimick, MD, MPH

Abstract Full Text

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JAMA Surg. 2016;151(12):e163635. doi:10.1001/jamasurg.2016.3635

Review

Confidence Crisis Among General Surgery Residents: A Systematic Review and Qualitative Discourse Analysis

Dawn M. Elfenbein, MD, MPH

Abstract Full Text

JAMA Surg. 2016;151(12):1166-1175. doi:10.1001/jamasurg.2016.2792

This study systematically reviews the quality of evidence collected on confidence levels in graduating general surgery residents and to critically analyze the language used to describe the findings using quantitative methods.

Invited Commentary
Sometimes Wrong, Always In Doubt: Is There a Crisis of Confidence in General Surgery Residents?
Steven Yule, PhD; Stanley W. Ashley, MD

JAMA Surg

JAMA Surgery Clinical Challenge

A Massive Retroperitoneal Mass With Leukocytosis

Kyle J. Van Arendonk, MD, PhD; Jin He, MD, PhD

Abstract Full Text

JAMA Surg. 2016;151(12):1177-1178. doi:10.1001/jamasurg.2016.3180

A man had worsening abdominal discomfort and a large recurrent umbilical hernia, early satiety but no nausea or vomiting, night sweats, and weight loss; examination revealed an umbilical hernia, palpable abdominal mass, and lower extremity edema. What is your diagnosis?

Acute Upper Abdominal Pain With a Distended Cecum in the Left Upper Quadrant

Wenliang Chen, MD, PhD; David M. Kelly, MD

Abstract Full Text

JAMA Surg. 2016;151(12):1179-1180. doi:10.1001/jamasurg.2016.3185

A woman in her 60s presented with acute-onset, diffuse abdominal pain for 24 hours accompanied by nausea and retching and a distended cecum in the upper left quadrant. What is your diagnosis?

Research Letter

Development of a Conceptual Model for Surgical Quality Improvement Collaboratives: Facilitating the Implementation and Evaluation of Collaborative Quality Improvement

Michael W. Wandling, MD, MS; Christina A. Minami, MD, MS; Julie K. Johnson, MSPH, PhD; et al.

Abstract Full Text

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JAMA Surg. 2016;151(12):1181-1183. doi:10.1001/jamasurg.2016.2817

This literature review examines the creation of a conceptual model of a surgical quality improvement collaborative to facilitate the development, implementation, and systematic evaluation of the Illinois Surgical Quality Improvement Collaborative.

Computer-Assisted Process Modeling to Enhance Intraoperative Safety in Cardiac Surgery

Christopher L. Tarola, MD, MPH; Jacquelyn A. Quin, MD, MPH; Miguel E. Haime, MD; et al.

Abstract Full Text

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JAMA Surg. 2016;151(12):1183-1186. doi:10.1001/jamasurg.2016.2839

This study documents and analyzes the first clinical use of the HUB, a computer-assisted system designed to support intraoperative team performance.

Association of VA Surgeons

Outcomes of Patients Undergoing Endoscopic Endonasal Skull Base Surgery at a VA Hospital

Michael Jones, MD; Stephen Johans, MD; Andrea Ziegler, MD; et al.

Abstract Full Text

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JAMA Surg. 2016;151(12):1186-1187. doi:10.1001/jamasurg.2016.2916

This study examines if outcomes of veterans undergoing endoscopic endonasal skull base surgery in the VA system rival those in other published studies.

Association of VA Surgeons

Association Between Postoperative Admission and Location of Hernia Surgery: A Matched Case-Control Study in the Veterans Administration

Hillary J. Mull, PhD, MPP; Amy K. Rosen, PhD; Steven D. Pizer, PhD; et al.

Abstract Full Text

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JAMA Surg. 2016;151(12):1187-1190. doi:10.1001/jamasurg.2016.3113

This case-control study examines postoperative outcomes following in Veterans Administration ambulatory surgery centers vs hospital outpatient departments in patients who underwent inguinal hernia surgery.

Comment & Response