Journal of the American College of Surgeons
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In this study, we aimed to report our experience with the use of intraoperative transcutaneous laryngeal ultrasonography (TLUSG) to evaluate the vocal cord twitch response during predissection vagus nerve stimulation in thyroid surgeries and examine the reliability of this technique when compared with that of laryngeal twitch palpation (LTP). ⋯ The innovative intraoperative application of TLUSG is better for evaluating the laryngeal twitch response than LTP. This technique provides practical troubleshooting guidance for patients with no IONM signals during predissection vagus nerve stimulation.
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Complication rates after colectomy remain high. Previous work has failed to establish the relative contribution of patient comorbidities, surgeon performance, and hospital systems in the development of complications after elective colectomy. ⋯ This study demonstrated that variance from measured factors at the patient level contributed more than 8-fold more to the development of complications after colectomy compared with variance at the surgeon and hospital level, highlighting the impact of patient comorbidities on postoperative outcomes. These results underscore the importance of initiatives that optimize patient foundational health to improve surgical care.
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Despite the growth of mentorship opportunities for women in surgery, women remain largely underrepresented in the surgical field. Mentorship is an effective strategy to increase female entry and retention within surgical careers. There is limited literature evaluating mentorship for women in surgery across different career levels and racial backgrounds. ⋯ Mentorship plays a pivotal role in early career development for women in the surgical field. Access to mentors with shared gender and racial compositions can provide a unique level of support for female and URiM mentees. Expanded and earlier mentorship access for women and minority students can increase diversity in the surgical field.
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ICD codes are used to identify patients with appendicitis and to classify disease severity for reimbursement and research purposes. We sought to compare the accuracy of ICD-9 vs ICD-10 codes in classifying appendicitis as uncomplicated vs complicated (defined as perforated, necrotic, or abscess) compared with the clinical gold standard: surgeon characterization of the appendix in the operative report. ⋯ Compared with ICD-9 codes, ICD-10 codes were less accurate in characterizing severity of appendicitis. The ICD-10 coding schema does not provide an accurate representation of disease severity. Until this system is improved, significant caution is needed for people who rely on these data for billing, quality improvement, and research purposes.
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Multicenter Study
Index Admission Cholecystectomy and Recurrence of Pediatric Gallstone Pancreatitis: Multicenter Cohort Analysis.
We aim to evaluate recurrence rates of gallstone pancreatitis in children undergoing early vs interval cholecystectomy. ⋯ Cholecystectomy during the index admission for children with gallstone pancreatitis reduces recurrent pancreatitis. Recurrence proportionally increases with time when patients are treated with a delayed approach.