Journal of the American College of Surgeons
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The COVID-19 pandemic abruptly, and perhaps irrevocably, changed the way we live, conduct our business affairs, and practice medicine and surgery. In mid-March 2020, as COVID-19 infections escalated exponentially across many areas of the US, the Centers for Disease Control (CDC), the Surgeon General, and the American College of Surgeons (ACS) recommended that hospitals and surgeons postpone non-urgent operations in order to provide care to COVID-19 patients.1-3 It quickly became obvious that the COVID-19 pandemic presented unprecedented medical challenges. ⋯ The aim of this effort was to support ACS members and Fellows, as well as the broader medical community, in continuing to provide optimal patient care. Because other similar public health crises could arise in the future, we report the measures taken by the ACS to respond to the COVID-19 pandemic.
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Global assessments of technical skill have been associated with surgical outcomes. More detailed understanding of which specific aspects of technique combine to make the "optimal" sleeve gastrectomy are necessary to help surgeons improve their practice. ⋯ Sleeve gastrectomy videos thought to have "optimal" technique by peer surgeons were associated with lower complication rates. Understanding how to quantify and assess optimal vs suboptimal techniques can serve as a guide for surgeons to improve their practice.
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Multicenter Study Observational Study
Impact of Antithrombotic Agents on Postpancreatectomy Hemorrhage: Results from a Retrospective Multicenter Study.
This retrospective multicenter study aimed to evaluate the risk of postpancreatectomy hemorrhage (PPH) in patients receiving antithrombotic agents (ATAs). PPH is the most severe complication after pancreatectomy. However, there is little known about the strength of the association between ATA use, PPH, and other clinical outcomes. ⋯ History of ATA use is a significant risk factor for PPH, and postoperative resumption of ATAs appears to be associated with an increased risk of PPH. Patients receiving combined antithrombotic therapy may be at particularly high risk for PPH.
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Gun violence remains a major burden on the US healthcare system, with annual cost exceeding $170 billion. Literature on the national trends in cost and survival of gun violence victims requiring operative interventions is lacking. ⋯ During the past decade, the increase in gun violence and severity has resulted in higher cost. Operations involving selected surgical treatments incurred higher in-hospital cost. Given the profound economic and social impact of surgically treated gunshot wounds, policy and public health efforts to reduce gun violence are imperative.