JAMA Surgery

Interview with Mehul V. Raval, MD, MS, MBA, and Jane L. Holl, MD, MPH, about the ENRICH-US Stepped-Wedge Cluster-Randomized Trial. Hosted by Jamie Coleman, MD. ja.ma/4uhms9k

Among pediatric patients undergoing elective GI surgery, higher adherence to a multicomponent enhanced recovery protocol was associated with shorter hospital stays, less opioid use, and fewer surgical complications. ja.ma/3R87uUP

Surgeons sponsored for H-1B visas represent a small fraction of the US workforce but are overrepresented in rural and high-poverty counties, where surgical shortages are most pronounced. ja.ma/4dm5q2T

From 2022 to 2024, #GLP1 use among adults with obesity, overweight, or diabetes increased sharply, while metabolic #BariatricSurgery utilization declined by over 30%. Treatment for obesity remains limited in this population. ja.ma/3P3j1UX

#RectalCancer hospital accreditation under the National Accreditation Program for Rectal Cancer correlated with increased annual patient and early-stage procedural volumes, without evidence of increased care fragmentation. ja.ma/3OWdpfe

🔗 Read "Small Bites vs Large Bites for Closure of Abdominal Midline Incisions" published in JAMA Surgery: ja.ma/4noCU5l

In the STITCH trial, small-bites fascial closure for elective midline laparotomy was associated w/ reduced long-term incidence and size of incisional hernias vs large-bites closure. At 13 years, cumulative incidence and width of hernias >20 mm were lower w/ small-bites technique.

💬 Invited Commentary: Emerging evidence supports de-escalation of axillary surgery for select patients with clinically palpable nodal #BreastCancer, but accurate staging and multidisciplinary care are essential for safe adoption. ja.ma/3QXOMiJ

Among patients with cN1 HR+/HER2- #BreastCancer, upfront sentinel lymph node biopsy was feasible, enabling omission of axillary lymph node dissection in nearly 70% with limited nodal disease burden. ja.ma/49EiK1A

#RectalCancer hospital accreditation under the National Accreditation Program for Rectal Cancer correlated with increased annual patient and early-stage procedural volumes, without evidence of increased care fragmentation. ja.ma/4wi2s8s

💬 Invited Commentary: Emerging evidence supports de-escalation of axillary surgery for select patients with clinically palpable nodal #BreastCancer, but accurate staging and multidisciplinary care are essential for safe adoption. ja.ma/4f4zcvA

Among patients with cN1 HR+/HER2- #BreastCancer, upfront sentinel lymph node biopsy was feasible, enabling omission of axillary lymph node dissection in nearly 70% with limited nodal disease burden. ja.ma/4narNgi

Robotic-assisted groin hernia repair was associated with a higher long-term operative recurrence rate than laparoscopic or open repair among #Medicare beneficiaries, with overall recurrence rates remaining low across all methods. ja.ma/3Rjftyo

Robotic-assisted groin hernia repair was associated with a higher long-term operative recurrence rate than laparoscopic or open repair among #Medicare beneficiaries, with overall recurrence rates remaining low across all methods. ja.ma/3QEoF05

The MySurgeryRisk model accurately predicts risk of #ICU admission, mechanical ventilation, acute kidney injury, and in-hospital mortality after major surgery, with procedure type and clinician-specific factors as primary predictors. ja.ma/4ejzwXc

The MySurgeryRisk model accurately predicts risk of #ICU admission, mechanical ventilation, acute kidney injury, and in-hospital mortality after major surgery, with procedure type and clinician-specific factors as primary predictors. ja.ma/4cQlRnX

In patients undergoing permanent colostomy for #RectalCancer, use of a funnel-shaped intra-abdominal mesh reduced parastomal hernia incidence and size at 3 years without increased complications compared with no mesh. ja.ma/4eGxikD

Reduction of air changes during unoccupied periods in 55 #OperatingRooms was not associated with increased surgical site infections or adverse surgical outcomes and reduced annual electricity use and cost. ja.ma/4cKQ0oV

Among patients at nutritional risk after #Pancreatoduodenectomy, early enteral nutrition in addition to oral intake resulted in a lower overall burden of postoperative complications versus oral nutrition alone. ja.ma/4d0i88w

Surgeons sponsored for H-1B visas represent a small fraction of the US workforce but are overrepresented in rural and high-poverty counties, where surgical shortages are most pronounced. ja.ma/4sRNKmn