JANUARY 2014 VOLUME 207, NUMBER 1

CLINICAL SCIENCE 24 Upgrade of High-Risk Breast Lesions Detected on Mammography in the Breast Cancer Surveillance 1 Risk Factors for Umbilical Trocar Site Incisional Consortium in Laparoscopic : A Tehillah S. Menes, Robert Rosenberg, Prospective 3-Year Follow-Up Study Steven Balch, Shabnam Jaffer, Karla Kerlikowske, Jordi Comajuncosas, Judit Hermoso, Pere Gris, and Diana L. Miglioretti Jaime Jimeno, Rolando Orbeal, Helena Vallverdú, Jose Luis López Negre, Joan Urgellés, Laia Estalella, Rates of high-risk breast lesions diagnosed on and David Parés screening mammography in the Breast Cancer Sur- In a series with long follow-up, trocar site inci- veillance Consortium were examined. Follow-up sional hernia (TSIH) was highly prevalent. Several was documented for all women regardless of fol- patient conditions (diabetes mellitus, obesity), low-up . Low rates of cancer were docu- technical factors (trocar site incision enlargement), mented during follow-up, suggesting that despite low and complications (infection of surgical wound) rates of surgery, physicians are triaging these women may be of use in introducing preventive measures appropriately. in high-risk patients to avoid this complication. A prospective randomized clinical trial to evaluate 32 Can Endoscopists Accurately Self-Assess measures to prevent TSIH in these patients is Performance During Simulated Colonoscopic warranted. Polypectomy? A prospective, Cross-Sectional Study James Ansell, Joanna J. Hurley, James Horwood, Chantelle Rizan, Konstantinos Arnaoutakis, 7 Timeliness and Quality of Surgical Discharge Stuart Goddard, Neil Warren, and Jared Torkington Summaries After the Implementation of an Electronic Format This article details the results of a study examining Caroline E. Reinke, Rachel R. Kelz, Charles A. Baillie, self-assessment versus expert appraisal for simu- Anne Norris, Sara Schmidt, Nicholas Wingate, lated colonic polypectomy. There is a poor correla- and Jennifer S. Myers tion between scores because novice endoscopists underestimate performance and expert endoscopists Electronic discharge summaries are becoming more tend to overestimate their ability. prevalent at a time when there is increased focus on transitions of care. This pre-post retrospective study 39 Randomized Controlled Trial of Alfacalcidol compared traditional dictated discharge summaries Supplementation for the Reduction of Hypocalcemia to electronic discharge summaries. Electronic dis- After Total Thyroidectomy charge summaries were found to improve the time- Laurent Genser, Christophe Trésallet, liness without sacrificing the overall quality of Gaëlle Godiris-Petit, Stéphanie Li Sun Fui, hospital discharge summaries for a surgical patient Harika Salepcioglu, Catherine Royer, population. and Fabrice Menegaux Symptomatic hypocalcemia is a major issue after 17 Obesity, Outcomes and Quality of Care: Body Mass total thyroidectomy and can cause significant mor- Index Increases the Risk of Wound-Related bidity. The routine administration of vitamin D has Complications in Colon Cancer Surgery been reported to decrease the risk of postoperative Ramzi Amri, Liliana G. Bordeianou, Patricia Sylla, hypocalcemia. The routine perioperative adminis- and David L. Berger tration of alfacalcidol in patients referred for total The authors evaluated the role of body habitus in thyroidectomy tends to accelerate the recovery of complication rates and stay characteristics during serum calcium concentration and to decrease the the surgical treatment of colon cancer in a consec- rate of transient hypocalcemia, limiting its severity utive series of 1,048 patients at a tertiary care and related symptoms. center. Higher body mass index (BMI) was asso- ciated with significantly higher rates of wound 46 Unshuntable Extrahepatic infections and slow wound healing. In right colec- Revisited: 43 Years' Experience with Radical tomies, higher BMI was also associated with Esophagogastrectomy Treatment of Bleeding higher odds of wound dehiscence. These findings Esophagogastric Varices underline how patient-controllable factors will play Marshall J. Orloff, Mark S. Orloff, Susan L. Orloff, an increasingly important role in cost containment Lisa A. Orloff, Pat O. Daily, Barbara Girard, and quality improvement. Jon I. Isenberg, and Henry O. Wheeler Contents continued This is a report of results of treatment by surgical a useful practical parameter for predicting prog- portal-systemic shunts of bleeding esophagogastric nostic outcomes. varices due to extrahepatic portal hypertension.

53 Incidence, Risk Factors, and Outcomes of 78 Peritoneal Carcinomatosis in Patients with Gastric Perioperative Acute Kidney Injury in Noncardiac and Cancer, and the Role for Surgical Resection, Nonvascular Surgery Cytoreductive Surgery, and Hyperthermic Murat Biteker, Akın Dayan, Ahmet _Ilker Tekkes¸in, Intraperitoneal Chemotherapy Mehmet M. Can, _Ibrahim Taycı, Erkan _Ilhan, Ki Won Kim, Oliver Chow, Kunal Parikh, Sima Blank, and Gülizar S¸ahin Ghalib Jibara, Hena Kadri, Daniel M. Labow, and Spiros P. Hiotis In this single-center, prospective study of 1200 consecutive patients with preoperative normal The results of this study suggest that patients with renal function who underwent noncardiac and gastric cancer at risk for peritoneal carcinomatosis nonvascular surgery, the incidence of perioperative may be targeted using a model incorporating tumor acute kidney injury (AKI) was 6.7%. Age, diabetes stage and patient age. Specifically, patients aged % mellitus, RCRI, and ASA physical status independ- 60 years with tumor stage T3 or T4 are at increased ently predicted AKI. Perioperative AKI was risk for the development of peritoneal carcinoma- strongly and independently associated with peri- tosis. This study further highlights the need for operative outcomes, postoperative length of stay, larger prospective studies to address the benefits of and in-hospital mortality. aggressive treatment modalities for gastric cancer with peritoneal carcinomatosis. 60 Complications of Hartmann Takedown in a Decade of Preferred Primary Anastomosis 84 Reliability of Robotic System During General Ari Garber, Neil Hyman, and Turner Osler Surgical Procedures in a University Hospital The purpose of this article was to define the compli- Nicolas C. Buchs, François Pugin, Francesco Volonté, cation rate of Hartmann takedown in a contemporary and Philippe Morel setting. Although the safety of the robotic approach has been proved even for complex procedures, data 65 The Role of Endoscopic Biliary Sphincterotomy for concerning the reliability of robotic systems re- the Treatment of Type 1 Biliary Dysfunction main scarce, especially for general surgery. In this (Papillary Stenosis) With or Without Biliary Stones large series concerning robotic general surgical Choichi Sugawa, Kristian L. Brown, Toshiki Matsubara, procedures in a teaching institution, the authors Rebecca Bachusz, Hiromi Ono, Akiko Chino, found a low malfunction rate (3.4%), with only 1 Takuji Yamasaki, and Charles E. Lucas robotic dysfunction that led to a laparoscopic This study assesses the safety and effectiveness conversion. of endoscopic biliary sphincterotomy (ES) in the treatment of papillary stenosis in patients with and without biliary stones. All 117 patients (46 with 89 Fatal Gunshot Wound to the Head: The Impact of cholecystectomy and 71 without cholecystectomy) Aggressive Management had biliary pain, a dilated with a maximum Bellal Joseph, Hassan Aziz, Moutamn Sadoun, 6 Narong Kulvatunyou, Viraj Pandit, Andrew Tang, diameter of 10 to 25 mm (mean 12.8 0.33 mm), Julie Wynne, Terence O' Keeffe, Randall S. Friese, and elevated function tests; subsequently, all Rainer W. G. Gruessner, and Peter Rhee patients were symptom free after ES with or without common bile duct stone retrieval. ES is the optimal Organ donation is an attainable goal in patients with treatment for papillary stenosis in patients with or fatal gunshot wounds to the head presenting with without biliary stones. low Glasgow Coma Scale (GCS) scores. Aggressive resuscitation for all patient regardless of GCS score is warranted. 70 Peritumoral Deposits as an Adverse Prognostic Indicator of Hideki Ueno, Yojiro Hashiguchi, Hideyuki Shimazaki, 95 Antiplatelet and Anticoagulation Medications and Eiji Shinto, Yoshiki Kajiwara, Kuniaki Nakanishi, the Surgical Patient Kei Kato, Kazuya Maekawa, Takahiro Nakamura, Junji Yamamoto, and Kazuo Hase Brian K. Yorkgitis, Christina Ruggia-Check, and Jay E. Dujon Two cohorts of patients with pT3/T4 colorectal cancer were pathologically reviewed to clarify the Antiplatelet and anticoagulation agents are com- clinical significance of the classification of the monly prescribed medications. Over the past years, nature of the invasive margin on the basis of the many new agents have been developed. Surgeons distance of discontinuous spread of cancer. Peritu- are often faced to provide care for patients on these moral cancer deposits with discontinuous spread R medications. This article summarizes the newer 2 mm were shown be superior to growth pattern in medications along with the older agents commonly terms of interobserver variation and could be encountered in clinical practice. Contents continued SOUTHWESTERN SURGICAL CONGRESS of colonic obstruction should be individually tail- PRESENTATION ored to each patient. 102 Prognostic Factors in Young Women with Cutaneous 139 Invited Commentary: Left-Sided Malignant Colonic Melanoma Obstruction: A Systematic Review Alison L. Burton, Michael E. Egger, Amy R. Quillo, Jon S. Thompson Arnold J. Stromberg, Lee Hagendoorn, Charles R. Scoggins, Robert C. G. Martin, II, Most of the controversies in the management of Kelly M. McMasters, and Glenda G. Callender malignant left colon obstruction have not been Young women with truncal location melanomas resolved. Clinical decision making continues to may represent a group of individuals at higher risk require an individually tailored approach for each for recurrence and metastasis. patient.

REVIEWS SURGICAL EDUCATION 109 Hand-Assisted Laparoscopic Surgery Versus Open 141 Formal Research Training During Surgical Surgery for Colorectal Disease: A Systematic Review Residency: Scaffolding for Academic Success and Meta-Analysis Helen Hsieh, Francis Paquette, Shannon A. Fraser, Jie Ding, Yu Xia, Guo-qing Liao, Zhong-min Zhang, Liane S. Feldman, Sarkis Meterissian, Gerald M. Fried, Sheng Liu, Yi Zhang, and Zhong-shu Yan and Simon Bergman Compared with open surgery, hand-assisted laparo- Graduates of a surgical residency program were scopic surgery has the advantages of minimal inva- surveyed to determine the impact of a formal sur- sion, lower blood loss, shorter incision length, and gical research program (leading to a postgraduate faster recovery, and it can shorten the length of degree) during residency on future research produc- hospitalization without increased costs. tivity. Faculty members who had participated in such programs during residency were more likely to 120 A Relic or Still Relevant: The Narrowing Role for publish more papers and achieve greater funding in the Treatment of Peptic Ulcer Disease success. Janaka Lagoo, Theodore N. Pappas, and Alexander Perez 146 Is the Skillset Obtained in Surgical Simulation This paper will review the increasing evidence that Transferable to the Operating Theatre? supports a diminished, yet necessary, role for Christina E. Buckley, Dara O. Kavanagh, Oscar Traynor, and Paul C. Neary surgery in the management of peptic ulcer disease. Specifically, the role of vagotomy will be examined This systematic review evaluated the evidence and re-evaluated in the surgical management of pertaining to the transfer of surgical skills learnt complicated peptic ulcer. through simulation to the live operative setting. The primary outcome was the difference between base- 127 Current Management of Acute Malignant Large line and post-intervention scores obtained during Bowel Obstruction: A Systematic Review live operative performances in both the simulation Ricardo Frago, Elena Ramirez, Monica Millan, trained group and the control group. Esther Kreisler, Emilio del Valle, and Sebastiano Biondo There is ongoing debate on the best strategy for INDEXES TO VOLUME 206 ARE AVAILABLE ONLINE AT malignant colonic obstruction treatment. Treatment WWW.AMERICANJOURNALOFSURGERY.COM