麻豆传媒

In this podcast series, the hosts speak with recently published authors about the motivation behind their latest research and the clinical implications it has for the practicing surgeon. Spread the word on social media by using the hashtag #JACSOperativeWord.

The Operative Word is available on , , , , or wherever you listen to your podcasts.

Episode 32: Validation of Artificial Intelligence-Based POTTER Calculator in Emergency General Surgery Patients Undergoing Laparotomy: Prospective, Bi-Institutional Study

In this episode, Tom Varghese, MD, FACS, is joined by Haytham Kaafarani, MD, MPH, FACS, and Vahe Panossian, MD, from the Department of Surgery, Massachusetts General Hospital and Harvard Medical School. They discuss the by Drs Kaafarani and Panossian, 鈥淰alidation of Artificial Intelligence-Based POTTER Calculator听in Emergency General Surgery Patients Undergoing Laparotomy: Prospective, Bi-Institutional Study.鈥� This study听found that POTTER accurately predicts mortality and postoperative complication, and the superior accuracy,听user-friendliness, and interpretability of POTTER make it a useful bedside tool for preoperative counseling.

Disclosure Information: Drs Varghese and Panossian have nothing to disclose. Dr Kaafarani receives honoraria payments from UpToDate. The POTTER calculator is available online for free, and Dr Kaafarani has not been compensated for the development or ongoing use of the calculator.听

Episode 31: 麻豆传媒 Cancer Programs Annual Report from 2021 Participant User File

In this episode, Lillian Erdahl, MD, FACS, is joined by Judy Boughey, MD, FACS, from the Mayo Clinic Department of Surgery. They discuss Dr. Boughey鈥檚 , 鈥溌槎勾�媒 Cancer Programs Annual Report from 2021 Participant User File.鈥� This inaugural annual report from the National Cancer Database describes the 2021 adult participant user files (PUF) as a whole, as well as the PUFs for breast, colon, and pancreatic cancer in more detail. It summarizes new observations and recent trends of cancer diagnoses, patient demographics, and treatment trends.

Disclosure Information: Drs Erdahl has nothing to disclose. Dr Boughey receives funding paid to her institution from Eli Lilly and SymBioSis; sits on the Data Safety Monitoring Committee of CairnsSurgical; and has received honoraria from PER, PeerView, OncLive, EndoMag, and UpToDate.

Episode 30: Cost-Effectiveness of Nonoperative Management vs Upfront Laparoscopic Appendectomy for Pediatric Uncomplicated Appendicitis Over 1 Year

In this episode, Lillian Erdahl, MD, FACS, is joined by Peter C. Minneci, MD, FACS, MHSc, from the Department of Surgery, Nemours Children鈥檚 Health, Delaware Valley. They discuss Dr. Minneci鈥檚 , 鈥淐ost-Effectiveness of Nonoperative Management vs Upfront Laparoscopic Appendectomy for Pediatric Uncomplicated Appendicitis Over 1 Year,鈥� in which the authors found that cost-effectiveness of management of pediatric appendicitis is sensitive to changes in utilities achieved by nonoperative management. Further studies should investigate reasons for treatment failure and the importance of shared decision-making in choosing treatment.

Disclosure Information: Drs Erdahl and Minneci have nothing to disclose. This research was funded by the Patient-Centered Outcomes Research Institute (PCORI ID CER-1507-31325) and the National Center for Advancing Translational Sciences (grant UL1TR001070).

Episode 29: Refractory and Recurrent Idiopathic Granulomatous Mastitis Treatment: Adaptive, Randomized Clinical Trial

In this episode, Lillian Erdahl, MD, FACS, is joined by Fatemeh Shojaeian, MD, MPH, from the Johns Hopkins University School of Medicine. They discuss Dr. Shojaeian鈥檚 , 鈥淩efractory and Recurrent Idiopathic Granulomatous Mastitis Treatment: Adaptive, Randomized Clinical Trial,鈥� in which the authors found that, for resistant or relapsing patients with idiopathic granulomatous mastitis, combining methotrexate and corticosteroids offers a promising strategy. This integration of disease-modifying antirheumatic drugs with corticosteroids not only reduces the necessity for high steroid doses but also effectively alleviates associated side effects.

Disclosure Information: Drs Erdahl and Shojaeian have nothing to disclose.

Episode 28: Protective Effects of Authenticity Against Depression, Suicide, and Burnout among Surgeons

In this episode, Lillian Erdahl, MD, FACS, is joined by Jessica Ching, MD, from the Baylor College of Medicine. They discuss Dr. Ching鈥檚 recent article, 鈥淧rotective Effects of Authenticity Against Depression, Suicide, and Burnout among Surgeons,鈥� in which the authors found that authenticity may protect against burnout, depression, and suicide, pointing to a vital intervention opportunity. This research highlights the importance of cultivating a culture that prioritizes mental health to foster a resilient, fulfilled surgical community.

Disclosure Information: Drs Erdahl and Ching have nothing to disclose.

Episode 27: Association of Daily Step Count and Postoperative Complication among All of Us Research Participants

In this episode, Tom Varghese, MD, MS, MBA, FACS, is joined by Anai N. Kothari MD, MS, FACS, FSSO, from the Medical College of Wisconsin. They discuss Dr. Kothari鈥檚 recent article, 鈥淎ssociation of Daily Step Count and Postoperative Complication among All of Us Research Participants,鈥� in which the authors used preoperative wearable device data from 475 patients to investigate the link between daily step counts and postoperative complications. Patients with fewer than 7,500 daily steps had a higher risk of complications, supporting the use of wearables for surgical risk assessment and preoperative fitness measurement.

Disclosure Information: Drs Varghese and Kothari have nothing to disclose.

Episode 26: Contemporary Evaluation of Work-Life Integration and Well-being in US Surgical Residents: A National Mixed-Methods Study

In this episode, Tom Varghese, MD, MS, MBA, FACS, is joined by Lauren M. Janczewski, MD, MS, from Northwestern University, and Yue-Yung Hu, MD, MPH, FACS, from the Ann & Robert H. Lurie Children鈥檚 Hospital and Northwestern Quality Improvement, Research, and Education in Surgery (NQUIRES). They discuss their recent article, 鈥淐ontemporary Evaluation of Work-Life Integration and Well-being in US Surgical Residents: A National Mixed-Methods Study,鈥� in which the authors found that parents and female residents were more likely to report work-life conflicts, which were associated with career dissatisfaction, burnout, thoughts of attrition, and suicidality. Qualitative data revealed work-life integration interventions: protecting health-maintenance time, supporting life outside of work, and allowing meaningful autonomy in scheduling.

Disclosure Information: Drs Varghese, Janczewski, and Hu have nothing to disclose.

Episode 25: Association of National Accreditation Program for Rectal Cancer Accreditation with Outcomes after Rectal Cancer Surgery

In this episode, Tom Varghese, MD, FACS, is joined by Calista M. Harbaugh, MD, MSc, from the University of Michigan. They discuss Dr. Harbaugh鈥檚 , 鈥淎ssociation of National Accreditation Program for Rectal Cancer Accreditation with Outcomes after Rectal Cancer Surgery,鈥� in which the authors found that hospitals accredited by the National Accreditation Program for Rectal Cancer are associated with lower short- and long-term morbidity and mortality, but few programs achieve accreditation status.

Disclosure Information: Drs Varghese and Harbaugh have nothing to disclose.

Episode 24: Sustaining Lifelong Competency of Surgeons: Multimodality Empowerment Personal and Institutional Strategy

In this episode, Lillian Erdahl, MD, FACS, is joined by Todd Rosengart, MD, FACS, from the Baylor College of Medicine. They discuss Dr. Rosengart鈥檚 recent article, 鈥淪ustaining Lifelong Competency of Surgeons: Multimodality Empowerment Personal and Institutional Strategy,鈥� which focuses on maintaining and ensuring the competency of an aging surgeon workforce. The study provides evidence-based guiding principles as part of a comprehensive 鈥渨hole of career鈥� strategy that can be adopted at a personal, institutional, and national level.

Disclosure Information: Drs Erdahl and Rosengart have nothing to disclose.

Episode 23: Home Is Not Always Where the Sleep Is鈥擳he Effect of Home Call on Sleep, Burnout, and Surgeon Well-Being

In this episode, Tom Varghese, MD, F麻豆传媒is joined by Jamie Coleman, MD, FACS, from the University of Louisville. They discuss Dr. Coleman鈥檚 recent article, 鈥淗ome Is Not Always Where the Sleep Is: The Effect of Home Call on Sleep, Burnout, and Surgeon Well-Being,鈥� which quantifies sleep loss and burnout associated with home call in acute care surgeons, emphasizing that there are both physical and emotional contributors to burnout.

Disclosure Information: Drs Varghese and Coleman have nothing to disclose.

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Episode 22: Expeditionary Surgeons - Essential to Surgical Leadership in World War II and Today

In this episode, Tom Varghese, MD, F麻豆传媒is joined by Jeremy Cannon, MD, SM, FACS, from the University of Pennsylvania. They discuss Dr. Cannon鈥檚 Excelsior Surgical Society Presidential Address, emphasizing the crucial contribution of expeditionary surgical leaders in World War II and how their legacy serves as an example for military and civilian surgeons seeking to lead in austere settings today.

Disclosure Information: Dr. Varghese has nothing to disclose. Dr. Cannon received royalties from UpToDate for authoring an article on an unrelated topic. Dr. Cannon's institute was supported by funding from CSL Behring.

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Episode 21: Social Determinants of Outcomes Disparity among Pediatric Solid Tumor Patients

In this episode, Lillian Erdahl, MD, F麻豆传媒is joined by Dai Chung, MD, FACS, from the University of Texas Southwestern Medical Center. They discuss Dr. Chung鈥檚 recent , which demonstrates that poor health outcomes among pediatric solid tumor patients are associated with minority race and residence in rural or border regions, and that the 5-year rate mortality rises with increasing area deprivation score.

Disclosure Information: Drs Erdahl and Chung have nothing to disclose.

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Episode 20: Anchors Aweigh! The History of Women Surgeons at Sea

In this episode, Lillian Erdahl, MD, F麻豆传媒is joined by Amy Hernandez, MD, FACS, from the Department of Surgery, Naval Medical Center San Diego. They discuss Dr. Hernandez鈥檚 recent study, which uses literature review, personal interviews, and correspondence with Navy Medicine administrative leaders to describe the evolution of women providing surgical care at sea.

Disclosure Information: Drs Erdahl and Hernandez have nothing to disclose.

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Episode 19: Practical and Ethical Guidelines for the Involvement of Trainees in Global Surgery: Consensus Statement and Recommendations from the Resident and Associate Society of the 麻豆传媒 Global Surgery Work Group

In this episode, Dr. Lillian Erdahl is joined by Erin M Scott, MD, MPH, from the University of Massachusetts Chan Medical School. They discuss Dr Scott鈥檚 recent study, which outlines the official recommendations of the 麻豆传媒 Resident and Associate Society Global Surgery Work Group guidelines for involvement of trainees in global surgery, with an aim to support equitable, sustainable collaborations that center on improving access to safe, timely, and affordable surgical care for the global community.

Disclosure Information: Drs Erdahl and Scott have nothing to disclose.

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Episode 18: Diverticulitis Familiality: A Statewide Case-Control Study

In this episode, Dr Tom Varghese is joined by Jessica Cohan, MD, from the University of Utah. They discuss Dr Cohan鈥檚 recent , which used statewide medical records linked with genealogy data to evaluate the familial contributions to diverticulitis. The results indicate that diverticulitis has a significant heritable component, which may inform surgeons as they counsel family members about diverticulitis risk and can be used to develop future risk-stratification tools.

Disclosure Information: Drs Varghese and Cohan have nothing to disclose.

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Episode 17: Novel Form of Breast Intraoperative Radiation Therapy with CT-Guided High-Dose-Rate Brachytherapy: Interim Results of a Prospective Phase II Clinical Trial

In this episode, Dr. Jamie Coleman is joined by Shayna Showalter, MD, from the University of Virginia School of Medicine, Charlottesville, VA. They discuss Dr. Showalter鈥檚 recent evaluating precision breast intraoperative radiation therapy (PB-IORT), which uses customized CT-based treatment plans for high-dose-rate (HDR) brachytherapy. Interim results show that PB-IORT has an acceptable breast cancer recurrence rate, minimal side effects, and excellent cosmetic outcomes.听

Disclosure Information: Drs. Coleman and Showalter have nothing to disclose.

听#闯础颁厂翱辫别谤补迟颈惫别奥辞谤诲

Episode 16: Comprehensive Cost Implications of Commercially Available Noninvasive Colorectal Cancer Screening Modalities

In this episode, Dr. Dante Yeh is joined by Casey Allen, MD, from the Institute of Surgery, Division of Surgical Oncology, Allegheny Health Network, Pittsburgh, Pennsylvania. They discuss Dr. Allen鈥檚 recent study, which found that widespread adoption of the fecal immunochemical test for noninvasive colorectal cancer screening could lead to substantial cost savings. This carries major value implications for a large population health system.

Episode 15: Operationalizing the Culture of Burnout and Well-Being: Multicenter Study of Value Congruence and Flourishing in General Surgery Residency

In this episode, Dr. Jamie Coleman is joined by Carter Lebares, MD, FACS, from the Department of Surgery, University of California San Francisco. They discuss Dr. Lebares鈥� recent at 16 academic general surgery training programs, in which residents indicated a perceived lack of value congruence with leadership regarding occupational well-being. Program directors expressed variable alignment with these perceptions. Value congruence was significantly associated with individual resident global well-being.

Epiosde 14: Leadership and Impostor Syndrome in Surgery

In this episode, Dr. Dante Yeh is joined by Lola Fayanju, MD, MA, MPHS, FACS, from the University of Pennsylvania, Philadelphia, PA. They discuss Dr Fayanju鈥檚 recent on impostor syndrome, an internalized sense of incompetence and not belonging. The study found that female physicians were more likely to experience impostor syndrome than male physicians, regardless of specialty or leadership role. While several identity-based gaps persist in leadership, impostor syndrome among racially minoritized groups may not be a significant contributor.

Episode 13: Quantifying the Prognostic Value of Preoperative Surgeon Intuition: Comparing Surgeon Intuition and Clinical Risk Prediction as Derived from the 麻豆传媒 NSQIP Risk Calculator

In this episode, Dr. Dante Yeh is joined by Gabriel Brat, MD, FACS, MPH, and Jayson Marwaha, MD, MBI, from Beth Israel Deaconess Medical Center, Boston, MA. They discuss their recent , which compared the predictive utility of preoperative surgeon intuition and surgical risk calculators and found that, while preoperative surgeon intuition alone is an independent predictor of patient outcomes, traditional risk calculators are more robust predictors of postoperative complication.

Episode 12: COVID Vaccination Status and Operative Outcomes after Kidney Transplantation

In this episode, Dr. Jamie Coleman is joined by Bradley Kushner, MD, from the Washington University School of Medicine, St Louis. They discuss Dr. Kushner鈥檚 , which found that patients who are unvaccinated against COVID-19 have worse compliance and healthcare follow-up after a kidney transplant compared with those who were preoperatively vaccinated.

Episode 11: Severe Increase in Nursing Labor Cost and Effect on Surgical Department Financial Margins at an Academic, Tertiary Medical Center

In this episode, Dr. Jamie Coleman is joined by Clayton Brinster, MD, FACS, from Ochsner Health. They discuss his , which demonstrates a significant increase in surgical nursing labor cost, with a resultant decrease in department of surgery financial margins. This nationwide, precarious trend is not sustainable, and fiscal recovery will require sustained, strategic workforce allocation.

Disclosure Information: Drs Brinster and Coleman have nothing to disclose.

Episode 10: Truth of Colorectal Enhanced Recovery Programs: Process Measure Compliance in 151 Hospitals

In this episode, Dr. Dante Yeh is joined by Tejen Shah, MD, from The Ohio State University Wexner Medical Center. They discuss his , which shows that contrary to published enhanced recovery program (ERP) literature, most study hospitals had difficulty improving process compliance, with 80% not achieving substantial improvement. ERP bundles should be implemented in a more deliberate manner with better-planned, pragmatic, and informed strategies.

Disclosure Information: Dr. Shah has nothing to disclose. Dr. Yeh receives author royalties from UpToDate, advisory panel/training honoraria from Takeda Pharmaceuticals, and advisory panel honoraria from Baxter, Eli Lilly, and Fresenius Kabi.

Episode 9: Fluoroscopic Intraoperative Breast Neoplasm and Node Detection

In this episode, Dr. Jamie Coleman is joined by Roi Weiser, MD, from the University of Texas MD Anderson Cancer Center, and Suzanne Klimberg, MD, PhD, MSHCT, FACS, from the Division of Surgical Oncology at the University of Texas Medical Branch. They discuss their , which shows that fluoroscopic intraoperative neoplasm and node detection (FIND) can be used to localize the biopsy clip marking a non-palpable breast or axillary lesion, obviating the need for an additional procedure to insert a localization device. Furthermore, FIND shows promising results, with decreased margin positivity and re-excision rate compared with wire localization.

Disclosure Information: Dr. Klimberg receives book royalties from Elsevier, Springer, and Saunders. Drs Coleman and Weiser have nothing to disclose.

Episode 8: Cost-Effectiveness of Universal Screening for Blunt Cerebrovascular Injury: A Markov Analysis听

In this episode, Dr. Dante Yeh is joined by Sharven Taghavi, MD, MPH, MS, FACS, from the Tulane University School of Medicine. They discuss his 听on blunt cerebrovascular injury (BCVI), which is a significant cause of morbidity and mortality in patients with blunt trauma. Using a Markov decision analysis, the authors found that universal screening for cerebrovascular injury using CT angiography in blunt trauma victims was the optimal strategy.

Disclosure Information: Nothing to disclose.

Disclosures outside the scope of this work: Dr. Taghavi receives funding from the CDC. Dr. Yeh receives author royalties from UpToDate, advisory panel/training honoraria from Takeda Pharmaceuticals, and advisory panel honoraria from Baxter, Eli Lilly, and Fresenius Kabi.

To earn听0.25 AMA PRA Category 1 Credits鈩�听for this episode of the J麻豆传媒Operative Word Podcast,听听to register for the course and complete the evaluation.

Episode 7: Disparity-Sensitive Measures in Surgical Care: A Delphi Panel Consensus

In this episode, Dr. Jamie Coleman is joined by Elzerie de Jager, MBBS(Hons), PhD, from the University of Vermont and the Center for Surgery and Public Health, Department of Surgery, Brigham and Women鈥檚 Hospital, Harvard Medical School and Harvard TH Chan School of Public Health; and LD Britt MD, MPH, FACS, from the Department of Surgery, Eastern Virginia Medical School. They discuss their study, in which a Delphi panel identified 125 potential disparity-sensitive measures which could be used to track health disparity, evaluate the impact of focused interventions, and reduce healthcare inequity.

Episode 6: Permanent vs Absorbable Mesh for Ventral Hernia Repair in Contaminated Fields

In this episode, Dr. Dante Yeh is joined by Flavio Malcher, MD, MSc, from the Department of Surgery at New York University. They discuss his study, which validates the findings of recent randomized controlled trials in a larger multicenter cohort, suggesting that permanent mesh is the ideal prosthetic to enhance ventral hernia repair even in contaminated fields, which challenges a longstanding surgical dogma.

Episode 5: Core Entrustable Professional Activities for Entering Residency: A National Survey of Graduating Medical Student Self-Assessed Skills by Specialty

In this episode, Dr. Coleman is joined by Dorothy Andriole, MD, FACS, who is a surgeon and the Senior Director of Medical Education Research at the Association of American Medical Colleges, and Jonathan Amiel, MD, who is a professor of psychiatry and Senior Associate Dean for Innovation in Health Professions Education at Columbia University. They discuss their recent study, which found that many graduating students intending to enter surgery agreed they had skills to perform some, although not all, Core Entrustable Professional Activities for Entering Residency. Continued efforts to prepare graduates more optimally for the start of residency training are warranted.听

Episode 4: Analyzing Impact of Multimorbidity on Long-Term Outcomes after Emergency General Surgery: A Retrospective Observational Cohort Study

In this episode, Dr. Yeh is joined by Claire Rosen, MD, from the Hospital of the University of Pennsylvania. They discuss her recent paper, which demonstrates that past medical history, specifically multimorbidity, influences the risk of adverse outcomes after emergency general surgery, from increased mortality to limited independence and function. When surgeons understand and communicate these risks, shared decision-making is improved.

Episode 3: Long-Term Outcomes after Adolescent Bariatric Surgery

In this episode, Dr. Coleman is joined by Nestor F. De la Cruz-Mu帽oz Jr, MD, Professor of Surgery and Section Chief of Bariatric Surgery at the University of Miami. They discuss his , which demonstrates the lasting, positive impact of bariatric surgery even decades later, and confirms that bariatric surgery should not be denied to adolescents struggling with morbid obesity.

Episode 2: Use of Direct Oral Anticoagulant and Associated Bleeding and Thrombotic Complication after Lower Extremity Bypass

In this episode, Dr. Yeh is joined by lead author Danielle C. Sutzko, MD, MS, from the University of Alabama at Birmingham, and senior author Andrea T. Obi, MD, FACS, from the University of Michigan, both vascular surgeons. They discuss their on outcomes associated with direct oral anticoagulant and vitamin K antagonist use after lower extremity bypass.

Episode 1: Mass Shootings in America: Consensus Recommendations for Healthcare Response

In the inaugural episode, Jamie Coleman, MD, FACS, and Dante Yeh, MD, FACS, speak with Craig Goolsby, MD, MEd, FACEP, Professor and Vice Chair of Emergency Medicine at the Uniformed Services University of the Health Sciences and Science Director at the National Center for Disaster Medicine and Public Health in Bethesda, MD about his group鈥檚 , which was conducted using a Delphi process and resulted in 19 recommendations for training, public education, triage, communication, patient tracking, medical records, family reunification, and mental health. These consensus recommendations from the surgeons, physicians, and medics who cared for recent mass shooting patients will help everyone prepare for future incidents.

About the Hosts

Lillian Erdahl, MD, FACS is a Clinical Associate Professor of Surgery and practices breast surgical oncology at the University of Iowa and the Iowa City VA Medical Center. She serves as Associate Program Director in for the Breast Surgical Oncology Fellowship. Her research interests include breast cancer prevention, faculty development, and simulation in teaching clinical examination.听

She completed her General Surgery residency at Penn State University including a 2-year research fellowship in surgical education. After residency, she also completed a 1-year fellowship in breast surgical oncology at the Mayo Clinic in Rochester, MN. She completed her Bachelor of Science in Biology at Iowa State University along with a minor in Spanish.

Outside of the hospital, she enjoys yoga, running, cross-country skiing, cooking, and gardening. Her 2 children help her to find joy in each moment of the day.

Disclosure Information: Dr. Erdahl has nothing to disclose.

Dr Thomas Varghese, Jr听is a cardiothoracic surgeon at the University of Utah (U of U) in Salt Lake City. He is chief of the Section of General Thoracic Surgery at U of U, chief value officer and associate chief medical quality officer at the Huntsman Cancer Institute, and a professor in the Department of Surgery at the U of U School of Medicine. He is a nationally funded researcher and author and holds prominent leadership positions in several surgical organizations. He spends his free time with his family, as well as actively engaging on social media (X: @tomvarghesejr LinkedIn:听)

Disclosure Information: Dr. Varghese has nothing to disclose.

The opinions expressed in this podcast are those of the participants and not necessarily that of the ACS.