JAMA Surgery

Among patients with #Melanoma and negative #SentinelLymphNodeBiopsy results, a low-risk 31-gene genetic expression profile identified a group with very low recurrence and no distant relapse after discharge to dermatology follow-up only. ja.ma/3UCwKoo

📝 Review: This review discusses current management for #IntrahepaticCholangiocarcinoma, including guidelines for chemoimmunotherapy, locoregional strategies, precision oncology approaches, and comprehensive genomic profiling. ja.ma/3UFtEjt

After elective #GICancer surgery, #DaysAtHome at 90 days was a valid, clinically meaningful, and patient-centered outcome that reflected complications, health care use, and survival. ja.ma/47tRMZl

Seasonal variation was observed in #Diverticulitis incidence but not in severity or the proportion of cases requiring an operation. Diverticulitis was more common in summer and autumn. #colonhealth 📖 Read full article: ja.ma/4jpTIt0

For refractory #SlowTransitConstipation, subtotal colectomy with cecorectal anastomosis and total colectomy with ileorectal anastomosis had similar 12-month outcomes, however patient-reported satisfaction at 1 year favored total colectomy. ja.ma/4hVZRMm

💬 Viewpoint: As #KidneyXenotransplant moves from early clinical trials toward broader use, benefit-risk assessment should include systematic measurement of patient risk tolerance alongside safety and effectiveness. ja.ma/4se9ZU0

Presented at #ANES26 from @jama.com: Among high-risk patients undergoing elective major abdominal surgery, individualized #CardiacIndex-guided hemodynamic therapy did not reduce postoperative organ injury, severe infection, cardiac arrest, or death. ja.ma/47voARD

📝 JAMA Surgery #Review: In adhesive small-bowel obstruction, #Nasogastric tube decompression remains a standard component of nonoperative management when there are no signs of bowel compromise or peritonitis. ja.ma/4zRtMeT

🩺 Among patients undergoing #CancerSurgery for 6 major nonmetastatic cancers, time from diagnosis to first-course therapy increased from 2012 to 2023 across all malignancies and among both up-front surgery and #NeoadjuvantTherapy pathways. ja.ma/4ycrIwt

In elective #DigestiveCancer surgery, preoperative high-dose #Corticosteroids did not improve postoperative complications, indicating that preoperative high-dose corticosteroids should not be recommended for postoperative risk reduction in this setting. ja.ma/4euO7hs

Among Medicare beneficiaries undergoing minimally invasive #Cholecystectomy, key surgical outcomes showed significant improvement from 2011 to 2021 despite increasing patient complexity. #gallbladder #gallbladdersurgery 📌 Read full article to learn more: ja.ma/4eo7WHd

Among patients undergoing open rectal resection for #RectalCancer, a powdered #ChondroitinSulfate adhesion barrier system reduced postoperative adhesion incidence, severity, and extent vs no additional procedure. ja.ma/4s9PmbB

📊 Among individuals with obesity, #BariatricSurgery was associated with a lower long-term risk of obesity-related cancer, with similar associations across age groups and sexes. ja.ma/481D5N3

In rural US counties, #FamilyMedicine-#GeneralSurgery dyad access declined from 2010 to 2021, driven mainly by loss of general surgeons, and was not independently associated with mortality outcomes after adjustment. ja.ma/4yLQMLT

💬 Viewpoint: Preparing the US for large-scale combat operations requires both facility readiness and clinician training in #CombatCasualty care. ja.ma/4yw8RNm

📉 Among women undergoing cardiac surgery, #AcuteNormovolemicHemodilution was not associated with reduced allogeneic packed red blood cell transfusion vs usual care and was associated with more intraoperative hypotension. ja.ma/4hMwJXK

💬 Viewpoint: Required transportation escorts after outpatient surgery may delay care and worsen access for patients with limited social support, transportation insecurity, or privacy concerns. ja.ma/4e5MIOg

Among patients with #GastricCancer and positive peritoneal lavage cytology or localized peritoneal metastasis, #chemotherapy plus #gastrectomy was associated with better survival than gastrectomy alone or chemotherapy alone. ja.ma/47Pt0CO

💬 Viewpoint: Required transportation escorts after outpatient surgery may delay care and worsen access for patients with limited social support, transportation insecurity, or privacy concerns. ja.ma/4Be7HIS

Among patients with #GastricCancer and positive peritoneal lavage cytology or localized peritoneal metastasis, #chemotherapy plus #gastrectomy was associated with better survival than gastrectomy alone or chemotherapy alone. ja.ma/4jP315G

💬 Viewpoint: Required transportation escorts after outpatient surgery may delay care and worsen access for patients with limited social support, transportation insecurity, or privacy concerns. ja.ma/4rT57DB

Among patients with #GastricCancer and positive peritoneal lavage cytology or localized peritoneal metastasis, #chemotherapy plus #gastrectomy was associated with better survival than gastrectomy alone or chemotherapy alone. ja.ma/47pUOxL

New #NationalInstitutesOfHealth awards to surgeon-scientists declined in 2025, driven mainly by fewer new R01 awards, while K awards remained stable. ja.ma/4rFZfxD

Among injured patients, Black patients were less likely to receive some #PrehospitalCare interventions, and these disparities were not significantly explained by neighborhood social determinants of health. ja.ma/3ThUvl8

For benign and low-grade #PancreaticHead tumors, enucleation was associated with more clinically relevant postoperative pancreatic fistula vs pancreatoduodenectomy, but fewer major complications and shorter hospitalization. ja.ma/3ThIZpT

In resectable #EsophagealCancer, robotic minimally invasive esophagectomy yielded more resected lymph nodes vs conventional minimally invasive esophagectomy, with similar postoperative complications and 1-year survival. ja.ma/4xXO2Kq

In prospective hepatobiliary #LaparoscopicSurgery videos, automated skill scores aligned more closely with expert ratings than scores from resident and attending surgeons. ja.ma/4iPemlO

In #AI-generated letters for surgical trainees, 4 large language models used more agentic descriptors for male-gendered vs female-gendered names based on the same curriculum vitae. ja.ma/3VLFNU4

In private payer data, complex procedures in The Transforming Episode Accountability Model by @CMSGov were associated with more intensive care unit use, readmissions, and postacute care, but hospital payments often did not increase proportionally. ja.ma/4x5kDNL

Among surgical faculty at 10 US medical centers, 41.1% reported seriously considering leaving, most often associated with unhappiness with leadership or governance, lacking work-life balance, and burnout. ja.ma/47dOYz7

Older age, elective surgery, open approach, and longer operative time were associated with greater likelihood of #Opioid prescribing at discharge in pediatric surgical care. ja.ma/3TgraHx

In academic #Surgery, about 4 in 10 faculty surveyed were considering leaving their current job. Departmental governance, work-life balance, and burnout were leading factors, discussed in the latest JAMA Surgery Author Interviews podcast. 🎧 Listen now: edhub.ama-assn.org/jn-learning/...

In #TuboOvarianAbscess, transvaginal drainage did not establish noninferiority vs #laparoscopy for 6-week cure and required reintervention more often. ja.ma/4dwuGEC

Among women with #BRCA1 or #BRCA2 pathogenic variants, the projected benefit of bilateral salpingo-oophorectomy declined with age but remained present into older age. ja.ma/3To6iy5

In youths after sleeve gastrectomy, early reinitiation of obesity medication was associated with greater 12-month weight loss vs surgery alone, without higher postoperative morbidity. ja.ma/4qZ4ecf

More than one-third of older adults at extreme risk for early mortality died within 48 hours of high-risk #EGS, highlighting a substantial rate of nonbeneficial surgery. ja.ma/4x7Qy00

Compared with nonoperative management, surgical stabilization of rib fractures was associated with lower risk of pulmonary complications, even when performed >3 days after blunt chest trauma. ja.ma/4zUX7G1

#WholeBlood transfusion delivers red cells, plasma, and platelets in physiologic proportions and may reduce transfusion burden and improve early outcomes in trauma, but definitive guidance awaits adequately powered randomized trials. ja.ma/4qWhZZj

Among patients with #PrimaryHyperparathyroidism without baseline end-organ damage, 32% developed osteoporosis, kidney stones, fractures, or chronic kidney disease during follow-up, indicating progression under usual care. ja.ma/3VeFjpe

In patients receiving massive #transfusion, survival differed by exposure to ABO nonidentical blood components, with poorer outcomes observed when larger numbers of ABO-mismatched transfusions were given. ja.ma/4xuYzfJ

During laparoscopic cholecystectomy, #IndocyanineGreen fluorescent cholangiography was associated with lower rates of #BileDuctInjury, biliary intervention, conversion to open surgery, and 30-day nonbiliary complications. ja.ma/4qXEaOQ

Congratulations to JAMA Surgery Editor in Chief Melina Kibbe, MD, who was invested today as the seventh president, and the first woman president, of @uthealthhouston.bsky.social. Additionally, the city of Houston named September 17, 2026, as Melina Kibbe Day.

🩺 #PigtailCatheters are used as first-line treatment for pneumothorax and a range of pleural effusions. This Review summarizes indications, Seldinger technique insertion, daily management, removal, and complications. ja.ma/3TBr4KK

📊 Spanish-speaking injured patients received less #TraumaInformedCare communication and were less likely to receive a complete examination than English-speaking patients, highlighting an equity gap in trauma resuscitation. ja.ma/4xmDG6s

Perioperative FLOT chemotherapy was linked to better survival and lower recurrence risk than CROSS chemoradiotherapy among esophageal adenocarcinoma patients achieving #pCR. ja.ma/4hcASDZ

💬 Editorial: In rare surgical adverse event studies, confounding, sparse outcomes, and clustering can distort associations. #Cholecystectomy research on #intraoperativecholangiography shows that analyses must account for rare events and clustering. ja.ma/4rnO2le

📊 Among patients undergoing minimally invasive #Cholecystectomy, #RoboticSurgery was associated with fewer adverse outcomes than #Laparoscopy in high-risk cases. A preoperative risk calculator may help match operative approach to patient risk. ja.ma/3Vzl2uH

Robotic-assisted #cholecystectomy for complex cases reduced postoperative interventions and complications, with no increase in overall health care cost compared to laparoscopy. ja.ma/4gBjUPw

In 2022, the mean cost of #OperatingRoom time in California hospitals was $57.71 per minute, while mean charges were $295 and mean revenue was $66 per minute, establishing updated benchmarks for surgical cost analyses. ja.ma/4gG7jKQ

📝 #Review from @jama.com: #Idiopathic normal pressure hydrocephalus is a progressive neurologic disorder in older adults associated with gait impairment and often urinary dysfunction and cognitive decline. 🔗 Learn more: ja.ma/3Tuhut6