Journal of the American College of Surgeons
Audio Summaries

Increased Medical Debt in Collections 1 Year After Emergency General Surgery Admission

Sep 23, 2026

The authors aimed to determine whether emergency general surgery (EGS) admissions are linked to lasting increases in medical debt and how this is influenced by patient demographics versus treatment factors. They found that nearly 10% of patients experienced increased medical debt in collections within a year after EGS, with significant associations identified between income levels and insurance status, rather than the intensity of medical treatment. This suggests that financial risk protection strategies may be more effective in addressing post-EGS financial burdens than altering clinical care practices.

Effect of Surgical Subspecialty on Time to Development of Postoperative Venous Thromboembolism

Sep 22, 2026

The authors aimed to investigate how the timing of postoperative venous thromboembolism (VTE) and the patterns of thromboprophylaxis differ across various surgical subspecialties. Their study found that VTE incidence and timing varied significantly, with neurosurgery showing the highest incidence and orthopedic surgery having the greatest adjusted hazard for VTE. Additionally, the timing of thromboprophylaxis initiation was crucial, as patients who did not receive prophylaxis developed VTE earlier than those who did, highlighting the need for tailored VTE risk assessments and prophylaxis strategies based on surgical specialty.

William Athol McElmoyle and the Forgotten Shield: Rediscovering an Early Principle of Safe Cholecystectomy

Sep 22, 2026

The authors aim to rediscover and highlight the contributions of William Athol McElmoyle's 1954 approach to gallbladder surgery, which emphasized the importance of intentionally leaving adherent tissue intact to prevent injury during difficult cholecystectomies. They argue that McElmoyle's principle of prioritizing safety over complete dissection is conceptually relevant to modern surgical practices, particularly in cases where inflammation obscures critical anatomical structures. This historical perspective underscores the need for surgical judgment in determining when to exercise restraint during operations.

Normothermic Machine Perfusion, Patient-Centered Recovery, and Graft Survival After Donation-After-Circulatory-Death Liver Transplantation

Sep 22, 2026

The authors aimed to investigate the impact of normothermic machine perfusion (NMP) on patient-centered recovery and graft survival in donation-after-circulatory-death (DCD) liver transplantation. Their findings suggest that while NMP did not show a significant independent association with days alive and out of hospital at 365 days, it was linked to improved two-year graft survival and reduced early allograft dysfunction compared to static cold storage. These results highlight the need for further multicenter studies to evaluate the benefits of NMP in liver transplantation.

Long-Term Patient-Reported Outcomes after Robotic, Laparoscopic, and Open Primary Ventral Hernia Repair

Sep 22, 2026

The authors aimed to compare long-term patient-reported outcomes among robotic, laparoscopic, and open primary ventral hernia repair methods. They found that while severe chronic pain and physical impact scores were similar across all approaches, laparoscopic and robotic repairs resulted in significantly lower scar dissatisfaction compared to open repair. Additionally, patient-reported recurrence was higher after laparoscopic repair, suggesting that scar-related outcomes may influence the choice of surgical approach based on patient priorities.

Lost in Interpretation: The Case for Standardized Radiologic Reporting of Liver Lesions in Colorectal Liver Metastases

Sep 21, 2026

The authors aim to address the need for a standardized radiologic reporting framework for colorectal liver metastases (CRLM) to improve the accuracy and consistency of resectability assessments. They highlight the current reliance on free-text reports, which often lack critical anatomical details, leading to variability in surgical decision-making. By proposing a structured reporting template that includes key domains, they advocate for a collaborative approach to enhance surgical outcomes for CRLM patients.

Robotic Operation After Interhospital Transfer for Emergency General Surgery: Adoption, Hospital-Level Variation, and National Outcomes

Sep 21, 2026

The authors aimed to evaluate the adoption and outcomes of robotic surgery in emergency general surgery (EGS) patients transferred between hospitals. They found that robotic surgery was infrequently utilized, with significant hospital-level variation in its use compared to laparoscopic approaches, and while robotic surgery was associated with shorter hospital stays and lower complications compared to open surgery, it also incurred higher costs without notable differences in clinical outcomes. The study highlights the need for clear selection criteria and equitable access to robotic surgical options.

Promoting Optimal Pediatric Readiness at US Trauma Centers: Understanding and Addressing Barriers

Sep 21, 2026

The authors aim to identify and address barriers to pediatric readiness in US trauma centers, recognizing that improved outcomes for children depend on access to facilities equipped for emergency pediatric care. Through a multidisciplinary session, they highlighted challenges such as limited personnel, financial constraints, and fragmented coordination, while proposing strategies for enhancing regional collaboration and resource sharing to improve pediatric readiness across all trauma facilities. Their recommendations, though based on expert opinion, offer a framework for implementing national pediatric readiness standards at the local level.

Evidence-aligned surgical cancer care at hub versus spoke hospitals of multihospital systems

Sep 18, 2026

The authors aimed to compare the quality of surgical cancer care, specifically the provision of evidence-aligned care (EAC), between hub and spoke hospitals within multihospital systems. Their analysis of SEER Medicare patients revealed that while adherence to EAC was generally high for well-adopted practices, patients at spoke hospitals were less likely to receive evidence-aligned care for poorly adopted practices compared to those treated at centralized hubs. The findings suggest that improving care quality may require either centralizing services at hubs or enhancing the dissemination of best practices to spoke hospitals.

Trends in Medicare Work Relative Value Unit Payment Rates Across Physician Specialties: 2018-2024

Sep 18, 2026

The authors aimed to assess the impact of recent Medicare Physician Fee Schedule revisions on work relative value unit (wRVU) payment rates across various physician specialties from 2018 to 2024. Their analysis revealed a narrowing of the payment-rate gap between medical and surgical specialties, from 5.4% in 2018 to 1.6% in 2024, although the trends indicated that primary care and nonsurgical specialties experienced faster increases compared to surgical specialties. The findings suggest that while the revisions have reduced the payment-rate disparity, the Medicare Physician Fee Schedule may not effectively address broader compensation differences among specialties.