AMERICAN SURGEON美国外科医师
AMERICAN SURGEON(英文缩写 AM SURGEON),ISSN 0003-1348,eISSN 1555-9823,中文译名:美国外科医师 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-09-27 至 2026-09-27，按本站收录文献的发表日期统计。
期刊介绍
历年影响因子趋势
| JCR 数据年份 | 影响因子 | JCR 分区 |
|---|---|---|
| 2021 | 1.002 | Q4 |
| 2022 | 1.000 | Q4 |
| 2023 | 1.000 | Q3 |
| 2024 | 0.900 | Q3 |
| 2025 | 1.000 | Q3 |
AMERICAN SURGEON 最新收录文献
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1. Physiologic Status at Cannulation Is Associated With Survival in Trauma Patients Receiving ECMO.
PMID:日期:2026-10-01Extracorporeal membrane oxygenation (ECMO) manages critical cardiac and pulmonary conditions. We hypothesized that ECMO utilization in trauma patients would result in overall favorable outcomes and sought to evaluate the factors leading to survival. We conducted a 10-year retrospective study at our Level One trauma center, including all adolescent and adult patients with traumatic injuries undergoing ECMO. We performed descriptive statistics and univariate analyses comparing survivors and non-survivors. Of the 28 patients who met our inclusion criteria, 42.9% survived. Non-survivors were cannulated on ECMO sooner and had a worse base deficit at time of cannulation. Most survivors discharged home (25%) or to a rehabilitation center (41.7%). High mortality in this population reveals the importance of understanding and following a standard selection criteria when cannulating trauma patients on ECMO. Further investigation is needed to evaluate what makes trauma patients appropriate to be cannulated on ECMO.
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2. Artificial Intelligence in Everyday Surgical Practice: A Practical Review.
PMID:日期:2026-10-01Artificial intelligence (AI) tools have moved from novelty to measurable clinical impact in surgical practice. This review organizes the literature and practical guidance around five problems surgeons face: documentation burden, information overload, administrative accumulation, practice intelligence, and implementation. Each section follows a consistent structure: the problem, the evidence for addressing it, the type of tool that fits, and what failure looks like. The review draws on the best available evidence across study designs and addresses compliance, implementation, and measurement throughout. The paper's central argument is that AI's near-term role in surgery is not to replace surgical judgment, but to reduce the cognitive and administrative overhead that surrounds it. Clinical judgment, technical skill, and operative intuition remain irreducibly human. A final section addresses the educational implications of training surgeons in an AI-enabled environment.
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3. Building the Conversation: Editorial Stewardship in Contemporary Surgical Publishing.
PMID:日期:2026-10-01Academic publishing in surgery has undergone profound change during the past several decades. Expansion of medical schools, residency programs, international academic centers, and digital publishing platforms has produced unprecedented growth in manuscript submissions and intensified competition for professional attention. Journals are judged both by readership, as measured by article downloads, and by scientific influence, as reflected in scholarly citation. At , these changes prompted development of editorial frameworks designed to identify contributions most likely to matter to practicing surgeons and subsequent investigators. Many manuscripts contained observations whose significance was underrecognized by their authors. This observation led to the Hidden Publishable Idea (HPI), a framework for identifying contributions most useful to readers. Once identified, the HPI often revealed methodological limitations that imposed an evidentiary ceiling, preventing definitive conclusions while suggesting new hypotheses for future investigation. Analysis of downloads and citations suggested that readership and scholarly adoption are related but distinct outcomes. This observation led to development of the CitDL matrix, a two-by-two framework based on high and low download and citation performance. The editorial objective was not simply manuscript acceptance, but identification and development of contributions that could move manuscripts toward greater readership, greater scholarly engagement, or both. These concepts represent adaptive responses to the contemporary challenge of helping useful ideas find their audience and contribute to the advancement of surgical practice and science.
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4. Atypical Presentation of Metastatic Prostate Adenocarcinoma in the Presacral Space: A Case Report of Diagnostic Resection via the Kraske Approach.
PMID:日期:2026-10-01Prostate adenocarcinoma most commonly metastasizes to bone and lymph nodes; isolated soft-tissue presacral metastasis without a known primary is exceedingly rare and poorly characterized. We report a 69-year-old man presenting with hematuria and an incidental 4-cm presacral mass. MRI demonstrated a solid, heterogeneously enhancing lesion within the right mesorectal compartment without intraluminal involvement, most consistent with a primary neurogenic tumor. Serum PSA was not obtained preoperatively, as symptoms were attributed to chronic suprapubic catheter irritation and imaging did not suggest a prostatic origin. Preoperative biopsy was not pursued given the lesion's deep posterior location at the S4 level-proximity to sacral nerve roots precluded safe percutaneous access, and transrectal biopsy is contraindicated. The mass was resected via a posterior transsacral (Kraske) approach for presumed primary presacral neoplasm. Histopathology revealed metastatic prostatic adenocarcinoma with positive PSA and prostatic acid phosphatase immunostaining, identifying an occult primary tumor. This case illustrates an atypical diagnostic scenario in which resection was undertaken for a presumed primary lesion; the metastatic diagnosis was an unexpected pathologic finding that would have substantially altered management had it been established preoperatively. This case underscores the importance of including serum PSA in the standard workup of solid presacral masses in older male patients and demonstrates that the Kraske approach can provide adequate exposure for selected posteriorly situated extrarectal masses when diagnosis remains uncertain and resection is clinically indicated.
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5. Medicaid Expansion and Stage-Specific Colorectal Cancer Survival.
PMID:日期:2026-10-01BackgroundMedicaid expansion under the Affordable Care Act has been associated with improved colorectal cancer (CRC) outcomes, predominantly attributed to earlier diagnosis and stage migration. However, it remains unclear whether survival benefits vary across disease stages.ObjectiveTo evaluate cancer-specific survival (CSS) after Medicaid expansion across disease stages among working-age adults with CRC, comparing the expansion state of California with the non-expansion state of Texas.MethodsWe conducted a retrospective cohort study using Surveillance, Epidemiology, and End Results (SEER) registry data (2007-2021) for patients aged 18-64 years with primary CRC. A difference-in-differences design compared pre-ACA (2007-2013) and post-ACA (2015-2021) periods between California and Texas. CSS was modeled using Cox proportional hazards regression adjusting for demographics, tumor characteristics, and treatments. Analyses were stratified by disease stage (localized, regional, distant) and race/ethnicity.ResultsAmong 122,543 patients, CSS improved after Medicaid expansion in California relative to Texas. Stage-stratified difference-in-differences models showed a modest reduction in cancer-specific mortality for localized disease 0.985 (0.974-0.996), a larger reduction for regional disease 0.941 (0.900-0.983), and the greatest reduction for distant metastatic disease 0.689 (0.525-0.903). Improvements were consistent across racial/ethnic groups, with the largest relative reduction among non-Hispanic Black patients 0.855 (0.763-0.958).ConclusionMedicaid expansion was associated with stage-dependent improvements in CRC survival, with the most pronounced benefit for patients with metastatic disease. These findings suggest that enhanced access to systemic therapy, multidisciplinary care, and financial protection may yield survival gains beyond those mediated by stage shift alone.
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6. Postoperative Transthoracic Echocardiography Following Penetrating Cardiac Injury: Moving From Routine Use to a Risk-Stratified Approach.
PMID:日期:2026-10-01BackgroundPatients undergoing surgical repair of penetrating cardiac injury are routinely evaluated postoperatively with a transthoracic echocardiogram (TTE). We hypothesized that patients undergoing a single operation for penetrating cardiac injuries without the need for cardiopulmonary bypass (CPB), coronary artery bypass grafting (CABG), or additional staged procedures do not benefit from routine postoperative TTEs.MethodsA retrospective chart review of patients presenting with cardiac injuries to a level I trauma center from January 2018 to March 2025 was performed. Patients with a blunt mechanism, age <18 years, or no identifiable penetrating cardiac injury were excluded. Demographic data, injury characteristics, postoperative care and complications, and TTE findings were analyzed.ResultsThirty-eight patients with penetrating cardiac injuries were identified. Twenty-one patients died within 4 hours of arrival, and 2 patients underwent advanced procedures (ie, CPB and CABG), leaving 15 patients for analysis. Thirteen (87%) were male with an average age of 36. The Median Injury Severity Score (ISS) was 26, with a median American Association for the Surgery of Trauma (AAST) heart injury grade of 3. Fourteen (93%) patients survived to discharge. Eight (53%) of the fifteen patients underwent postoperative TTEs, none of which revealed clinically significant findings relative to their procedure.DiscussionRoutine postoperative TTE demonstrated low clinical utility in this cohort. These findings support a selective approach to TTE based on injury complexity and clinical indicators. Postoperative TTE may be deferred in asymptomatic patients following uncomplicated repair but remains indicated in patients with new cardiac symptoms, higher-risk injury patterns, or complex operative repair.
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7. Managing Pyogenic Soft-Tissue Infections in People Living With HIV in a Resource-Limited Setting: Field Lessons and a Pragmatic Algorithm From South Sudan.
PMID:日期:2026-10-01Severe pyogenic soft-tissue infections (SSTI) are a frequent cause of morbidity among people living with HIV (PLHIV) in resource-limited hospitals. Drawing on five months of frontline work in a district surgical unit in South Sudan, this field report distills practical lessons into a simple, resource-adapted algorithm for triage, source control, antibiotics, and wound care. Core steps include bedside sepsis screening with qSOFA, prompt empiric antibiotics aligned with the WHO EML/AWaRe approach, and decisive operative debridement without waiting for advanced diagnostics when necrotizing infection is suspected, followed by planned re-look procedures. Low-cost wound-care options (eg, diluted hypochlorite/povidone-iodine transitioning to saline gauze) and loss-to-follow-up-aware discharge practices are emphasized. The aim is to standardize care and shorten time to debridement in district-level services rather than report outcomes. Keywords: pyogenic soft-tissue infection; HIV; resource-limited settings; necrotizing fasciitis.
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8. Unmasking Hyperammonemia: Psychomotor Slowing as a Diagnostic Trigger During PEG and Enteral Nutrition.
PMID:日期:2026-10-01A 63-year-old woman developed severe hyperammonemia and psychomotor slowing following percutaneous endoscopic gastrostomy (PEG) and continuous enteral nutrition (EEN) for anxiety-related feeding difficulties. Despite normal neuroimaging, her plasma ammonia levels peaked at 117.6 μmol/L. Immediate management via PEG removal and transition to a semi-liquid oral diet successfully normalized ammonia levels and restored cognitive function. This case highlights that PEG-associated EEN, potentially combined with specific formula deficiencies or metabolic vulnerabilities, can precipitate hyperammonemia. Surgeons and gastroenterologists should recognize unexplained psychomotor slowing as a critical diagnostic trigger for hyperammonemia in patients on long-term enteral feeding to ensure prompt intervention.
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9. Coated Polypropylene Mesh Is Not an Independent Predictor of Wound Morbidity in Open Abdominal Wall Reconstruction.
PMID:日期:2026-10-01BackgroundBarrier-coated meshes were developed to minimize adhesion formation between the PM and adjacent viscera. However, prior data has shown an increased infectious risk associated with rapidly absorbable coated PM vs uncoated PM in open preperitoneal AWR (OPPAWR). This study evaluated differences in wound and mesh infection rates between coated and uncoated PM in patients undergoing OPPAWR.Materials and MethodsA prospectively maintained, tertiary hernia center database was queried for patients undergoing OPPAWR with PM in CDC class 1/2 wounds. Using 1:1 propensity-score matching (PSM), coated and uncoated groups were matched on factors known to influence outcomes. Multivariable regression models determined independent predictors of wound and infectious complications.ResultsOf 1450 patients with coated and uncoated PM, 382 pairs were well-matched. Propensity-score matching covariates were similar (all 0.05). The coated group had higher rates of wound infection (6.3% vs 3.1%), postoperative IV antibiotics (8.6% vs 4.7%), percutaneous drain placement (6.8% vs 3.1%), and mesh infection (2.4% vs 0.0%) (all < 0.05), but no significant difference in composite wound complications (20.4% vs 16.5%; = 0.162). Multivariable regression showed panniculectomy (OR: 1.87, 95% CI: 1.25-2.82; = 0.003) and BMI (OR: 1.05, 95% CI: 1.02-1.08; = 0.002) were independent predictors of wound complications, but coated mesh was not (OR: 0.78, 95% CI: 0.53-1.15; = 0.211). In the infectious model regression, panniculectomy remained an independent predictor (OR: 2.01, 95% CI: 1.24-3.25; = 0.005), while coated mesh again was not (OR: 0.65, 95% CI: 0.41-1.04; = 0.074).DiscussionIn the largest reported cohort, following complex OPPAWR, multivariable regression demonstrated that coated PM did not independently predict wound or infectious complications.