JAMA SurgeryJAMA 外科
JAMA Surgery(英文缩写 JAMA SURG),ISSN 2168-6254,eISSN 2168-6262,中文译名:JAMA 外科 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：2025-11-01 至 2026-10-31，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 | 16.685 | Q1 |
| 2022 | 16.900 | Q1 |
| 2023 | 15.700 | Q1 |
| 2024 | 14.900 | Q1 |
| 2025 | 15.600 | Q1 |
JAMA Surgery 最新收录文献
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1. Robotic vs Thoracolaparoscopic Esophagectomy for Esophageal Cancer: A Randomized Clinical Trial.
1. 机器人对比胸腹腔镜食管切除术治疗食管癌：一项随机临床试验PMID:日期:2026-09-30The optimal surgical approach for oncological thoracoabdominal esophagectomy for adenocarcinoma is unclear. Robot-assisted minimally invasive esophagectomy (RAMIE) may facilitate a more extensive lymphadenectomy compared with conventional minimally invasive esophagectomy (MIE), which is crucial to achieve a favorable oncological outcome. To determine whether RAMIE results in a higher yield of resected lymph nodes compared with conventional MIE in patients undergoing surgery for esophageal or esophagogastric junction adenocarcinoma. This was a phase 3 randomized clinical trial conducted between January 2021 and March 2025 at 4 high-volume tertiary referral centers in Mainz, Germany; Amsterdam, the Netherlands; Zurich, Switzerland; and Cologne, Germany. Patients with resectable adenocarcinoma of the esophagus or esophagogastric junction staged as cT1-4a, cN0-3, and cM0 were included. Both primary surgery and multimodal treatment settings were eligible. A total of 218 patients were initially randomized, 202 of whom completed the study and underwent transthoracic esophagectomy with follow-up up to 5 years. Participants were randomly assigned (1:1) to RAMIE or conventional MIE. The primary end point was the number of resected lymph nodes, planned a priori and analyzed on a modified intention-to-treat basis. Secondary measures included luminal R0 resection rates, postoperative complication rates, 90-day mortality, and 1-year survival. Between 2021 and 2025, 218 patients were included in the study, 202 of whom (mean [SD] age, 64.8 [10.1] years; 181 [89.6%] male) underwent transthoracic esophagectomy (101 RAMIE and 101 MIE). The median number of resected lymph nodes was significantly higher in RAMIE compared to MIE (36 vs 32; P = .005). Luminal R0 resection was 99.0% with RAMIE and 97.0% with MIE. Rates of postoperative complications were similar between groups; 90-day mortality was 1.0% in the RAMIE group and 3.0% in the MIE group (P = .62). There was no difference in survival after 1 year. In this study, robotic esophagectomy provided a more radical lymphadenectomy compared to conventional minimally invasive esophagectomy with equal results for surgical safety. These results support the use of robotic esophagectomy as a standard approach for adenocarcinoma of the esophagus or esophagogastric junction. ClinicalTrials.gov Identifier: NCT04306458.
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2. Trends in New National Institutes of Health Awards to Surgeon-Scientists in 2025.
2. 2025年美国国立卫生研究院对外科科学家新资助项目的趋势PMID:日期:2026-09-30该文献暂无摘要。
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3. Enucleation vs Pancreatoduodenectomy for Benign and Low-Grade Pancreatic Head Tumors.
3. 良性及低级别胰头肿瘤的剜除术与胰十二指肠切除术比较PMID:日期:2026-09-30Pancreatic enucleation may offer a parenchyma-sparing alternative to pancreatoduodenectomy for benign and low-grade malignant pancreatic head tumors, but its perioperative risk-benefit profile relative to pancreatoduodenectomy remains incompletely defined. To compare short-term outcomes and long-term quality of life after enucleation vs pancreatoduodenectomy for benign and low-grade malignant tumors of the pancreatic head and uncinate process. This multicenter, retrospective cohort study assessed patients undergoing enucleation or pancreatoduodenectomy for benign or low-grade pancreatic head or uncinate process tumors at 4 high-volume Chinese centers (January 1, 2015, to December 31, 2024; median follow-up, 36 months) with 1:1 propensity score matching. Data analysis was performed from March to May 2026. Pancreatic enucleation vs pancreatoduodenectomy. The primary end point was clinically relevant postoperative pancreatic fistula (CR-POPF; International Study Group on Pancreatic Surgery grade B or C). Secondary end points included major complications (Clavien-Dindo grade III or higher), delayed gastric emptying, length of stay, long-term quality of life (European Organisation for Research and Treatment of Cancer Quality of Life Core Questionnaire and 26-item Quality of Life Pancreatic Cancer Questionnaire), and new-onset diabetes. Tumor-to-main pancreatic duct distance was evaluated through stratified and multivariable analyses. Of 660 patients (297 undergoing enucleation and 363 undergoing pancreatoduodenectomy; 355 [53.8%] female; median [IQR] age, 55.0 [41.0-65.0] years), 217 matched pairs were formed. CR-POPF was higher after enucleation (72 [33.2%] vs 23 [10.6%]; adjusted odds ratio, 4.22; 95% CI, 2.47-7.21; P < .001). Major complications were lower (19 [8.8%] vs 37 [17.1%]; adjusted odds ratio, 0.37; 95% CI, 0.20-0.70; P = .002) as was delayed gastric emptying (10 [4.6%] vs 55 [25.3%]; P < .001). Median (IQR) stay was 9 (6-14) vs 15 (11-22) days (P < .001). A total of 551 patients (83.5%) completed quality-of-life assessment; enucleation was associated with higher global health status (mean [SD] scores, 77.4 [13.7] vs 62.1 [18.0]; P < .001), lower new-onset diabetes (7.8% [20 of 257] vs 33.3% [98 of 294]; P < .001), and higher return to work (92.7% [191 of 206] vs 72.0% [121 of 168]; P < .001). Enucleation's complication advantage was greatest for tumors 2.5 cm or smaller (5.8% [6 of 104 patients] vs 26.2% [17 of 65 patients]; P for interaction = .01). In this multicenter cohort study, enucleation for benign and low-grade pancreatic head tumors was associated with higher CR-POPF than pancreatoduodenectomy but fewer major complications, less delayed gastric emptying, shorter hospitalization, and superior long-term quality of life. These findings support enucleation as a viable option when technically feasible, particularly for tumors 2.5 cm or smaller; residual tumor size imbalance after matching warrants prospective confirmation.
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4. Racial Disparities in Prehospital Interventions Among Injured Patients.
PMID:日期:2026-09-30Recent studies suggest racial disparities exist in prehospital interventions among injured patients. Further evaluation is needed to understand how other social determinants of health may influence these findings and if these disparities translate to differences in outcomes. To evaluate the association between race and ethnicity and receiving prehospital interventions, how these associations change based on neighborhood social determinants of health, and if these interventions are associated with patient outcomes. This is a retrospective cohort study of the Linking Investigations in Trauma and Emergency Medical Services Task Order 1 database from 2017 through 2021. Patients included were 18 years or older with an injury severity score higher than 9 and had race and ethnicity data available. Data were linked to the Distressed Communities Index (DCI). These data were analyzed from January 2025 to June 2025. Associations between race and prehospital interventions were evaluated, including prehospital blood products, prehospital needle decompression, prehospital airway, prehospital intubation, and prehospital tourniquet placement. The study team also evaluated if receiving prehospital interventions was associated with 24-hour and in-hospital mortality. A total of 18 280 patients meeting inclusion criteria were identified, of which 4327 self-identified as Black, 11 140 as White, and 2813 as other race. Patients of other race were more likely to receive prehospital blood products (492 [4.4%]) and prehospital intubation (882 [7.9%]) compared with Black patients (101 [2.3%] and 171 [4.0%], respectively). White patients were more likely to receive prehospital airway (1018 [9.1%]) and intubation (882 [7.9%]) compared with Black patients (250 [5.8%] and 171 [4.0%], respectively). Patients in socially disadvantaged neighborhoods were less likely to receive prehospital airway and intubation compared with more affluent communities. No significant interactions or significant mediation by the DCI was seen. Prehospital airway and prehospital intubation were associated with a 30% and 37% reduction in odds of in-hospital mortality (adjusted odds ratio [aOR], 0.70; 95% CI, 0.52-0.93 P = .05) and (aOR, 0.63; 95% CI, 0.46-0.86; P = .004). These results demonstrate that disparities in prehospital interventions among injured patients exist and these disparities are not significantly explained by neighborhood social determinants of health. Further studies are needed to better understand the underlying causes and employ targeted interventions.
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5. Gender Bias in AI-Generated Letters of Recommendation for Surgical Trainees.
5. 人工智能生成的外科实习生推荐信中的性别偏见PMID:日期:2026-09-23该文献暂无摘要。
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6. Transvaginal Drainage vs Laparoscopy for Tubo-Ovarian Abscess: A Randomized Clinical Trial.
PMID:日期:2026-09-23The treatment of tubo-ovarian abscess involves a combination of antibiotic therapy and abscess evacuation, which is usually performed by transvaginal drainage or laparoscopy. To demonstrate noninferiority of transvaginal drainage compared with laparoscopy for treatment of tubo-ovarian abscess in terms of the cure rate. The PACTOL (Efficacité de la Ponction transvaginale pour le traitement des AbCès Tubo-Ovariens par rapport à la Laparoscopie) multicenter, randomized, controlled, open, noninferiority clinical trial included patients aged 18 years or older and planning to undergo tubo-ovarian abscess evacuation who were recruited from 19 French hospitals and randomized between April 30, 2019, and April 29, 2023, with a 6-week follow-up duration. Data analysis was conducted from April 2024 to May 2025. Ultrasound-guided transvaginal drainage or laparoscopy. The primary outcome was the cure rate, defined using a composite criterion, evaluated at 6 weeks after tubo-ovarian abscess evacuation. The criteria were (1) no surgical reintervention, (2) no reintroduction of antibiotic therapy, and (3) disappearance of the tubo-ovarian collection. Noninferiority was defined as a difference of 12.5 percentage points or less for the main outcome. Among the 208 patients included (mean [SD] age, 34.7 [8.8]; all female), 130 were included in the per-protocol analysis. Six weeks after evacuation, 50 of 69 patients (72.5%) in the transvaginal drainage group and 47 of 61 patients (77.0%) in the laparoscopy group achieved the primary outcome (difference, -4.6 percentage points [95% CI, -19.4 to 10.7 percentage points]). There were no differences in persistence of the tubo-ovarian collection and reintroduction of antibiotic therapy. Reintervention was more frequently necessary in the transvaginal drainage group than in the laparoscopy group (9 of 69 patients [13.0%] vs 2 of 61 patients [3.3%], respectively; P = .046). In the intention-to-treat population, 201 women were included. The duration of hospitalization was significantly longer for laparoscopy than for transvaginal drainage (median [IQR], 3 [2-4] vs 2 [2-3] days, respectively; P = .01). The rates of Clavien-Dindo surgical complications of grade II or higher did not differ between groups. The pain score after tubo-ovarian abscess evacuation decreased more quickly in the transvaginal drainage group. In this randomized clinical trial, the noninferiority of transvaginal drainage compared with laparoscopy for tubo-ovarian abscess evacuation was not established, and transvaginal drainage required reintervention more frequently than laparoscopy. Considering the less invasive nature of transvaginal drainage, this approach should be offered as an alternate to laparoscopy, although patients should be aware that it has a higher probability of reintervention. ClinicalTrials.gov Identifier: NCT03819309.
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7. Projected Benefit of Bilateral Salpingo-Oophorectomy by Age in BRCA Carriers.
7. BRCA携带者按年龄行双侧输卵管卵巢切除术的预期获益PMID:日期:2026-09-23Women with a BRCA1 or BRCA2 variant face a high lifetime risk of ovarian cancer and are often advised to undergo preventive surgery (bilateral salpingo-oophorectomy [BSO]) before cancer develops. The recommended age of BSO is 35 years for BRCA1 carriers and is 45 years for BRCA2 carriers, but some women choose to delay surgery until the age of menopause; there is no standard upper age at which surgery is no longer advised. To estimate the residual lifetime risk of ovarian cancer among BRCA carriers by current age and projected age at BSO. This was a prospective cohort study in an international cohort of BRCA carriers monitored for incident ovarian cancer. A life table analysis used age-specific ovarian cancer incidence rates and competing mortality rates to estimate lifetime risk of ovarian cancer among women with a BRCA1 or BRCA2 pathogenic variant with both ovaries intact and no prior ovarian cancer at baseline. Patients were recruited between 1995 and 2024 across 24 international centers, and the mean (SD) follow-up was 4.4 (3.9) years. Timing of BSO, defined as immediate BSO, delayed BSO, or no BSO. Residual lifetime risk of ovarian cancer. The cohort consisted of 4286 BRCA1 and 1427 BRCA2 carriers between the ages of 30 and 74 years at baseline (mean [SD] age, 42.0 [10.8] years). There were 249 incident ovarian cancers in the follow-up period. The lifetime risk of ovarian cancer was 55.0% (95% CI, 48.8-61.9) for a BRCA1 carrier and 24.1% (95% CI, 15.1-36.6) for a BRCA2 carrier. A 30-year-old BRCA1 carrier with BSO delayed to age 50 years had a projected residual ovarian cancer risk of 23.9% (95% CI, 20.7-27.4). At age 75 years, the residual risk of ovarian cancer was estimated to be 8.4% (95% CI, 1.7-22.7) for a BRCA1 carrier and 3.7% (95% CI, 0.1-22.7) for a BRCA2 carrier. The residual risk of ovarian cancer for older women in good health is sufficiently high to consider preventive surgery. BRCA1 carriers who defer BSO until age 50 years may face a substantial risk of developing ovarian cancer.
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8. Management of Colon and Rectal Injuries From Blunt and Penetrating Trauma: Evidence-Based Recommendations From the World Society of Emergency Surgery.
8. 钝性和穿透性创伤所致结肠和直肠损伤的管理：世界急诊外科学会的循证建议PMID:日期:2026-09-23Traumatic colon and rectal injuries generate wide practice variation across diagnosis, operative strategy, technical conduct, and perioperative care. Management has shifted from mandatory fecal diversion toward selective primary repair and physiology-guided reconstruction, but decision-making remains inconsistent. To develop evidence-based recommendations for the diagnosis, operative strategy, technical conduct, and perioperative management of adult colon and rectal trauma. An international World Society of Emergency Surgery panel prioritized 17 clinical questions in the format Population, Intervention, Comparator, Outcome across 3 domains (colon, rectum, and technical/perioperative considerations). For each question, designated authors performed structured literature reviews through early 2026; evidence was synthesized and recommendations were drafted with an assigned strength (strong or conditional) and certainty (high, moderate, low, or very low) using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach and then harmonized by consensus. Reporting followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) conventions. Contrast-enhanced computed tomography (CT) anchors diagnosis but is a sensitive screening tool whose negative result does not exclude injury; specific signs (bowel wall discontinuity, extraluminal air, active mesenteric extravasation) warrant operation. For suspected rectal injury, CT is first-line, with adjunctive rigid or flexible proctoscopy raising combined sensitivity to approximately 97%; routine rectal contrast is not recommended. Primary repair or resection with anastomosis is preferred over routine diversion for most stable patients, including many traditionally deemed high risk; for low-grade injuries, primary repair alone is preferred over resection with anastomosis. Selective diversion is reserved for persistent vasopressor dependence after damage-control laparotomy, inability to achieve fascial closure at the first reoperation, or compounded physiologic derangement. Proximal diversion is the default for extraperitoneal rectal injury, and routine presacral drainage and distal rectal washout are not recommended. Stapled and hand-sewn anastomoses are equivalent; antibiotic prophylaxis should not exceed 24 hours; and early enteral nutrition is advised in selected patients. These recommendations support a selective, physiology-driven approach to colorectal trauma, in which patient physiology, contamination, perfusion, and the ability to achieve fascial closure-rather than the injured organ or any single risk factor-guide management. Much of the supporting evidence remains observational, and prospective study is warranted.
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10. Factors Associated With Surgical Faculty's Desire to Leave or Stay at Their Jobs.
10. 与外科教职员工离职或留任意愿相关的因素PMID:日期:2026-09-23Surgical faculty turnover in academic centers causes interruptions in continuity of patient care, trainee education, and loss of funding from research and clinical revenue, while burdening departments with new recruitment efforts. To identify variables associated with surgical faculty's desire both to leave and to stay in their job. A cross-sectional 67-item survey based on the job demands-resources model was administered to 452 surgical faculty at 10 medical centers across the US from February 2025 to September 2025. Demographics and factors related to attrition/intent to leave/retention were queried. Satisfaction was measured on a 5-point Likert scale. Reliability was high (Cronbach α > 0.70). χ2 testing and Mann-Whitney U tests were used for analysis. These data were analyzed from September 2025 through February 2026. Surgical faculty in full-time practice at 1 of 10 medical centers. The primary outcome measure was surgical faculty seriously considering leaving (SCL) their current job. Secondary outcome was attrition from prior faculty position. There were 209 respondents (response rate, 46.2% [209 of 452]); 59.4% were in their first job (FJ) after training, with 36.7% serving as assistant professors, 29.4% as associate professors, and 29.4% as full professors. Overall, 41.1% (95% CI, 34.3%-48.1%) reported SCL. SCL was higher for FJ (47.2%; 95% CI, 38.1%-56.4% vs 32.1%; 95% CI, 22.4%-43.2% for non-FJ faculty [P = .03]), those working longer clinical hours (50; 95% CI, 40-58.75 vs 40; 95% CI, 40-50; P = .05), and the university-academic SCL rate (45.5% [55 of 121]) vs university-affiliated SCL (48% [24 of 50]) vs nonprofit independent SCL (16.7% [6 of 36]) (P = .004). The top reasons cited for SCL were unhappiness with current leadership/governance (60% strongly agreed/agreed), lacking work-life balance (51.8%), feeling burnout (51.8%), and seeking new leadership opportunities (48.2%). Age, gender, race and ethnicity, geographic region, and academic rank were not associated with SCL. The most cited reasons for why faculty stayed in their present position were enjoying teaching trainees, relationship with colleagues, and the variety of cases. These results demonstrated that a significant number of surgical faculty reported seriously considering leaving their positions. The results provide actionable insights for improving retention, including greater engagement from departmental leadership and the creation of a nurturing, collaborative environment with career advancement opportunities.