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In This Issue of JAMA Surgery
August 2019

JAMA Surgery

JAMA Surg. 2019;154(8):681. doi:10.1001/jamasurg.2018.3827
Research

This study examines the association between increased domestic workload and career dissatisfaction for physicians who are mothers, comparing those in proceduralist vs nonproceduralist roles. In a survey of 1712 attending physician-mothers from the Physician Moms Group, Lyu and colleagues identified factors associated with career dissatisfaction. For those in proceduralist positions, self-reported higher levels of domestic responsibility were associated with career dissatisfaction.

Invited Commentary

Continuing Medical Education

Venous thromboembolism is a source of morbidity and mortality in patients undergoing colorectal surgery. Pannucci and colleagues enrolled 116 patients undergoing colorectal surgery at the University of Utah; each received a 40-mg dose of enoxaparin once daily. The study examined anti–Factor Xa levels, a marker of the extent of anticoagulation, and found that 2 of every 3 patients (67.9%) had insufficient anticoagulation with a 40-mg, once-daily dose of enoxaparin. This nonrandomized trial calls into question the current, one-size-fits-all mentality for enoxaparin dosing.

Invited Commentary

The Enhanced Recovery After Surgery protocols have been associated with improvement in outcomes. In this multicenter prospective cohort study, 2084 consecutive patients scheduled for elective colorectal surgery were recruited from 80 centers in Spain over a 2-month period, with follow-up for 1 month. The authors found that increased adherence to the Enhanced Recovery After Surgery protocols appeared to be associated with a decrease in postoperative complications.

Invited Commentary

Clinical Education & Review

The Enhanced Recovery After Surgery protocols are associated with reductions in overall complications and length of stay. Engelman and colleagues performed a systematic review of the cardiac surgical literature and selected and graded the evidence for 22 expert consensus–driven recommendations for optimal perioperative care of patients undergoing cardiac surgery.

Invited Commentary

Continuing Medical Education

Hepatic disease control and conversion to resectability are important considerations in patients with initially unresectable colorectal liver metastasis who have liver-dominant disease. This narrative review discusses the biological rationale for hepatic arterial infusion chemotherapy, evidence for conversion to resectability using hepatic arterial infusion chemotherapy and systemic chemotherapy, and morbidity and toxic effect profiles of hepatic arterial infusion chemotherapy.

Continuing Medical Education

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