Scholars@Duke
Jay S Lee

Jay S Lee

Assistant Professor of Surgery
Surgical Oncology
jay.lee@duke.edu
20 Medicine Circle, DUMC 3966, Durham, NC 27710

Selected Publications

National Trends in Management of the Nodal Basin for Pediatric Patients With Occult Stage III Melanoma in the United States.

Journal Article Pediatr Blood Cancer · May 2025 BACKGROUND: Following the publication of recent trials (MSLT-I, MSLT-II, DeCOG), routine completion lymph node dissection (CLND) after positive sentinel lymph node biopsy (SLNB) is no longer recommended for adults with melanoma, while adjuvant immunotherap ... Full text Link to item Cite

Association of Postoperative Opioid Prescription Size and Patient Satisfaction.

Journal Article Ann Surg · December 1, 2022 OBJECTIVE: To evaluate the association between postoperative opioid prescription size and patient-reported satisfaction among surgical patients. SUMMARY BACKGROUND DATA: Opioids are overprescribed after surgery, which negatively impacts patient outcomes. T ... Full text Link to item Cite

Management of pelvic sarcoma.

Journal Article Eur J Surg Oncol · November 2022 Pelvic sarcomas are a rare and heterogenous group of tumors divided into two groups: soft tissue sarcomas and bone sarcomas. Soft tissue sarcomas of the pelvis include most commonly liposarcoma, leiomyosarcoma, gastrointestinal stromal tumors, malignant pe ... Full text Link to item Cite

Prevalence and Patterns of Opioid Use Before and After Liver Transplantation.

Journal Article Transplantation · January 1, 2021 BACKGROUND: Opioid use in liver transplantation is poorly understood and has potential associated morbidity. METHODS: Using a national data set of employer-based insurance claims, we identified 1257 adults who underwent liver transplantation between Decemb ... Full text Link to item Cite

Opioid prescribing exceeds consumption following common surgical oncology procedures.

Journal Article J Surg Oncol · January 2021 BACKGROUND AND OBJECTIVES: Surgical oncology patients are vulnerable to persistent opioid use. As such, we aim to compare opioid prescribing to opioid consumption for common surgical oncology procedures. METHODS: We prospectively identified patients underg ... Full text Link to item Cite

Health Care Spending and New Persistent Opioid Use After Surgery.

Journal Article Ann Surg · July 2020 OBJECTIVE: We sought to describe the differences in health care spending and utilization among patients who develop persistent postoperative opioid use. SUMMARY OF BACKGROUND DATA: Although persistent opioid use following surgery has garnered concern, its ... Full text Link to item Cite

Classifying Preoperative Opioid Use for Surgical Care.

Journal Article Ann Surg · June 2020 OBJECTIVE: We characterized patterns of preoperative opioid use in patients undergoing elective surgery to identify the relationship between preoperative use and subsequent opioid fill after surgery. BACKGROUND: Preoperative opioid use is common, and varie ... Full text Link to item Cite

Provider Characteristics Associated With Outpatient Opioid Prescribing After Surgery.

Journal Article Ann Surg · April 2020 OBJECTIVE: To characterize differences in postoperative opioid prescribing across surgical, nonsurgical, and advanced practice providers. BACKGROUND: There is a critical need to identify best practices around perioperative opioid prescribing. To date, diff ... Full text Link to item Cite

Patterns of Initial Opioid Prescribing to Opioid-Naive Patients.

Journal Article Ann Surg · February 2020 OBJECTIVE: To determine the proportion of initial opioid prescriptions for opioid-naive patients prescribed by surgeons, dentists, and emergency physicians. We hypothesized that the percentage of such prescriptions grew as scrutiny of primary care and pain ... Full text Link to item Cite

A Pathway for Developing Postoperative Opioid Prescribing Best Practices.

Journal Article Ann Surg · January 2020 OBJECTIVE: Opioid prescriptions after surgery are effective for pain management but have been a significant contributor to the current opioid epidemic. Our objective is to review pragmatic approaches to develop and implement evidence-based guidelines based ... Full text Link to item Cite

Association of State Opioid Duration Limits With Postoperative Opioid Prescribing.

Journal Article JAMA Netw Open · December 2, 2019 IMPORTANCE: Since the Centers for Disease Control and Prevention published opioid prescribing guidelines in March 2016, 31 states have implemented legislation to restrict the duration of opioid prescriptions for acute pain. However, the association of thes ... Full text Link to item Cite

Postoperative opioid prescribing is not my job: A qualitative analysis of care transitions.

Journal Article Surgery · November 2019 BACKGROUND: Persistent opioid use is common after surgical procedures, and postoperative opioid prescribing often transitions from surgeons to primary care physicians in the months after surgery. It is unknown how surgeons currently transition these patien ... Full text Link to item Cite

Patient Satisfaction and Pain Control Using an Opioid-Sparing Postoperative Pathway.

Journal Article J Am Coll Surg · September 2019 BACKGROUND: Opioids are overprescribed after surgical procedures, leading to dependence and diversion into the community. This can be mitigated by evidence-based prescribing practices. We investigated the feasibility of an opioid-sparing pain management st ... Full text Link to item Cite

Effect of new persistent opioid use on physiologic and psychologic outcomes following bariatric surgery.

Journal Article Surg Endosc · August 2019 INTRODUCTION: New persistent opioid use following surgery is a common iatrogenic complication, developing in roughly 6% of patients after elective surgery. Despite increased awareness of misuse and associated morbidity, opioids remain the cornerstone of pa ... Full text Link to item Cite

A statewide comparison of opioid prescribing in teaching versus nonteaching hospitals.

Journal Article Surgery · April 2019 BACKGROUND: Postoperative opioid prescribing is often excessive, but the differences in opioid prescribing between teaching hospitals and nonteaching hospitals is not well understood. Given the workload of surgical training and frequent turnover of prescri ... Full text Link to item Cite

Association Between Long-term Opioid Use in Family Members and Persistent Opioid Use After Surgery Among Adolescents and Young Adults.

Journal Article JAMA Surg · April 1, 2019 IMPORTANCE: Prior studies have found a substantial risk of persistent opioid use among adolescents and young adults undergoing surgical and dental procedures. It is unknown whether family-level factors, such as long-term opioid use in family members, is as ... Full text Link to item Cite

Completion Lymph Node Dissection or Radiation Therapy for Sentinel Node Metastasis in Merkel Cell Carcinoma.

Journal Article Ann Surg Oncol · February 2019 BACKGROUND: For sentinel lymph node (SLN) metastasis from Merkel cell carcinoma (MCC), the benefit of completion lymph node dissection (CLND) versus radiation therapy (RT) is unclear. This study compares outcomes for patients with SLN metastasis undergoing ... Full text Link to item Cite

Factors Associated With New Persistent Opioid Usage After Lung Resection.

Journal Article Ann Thorac Surg · February 2019 BACKGROUND: Opioid dependence, misuse, and abuse in the United States continue to rise. Prior studies indicate an important risk factor for persistent opioid use includes elective surgical procedures, though the probability following thoracic procedures re ... Full text Link to item Cite

Association of Opioid Prescribing With Opioid Consumption After Surgery in Michigan.

Journal Article JAMA Surg · January 1, 2019 IMPORTANCE: There is growing evidence that opioids are overprescribed following surgery. Improving prescribing requires understanding factors associated with opioid consumption. OBJECTIVE: To describe opioid prescribing and consumption for a variety of sur ... Full text Link to item Cite

The Impact of Education and Prescribing Guidelines on Opioid Prescribing for Breast and Melanoma Procedures.

Journal Article Ann Surg Oncol · January 2019 BACKGROUND: Excessive opioid prescribing is common in surgical oncology, with 72% of prescribed opioids going unused after curative-intent surgery. In this study, we sought to reduce opioid prescribing after breast and melanoma procedures by designing and ... Full text Link to item Cite

Persistent Opioid Use and High-Risk Prescribing in Body Contouring Patients.

Journal Article Plast Reconstr Surg · January 2019 BACKGROUND: Opioid misuse occurs commonly among obese patients and after bariatric surgery. However, the risk of new persistent use following postbariatric body contouring procedures remains unknown. METHODS: The authors examined insurance claims from Clin ... Full text Link to item Cite

Association of Hydrocodone Schedule Change With Opioid Prescriptions Following Surgery.

Journal Article JAMA Surg · December 1, 2018 IMPORTANCE: In 2014, the US Drug Enforcement Administration moved hydrocodone-containing analgesics from schedule III to the more restrictive schedule II to limit prescribing and decrease nonmedical opioid use. The association of this policy change with po ... Full text Link to item Cite

Quality Measurement and Pay for Performance.

Journal Article Surg Oncol Clin N Am · October 2018 Recent debate has focused on which quality measures are appropriate for surgical oncology and how they should be implemented and incentivized. Current quality measures focus primarily on process measures (use of adjuvant therapy, pathology reporting) and p ... Full text Link to item Cite

Transitions of Care for Postoperative Opioid Prescribing in Previously Opioid-Naïve Patients in the USA: a Retrospective Review.

Journal Article J Gen Intern Med · October 2018 BACKGROUND: New persistent opioid use is a common postoperative complication, with 6% of previously opioid-naïve patients continuing to fill opioid prescriptions 3-6 months after surgery. Despite these risks, it is unknown which specialties prescribe opioi ... Full text Link to item Cite

Spillover Effect of Evidence-Based Postoperative Opioid Prescribing.

Journal Article J Am Coll Surg · September 2018 BACKGROUND: Opioid prescribing after operations is often excessive, resulting in leftover pills in the community available for diversion. Procedure-specific postoperative prescribing guidelines can reduce excessive prescribing, however, it is unclear wheth ... Full text Link to item Cite

Opioid Prescribing After Curative-Intent Surgery: A Qualitative Study Using the Theoretical Domains Framework.

Journal Article Ann Surg Oncol · July 2018 BACKGROUND: Excessive opioid prescribing is common after curative-intent surgery, but little is known about what factors influence prescribing behaviors among surgeons. To identify targets for intervention, we performed a qualitative study of opioid prescr ... Full text Link to item Cite

Specialist Physicians' Attitudes and Practice Patterns Regarding Disclosure of Pre-referral Medical Errors.

Journal Article Ann Surg · June 2018 OBJECTIVE: Our objective was to determine specialist physicians' attitudes and practices regarding disclosure of pre-referral errors. SUMMARY BACKGROUND DATA: Physicians are encouraged to disclose their own errors to patients. However, no clear professiona ... Full text Link to item Cite

Reduction in Opioid Prescribing Through Evidence-Based Prescribing Guidelines.

Journal Article JAMA Surg · March 1, 2018 This interrupted time series analysis found significant changes in multiple dimensions of pain medication usage after the implementation of postoperative opioid prescription guidelines in a single hospital. ... Full text Link to item Cite

Persistent Opioid Use Among Pediatric Patients After Surgery.

Journal Article Pediatrics · January 2018 BACKGROUND: Despite efforts to reduce nonmedical opioid misuse, little is known about the development of persistent opioid use after surgery among adolescents and young adults. We hypothesized that there is an increased incidence of prolonged opioid refill ... Full text Link to item Cite

New Persistent Opioid Use Among Patients With Cancer After Curative-Intent Surgery.

Journal Article J Clin Oncol · December 20, 2017 Purpose The current epidemic of prescription opioid misuse has increased scrutiny of postoperative opioid prescribing. Some 6% to 8% of opioid-naïve patients undergoing noncancer procedures develop new persistent opioid use; however, it is unknown if a sim ... Full text Link to item Cite

The Michigan Surgical Home and Optimization Program is a scalable model to improve care and reduce costs.

Journal Article Surgery · June 2017 BACKGROUND: The Michigan Surgical Home and Optimization Program is a structured, home-based, preoperative training program targeting physical, nutritional, and psychological guidance. The purpose of this study was to determine if participation in this prog ... Full text Link to item Cite

Postoperative Opioid Prescribing and the Pain Scores on Hospital Consumer Assessment of Healthcare Providers and Systems Survey.

Journal Article JAMA · May 16, 2017 This study uses insurance claims and HCAHPS data to investigate correlations between measures of pain and patient satisfaction after hospital discharge and postoperative opioid prescriptions. ... Full text Link to item Cite

Morphomics predicts response to ipilimumab in patients with stage IV melanoma.

Journal Article J Surg Oncol · September 2015 INTRODUCTION: Factors predictive of response to immunotherapy are needed to select appropriate patients. As morphometric analysis can be an objective surrogate for underlying physiology, we explored the possibility that morphomics may predict response amon ... Full text Link to item Cite

Morphometric age and surgical risk.

Journal Article J Am Coll Surg · May 2013 BACKGROUND: A cornerstone of a surgeon's clinical assessment of suitability for major surgery is best described as the "eyeball test." Preoperative imaging may provide objective measures of this subjective assessment by calculating a patient's morphometric ... Full text Link to item Cite

Abdominal aortic calcification and surgical outcomes in patients with no known cardiovascular risk factors.

Journal Article Ann Surg · April 2013 INTRODUCTION: In the setting of cardiovascular (CV) risk evaluation before major elective surgery, current risk assessment tools are relatively poor for discriminating among patients. For example, patients with clinical CV risk factors can be clearly ident ... Full text Link to item Cite

Analytic morphomics, core muscle size, and surgical outcomes.

Journal Article Ann Surg · August 2012 OBJECTIVE: Assess the relationship between lean core muscle size, measured on preoperative cross-sectional images, and surgical outcomes. BACKGROUND: Novel measures of preoperative risk are needed. Analytic morphomic analysis of cross-sectional diagnostic ... Full text Link to item Cite

Sarcopenia as a prognostic factor among patients with stage III melanoma.

Journal Article Ann Surg Oncol · December 2011 BACKGROUND: Several hypotheses proposed to explain the worse prognosis for older melanoma patients include different tumor biology and diminished host response. If the latter were true, then biologic frailty, and not age, should be an independent prognosti ... Full text Link to item Cite

Local anesthesia: a strategy for reducing surgical site infections?

Journal Article World J Surg · December 2011 BACKGROUND: Surgical site infections (SSIs) contribute to increased morbidity, mortality, and hospitalization costs. A previously unidentified factor that may reduce SSIs is the use of local anesthesia. The objective of this study was to determine if the u ... Full text Link to item Cite

Surgical site infection and analytic morphometric assessment of body composition in patients undergoing midline laparotomy.

Journal Article J Am Coll Surg · August 2011 BACKGROUND: Obesity is a known risk factor for surgical site infection (SSI). Our hypothesis is that morphometric measures of midline subcutaneous fat will be associated with increased risk of SSI and will predict SSI better than conventional measures of o ... Full text Link to item Cite

Frailty, core muscle size, and mortality in patients undergoing open abdominal aortic aneurysm repair.

Journal Article J Vasc Surg · April 2011 OBJECTIVES: Determining operative risk in patients undergoing aortic surgery is a difficult process, as multiple variables converge to affect overall mortality. Patient frailty is certainly a contributing factor, but is difficult to measure, with surgeons ... Full text Link to item Cite

Portrayal of organ donation and transplantation on American primetime television.

Journal Article Clin Transplant · 2011 Recently, both living and deceased organ donation rates have hit a plateau, despite increases in need for viable organs. One approach to improve donation rate is public education and policy; thus, it is necessary to understand the information the public is ... Full text Link to item Cite

Portrayal of Organ Donation and Transplantation on American Primetime Television

Conference AMERICAN JOURNAL OF TRANSPLANTATION · January 1, 2011 Link to item Cite

Resident workload, pager communications, and quality of care.

Journal Article World J Surg · November 2010 With the recent regulations limiting resident work hours, it has become more important to understand how residents spend their time. The volume and content of the pages they receive provide a valuable source of information that give insight into their work ... Full text Link to item Cite

Hard top soft bottom microfluidic devices for cell culture and chemical analysis.

Journal Article Anal Chem · May 15, 2009 We report fabrication and characterization of microfluidic devices made of thermoplastic and elastomeric polymers. These hard-soft hybrid material devices are motivated by the combined need for large scale manufacturability, enhanced barrier properties to ... Full text Link to item Cite