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Standards for General Surgery

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https://www.readbyqxmd.com/read/28231577/response-evaluation-in-head-and-neck-oncology-definition-and-prediction
#1
T K Hoffmann, P J Schuler, S Laban, R Grässlin, M Beer, A J Beer, U Friebe-Hoffmann, L Bullinger, P Möller, T Wiegel
Curative treatment of head and neck squamous cell carcinoma includes surgery and/or (chemo)radiation, whereas in the palliative setting, chemotherapy and/or immunotherapy represent(s) the standard approach. With regard to quality control, methods for determining treatment response are sorely needed. For surgical therapy, histopathology is the standard quality control. Established criteria for high-risk patients include resection margins of the primary tumor and extracapsular extension of lymph node metastases...
February 24, 2017: ORL; Journal for Oto-rhino-laryngology and its related Specialties
https://www.readbyqxmd.com/read/28225921/model-for-simulated-training-of-laparoscopic-gastroenterostomy
#2
Márcio Alencar Barreira, Delano Gurgel Siveira, Hermano Alexandre Lima Rocha, Luiz Gonzaga de Moura, Charles Jean Gomes de Mesquita, Gleydson Cesar de Oliveira Borges
Purpose: To develop a model of gastroenterostomy and to analyze the acquisition of skills after training by simulation. Methods: Experimental longitudinal study and of a quantitative character. The sample consisted of twelve general surgery residents from four hospitals. The training consisted of making ten anastomoses divided equally into five sessions and it took place over a period of six weeks. The evaluation of the anastomoses considered the time and the analysis of the operative technique through the global evaluation scale Objective Structured Assessment of Technical Skills (OSATS)...
January 2017: Acta Cirúrgica Brasileira
https://www.readbyqxmd.com/read/28222145/cataract-surgery-causes-biomechanical-alterations-to-the-eye-detectable-by-corvis-st-tonometry
#3
Yoshitake Kato, Shunsuke Nakakura, Ryo Asaoka, Kanae Matsuya, Yuki Fujio, Yoshiaki Kiuchi
PURPOSE: Modern cataract surgery is generally considered to bring about modest and sustained intraocular pressure (IOP) reduction. However, the pathophysiological mechanism for this remains unclear. Moreover, a change in ocular biomechanical properties after surgery can affect the measurement of IOP. The aim of the study is to investigate ocular biomechanics, before and following cataract surgery, using Corvis ST tonometry (CST). PATIENTS AND METHODS: Fifty-nine eyes of 59 patients with cataract were analyzed...
2017: PloS One
https://www.readbyqxmd.com/read/28219677/nsqip-based-quality-improvement-curriculum-for-surgical-residents
#4
Mary M Mrdutt, Claire L Isbell, Justin L Regner, Bonnie R Hodges, Yolanda Munoz Maldonado, J Scott Thomas, Harry T Papaconstantinou
BACKGROUND: General surgery training has historically lacked a standardized approach to resident Quality Improvement (QI) education aside from traditional Morbidity and Mortality conference. In 2013, the Accreditation Council for Graduate Medical Education (ACGME) formalized QI as a component of residency training. Our residency chose the National Surgical Quality Improvement Program (NSQIP) Quality In-Training Initiative (QITI) as the foundation for our QI training. We hypothesized that a focused curriculum based on outcomes would produce change in culture and improve quality of patient care...
February 17, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28219086/first-report-of-awake-craniotomy-of-a-famous-musician-suprasellar-tumor-surgery-of-pianist-clara-haskil-in-1942
#5
Elena Romana Gasenzer, Ayhan Kanat, Edmund A M Neugebauer
Clara Haskil (January 7, 1895-December 7, 1960) was one of the most famous female pianists of the 20th century. In her life and work she set new standards in piano playing. However, her career was beset by poor health and the adversities of two world wars. In her lifetime Haskil had three major disorders: juvenile scoliosis requiring treatment in her adolescence, a tumor of the sellar region requiring surgery at age 47 years, and a traumatic brain injury causing her death at the age of 65. Her medical history illustrates the development of surgical methods and rehabilitation in medicine before and after World War II...
February 20, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28215039/impact-of-surgical-experience-on-management-and-outcome-of-pancreatic-surgery-performed-in-high-and-low-volume-centers
#6
Marco Stella, Massimiliano Bissolati, Daniele Gentile, Alessandro Arriciati
Pancreaticoduodenectomy (PD) is one of the procedures in general surgery with the highest rate of life-threatening complications. The positive impact of the volume-outcome ratio on outcomes and mortality in pancreatic surgery (PS) has led to policy-level efforts toward centralization of care for PS that is currently under evaluation by some Regional Health Services. The role of the surgeon's experience and training is still under debate. The aim of this paper is to compare the outcomes of PS by the same surgeon in a high volume (HV) and in a low volume (LV) hospital to assess whether a specific training in PS could outdo the benefits of hospital volume...
February 18, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28214482/catheter-directed-ultrasound-assisted-thrombolysis-is-a-safe-and-effective-treatment-for-pulmonary-embolism-even-in-high-risk-patients
#7
Kristen A Lee, Andrew Cha, Mark H Kumar, Combiz Rezayat, Clifford M Sales
OBJECTIVE: We sought to assess the early success and safety of catheter-directed, ultrasound-assisted (CDUA) thrombolysis for acute pulmonary embolism (PE) in patients deemed to be "high risk" for thrombolytic therapy. METHODS: A retrospective evaluation of patients who underwent CDUA pulmonary thrombolysis in our practice during 39 months is reported. There were 91 patients considered, all of whom presented with acute PE as diagnosed by computed tomography angiography...
March 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28214318/clinical-course-treatment-modalities-and-quality-of-life-in-patients-with-congenital-melanocytic-nevi-data-from-the-german-cmn-registry
#8
Maria Elisabeth Wramp, Anna Langenbruch, Matthias Augustin, Detlef Zillikens, Sven Krengel
BACKGROUND: Congenital melanocytic nevi (CMN) are associated with mental stress as well as medical risks for those affected. The German CMN registry was initiated in 2005. Herein, we present results from an interim analysis focusing on disease course, treatment modalities, and quality of life. PATIENTS AND METHODS: One hundred patients enrolled in the registry between 2005 and 2012 were included in this prospective cohort study, and asked to participate in a follow-up survey...
February 2017: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/28212976/functional-lumen-imaging-probe-for-the-management-of-esophageal-disorders-expert-review-from-the-clinical-practice-updates-committee-of-the-aga-institute
#9
REVIEW
Ikuo Hirano, John E Pandolfino, Guy E Boeckxstaens
The functional luminal imaging probe is a Food and Drug Administration-approved measurement tool used to measure simultaneous pressure and diameter to guide management of various upper gastrointestinal disorders. Additionally, this tool is also approved to guide therapy during bariatric procedures and specialized esophageal surgery. Although it has been commercially available since 2009 as the endolumenal functional lumen imaging probe (EndoFLIP), the functional luminal imaging probe has had limited penetrance into clinical settings outside of specialized centers...
March 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28212579/suicidal-ideation-among-chinese-cancer-inpatients-of-general-hospitals-prevalence-and-correlates
#10
Bao-Liang Zhong, Si-Heng Li, Shu-Yan Lv, Shun-Li Tian, Zhi-Dong Liu, Xu-Bin Li, Hong-Qing Zhuang, Ran Tao, Wei Zhang, Chuan-Jun Zhuo
Cancer patients are at high risk for suicide, particularly when they are informed about the cancer diagnosis or hospitalized for cancer treatment. Therefore, oncology healthcare settings such as large general hospitals in China, may represent an ideal setting to identify and treat suicidality in cancer patients. However, the clinical epidemiology of suicidality of Chinese cancer patients remains largely unknown. This study examined the prevalence and correlates of suicidal ideation among Chinese cancer inpatients of large general hospitals...
February 15, 2017: Oncotarget
https://www.readbyqxmd.com/read/28210824/ultrasound-palpation-for-fast-in-situ-quantification-of-articular-cartilage-stiffness-thickness-and-relaxation-capacity
#11
M Schöne, R M Schulz, H Tzschätzsch, P Varga, K Raum
Most current cartilage testing devices require the preparation of excised samples and therefore do not allow intra-operative application for diagnostic purposes. The gold standard during open or arthroscopic surgery is still the subjective perception of manual palpation. This work presents a new diagnostic method of ultrasound palpation (USP) to acquire applied stress and strain data during manual palpation of articular cartilage. With the proposed method, we obtain cartilage thickness and stiffness. Moreover, repeated palpations allow the quantification of relaxation effects...
February 16, 2017: Biomechanics and Modeling in Mechanobiology
https://www.readbyqxmd.com/read/28209501/comparing-surgical-clerkship-performance-of-medical-and-physician-assistant-students
#12
Nasser N Alamiri, Charles Miles Maliska, Heather Chancellor-McIntosh, Guido Sclabas
OBJECTIVE: Third-year medical students (MS-III) and second-year physician assistant students (PA-S) have similar core clinical rotations during their education. Uniquely at our institution, both groups rotate together and are assessed by the same evaluation and grading standards. This study compares the performance of MS-III and PA-S during their combined surgical clerkship rotation. DESIGN: A retrospective analysis on students' final clerkship grades, individual grades for clinical performance evaluation, objective structured clinical examination, faculty tutorials, and National Board of Medical Education (NBME) general surgery examination for academic years 2013 and 2014...
February 13, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28209437/the-accuracy-of-preoperative-rigid-stroboscopy-in-the-evaluation-of-voice-disorders-in-children
#13
Jobran Mansour, Ofer Amir, Doron Sagiv, Eran E Alon, Michael Wolf, Adi Primov-Fever
OBJECTIVES: Stroboscopy is considered the most appropriate tool for evaluating the function of the vocal folds but may harbor significant limitations in children. Still, direct laryngoscopy (DL), under general anesthesia, is regarded the "gold standard" for establishing a diagnosis of vocal fold pathology. The aim of the study is to examine the accuracy of preoperative rigid stroboscopy in children with voice disorders. STUDY DESIGN: This is a retrospective study...
February 13, 2017: Journal of Voice: Official Journal of the Voice Foundation
https://www.readbyqxmd.com/read/28183345/robot-assisted-single-site-compared-with-laparoscopic-single-incision-cholecystectomy-for-benign-gallbladder-disease-protocol-for-a-randomized-controlled-trial
#14
Lukasz Filip Grochola, Christopher Soll, Adrian Zehnder, Roland Wyss, Pascal Herzog, Stefan Breitenstein
BACKGROUND: Recent advances in robotic technology suggest that the utilization of the da Vinci Single-Site™ platform for cholecystectomy is safe, feasible and results in a shorter learning curve compared to conventional single-incision laparoscopic cholecystectomy. Moreover, the robot-assisted technology has been shown to reduce the surgeon's stress load compared to standard single-incision laparoscopy in an experimental setup, suggesting an important advantage of the da Vinci platform...
February 9, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28179351/a-multicenter-phase-ii-study-of-gemcitabine-plus-s-1-chemotherapy-for-advanced-biliary-tract-cancer
#15
Shiho Arima, Kyoko Shimizu, Tomoyoshi Okamoto, Masao Toki, Yutaka Suzuki, Naohiro Okano, Daisuke Naruge, Kirio Kawai, Takaaki Kobayashi, Akiyoshi Kasuga, Hiroshi Kitamura, Atuko Takasu, Fumio Nagashima, Masanori Sugiyama, Junji Furuse
BACKGROUND: Gemcitabine (GEM) plus cisplatin (CDDP) chemotherapy has been used worldwide as the standard first-line treatment for advanced biliary tract cancer (BTC). A phase II trial has also suggested promising activity of GEM plus S-1 chemotherapy against advanced BTC. The aim of this study was to evaluate the efficacy and safety of GEM plus S-1 chemotherapy in patients with advanced BTC. PATIENTS AND METHODS: The eligibility criteria were as follows: histologically-proven BTC, unresectable or recurrent disease, ECOG performance status (PS) 0-1 regardless of previous treatment...
2017: Anticancer Research
https://www.readbyqxmd.com/read/28177978/the-relationship-between-geographic-access-to-plastic-surgeons-and-breast-reconstruction-rates-among-women-undergoing-mastectomy-for-cancer
#16
Andrew R Bauder, Cary P Gross, Brigid K Killelea, Paris D Butler, Stephen J Kovach, Justin P Fox
INTRODUCTION: Despite a national health care policy requiring payers to cover breast reconstruction, rates of postmastectomy reconstruction are low, particularly among minority populations. We conducted this study to determine if geographic access to a plastic surgeon impacts breast reconstruction rates. METHODS: Using 2010 inpatient and ambulatory surgery data from 10 states, we identified adult women who underwent mastectomy for breast cancer. Data were aggregated to the health service area (HSA) level and hierarchical generalized linear models were used to risk-standardize breast reconstruction rates (RSRR) across HSAs...
March 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28177565/the-impact-of-capnography-monitoring-among-children-and-adolescents-in-the-postanesthesia-care-unit-a-randomized-controlled-trial
#17
Melissa L Langhan, Fang-Yong Li, J Lance Lichtor
BACKGROUND: Pulse oximetry does not reliably recognize respiratory depression, particularly in the presence of supplemental oxygen. Capnography frequently detects hypoventilation and apnea among children recovering from anesthesia. Although children are routinely monitored with capnography during anesthesia, reducing the rate of adverse events, it is not routinely used in the postanesthesia care unit (PACU), where patients remain at risk for respiratory depression. AIM: We hypothesized that children monitored with capnography would have more frequent staff interventions and fewer adverse events than children monitored with pulse oximetry alone...
February 8, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28175931/determining-patient-preferences-for-indeterminate-thyroid-nodules-observation-surgery-or-molecular-tests
#18
Daniel Joonil Lee, Jason J Xu, Dale H Brown, Ralph W Gilbert, Patrick J Gullane, Jonathan C Irish, Lorne E Rotstein, David P Goldstein, John R de Almeida
BACKGROUND: Gene-expression classifiers (GEC) and genetic mutation panels (GMP) have been shown to improve preoperative diagnostic evaluations of indeterminate thyroid nodules. Despite the improvement, uncertainty regarding the proper management exists. Patient preferences may better inform the management of these indeterminate thyroid nodules. METHODS: Hypothetical scenarios were administered to two groups of patients: those with previous FNA-confirmed indeterminate thyroid nodules (Group A, n = 50) and those presenting to a general otolaryngology clinic for other reasons (Group B, n = 50)...
February 7, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28174394/-past-present-and-future-of-national-clinical-database
#19
Tadashi Iwanaka
The National Clinical Database of Japan( NCD) was established in April 2010 in the collaboration of 9 surgical subspecialty societies on the platform of the Japan Surgical Society(JSS). Registrations began in 2011, and because NCD is strongly linked to the board certification system by JSS, the ratio of registration of surgical procedures is very high, over than 97%. To date, more than 4,000 facilities have enrolled and over 7 million cases were registered over a 5-year period. The analyses of NCD are compared to the foreign database, such as American College of Surgeon National Surgical Quality Improvement Program in the gastrointestinal (GI) surgical field, and the Society of Thoracic Surgeons National Adult Cardiac Database in the cardiovascular surgical field, with a goal of creating a standardized surgery database for quality improvement...
January 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28169925/hospital-teaching-status-and-medicare-expenditures-for-complex-surgery
#20
Jason C Pradarelli, Christopher P Scally, Hari Nathan, Jyothi R Thumma, Justin B Dimick
OBJECTIVE: To evaluate the relationship between hospital teaching intensity, Medicare payments, and perioperative outcomes. BACKGROUND: Several emerging payment policies penalize hospitals for low-value healthcare. Teaching hospitals may be at a disadvantage given the perception that they deliver care less efficiently. METHODS: Using Medicare Provider and Analysis Review files, we studied patients from age 65 to 100 years who underwent abdominal aortic aneurysm (AAA) repair (n = 71,422), pulmonary resection (n = 93,056), or colectomy (n = 277,619) from 2009 to 2012...
March 2017: Annals of Surgery
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