Archives of Surgery最新文献

{"title":"Finding 'em? Following 'em? Fixing 'em?: Comment on \"Risk and Cost-Effectiveness of Surveillance Followed by Cholecystectomy for Gallbladder Polyps\".","authors":"Jonathan Koea","doi":"10.1001/archsurg.2012.1959","DOIUrl":"https://doi.org/10.1001/archsurg.2012.1959","url":null,"abstract":"","PeriodicalId":8298,"journal":{"name":"Archives of Surgery","volume":" ","pages":"1084"},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archsurg.2012.1959","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30848714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Venous thromboembolism prophylaxis: one size does not fit all: comment on \"Comparative effectiveness of unfractionated and low-molecular-weight heparin for prevention of venous thromboembolism following bariatric surgery\".","authors":"M Margaret Knudson","doi":"10.1001/archsurg.2012.2318","DOIUrl":"https://doi.org/10.1001/archsurg.2012.2318","url":null,"abstract":"","PeriodicalId":8298,"journal":{"name":"Archives of Surgery","volume":"147 11","pages":"998-9"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archsurg.2012.2318","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31062090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is insurance status a modifiable factor in brain tumor treatment outcomes?: comment on \"Postoperative mortality after surgery for brain tumors by patient insurance status in the United States\".","authors":"Shawn L Hervey-Jumper, Cormac O Maher","doi":"10.1001/archsurg.2012.1493","DOIUrl":"https://doi.org/10.1001/archsurg.2012.1493","url":null,"abstract":"","PeriodicalId":8298,"journal":{"name":"Archives of Surgery","volume":"147 11","pages":"1025"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archsurg.2012.1493","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31062094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Publication of postdischarge and readmission complications: failure, folly, or funding opportunity?: comment on \"Association of postdischarge complications with reoperation and mortality in general surgery\".","authors":"Desmond C Winter","doi":"10.1001/jamasurg.2013.496","DOIUrl":"https://doi.org/10.1001/jamasurg.2013.496","url":null,"abstract":"Correspondence: Julie A. Sosa, MD, MA, Department of Surgery, Yale University School of Medicine, 330 Cedar St, FMB 130B, PO Box 208062, New Haven, CT 06510 (julie.sosa@yale.edu). Author Contributions: Dr Sosa takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: Kazaure and Roman. Acquisition of data: Kazaure and Sosa. Analysis and interpretation of data: Kazaure, Roman, and Sosa. Drafting of the manuscript: Kazaure and Roman. Critical revision of the manuscript for important intellectual content: Roman and Sosa. Statistical analysis: Kazaure. Administrative, technical, and material support: Roman and Sosa. Study supervision: Roman. Conflict of Interest Disclosures: None reported. Online-Only Material: Listen to an author interview about this article, and others, at http://bit.ly/L4By6t.","PeriodicalId":8298,"journal":{"name":"Archives of Surgery","volume":"147 11","pages":"10007-8"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/jamasurg.2013.496","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31062099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term Outcome of Patients Managed With Sentinel Lymph Node Biopsy Alone for Node-Negative Invasive Breast Cancer.","authors":"Nimmi S Kapoor,&nbsp;Myung-Shin Sim,&nbsp;Jennifer Lin,&nbsp;Armando E Giuliano","doi":"10.1001/archsurg.2012.1563","DOIUrl":"https://doi.org/10.1001/archsurg.2012.1563","url":null,"abstract":"<p><p>OBJECTIVE To examine the long-term outcome of patients with early breast cancer with hematoxylin-eosin-negative sentinel lymph nodes (SLNs) who did not undergo completion axillary lymph node dissection. DESIGN, SETTING, AND PATIENTS Patients with invasive breast cancer surgically treated between May 1, 1995, and December 31, 2002, with SLN biopsy alone without axillary lymph node dissection who had hematoxylin-eosin-negative SLNs were identified. MAIN OUTCOME MEASURES Patient and tumor characteristics, adjuvant treatment, disease recurrence, and survival were recorded. A multivariable analysis model was used to identify significant variables associated with disease-free survival and overall survival. RESULTS A total of 811 patients were included, with a median follow-up of 103.1 months (range, 12.2-182.8 months). The mean patient age was 57.8 years (range, 26-91 years), the mean tumor size was 1.5 cm (range, 0.1-7.5 cm), and the median number of SLNs obtained was 2 (range, 1-8). Seventy-six patients (9.4%) developed disease recurrence; there were 2 patients (0.2%) with isolated axillary recurrences, 40 (4.9%) with local recurrences, 4 (0.5%) with local and regional recurrences, 22 (2.7%) with distant recurrences, and 8 (1.0%) with both local and distant recurrences. The median time to recurrence was 57.2 months (range, 3.1-163.3 months), with 5-year and 10-year disease-free survival rates of 95.1% and 89.9%, respectively. One hundred one patients (12.5%) died; only 15 (1.8%) had distant metastatic disease at the time of death. Patients were significantly more likely to have disease recurrence if they had high-grade tumors (P = .004). Older age and larger tumor size were significant predictors of worse overall survival on multivariate analysis (P &lt; .001 and P = .01, respectively). CONCLUSIONS This study reports the long-term follow-up of patients with breast cancer and hematoxylin-eosin-negative, tumor-free SLNs, showing a remarkably low axillary recurrence of 0.2% and high disease-free survival. Long-term results of SLN biopsy alone are excellent, and the addition of immunohistochemistry analysis does not contribute to survival.</p>","PeriodicalId":8298,"journal":{"name":"Archives of Surgery","volume":"147 11","pages":"1047-52"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archsurg.2012.1563","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30766688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Realistic distractions and interruptions that impair simulated surgical performance by novice surgeons.","authors":"Robin L Feuerbacher,&nbsp;Kenneth H Funk,&nbsp;Donn H Spight,&nbsp;Brian S Diggs,&nbsp;John G Hunter","doi":"10.1001/archsurg.2012.1480","DOIUrl":"https://doi.org/10.1001/archsurg.2012.1480","url":null,"abstract":"<p><p>HYPOTHESIS Although the risks for operating room distractions and interruptions (ORDIs) are acknowledged, most research on this topic is unrealistic, inconclusive, or methodologically unsound. We hypothesized that realistic ORDIs induce errors in a simulated surgical procedure performed by novice surgeons. DESIGN, SETTING, AND PARTICIPANTS Eighteen second-year, third-year, and research-year surgical residents completed a within-subjects experiment on a laparoscopic virtual reality simulator. Based on 9 months of operating room observations, 4 distractions and 2 interruptions were designed and timed to occur during critical stages in simulated laparoscopic cholecystectomy. The control factor was the absence or presence of ORDIs, with order randomly counterbalanced across the subjects. MAIN OUTCOME MEASURES The primary outcome measure was surgical errors measured by the simulator as damage to arteries, bile duct, or other organs. The second outcome measure was whether the participants remembered a prospective memory task assigned prior to the procedure and important to operative conduct. RESULTS Major surgical errors were committed in 8 of 18 simulated procedures (44%) with ORDIs vs only 1 of 18 (6%) without ORDIs (P = .02). Interrupting questions caused the most errors. Sidebar conversations were the next most likely distraction to lead to errors. Ten of 18 participants (56%) forgot the prospective memory task with ORDIs, while 4 of 18 (22%) forgot the task without ORDI (P = .04). All 8 surgical errors with ORDIs occurred after 1 PM (P = .001). CONCLUSIONS Typical ORDIs have the potential to cause operative errors in surgical trainees. This performance deficit was prevalent in the afternoon.</p>","PeriodicalId":8298,"journal":{"name":"Archives of Surgery","volume":"147 11","pages":"1026-30"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archsurg.2012.1480","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30766900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Need for randomized clinical trials on intraoperative parathyroid hormone kinetics: comment on \"impact of race on intraoperative parathyroid hormone kinetics\".","authors":"John A Ryan","doi":"10.1001/archsurg.2012.1496","DOIUrl":"https://doi.org/10.1001/archsurg.2012.1496","url":null,"abstract":"T he use of intraoperative PTH testing to assure that no abnormally functioning parathyroids remain in the patient after removal of 1 parathyroid adenoma has slipped into widespread clinical use. In my opinion, this is unfortunate since the outcomes of this strategy have not been subjected to randomized clinical trials. Observational studies from the active, experienced, and world-renowned endocrine surgeons at the University of California, San Francisco have demonstrated less than 50% predictive success rate in patients with double parathyroid adenomas, a 13% falsenegative rate with single parathyroid adenomas, a negative influence of hemolysis on the reliability of IOPTH measurement, and now the suggestion that race and BMI may impact PTH kinetics. I worry about the statistical validity of comparing 28 African American patients with 734 white patients, especially when other variables are in play (BMI, vitamin D deficiencies, and 24-hour urinary calcium excretion). Using IOPTH changes for clinical decision making in the operating room requires expense of time, material, and people, both in the operating room and in the laboratory. Reliability of this strategy suggests that all types of patients with all varieties of hyperparathyroidism would have uniform response of PTH kinetics in a predictable fashion. To me, this seems unlikely. Different anesthetics, length of operation, avenues for blood acquisition (peripheral vein, central vein, jugular vein, or peripheral artery), and operative techniques of parathyroid manipulation might all have effects on IOPTH kinetics and values. Because of their expertise and high volume of cases, the surgeons of the University of California, San Francisco and their cadre of trained fellows would be ideally suited to conduct a randomized clinical study in a standardized fashion that could determine the values, reliability, and costs of using IOPTH strategies vs not using them.","PeriodicalId":8298,"journal":{"name":"Archives of Surgery","volume":"147 11","pages":"1041"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archsurg.2012.1496","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30766139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Image of the month-quiz case.","authors":"Emmanouil P Pappou,&nbsp;Catherine Velopulos,&nbsp;Elliot K Fishman,&nbsp;Elliott R Haut","doi":"10.1001/archsurg.2011.2043a","DOIUrl":"https://doi.org/10.1001/archsurg.2011.2043a","url":null,"abstract":"","PeriodicalId":8298,"journal":{"name":"Archives of Surgery","volume":"147 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archsurg.2011.2043a","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32399395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Image of the month-quiz case.","authors":"Antonio Pio Tortorelli,&nbsp;Sergio Alfieri,&nbsp;Alejandro Martin Sanchez,&nbsp;Fausto Rosa,&nbsp;Giovanni Battista Doglietto","doi":"10.1001/archsurg.2011.1620a","DOIUrl":"https://doi.org/10.1001/archsurg.2011.1620a","url":null,"abstract":"","PeriodicalId":8298,"journal":{"name":"Archives of Surgery","volume":"147 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archsurg.2011.1620a","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32399394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effective perioperative management of multiple endocrine neoplasia type 1-associated insulinomas.","authors":"Kazuhiro Hanazaki,&nbsp;Akihiro Sakurai,&nbsp;Masaya Munekage,&nbsp;Takehiro Okabayashi,&nbsp;Masayuki Imamura","doi":"10.1001/2013.jamasurg.121","DOIUrl":"https://doi.org/10.1001/2013.jamasurg.121","url":null,"abstract":"","PeriodicalId":8298,"journal":{"name":"Archives of Surgery","volume":"147 11","pages":"991-2"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/2013.jamasurg.121","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31062088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}