Abstract：
BACKGROUND:Every day thousands of surgeons and patients negotiate their way through the complex process of decision-making about operative treatments. We conducted a series of qualitative studies, asking patients and surgeons to describe their experience and beliefs about informed decision-making and consent. This study focuses on surgeons' views. METHODS:Open-ended interviews and focus group discussions were conducted with thoracic surgeons who treated esophageal cancer patients by esophagectomy, and general surgeons who routinely performed laparoscopic cholecystectomy. Their views were analyzed using a qualitative approach, grounded in the perspectives of the participants. RESULTS:Five dominant themes emerged from the analysis: (1) making informed decisions; (2) communicating information and confidence; (3) managing expectations and fears; (4) consent as a decision to trust; (5) commitment inspired by trust. These themes are illustrated by verbatim quotes from the surgeon interviews. CONCLUSIONS:Surgeons carefully assess the risks and benefits of treatment before consenting to perform operative interventions. They are influenced by objective findings and by affective factors such as courage and the determination to survive expressed by their patients. They manage risks, doubts, and fears-both their patients' and their own-relying on trust and commitment on both sides to ensure the success of the surgical mission. The trust of their patients has a strong influence on the surgeons' decisions and actions.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
McKneally MF,Martin DK,Ignagni E,D'Cruz Jdoi
10.1007/s00268-009-0021-7subject
Has Abstractpub_date
2009-07-01 00:00:00pages
1341-7issue
7eissn
0364-2313issn
1432-2323journal_volume
33pub_type
杂志文章abstract：:Because of the rarity of adrenocortical carcinoma, survival rates and the prognosis for patients who have undergone operation are not well known. The purpose of the French Association of Endocrine Surgery was to evaluate these factors over an 18-year period. A trend study was associated to assess changes in the clinic...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-001-0047-y
更新日期：2001-07-01 00:00:00
abstract：:Herniographic examinations were performed on more than 4,000 patients. The method was found to be of great value in patients with obscure symptoms in the groin or pelvis. Herniography shows not only hernial sacs but also the general condition and tissue strength of the inguinal part of the abdominal wall. The differen...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/BF01658871
更新日期：1989-09-01 00:00:00
abstract：BACKGROUND:The survival outcome in lung cancer patients with chronic kidney disease (CKD) has not been well evaluated. The aim of this study was to evaluate the survival outcomes following non-small cell lung cancer (NSCLC) surgery in patients with CKD as a preoperative comorbidity. METHODS:Among 671 patients who unde...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-019-05143-3
更新日期：2019-12-01 00:00:00
abstract：BACKGROUND:Frequent use of computed tomography (CT) in trauma patients results in frequent detection of non-trauma-related incidental findings (IFs). Inpatient documentation and disclosure at discharge are infrequent, even when they are potentially serious. We aimed to not only identify the incidence of IFs but also to...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-013-2092-8
更新日期：2013-09-01 00:00:00
abstract：:This study was designed to investigate the optimal dose of garlic during long-term feeding and its preventive and therapeutic effects on colon cancer in rats induced by 1,2-dimethylhydrazine (DMH). A total of 240 male Sprague-Dawley rats were grouped and fed with either a basal or a garlic diet of different concentrat...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/BF00294738
更新日期：1995-07-01 00:00:00
abstract：BACKGROUND:We reported phonatory recovery in the majority of 88 patients after recurrent laryngeal nerve (RLN) reconstruction. Here we analyzed factors that might influence the recovery, in a larger patient series. METHODS:At Kuma Hospital, 449 patients (354 females and 95 males) underwent RLN reconstruction with dire...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-016-3634-7
更新日期：2016-12-01 00:00:00
abstract：:The lack of sufficient suitable human donor lungs for the many patients requiring pulmonary transplantation as life-saving therapy for end-stage lung diseases has generated extensive interest in cross-species lung transplantation. Ethical concerns and those of animal rights advocates have prompted studies of nonprimat...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s002689900332
更新日期：1997-11-01 00:00:00
abstract：:Factors influencing postoperative hospital mortality and long-term survival after radical resection of stage IV gallbladder carcinoma remain unclear. The objective of this study was to identify characteristics of patients who are good candidates in terms of surgical risk and long-term survival for radical resection of...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-002-6654-4
更新日期：2003-03-01 00:00:00
abstract：BACKGROUND:Classification of the open abdomen (OA) status is essential for clinical studies on the subject and may help to improve OA therapy. This is a validity and reliability analysis of the OA classification proposed by the World Society of the Abdominal Compartment Syndrome in 2013. METHODS:Prospective data on 11...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-014-2716-7
更新日期：2014-12-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/pl00013179
更新日期：1999-03-01 00:00:00
abstract：BACKGROUND:The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Cancer (QLQ-C30) and the site-specific module for gastric cancer (QLQ-STO22) have seldom been used to measure the postoperative health-related quality of life (HRQOL) in Japanese gastric cancer patients. The ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-010-0860-2
更新日期：2011-02-01 00:00:00
abstract：BACKGROUND:We aimed to describe the pattern of solid organ injuries (SOIs) and analyze the characteristics, management and outcomes based on the multiplicity of SOIs. METHODS:A retrospective study in a Level 1 trauma center was conducted and included patients admitted with blunt abdominal trauma between 2011 and 2014....
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-017-4087-3
更新日期：2017-11-01 00:00:00
abstract：:Clinical, endoscopic, and laboratory data were collected prospectively in 701 patients with bleeding peptic ulcer. The overall rebleeding rate was 16.1% and increased the risk of a fatal outcome by 17 fold (1.2% versus 20.6%, p less than 0.001). Rebleeding was documented in more than 75% of the group who did not survi...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/BF01664889
更新日期：1990-03-01 00:00:00
abstract：BACKGROUND:Recent studies have shown a 7-15% lymph node (LN) metastasis rate in submucosal invasive colorectal cancer (SICC). Identifying risk factors for LN metastasis is crucial in selecting therapeutic modalities for SICC. We assessed the possibility of and the risk factors for LN metastasis in SICC. METHODS:We per...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-008-9628-3
更新日期：2008-09-01 00:00:00
abstract：:Numerous clinicopathologic factors have been reported to have prognostic significance for gastrointestinal cancer. Many problems, however, confront the surgeon assessing the extent of disease and the clinical and molecular pathologist distinguishing differences in tumor differentiation, behavior, and defining importan...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/BF00308623
更新日期：1995-03-01 00:00:00
abstract：BACKGROUND:Postoperative peritonitis (POP) following gastrointestinal surgery is associated with significant morbidity and mortality, with no clear management option proposed. The aim of this study was to report our surgical management of POP and identify pre- and perioperative risk factors for morbidity and mortality....
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-018-4687-6
更新日期：2018-11-01 00:00:00
abstract：:This paper investigates methodological limitations of the volume-outcome relationship. A brief overview of quality measurement is followed by a discussion of two important aspects of the relationship. ...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s00268-005-7993-8
更新日期：2005-10-01 00:00:00
abstract：BACKGROUND:The aim of this study was to report on the application of a minimally invasive technique to the radical extirpation of primary and recurrent pilonidal disease. This technique does not require specific equipments, is ordinarily performed under local anesthesia on an outpatient basis, and provides optimal cosm...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-019-05313-3
更新日期：2020-04-01 00:00:00
abstract：:One hundred years ago, Edoardo Bassini said: "L'ernia é una malattia meccanica." Before that, Ambroise Paré (1598) and Joseph-Pierre Desault (1798) asserted the mechanical nature of strangulation. Beside strangulation, the most serious of all complications even today, I have studied huge hernias, which are natural com...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/BF01658869
更新日期：1989-09-01 00:00:00
abstract：:The surgical morbidity, mortality, and effectiveness of a modified nonshunting operation that includes splenic artery division instead of splenectomy, devascularization, and esophageal transection (SAD group) were evaluated. Eighteen cirrhotic patients with varices who underwent this modified procedure were compared w...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/BF00299180
更新日期：1995-05-01 00:00:00
abstract：:A total of 143 patients who underwent hepatic resection for hepatocellular carcinoma in our department were reviewed. The review was conducted for two periods: 1970-1982 (early period) and 1983-1990 (late period), that is, the periods before and after introduction of the hepatic surgical technique involving the use of...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/BF01659138
更新日期：1993-09-01 00:00:00
abstract：BACKGROUND:The adoption of robotic systems for gastric cancer surgery has been proven feasible and safe; however, a benefit over the laparoscopic approach has not yet been well-documented. We aimed to investigate the surgical outcomes of robotic versus laparoscopic gastrectomy for gastric cancer, according to the exten...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-015-2998-4
更新日期：2015-07-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-020-05530-1
更新日期：2020-08-01 00:00:00
abstract：:Technetium 99m ((99m)Tc)-methoxyisobutylisonitrile (MIBI) scintigraphy has been reported to be a useful method for visualizing the parathyroid glands for the diagnosis of hyperparathyroidism. Some drug metabolism transporters, such as p-glycoprotein (P-GP) or multidrug resistance-associated protein (MRP), are believed...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-001-0177-2
更新日期：2002-01-01 00:00:00
abstract：BACKGROUND:The goal of the present study was to critically review and identify the strength of available evidence in the literature on the use of laparoscopic appendectomy (LA) in complicated appendicitis (CA). METHODS:The Cochrane Library and Controlled Trials Registry, MEDLINE (Ovid), PubMed, Web of knowledge, and S...
journal_title：World journal of surgery
pub_type： 杂志文章,meta分析,评审
doi：10.1007/s00268-010-0669-z
更新日期：2010-09-01 00:00:00
abstract：:Pancreas transplantation has emerged as the single most effective way to achieve normal glucose homeostasis inpatients with type I insulin-dependent diabetes mellitus. Optimal immunosuppressive strategies for pancreas transplantation continue to evolve with the use of newer, more potent immunosuppressive agents,partic...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s00268-001-0207-0
更新日期：2002-02-01 00:00:00
abstract：BACKGROUND:PDGFR-β is used as a stromal biomarker and is functional in mesenchymal cells of the tumor microenvironment. The significance of stromal PDGFR-β expression in non-small cell lung cancer (NSCLC) in patients undergoing preoperative chemo- or chemoradiotherapy had not been determined. METHODS:Patients with NSC...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-018-4560-7
更新日期：2018-09-01 00:00:00
abstract：BACKGROUND:Breast cancer in young women is uncommon, but when it does occur it has been reported to have aggressive biological characteristics. The incidence of breast cancer peaks at age 40 in Hong Kong Chinese women, earlier than in Caucasians. This study is the first to report the tumor characteristics and managemen...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-008-9589-6
更新日期：2008-12-01 00:00:00
abstract：:Surgical treatment of adenomas may become necessary when the base of the polyp is too wide for snaring, increasing the risk of incomplete removal or perforation of the bowel wall. Suspicion of malignancy may also indicate surgery. Multiple adenomas not controlled by snare polypectomy can be treated by colectomy. The d...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/BF01658955
更新日期：1991-01-01 00:00:00
abstract：BACKGROUND:A majority of patients with small intestinal neuroendocrine tumors (SI-NETs) present with or develop liver metastases (LM). A number of treatments for LM are used clinically, including liver transplantation (LTx). Indications for LTx are under debate; young age(<65 years), absence of extrahepatic disease, re...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-013-2331-z
更新日期：2014-03-01 00:00:00
