Abstract:
BACKGROUND:The purpose of the present study was to develop and validate a multidimensional, surgery-specific workload measure (the SURG-TLX), and to determine its utility in providing diagnostic information about the impact of various sources of stress on the perceived demands of trained surgical operators. As a wide range of stressors have been identified for surgeons in the operating room, the current approach of considering stress as a unidimensional construct may not only limit the degree to which underlying mechanisms may be understood but also the degree to which training interventions may be successfully matched to particular sources of stress. METHODS:The dimensions of the SURG-TLX were based on two current multidimensional workload measures and developed via focus group discussion. The six dimensions were defined as mental demands, physical demands, temporal demands, task complexity, situational stress, and distractions. Thirty novices were trained on the Fundamentals of Laparoscopic Surgery (FLS) peg transfer task and then completed the task under various conditions designed to manipulate the degree and source of stress experienced: task novelty, physical fatigue, time pressure, evaluation apprehension, multitasking, and distraction. RESULTS:The results were supportive of the discriminant sensitivity of the SURG-TLX to different sources of stress. The sub-factors loaded on the relevant stressors as hypothesized, although the evaluation pressure manipulation was not strong enough to cause a significant rise in situational stress. CONCLUSIONS:The present study provides support for the validity of the SURG-TLX instrument and also highlights the importance of considering how different stressors may load surgeons. Implications for categorizing the difficulty of certain procedures, the implementation of new technology in the operating room (man-machine interface issues), and the targeting of stress training strategies to the sources of demand are discussed. Modifications to the scale to enhance clinical utility are also suggested.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Wilson MR,Poolton JM,Malhotra N,Ngo K,Bright E,Masters RSdoi
10.1007/s00268-011-1141-4subject
Has Abstractpub_date
2011-09-01 00:00:00pages
1961-9issue
9eissn
0364-2313issn
1432-2323journal_volume
35pub_type
杂志文章abstract::The phrase "outcomes studies" is usually used to describe those studies where outcome is assessed in large cohorts of patients, often using data from administrative databases. They are used to determine the role and impact of variations in the structure and process of health care delivery play in routine practice. Opt...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s002689900651
更新日期:1999-12-01 00:00:00
abstract::This retrospective study reports our experience managing 78 patients with adenocarcinoma of the esophagus and gastroesophageal junction operated between January 1982 and December 1996. Altogether 18 patients presented with stage I and II disease, and 60 patients had stage III and IV disease at presentation; 56 patient...
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::With limited resources and the current concerns about using animals for research purposes, the needs must be clear when setting up trauma and sepsis experiments for pharmacologic interventions. Such interventions are performed typically for four reasons: (1) to study the pathophysiologic role of certain mediators (whi...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s002689900077
更新日期:1996-05-01 00:00:00
abstract::Although a number of histologic and treatment factors that individually and in combination predict for an increased risk of local recurrence after breast conserving surgery can be identified, none so obviously compromises survival that breast conservation is contraindicated because that risk factor is present. In-brea...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF00348195
更新日期:1994-01-01 00:00:00
abstract::This article surveys in an interdisciplinary fashion the evolution of ancient Greek medicine and traumatology in particular. In sounding out the key methods and themes of Greek medicine, we cite a range of medical treatises and correlate them to the rich evidence of ancient Greek art (iconography), which often is expl...
journal_title:World journal of surgery
pub_type: 历史文章,杂志文章
doi:10.1007/s00268-003-6931-x
更新日期:2004-04-01 00:00:00
abstract::In the Surgical Department of the University of Erlangen, 307 reconstructions in all areas of the arterial tree were performed with PTFE (GORE-TEX) grafts, of which 188 were performed in the femoral-popliteal and femoral-crural areas. Femoral-popliteal bypass grafts above the knee joint remained patent in 93% of the p...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF02393582
更新日期:1980-01-01 00:00:00
abstract::This article presents an analysis of acute gastroduodenal mucosal lesions (AGML) based on a review of current literature and the personal experience of the authors. The pathology of AGML involes two distinct types of lesions, namely, superficial erosions confined to the acid-secreting gastric mucosa and presenting as ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF01654729
更新日期:1977-01-01 00:00:00
abstract:BACKGROUND:Retroperitoneal soft tissue sarcomas (RSTS) are a rare and uncommon entity with a poor 5-year overall survival (OS) of approximately 50%, even though they rarely metastasize. The aim of the present study was to analyze the survival of patients with RSTS treated at our institution. PATIENTS AND METHODS:Patie...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-010-0473-9
更新日期:2010-07-01 00:00:00
abstract::The aim of this study was to investigate the effects of various surgical modalities directed at the cavity of hydatid cysts in patients with occult intrabiliary rupture. In this respect, 324 patients with hydatid cyst of the liver operated on during 1983-2003 were analyzed; among them, 39 patients with occult intrabil...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-004-7571-5
更新日期:2005-02-01 00:00:00
abstract::Pepsinogen C is a proteolytic enzyme involved in the digestion of proteins in the stomach; it is also synthesized by a significant percentage of female breast carcinomas. In addition, it has been demonstrated that pepsinogen C is one of the few proteins induced by androgens in breast carcinoma cells. Here we evaluate ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/pl00012325
更新日期:1999-05-01 00:00:00
abstract:BACKGROUND:Little is known of the oncological outcomes after adjuvant FOLFOX chemotherapy in patients with stage III colon cancer showing microsatellite instability high (MSI-H). In the present study we investigated the prognostic impact of MSI-H in patients with stage III colon cancer receiving FOLFOX chemotherapy. M...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-013-2120-8
更新日期:2013-10-01 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::The present study documents the indications and results of endoscopic sphincterotomy (ES) performed over 7 years in a surgical endoscopy unit. Potential improvement of results over this time period was analyzed. ES was associated with rare but undesirable morbidity and mortality. Specific improvement of results over t...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900195
更新日期:1997-01-01 00:00:00
abstract:BACKGROUND:Esophagectomy remains the standard treatment for resectable esophageal cancer, but the cure rate is low. Neoadjuvant therapy has been tried in attempts to prolong survival and reduce tumor recurrence. The aim of this study was to assess the surgical outcomes with and without neoadjuvant treatment for resecta...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-006-0016-6
更新日期:2006-12-01 00:00:00
abstract::Congenital short colon (CSC) is a condition in which the colon is replaced, wholly or partially, by a dilated pouch together with anorectal malformation and a colourinary fistula. Most of the reported series have been from northern India where this malformation is frequent. This paper details the management of 108 pat...
journal_title:World journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1007/s002689900019
更新日期:1996-01-01 00:00:00
abstract::The first laparoscopic Nissen fundoplication was performed 20 years ago. Surgical management of gastroesophageal reflux disease (GERD) should be offered only to appropriately studied and selected patients, with the ultimate aim of improving the well-being of the individual, the "quality of life." The choice of fundopl...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-011-1050-6
更新日期:2011-07-01 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:INTRODUCTION:The coexistence of an enterocutaneous fistula (ECF) with large abdominal wall defects represent one of the most demanding situations seen by a surgeon. Simultaneous treatment of ECF closure with abdominal wall defect closure has been widely debated. Our objective was to determine if the type of abdominal w...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05635-7
更新日期:2020-10-01 00:00:00
abstract::Different types of vagotomy have been widely used in the treatment of peptic ulcer disease. A close relationship between the vagus nerve and the release or action of gastrointestinal hormones is necessary for the optimal activation of the gastrointestinal tract. The serum concentrations of the antral hormone gastrin a...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF01654771
更新日期:1979-09-20 00:00:00
abstract::Malignant melanoma is notoriously resistant to chemotherapy. Standard single agents include dacarbazine and the nitrosoureas, but most series treating patients with metastatic melanoma report response rates of about 20%. Occasional patients, however, achieve long term remission, amounting to cure, after such treatment...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF02071532
更新日期:1992-03-01 00:00:00
abstract::A wide range of clinical symptoms and signs are observed with venous thrombosis. Nonetheless, clinical diagnosis has been found to be unreliable and accurate diagnostic methods must be used before potent therapy such as anticoagulation is instituted, since the complications of treatment themselves can be life-threaten...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF01658825
更新日期:1990-09-01 00:00:00
abstract:BACKGROUND:The use of the Harmonic Scalpel (HS) for cystic duct ligation began with little data about its efficacy or safety. On the other hand, there is not any literature available about the use of PlasmaKinetic Sealer (PK) for closing the cystic duct in laparoscopic cholecystectomy (LC). Therefore, this study was de...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-010-0819-3
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:Donor variational arteries often require complex reconstruction. METHODS:We analysed the incidence of different variations, types of arterial reconstructions and their impact on post-operative results from 409 patients undergoing liver transplantation at Karolinska Institute between 2007 and 2015. RESULTS:...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05406-4
更新日期:2020-06-01 00:00:00
abstract:INTRODUCTION:Jejunal diverticula are rare lesions, and when complications arise, they pose diagnostic difficulties. Perforation is a common complication resulting in an acute abdomen, although preoperative diagnosis is usually not possible. The "gold standard" for management for patients with complications is surgery. ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9469-0
更新日期:2008-07-01 00:00:00
abstract::Uncontrolled bleeding from the cystic artery and its branches is a serious problem that may increase the risk of intraoperative lesions to vital vascular and biliary structures. On laparoscopic visualization anatomic relations are seen differently than during conventional surgery, so proper knowledge of the hepatobili...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/pl00012372
更新日期:1999-07-01 00:00:00
abstract:BACKGROUND:Laparoscopic resection of posterosuperior (PS) tumors of the liver is more difficult than that of anterolateral (AL) tumors, owing to the narrow surgical field in the PS location. In this retrospective cohort study, our aim was to determine if port insertion through the intercostal space would lead to improv...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-016-3867-5
更新日期:2017-05-01 00:00:00
abstract::Most adrenal incidentalomas are nonfunctioning cortical adenomas that do not require surgery. Operative treatment is indicated if the incidentaloma has malignant features as seen during the radiologic workup, is hormonally active, or grows during follow-up. A conservative attitude is justified in asymptomatic patients...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689910095
更新日期:2000-05-01 00:00:00
abstract::Cancers of the distal rectum (less than 7.5 cm from the anal verge) that are freely mobile, moderately well or well differentiated, less than 4 cm in size, limited to the bowel wall, and without evidence of metastasis should be considered candidates for treatment with electrocoagulation for cure. Tumor cell ploidy and...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF02104447
更新日期:1992-05-01 00:00:00
abstract:BACKGROUND:The manifestations associated with non-survival after multiple trauma may vary importantly between countries and institutions. The aim of the present study was to assess the quality of performance by comparing actual mortality rates to the literature. METHODS:The study involved evaluation of a prospective c...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0193-1
更新日期:2009-11-01 00:00:00
abstract::The authors' affiliations are updated as reflected here. ...
journal_title:World journal of surgery
pub_type: 杂志文章,已发布勘误
doi:10.1007/s00268-020-05519-w
更新日期:2020-08-01 00:00:00