Abstract:
BACKGROUND:There is emerging evidence indicating that distractions in the operating room (OR) are prevalent. Studies have shown a negative impact of distractions, but they have been conducted mostly with residents in simulated environments. We tested the hypothesis that intraoperative distractions are associated with deterioration in patient safety checks in the OR. METHODS:We assessed 24 elective urologic procedures. Blinded trained assessors (two surgeons, one psychologist) used validated instruments to prospectively assess in vivo frequency and severity of distractions (related to communication, phones/pagers, equipment/provisions, OR environment, other hospital departments, or a member of the OR team) and completion of safety-related tasks (related to the patient, equipment, and communication). Descriptive and correlational analyses were conducted. RESULTS:Mean case duration was 70 min (mean intraoperative time 31 min). A mean of 4.0 communication distractions (range 0-9) and 2.48 other distractions (range 0-5) were recorded per case (distraction rate of one per 10 min). Distractions from external visitors (addressed to the entire team or the surgeon) and distractions due to lack of coordination between hospital departments were most disruptive. Regarding safety checks, patient tasks were completed most often (85-100 %) followed by equipment tasks (75-100 %) and communication tasks (55-90 %). Correlational analyses showed that more frequent/severe communication distractions were linked to lower completion of patient checks intraoperatively (median rho -0.56, p < 0.05). CONCLUSIONS:Distractions are prevalent in ORs and in this study were linked to deterioration in intraoperative patient safety checks. Surgeons should be mindful of their tolerance to distractions. Surgical leadership can help control distractions and reduce their potential impact on patient safety and performance.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Sevdalis N,Undre S,McDermott J,Giddie J,Diner L,Smith Gdoi
10.1007/s00268-013-2315-zsubject
Has Abstractpub_date
2014-04-01 00:00:00pages
751-8issue
4eissn
0364-2313issn
1432-2323journal_volume
38pub_type
杂志文章abstract::Breast cancer is a common disease, and the surgical management is continually evolving. The objective of this study was to describe the current breast cancer practice patterns among Canadian surgeons. All active General Surgeons (n=1172), as accredited by the Royal College of Physicians and Surgeons of Canada, were se...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-003-7040-6
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Ghrelin is a brain-gut peptide with GH-releasing and appetite-inducing properties. Because ghrelin is secreted mainly by the stomach, fasting levels fall after distal gastrectomy. The vagal nerve is responsible for periprandial changes. The presents study investigated the impact of preserving the celiac bran...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-013-2078-6
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:This is a baseline assessment of surgical capacity in the Federal Capital Territory (FCT), in preparation for the creation of a National Surgical, Obstetric, Anesthesia, and Nursing Plan. METHODS:In October 2017, all 10 of the 11 secondary hospitals in FCT that provide surgical and/or obstetric care were su...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-4835-z
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:Postoperative outcome prediction in elderly is based on preoperative physical status but its predictive value is uncertain. The goal was to evaluate the value of risk assessment performed perioperatively in predicting outcome in case of admission to an intensive care unit (ICU). METHODS:A total of 108 posts...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05742-5
更新日期:2020-12-01 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
abstract:BACKGROUND:Incidental gallbladder cancer (GBC) is frequently discovered on the specimen when cholecystectomy for a benign disease is performed. The objective of the present study was to assess the management of incidental GBC patients in a French registry. METHODS:Data on patients with GBC treated between 1998 and 200...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-011-1134-3
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:The only potential cure for neuroendocrine tumors (NETs) is operative resection, which may also offer a survival benefit for advanced disease. We aimed to assess the role of 68Ga-DOTATATE PET/CT in preoperative planning and compared its performance to CT with IV contrast and MRI with Eovist®, for abdominal N...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05216-3
更新日期:2020-02-01 00:00:00
abstract::Endocrine surgeons have had an important role in the management of hyperthyroidism due to either Graves' disease or toxic nodule(s). Since alternative treatments such as antithyroid drugs or radioiodine are also available, the decision-making for management should be based on clear assessment of advantages and limitat...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s002680010167
更新日期:2000-08-01 00:00:00
abstract:BACKGROUND:The aim of this study was to evaluate and investigate the complications of carotid endarterectomy (CEA) and carotid artery stenting (CAS) by performing a meta-analysis based on prospective randomized controlled trials (RCTs). METHODS:We performed a search of multiple electronic databases for RCTs containing...
journal_title:World journal of surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s00268-008-9862-8
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:The aim of this study was to evaluate the therapeutic efficacy of two surgical procedures used to treat middle thoracic esophageal squamous cell carcinoma and compare the results. METHODS:A total of 167 patients with middle thoracic esophageal squamous cell carcinoma were included in the study, including 10...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0341-7
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND:Enhanced Recovery After Surgery (ERAS®) Society guidelines integrate evidence-based practices into multimodal care pathways that have improved outcomes in multiple adult surgical specialties. There are currently no pediatric ERAS® Society guidelines. We created an ERAS® guideline designed to enhance quality ...
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:INTRODUCTION:The role for diverting ostomy as a method to help reduce morbidity and mortality has been well established in the combat trauma population. However, factors that influence the type of ostomy used and which ostomies become permanent are poorly studied. We examine patterns of ostomy usage and reversal in a l...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-4759-7
更新日期:2019-01-01 00:00:00
abstract::Although most papillary thyroid microcarcinomas (PMCs) are of little clinical significance, patients with PMCs occasionally have an unfavorable outcome, especially when they present with bulky nodal metastasis or distant metastasis. We have attempted to identify "high-risk" PMCs by evaluating clinical, pathologic, and...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900461
更新日期:1998-07-01 00:00:00
abstract::This study aims to examine the frequency of the pheochromocytoma (pheo), defined as a "benign, intra-adrenal, hypertensive, sporadic, unilateral tumor." Three large series amounting to 310 subphrenic chromaffin tumors operated over periods of 17, 23, and 41 years, respectively, have been reviewed. Among those combined...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF00353738
更新日期:1994-07-01 00:00:00
abstract:BACKGROUND:The aim of the present study was to determine whether early oral feeding after curative resection for gastric cancer can be tolerated and whether it has an effect on recovery. METHODS:From September 2007 to January 2008, we provided early postoperative oral feeding for 35 patients who underwent curative dis...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0009-3
更新日期:2009-07-01 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::Little evidence is available regarding long-term survival of patients with gallbladder cancer that is discovered at the time of laparoscopic cholecystectomy (LC). Therefore the present study was performed to evaluate long-term outcomes of this disease. Of 1546 patients who underwent LC for benign gallbladder disease b...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-7886-x
更新日期:2005-09-01 00:00:00
abstract::Mesosigmoidoplasty is a nonresective procedure for nongangrenous sigmoid volvulus. It aims to correct the main pathogenetic factor of this condition, the narrow but long mesosigmoid. Although it had been demonstrated by intraoperative measurements that this has indeed achieved its purpose, recurrent volvulus has been ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-003-7010-z
更新日期:2003-12-01 00:00:00
abstract:BACKGROUND:Beginning in 2004, a standardized medial-to-lateral approach was adopted in laparoscopic colorectal resection (LapCR) in our institution. The present study aimed to compare the outcomes of patients operated on by this approach with those who were operated on prior to the adoption of this technique. METHODS:...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0173-5
更新日期:2009-10-01 00:00:00
abstract:BACKGROUND:Artificial intelligence is touted as the future of medicine. Classical algorithms for the detection of common bile duct stones (CBD) have had poor clinical uptake due to low accuracy. This study explores the challenges of developing and implementing a machine-learning model for the prediction of CBD stones i...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05820-8
更新日期:2021-02-01 00:00:00
abstract::It has been widely acknowledged that exomphalos and gastroschisis are two different clinical entities. Their etiology and pathogenesis, however, remain controversial. Several techniques are available for making a prenatal diagnosis of these as well as many other malformations. Some prenatal treatment is possible, but ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF01658701
更新日期:1993-05-01 00:00:00
abstract::The development of laparoscopic surgery has provided minimally invasive surgeons with advanced laparoscopic instrumentation and high definition imaging. The resulting surgical expertise and technology has now been extended to gastric endoluminal surgery. Laboratory and clinical investigations have been initiated for v...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/pl00012311
更新日期:1999-04-01 00:00:00
abstract:BACKGROUND:Perioperative blood transfusion has been shown to be associated with poor outcome in various types of malignancy. However, the relationship between the amount of blood loss and specific types of cancer recurrence has not been documented. METHODS:We retrospectively examined the amount of intraoperative blood...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-9979-4
更新日期:2009-06-01 00:00:00
abstract::In the original article there is an error in Fig. 2. Following is the corrected figure. ...
journal_title:World journal of surgery
pub_type: 杂志文章,已发布勘误
doi:10.1007/s00268-018-04886-9
更新日期:2019-03-01 00:00:00
abstract::The effects of pneumoperitoneum on the lower esophageal sphincter (LES) were evaluated during laparoscopic operation for esophageal achalasia. Intraoperative manometry was performed in three patients who underwent laparoscopic cardiomyectomy with Dor's fundoplication and five patients who underwent laparoscopic cholec...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900146
更新日期:1996-10-01 00:00:00
abstract:BACKGROUND:This study compares survival in patients with the rare subtypes of follicular (FTmC) and Hurthle cell (HCmC) microcarcinoma compared to that of papillary thyroid (PTmC) microcarcinoma. METHODS:Patients with FTmC and HCmC were selected from the National Cancer Database 2004-2015 and compared with PTmC. Patie...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05264-9
更新日期:2020-02-01 00:00:00
abstract::The aim of this study was to determine if fat absorption is better after pylorus-preserving pancreatoduodenectomy (PPPD) or duodenum-preserving pancreatic head resection (DPPHR) compared with that following pancreatoduodenectomy with gastrectomy (SPD), provided the patients have similar pancreatic exocrine function. F...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900156
更新日期:1996-10-01 00:00:00
abstract::We have previously demonstrated that there are two subgroups of patients with different types of biliary bile acid output after relief of obstructive jaundice by percutaneous transhepatic biliary drainage (PTBD). The reason for two groups is not clear but is possibly the difference in hepatic reserve function. The aim...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-001-0249-3
更新日期:2002-04-01 00:00:00
abstract:BACKGROUND:A precise understanding of anastomotic recurrence (AR) permits efficient surveillance and treatment strategies. This study aimed to evaluate the clinicopathologic characteristics of patients with AR undergoing curative resection for colorectal cancer (CRC), compare colonic with rectal tumors and investigate ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-016-3663-2
更新日期:2017-01-01 00:00:00
abstract:INTRODUCTION:Accidental intraoperative gallbladder perforation is a problem in laparoscopic surgery, especially in cases with incidental gallbladder carcinoma (IGBC). The question is whether intraoperative gallbladder perforation has a prognostic disadvantage or a retrieval bag provides protection against tumor dissemi...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0163-7
更新日期:2009-10-01 00:00:00