Abstract：
:Innovation is responsible for most advances in the field of surgery. Innovative approaches to solving clinical problems have significantly decreased morbidity and mortality for many surgical procedures, and have led to improved patient outcomes. While innovation is motivated by the surgeon's expectation that the new approach will be beneficial to patients, not all innovations are successful or result in improved patient care. The ethical dilemma of surgical innovation lies in the uncertainty of whether a particular innovation will prove to be a "good thing." This uncertainty creates challenges for surgeons, patients, and the healthcare system. By its very nature, innovation introduces a potential risk to patient safety, a risk that may not be fully known, and it simultaneously fosters an optimism bias. These factors increase the complexity of informed consent and shared decision making for the surgeon and the patient. Innovative procedures and their associated technology raise issues of cost and resource distribution in the contemporary, financially conscious, healthcare environment. Surgeons and institutions must identify and address conflicts of interest created by the development and application of an innovation, always preserving the best interest of the patient above the academic or financial rewards of success. Potential strategies to address the challenges inherent in surgical innovation include collecting and reporting objective outcomes data, enhancing the informed consent process, and adhering to the principles of disclosure and professionalism. As surgeons, we must encourage creativity and innovation while maintaining our ethical awareness and responsibility to patients.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Miller ME,Siegler M,Angelos Pdoi
10.1007/s00268-014-2568-1subject
Has Abstractpub_date
2014-07-01 00:00:00pages
1638-43issue
7eissn
0364-2313issn
1432-2323journal_volume
38pub_type
杂志文章abstract：BACKGROUND:Over the past decade, assessments of surgical capacity in low- and middle-income countries (LMICs) have contributed to our understanding of barriers to the delivery of surgical services in a number of countries. It is yet unclear, however, how the findings of these assessments have been applied and built upo...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s00268-014-2938-8
更新日期：2015-04-01 00:00:00
abstract：BACKGROUND:Surgery is increasingly recognized as a means to reduce the morbidity and mortality of disabling impairments in resource-limited environments. We sought to estimate the burden of surgically correctable disabling impairments and the cost-effectiveness of their treatment among children in a large refugee camp....
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-012-1899-z
更新日期：2013-07-01 00:00:00
abstract：BACKGROUND:The most important problem in pancreatic fistula is whether one can distinguish clinical pancreatic fistula, grade B + C fistula by the International Study Group on Pancreatic Fistula (ISGPF), from transient pancreatic fistula (grade A), in the early period after pancreaticoduodenectomy (PD). It remains uncl...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-009-0220-2
更新日期：2009-12-01 00:00:00
abstract：BACKGROUND:Tumor size has been advocated as possible risk factors for occult central lymph node metastases (CNM) in papillary thyroid carcinoma (PTC) patients. This prospective study evaluated factors that could identify patients at higher risk of occult CNM, especially comparing micro-PTC and macro-PTC. METHODS:One h...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-017-4390-z
更新日期：2018-03-01 00:00:00
abstract：INTRODUCTION:Urogenital dysfunction is a well recognized complication of rectal cancer surgery. The aim of this study was to assess the impact of autonomic nerve preservation (ANP) and lateral node dissection (LND) on male urogenital function after total mesorectal excision for lower rectal cancer. METHODS:We studied,...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-005-0050-9
更新日期：2006-06-01 00:00:00
abstract：BACKGROUND:Critical limb ischemia (CLI) caused by peripheral arterial disease is associated with significant morbidity and mortality. This condition is associated with a 30 % amputation rate as well as mortality levels which might be as high as 25 %. There is no pharmacological therapy available, but several reports ha...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-012-1892-6
更新日期：2013-04-01 00:00:00
abstract：:The present article summarizes scientific observations of the endocrine pancreas anatomy and physiology into a unifying hypothesis. The data were generated over the years by surgical fellows using human and rat isolated perfused pancreas models and in vivo islet microcirculation models. The endocrine pancreas secretes...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s002680020339
更新日期：2001-04-01 00:00:00
abstract：:A large number of families with familial isolated hyperparathyroidism (FIHP) have been reported. We wanted to determine if some of these families represent early manifestations of full-blown syndromes such as multiple endocrine neoplasia type 1 (MEN-1), as early identification may alter surgical and medical management...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-002-6617-9
更新日期：2002-08-01 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：BACKGROUND:Significant barriers limit the safe and timely provision of surgical and anaesthetic care in low- and middle-income countries. Nearly one-half of Mongolia's population resides in rural areas where the austere geography makes travel for adequate surgical care very difficult. Our goal was to characterize the a...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-010-0904-7
更新日期：2011-02-01 00:00:00
abstract：BACKGROUND:Heterotopic pancreas (HP) in the stomach can be difficult to diagnose and there are many treatment options. The aim of this article is to review the contemporary diagnosis of and treatment options for HP in the stomach. METHODS:We undertook a retrospective review of patients with the diagnosis heterotopic p...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-005-0669-6
更新日期：2006-09-01 00:00:00
abstract：BACKGROUND:Hepatocellular carcinoma (HCC) is the most common primary liver cancer, causing approximately 660,000 deaths worldwide annually. The preferred treatment of HCC is surgical resection or orthotopic liver transplantation (OLT) for patients meeting specific criteria. For patients outside these criteria, options ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-010-0954-x
更新日期：2011-08-01 00:00:00
abstract：INTRODUCTION:An increasing body of evidence is being published about single-incision laparoscopic cholecystectomy (SILC), but there are no well-powered trials with an adequate evaluation of post-operative pain. This randomized trial compares SILC against four-port laparoscopic cholecystectomy (LC) with post-operative p...
journal_title：World journal of surgery
pub_type： 杂志文章,随机对照试验
doi：10.1007/s00268-014-2903-6
更新日期：2015-04-01 00:00:00
abstract：:Cardiovascular disease [atherosclerosis and subsequent myocardial infarction (MI)] has been associated with primary hyperparathyroidism. We aimed at studying cardiovascular events before and after surgery and mortality after surgery for primary hyperparathyroidism using a historical follow-up design. A total of 674 pa...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-002-6541-z
更新日期：2003-02-01 00:00:00
abstract：INTRODUCTION:Hypoxic stress is a feature of rapidly growing thyroid tumours. Cancer progression is thought to be driven by a small population of tumour cells possessing stem cell properties. Hypoxia-inducible factors (HIFs) are important mediators of hypoxia. Both HIF-1alpha and HIF-2alpha have been reported to be expr...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-017-4331-x
更新日期：2018-02-01 00:00:00
abstract：BACKGROUND:Intraoperative cerebral oxygen desaturation was reported to be associated with postoperative cognitive dysfunction in elderly patients. The effect of the anesthesia method on regional cerebral oxygen saturation (rSO(2)) is still a question under debate. The purpose of this study was to compare the effects of...
journal_title：World journal of surgery
pub_type： 杂志文章,随机对照试验
doi：10.1007/s00268-012-1676-z
更新日期：2012-10-01 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：:Experience with screening for colorectal cancer has been disappointing. Prevention of this disease seems to be a more beneficial research direction. Although radical surgery presents the best treatment option, it is nonetheless an inadequate strategy by itself. A new dose intensive approach would temporally combine su...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/BF01789207
更新日期：1991-09-01 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：BACKGROUND:The reported high incidence of 30-60% postoperative pain after an elective day surgical orchidopexy is undesirable. We evaluated the efficacy of our analgesic regimen for unilateral orchidopexy in preschool children performed as a day surgical procedure. METHODS:Between January 2004 and December 2006, 247 c...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-008-9847-7
更新日期：2009-03-01 00:00:00
abstract：BACKGROUND:The risk of developing chronic kidney disease (CKD) among living kidney donors (LKDs) is seldom included in evaluations of patients' outcomes. Potential risk factors and new criteria for estimating the glomerular filtration rate (eGFR) indexed for body surface area (BSA) were investigated with a view to prev...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-013-1906-z
更新日期：2013-04-01 00:00:00
abstract：:The role of the tumor suppressor gene p53 and proto-oncogenes mdm-2, waf-1,and bcl-2 in sporadic colorectal carcinoma (CRC) has been well investigated. However, little is known about the role of these genes in the development of ulcerative colitis-associated colorectal carcinoma (CAC). Colectomy specimens from patient...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-001-0237-7
更新日期：2002-03-01 00:00:00
abstract：BACKGROUND:The prognosis of intrahepatic cholangiocarcinoma (ICC) remains poor despite improvements in treatment and post-operative clinical management. We review our experiences and evaluate our current surgical approaches by comparing patients from two consecutive treatment periods. METHODS:One hundred forty-four pa...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-016-3583-1
更新日期：2016-09-01 00:00:00
abstract：BACKGROUND:Traditional chemotherapy agents adversely affect wound healing and need to be held prior to or after surgery. Immune checkpoint inhibitors (ICIs) and targeted agents are now standard of care for the several treatment cancers. We hypothesize that ICI and targeted therapy do not have similar adverse effects on...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s00268-019-05314-2
更新日期：2020-04-01 00:00:00
abstract：:Postoperative complications in patients with obstructive jaundice remain increased when associated with endotoxemia and the inflammatory response due to gut barrier failure. Administration of glutamine has been proposed to maintain the integrity of the gut mucosa and thus reduce bacterial translocation (BT), but the e...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-005-7721-4
更新日期：2005-10-01 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：:Although palpable axillary lymphadenopathy is most often related to benign disorders, it may be a harbinger of an underlying advanced malignancy. Fewer than 1% of patients diagnosed with breast cancer initially present with axillary metastases as their only clinical manifestation. This study represents the Mayo Clinic...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-004-7290-y
更新日期：2004-06-01 00:00:00
abstract：:Transsphenoidal pituitary surgery has radically modified the management of pituitary-dependent hypercortisolism (Cushing's disease). Bilateral adrenalectomy may, however, represent the ultimate treatment in some cases of hypercortisolism. In the present study we report our experience of bilateral adrenalectomy in 82 p...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s002689900118
更新日期：1996-09-01 00:00:00
abstract：:Factors responsible for recurrence of esophageal cancer were investigated in 90 patients who underwent extended radical esophagectomy with three-field dissection for a squamous cell carcinoma in the thoracic esophagus. The initial tumor recurrence was grouped as either locoregional (site of the primary tumor, anastomo...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s002689900228
更新日期：1997-03-01 00:00:00
abstract：OBJECTIVE:To evaluate comparative outcomes of laparoscopic transcystic (TC) and transductal (TD) common bile duct (CBD) exploration. METHODS:We systematically searched MEDLINE, EMBASE, CINAHL, CENTRAL, the World Health Organization International Clinical Trials Registry, ClinicalTrials.gov, ISRCTN Register, and biblio...
journal_title：World journal of surgery
pub_type： 杂志文章,meta分析
doi：10.1007/s00268-019-05005-y
更新日期：2019-08-01 00:00:00
