Abstract:
OBJECTIVE:To evaluate the effectiveness of surgical simulation compared with other methods of surgical training. SUMMARY BACKGROUND DATA:Surgical simulation (with or without computers) is attractive because it avoids the use of patients for skills practice and provides relevant technical training for trainees before they operate on humans. METHODS:Studies were identified through searches of MEDLINE, EMBASE, the Cochrane Library, and other databases until April 2005. Included studies must have been randomized controlled trials (RCTs) assessing any training technique using at least some elements of surgical simulation, which reported measures of surgical task performance. RESULTS:Thirty RCTs with 760 participants were able to be included, although the quality of the RCTs was often poor. Computer simulation generally showed better results than no training at all (and than physical trainer/model training in one RCT), but was not convincingly superior to standard training (such as surgical drills) or video simulation (particularly when assessed by operative performance). Video simulation did not show consistently better results than groups with no training at all, and there were not enough data to determine if video simulation was better than standard training or the use of models. Model simulation may have been better than standard training, and cadaver training may have been better than model training. CONCLUSIONS:While there may be compelling reasons to reduce reliance on patients, cadavers, and animals for surgical training, none of the methods of simulated training has yet been shown to be better than other forms of surgical training.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Sutherland LM,Middleton PF,Anthony A,Hamdorf J,Cregan P,Scott D,Maddern GJdoi
10.1097/01.sla.0000200839.93965.26subject
Has Abstractpub_date
2006-03-01 00:00:00pages
291-300issue
3eissn
0003-4932issn
1528-1140pii
00000658-200603000-00001journal_volume
243pub_type
杂志文章,评审abstract:OBJECTIVE:To determine very late clinical outcomes at up to 20 years follow-up from a randomized controlled trial of Nissen vs. anterior 180-degree partial fundoplication. SUMMARY BACKGROUND DATA:Nissen fundoplication for gastroesophageal reflux can be followed by troublesome side effects. To address this, partial fun...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004643
更新日期:2020-11-18 00:00:00
abstract:OBJECTIVE:This study aimed to identify risk factors for recurrence after pancreatic resection for intraductal papillary mucinous neoplasm (IPMN). SUMMARY BACKGROUND DATA:Long-term follow-up data on recurrence after surgical resection for IPMN are currently lacking. Previous studies have presented mixed results on the ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004427
更新日期:2020-11-17 00:00:00
abstract:OBJECTIVE:To determine the long-term results of liver transplantation for hepatocellular carcinoma (HCC) measuring 5 cm or larger treated in a multimodality adjuvant protocol. SUMMARY BACKGROUND DATA:Transplant has been established as a viable treatment of HCC measuring less than 5 cm, but the results for larger tumor...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00000658-200204000-00012
更新日期:2002-04-01 00:00:00
abstract::Survival after distal splenorenal shunt in appreciably better in nonalcoholic patients than in alcoholics. This increase in survival does not appear to be dependent upon the state of biochemical liver function or the severity of changes in liver histology since these latter were similar for both groups. We suggest tha...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197805000-00008
更新日期:1978-05-01 00:00:00
abstract::Hypermetabolism characterizes the metabolic response to thermal injury and the extent of energy production is positively related to the rate of urinary catecholamine excretion. Alpha and beta adrenergic blockade decreased metabolism from 69.6 +/- 5.3 Kcal/m(2)/hr to 57.4 +/- 5.2 (p < 0.01), and infusion of 6 microgm e...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197410000-00031
更新日期:1974-10-01 00:00:00
abstract::Low mortality rates for elective surgical treatment of abdominal aortic aneurysms justify an aggressive approach in most patients. However, in high-risk patients with small aneurysms and no symptoms, the decision to operate remains a delicate balance of risk and benefit. Our observations include 99 high-risk patients ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198409000-00003
更新日期:1984-09-01 00:00:00
abstract::The records of 161 adult patients who underwent a modification of the Witzel gastrostomy without gastropexy at Ellis Fischel State Cancer Hospital, Columbia, Missouri, between 1977 and 1980, are reviewed in detail and form the basis of this report. Six of these patients had gastrostomies on two different occasions. Th...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198206000-00003
更新日期:1982-06-01 00:00:00
abstract::A previously described balloon tipped dilatation catheter has been used during revascularization surgery to dilate lesions which potentially could limit the runoff of the saphenous bypass grafts. A total of 34 lesions were dilated in 25 patients. Restudy of 12 patients (15 lesions) demonstrated positive results and no...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198002000-00017
更新日期:1980-02-01 00:00:00
abstract:OBJECTIVE:To determine the optimal method of wound closure for dirty abdominal wounds. SUMMARY BACKGROUND DATA:The rate of wound infection for dirty abdominal wounds is approximately 40%, but the optimal method of wound closure remains controversial. Three randomized studies comparing delayed primary closure (DPC) wit...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-200103000-00016
更新日期:2001-03-01 00:00:00
abstract::Because of important differences in prognosis and treatment, prompt and accurate diagnosis of fever, decreasing function, and pain and tenderness around a renal allograft is crucial for differentiation between acute rejection and other post-operative conditions which may give a similar picture. Ultrasound examinations...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197704000-00012
更新日期:1977-04-01 00:00:00
abstract:OBJECTIVE:To test the total burden of complications in the early postoperative period after liver transplantation (LT) between donation after circulatory death (DCD) and donation after brain death (DBD) grafts with the novel Comprehensive Complication Index (CCI). BACKGROUND:LT is complex surgery and the increasing us...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002419
更新日期:2017-11-01 00:00:00
abstract:OBJECTIVE:To evaluate the outcome of artificial anal sphincter implantation for severe fecal incontinence in 37 consecutive patients operated on in a single institution from 1993 through 2001. SUMMARY BACKGROUND DATA:Implantation of an artificial anal sphincter is proposed in severe fecal incontinence when local treat...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200301000-00008
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the potential of postischemic intravenous infusion of the endogenous antioxidant glutathione (GSH) to protect the liver from reperfusion injury following prolonged warm ischemia. BACKGROUND DATA:The release of reactive oxygen species (ROS) by activated Kupffer cells (KC) and leukocytes causes rep...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000110321.64275.95
更新日期:2004-02-01 00:00:00
abstract:OBJECTIVE:To investigate the correlation between in-hospital surgical delay before appendectomy for suspected appendicitis and the finding of perforated appendicitis in children. METHODS:All children undergoing acute appendectomy for suspected acute appendicitis at Karolinska University Hospital, Stockholm, Sweden fro...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001694
更新日期:2017-03-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to investigate whether the Hospital Readmissions Reduction Program, a national program that introduced financial penalties for high readmission rates for certain medical conditions, had a "spillover" effect on surgical conditions. SUMMARY BACKGROUND DATA:During the past decade, ther...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002350
更新日期:2018-04-01 00:00:00
abstract::The myocardial effects of protamine, with and without heparin, were documented in this investigation. Isolated rabbit hearts (n = 30) were retrograde perfused with Krebs-Ringers bicarbonate solution aerated with 95% O2/5% CO2 through the aortic root (37 C, 80 mmHg). Developed left ventricular blood pressure, heart rat...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199010000-00001
更新日期:1990-10-01 00:00:00
abstract:OBJECTIVE:To assess the accuracy of physical examination, ultrasonography, and mammography in predicting residual size of breast tumors following neoadjuvant chemotherapy. BACKGROUND:Neoadjuvant chemotherapy is an accepted part of the management of stage II and III breast cancer. Accurate prediction of residual pathol...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000197714.14318.6f
更新日期:2006-02-01 00:00:00
abstract:OBJECTIVE:To determine the effect of 9-cis retinoic acid (9-cis RA) on postsurgical lymphedema. BACKGROUND:9-cis RA promotes lymphangiogenesis in vitro and in vivo and has promise as a therapeutic agent to limit the development of postsurgical lymphedema. METHODS:Lymphedema was induced in the right hind limb after a ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001525
更新日期:2016-08-01 00:00:00
abstract::Thirty-two conditioned 15-18 kg dogs underwent laparotomy, heparinization, left lateral hepatic lobe injury and subsequent partial left lateral hepatic lobectomy. The hemostatic capabilities of the surgical scalpel combined with suture ligatures and stay sutures, the Bovie, and the CO2 laser were compared. The CO2 las...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197501000-00016
更新日期:1975-01-01 00:00:00
abstract:PURPOSE:Though histological grade is known to have a major prognostic impact in metastatic mucinous appendiceal adenocarcinomas, the prognostic impact of grade in localized disease, and the validity of the American Joint Committee on Cancer AJCC Staging Manual 7th edition's decision to combine moderately and poorly dif...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318269d680
更新日期:2013-06-01 00:00:00
abstract:OBJECTIVE:We investigated whether proteomic analysis of the low molecular weight region of the serum proteome could predict histologic response of locally advanced rectal cancer to neoadjuvant radiochemotherapy (RCT). SUMMARY BACKGROUND DATA:Proteomic analysis of serum is emerging as a powerful new modality in cancer,...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000245577.68151.bd
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVE:To assess the mechanistic role of group IIA phospholipase A2 (PLA2) in the process of local and distant organ injury after intestinal ischemia-reperfusion. SUMMARY BACKGROUND DATA:Intestinal ischemia-reperfusion produces lung injury by a mechanism that involves PLA2 activation, but it is unclear which isozym...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200007000-00013
更新日期:2000-07-01 00:00:00
abstract::Although survival from primary breast cancer has improved with earlier diagnosis and treatment, the management of the opposite breast is still in question. The risk factors for bilaterality are known, and preoperative mammography is occasionally helpful, but identification of early second breast cancer is very limited...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198506000-00001
更新日期:1985-06-01 00:00:00
abstract::Ileovesical and ileosigmoid fistulae were found to coexist in 22 patients with Crohn's ileocolitis. Persistent or recurrent urinary tract infection was a complaint in all cases, and 11 patients reported pneumaturia and/or fecaluria. Thus, bladder involvement was either suspected or clinically apparent in each patient....
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198801000-00010
更新日期:1988-01-01 00:00:00
abstract::The prolonged feeding of chenodeoxycholic acid produces hepatic injury in both pregnant and non-pregnant baboons. CDC feeding does not adversely affect ovarina function and no teratogenic effects of this bile acid were noted in 16 live birth and two stillborn progeny of CDC fed animals. However, 10 of the 16 live birt...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197610000-00012
更新日期:1976-10-01 00:00:00
abstract:OBJECTIVE:To determine the prognostic influence of residual tumor at or within 1 mm of the mobilization margins (R1Mobilization) compared with transection margins (R1Transection) following pancreaticoduodenectomy for pancreatic ductal adenocarcinoma (PDAC). BACKGROUND:The prognostic strength of R1 status increases wit...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181d77369
更新日期:2010-06-01 00:00:00
abstract:OBJECTIVE:To estimate long-term mortality following major burn injury compared with matched controls. SUMMARY BACKGROUND DATA:The effect of sustaining a major burn injury on long-term life expectancy is poorly understood. METHODS:Using health administrative data, all adults who survived to discharge after major burn ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002722
更新日期:2019-06-01 00:00:00
abstract:OBJECTIVE:This study investigated the current state of fecal and urinary continence in an extensive group of adults after operative correction for high anorectal malformations and how they cope with their incontinence. SUMMARY BACKGROUND DATA:Normal fecal continence is hardly to be expected after correction for high a...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199308000-00012
更新日期:1993-08-01 00:00:00
abstract:OBJECTIVE:Influence of sacral nerve modulation (SNM) on cerebral somatosensory evoked potentials (SEP) was determined in patients with incontinence and constipation. BACKGROUND:Selection of patients with incontinence and constipation for SNM could be improved. METHODS:The latency (ms) of SEP induced by pudendal nerve...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3182196ff4
更新日期:2011-07-01 00:00:00
abstract::Delivery of cardioplegic (CP) solutions to all regions of the myocardium is critical for optimal myocardial protection during cardiac surgery. However, there are little data regarding the effects of CP agents upon coronary vascular resistance (CVR) and CP delivery. Accordingly, we evaluated blood CP (Hct 30) delivery ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198309000-00003
更新日期:1983-09-01 00:00:00