Abstract:
OBJECTIVES:Surgical simulation has been shown to enhance the training of general surgery residents. Since catheter-based techniques have become an important part of the vascular surgeon's armamentarium, we explored whether simulation might impact the acquisition of catheter skills by surgical residents. METHODS:Twenty general surgery residents received didactic training in the techniques of catheter intervention. Residents were then randomized with 10 receiving additional training with the Procedicus, computer-based, haptic simulator. All 20 residents then participated in 2 consecutive mentored catheter-based interventions for lower extremity occlusive disease in an OR/angiography suite. Resident performance was graded by attending surgeons blinded to the resident's training status, using 18 procedural steps as well as a global rating scale. RESULTS:There were no differences between the 2 resident groups with regard to demographics or scores on a visuospatial test administered at study outset. Overall, residents exposed to simulation scored higher than controls during the first angio/OR intervention: procedural steps (simulation/control) (50 +/- 6 vs. 33 +/- 9, P = 0.0015); global rating scale (30 +/- 7 vs. 19 +/- 5, P = 0.0052). The advantage provided by simulator training persisted with the second intervention (53 +/- 6 vs. 36 +/- 7, P = 0.0006); global rating scale (33 +/- 6 vs. 21 +/- 6, P = 0.0015). Moreover, simulation training, particularly for the second intervention, led to enhancement in almost all of the individual measures of performance. CONCLUSION:Simulation is a valid tool for instructing surgical residents and fellows in basic endovascular techniques and should be incorporated into surgical training programs. Moreover, simulators may also benefit the large number of vascular surgeons who seek retraining in catheter-based intervention.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Chaer RA,Derubertis BG,Lin SC,Bush HL,Karwowski JK,Birk D,Morrissey NJ,Faries PL,McKinsey JF,Kent KCdoi
10.1097/01.sla.0000234932.88487.75subject
Has Abstractpub_date
2006-09-01 00:00:00pages
343-52issue
3eissn
0003-4932issn
1528-1140pii
00000658-200609000-00002journal_volume
244pub_type
杂志文章,随机对照试验abstract:OBJECTIVE:To review the literature with regard to outcome of surgical management for hilar cholangiocarcinoma (Klatskin tumor). BACKGROUND:Hilar cholangiocarcinoma is a rare tumor with a poor prognosis. Surgical resection provides the only possibility for cure. Advances in hepatobiliary imaging and surgical strategies...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/SLA.0b013e3181afe0ab
更新日期:2009-08-01 00:00:00
abstract:OBJECTIVE:To study risk factors for early and late death after heart transplantation in the current era. SUMMARY BACKGROUND DATA:The current cardiac transplant population differs from earlier periods in that an increasing number of sicker patients, such as those with ventricular assist device (LVAD) support, prior car...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200009000-00002
更新日期:2000-09-01 00:00:00
abstract:OBJECTIVE:To evaluate the influence of the response to preoperative chemotherapy, especially tumor progression, on the outcome following resection of multiple colorectal liver metastases (CRM). SUMMARY BACKGROUND DATA:Hepatic resection is the only treatment that currently offers a chance of long-term survival, althoug...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000145964.08365.01
更新日期:2004-12-01 00:00:00
abstract:OBJECTIVE:To explore challenges and opportunities for surgery departments' academic missions as they become increasingly affiliated with expanding health systems. SUMMARY BACKGROUND DATA:Academic medicine is in the midst of unprecedented change. In addition to facing intense competition, narrower margins, and decrease...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004462
更新日期:2020-11-12 00:00:00
abstract::Eighty-nine grafts of expanded microporous polytetrafluoroethylene (PTFE) with a diameter of 4 mm, were placed in the carotid and femoral arteries of dogs. The animals were sacrificed at varying intervals beginning three days after operation. Four animals remain alive with patent grafts 10 months post-operatively. Twe...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197508000-00010
更新日期:1975-08-01 00:00:00
abstract::Thin melanomas can metastasize and be lethal. The purpose of this review was to identify negative risk factors in patients with melanomas less than 0.76 mm thick. Six hundred and eighty-one (681) such patients are reviewed in this study. Of those referred without metastatic disease (583 patients), metastases developed...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198808000-00004
更新日期:1988-08-01 00:00:00
abstract::Patients recovering from acute respiratory insufficiency are usually not extubated until they can ventilate adequately while breathing spontaneously at ambient end-expiratory pressure (T-tube). It is hypothesized that this period of T-tube breathing might be detrimental to gas exchange since the endotracheal tube abol...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198005000-00004
更新日期:1980-05-01 00:00:00
abstract:OBJECTIVE:To isolate heat exposure as a cause of cognitive impairment and increased subjective workload in burns surgical teams. SUMMARY BACKGROUND DATA:Raising ambient temperature of the operating room can improve burns patient outcomes, but risks increased cognitive impairment and workload of surgical team members. ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004598
更新日期:2020-11-13 00:00:00
abstract:OBJECTIVE:To evaluate the impact of improved surgical management of hepatocellular carcinoma (HCC) on the survival of patients with screened HCC. SUMMARY BACKGROUND DATA:It is unclear whether the advent of new treatment modalities such as liver transplantation and radiofrequency ablation (RFA) in recent years have imp...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31816a747a
更新日期:2008-04-01 00:00:00
abstract::The object of this study was to compare the ultrastructure pulmonary effects of the infusion of homologous and heterologous serum albumin solution in the treatment of hemorrhagic shock in baboons. Adult baboons subjected to hemorrhagic shock were resuscitated with either baboon serum albumin, human serum albumin, or R...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197902000-00016
更新日期:1979-02-01 00:00:00
abstract::In an attempt to prevent portoprival malcirculation after distal splenorenal shunt (DSRS), a splenic hilar renal shunt (HRS) with proximal flush ligation of splenic vein was designed. To accomplish this procedure, two methods were compared: HRS alone (Group A) and HRS plus proximal flush ligation of the splenic vein (...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198412000-00007
更新日期:1984-12-01 00:00:00
abstract:OBJECTIVE:Few studies have evaluated long-term outcomes after orthotopic liver transplantation (OLT). This work analyzes the experience of nearly 2 decades by the same team in a single center. Outcomes of OLT and factors affecting survival were analyzed. METHODS:Retrospective analysis of 3200 consecutive OLTs that wer...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000164077.77912.98
更新日期:2005-06-01 00:00:00
abstract:OBJECTIVE:Our experience with omental flap transposition in the treatment of deep sternal wound infections is reviewed here with an emphasis on efficacy, risk factors for in-hospital mortality rates, and long-term results. SUMMARY BACKGROUND DATA:Even with improvements in muscle and omental flap transposition, the tim...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199803000-00019
更新日期:1998-03-01 00:00:00
abstract:OBJECTIVE:To investigate the safety of radical resection for retroperitoneal sarcoma (RPS). BACKGROUND:The surgical management of RPS frequently involves complex multivisceral resection. Improved oncologic outcomes have been demonstrated with this approach compared to marginal excision, but the safety of radical resec...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000002250
更新日期:2018-05-01 00:00:00
abstract:OBJECTIVE:To compare resection rates and outcome of patients subsequently referred with hepatic metastases whose initial colon cancers were resected by surgeons with different specialty interests. SUMMARY BACKGROUND DATA:Variation in practice among noncolorectal specialist surgeons has led to recommendations that colo...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199912000-00004
更新日期:1999-12-01 00:00:00
abstract:BACKGROUND:The advice to individuals with identified CDH1 mutations is generally to undertake prophylactic total gastrectomy (PTG). This study evaluated the effect of PTG on health-related quality of life (HRQL) in asymptomatic individuals with identified CDH1 mutations at high risk for gastric cancer. METHODS:Individ...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000000446
更新日期:2014-07-01 00:00:00
abstract::Five patients were studied before and two to three days after major, uncomplicated abdominal operation. Muscle tissue was obtained by needle biopsy from m. quadriceps femoris after eight hours overnight fast. Plasma free amino acids were analyzed in simultaneously obtained samples. In the homogenized muscle samples th...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197512000-00001
更新日期:1975-12-01 00:00:00
abstract::Most patients with Marfan's syndrome have cardiovascular manifestations and complications of these abnormalities lead to death in 50% of patients by the age of 32. This report is concerned with the performance of 79 operations to control these problems in 41 patients during a 16-year period. There were 3 early deaths ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198310000-00009
更新日期:1983-10-01 00:00:00
abstract:OBJECTIVE:We aimed to determine whether the severity of inhalation injury evokes an immune response measurable at the systemic level and to further characterize the balance of systemic pro- and anti-inflammation early after burn and inhalation injury. BACKGROUND:Previously, we reported that the pulmonary inflammatory ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318275f424
更新日期:2013-06-01 00:00:00
abstract:OBJECTIVE:To assess the efficacy of adjunctive IPC to standard prophylaxis of postoperative VTE in patients at extremely high-risk. SUMMARY OF BACKGROUND DATA:The standard prophylaxis for postoperative VTE is insufficient in extremely high-risk patients. It is unclear whether an adjunctive use of IPC would result in a...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004556
更新日期:2020-11-12 00:00:00
abstract:OBJECTIVE:The study was conducted to determine whether the performance of an extended lymphadenectomy and retroperitoneal soft-tissue clearance in association with a pancreatoduodenal resection improves the long-term survival of patients with a potentially curable adenocarcinoma of the head of the pancreas. SUMMARY BA...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/00000658-199810000-00007
更新日期:1998-10-01 00:00:00
abstract:OBJECTIVE:To assess the impact of the 80-hour resident workweek restrictions on surgical residents and attending surgeons. SUMMARY BACKGROUND DATA:The ACGME mandated resident duty hour restrictions have required a major workforce restructuring. The impact of these changes needs to be critically evaluated for both the ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000220042.48310.66
更新日期:2006-06-01 00:00:00
abstract::Severe hemorrhage associated with major trauma and vascular procedures is seen frequently in our operating rooms. Immediate autotransfusion has enabled us to safely and adquately correct blood losses without placing overwhelming demands on our blood bank. Since October 1973, a device capable of retrieving, filtering a...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197703000-00013
更新日期:1977-03-01 00:00:00
abstract:OBJECTIVE:This study compared the results of video-assisted thoracic surgery (VATS) with thoracoscopic surgery (TS) for diseases of the lung and pleura. SUMMARY BACKGROUND DATA:No studies exist that compare the capabilities of VATS with advanced video systems and instrumentation to that of TS which has been done for 8...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199305010-00018
更新日期:1993-05-01 00:00:00
abstract::Emergency portacaval shunt for variceal bleeding is associated with a high operative mortality, particularly if used as a last resort. Because of this, a strong case has been made against emergency shunt. This report describes an experience with emergency portacaval shunt for the treatment of variceal bleeding when us...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198707000-00007
更新日期:1987-07-01 00:00:00
abstract:BACKGROUND:Gastrectomy remains a major operation with potential for significant deterioration in patients' health-related quality of life (QOL). This study assessed differences in QOL among patients after distal (DG), proximal (PG), or total (TG) gastrectomy. METHODS:We prospectively enrolled patients undergoing gastr...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31828c4a19
更新日期:2013-06-01 00:00:00
abstract:OBJECTIVE:Our goal was to describe contemporary management and in-hospital mortality associated with blunt thoracic aortic intimal tears (IT) within the American College of Surgeons Trauma Quality Improvement Program. SUMMARY BACKGROUND DATA:The evidence basis for nonoperative expectant management of traumatic IT of t...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004415
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVE:Comparative analyses of survival and funding statistics in cancers with high mortality were performed to quantify discrepancies and identify areas for intervention. BACKGROUND:Discrepancies in research funding may contribute to stagnant survival rates in pancreatic ductal adenocarcinoma (PDAC). METHODS:The ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003042
更新日期:2020-02-01 00:00:00
abstract::A retrospective analysis was made of the complications from pelvic exenterations performed over the past 30 years for colorectal adenocarcinoma at the Roswell Park Cancer Institute. Seventy-five patients underwent exenteration, 51 for primary disease (PD) and 24 for recurrent disease (RD). Both total and posterior exe...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199201000-00009
更新日期:1992-01-01 00:00:00
abstract:OBJECTIVE:Cetuximab, a monoclonal antibody targeting epidermal growth factor receptor (EGFR), has been proven to be efficient in metastatic colorectal cancer (mCRC); however, the therapeutic response is variable and markers predictive of response are urgently required. This study was conducted to determinate the predic...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181bc9d96
更新日期:2010-02-01 00:00:00