Resident operative experience in general surgery, plastic surgery, and urology 5 years after implementation of the ACGME duty hour policy.

Abstract:

OBJECTIVE:Resident duty hour restrictions were implemented in 2002-2003. This study examines changes in resident surgical experience since these restrictions were put into place. METHOD:Operative log data for 3 specialties were examined: general surgery, urology, and plastic surgery. The academic year immediately preceding the duty hour restrictions, 2002-2003, was used as a baseline for comparison to subsequent academic years. Operative log data for graduating residents through 2007-2008 were the primary focus of the analysis. Examination of associated variables that may moderate the relationship between fewer duty hours and surgical volume was also included. RESULTS:Plastic surgery showed no changes in operative volume following duty hour restrictions. Operative volume increased in urology programs. General surgery showed a decrease in volume in some operative categories but an increase in others. Specifically the procedures in vascular, plastic, and thoracic areas showed a consistent decrease. There was no increase in the percentage of programs' graduates falling below minimum requirements. Procedures in pancreas, endocrine, and laparoscopic areas demonstrated an increase in volume. Graduates in larger surgical programs performed fewer procedures than graduates in smaller programs; this was not the case for urology or plastic surgery programs. CONCLUSIONS:The reduction of duty hours has not resulted in an across the board decrease in operative volume. Factors other than duty hour reforms may be responsible for some of the observed findings.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Simien C,Holt KD,Richter TH,Whalen TV,Coburn M,Havlik RJ,Miller RS

doi

10.1097/SLA.0b013e3181e62299

subject

Has Abstract

pub_date

2010-08-01 00:00:00

pages

383-9

issue

2

eissn

0003-4932

issn

1528-1140

journal_volume

252

pub_type

杂志文章
  • Should perioperative supplemental oxygen be routinely recommended for surgery patients? A Bayesian meta-analysis.

    abstract:OBJECTIVE:The purpose of this study is to use updated data and Bayesian methods to evaluate the effectiveness of hyperoxia to reduce surgical site infections (SSIs) and/or mortality in both colorectal and all surgery patients. Because few trials assessed potential harms of hyperoxia, hazards were not included. BACKGRO...

    journal_title:Annals of surgery

    pub_type: 杂志文章,meta分析

    doi:10.1097/SLA.0b013e31826cc8da

    authors: Kao LS,Millas SG,Pedroza C,Tyson JE,Lally KP

    更新日期:2012-12-01 00:00:00

  • The Effect of Arterial Disease Level on Outcomes of Supervised Exercise Therapy for Intermittent Claudication: A Prospective Cohort Study.

    abstract:OBJECTIVE:To assess whether level of arterial obstruction determines the effectiveness of SET in patients with IC. BACKGROUND DATA:Guidelines advocate SET before invasive treatment for IC, but early revascularization remains widespread, especially in patients with aortoiliac disease. METHODS:Patients were recruited f...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000004073

    authors: van den Houten MML,Jansen S,van der Laan L,Vriens PWHE,Willigendael EM,Koelemay MJW,Scheltinga MRM,Teijink JAW,ELECT Study Group.

    更新日期:2020-07-24 00:00:00

  • Overestimation of hereditary breast cancer risk.

    abstract:OBJECTIVE:To find out how women with breast or ovarian cancer rate their chances of carrying hereditary factors for these cancers and to determine the extent to which they overestimate their risk. SUMMARY BACKGROUND DATA:BRCA1 and BRCA2 are genes that cause breast and ovarian cancer when they are inherited in families...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199809000-00010

    authors: Iglehart JD,Miron A,Rimer BK,Winer EP,Berry D,Shildkraut MJ

    更新日期:1998-09-01 00:00:00

  • Prophylactic revascularization of the gut.

    abstract::Reconstitution of the mesenteric vascular circulation, in our experience, is advisable when advanced occlusive disease is noted on the preoperative arteriogram of patients selected for aortoiliofemoral, renal artery, or aortic aneurysm surgery. A lateral aortogram is mandatory, and the presence of an anastomotic meand...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197910000-00011

    authors: Connolly JE,Kwaan JH

    更新日期:1979-10-01 00:00:00

  • Prospective Phase II Trials Validate the Effect of Neoadjuvant Chemotherapy on Pattern of Recurrence in Pancreatic Adenocarcinoma.

    abstract:OBJECTIVE:The objective of this study was to characterize the patterns of first recurrence after curative-intent resection for pancreatic adenocarcinoma (PDAC). SUMMARY BACKGROUND DATA:We evaluated the first site of recurrence after neoadjuvant treatment as locoregional (LR) or distant metastasis (DM). To validate our...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000004585

    authors: Chawla A,Qadan M,Castillo CF,Wo JY,Allen JN,Clark JW,Murphy JE,Catalano OA,Ryan DP,Ting DT,Deshpande V,Weekes CD,Parikh A,Lillemoe KD,Hong TS,Ferrone CR

    更新日期:2020-10-19 00:00:00

  • Is ambulatory laparoscopic Roux-en-Y gastric bypass associated with higher adverse events?

    abstract:OBJECTIVE:To determine the impact of length of stay upon 30-day outcomes. BACKGROUND:It has been recommended the goal length of stay (LOS) after laparoscopic Roux-en-Y gastric bypass (LRYGB) should be 1 day to improve resource utilization. This study's aim was to assess LRYGB outcomes by LOS. METHODS:Data were obtain...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000000227

    authors: Morton JM,Winegar D,Blackstone R,Wolfe B

    更新日期:2014-02-01 00:00:00

  • Common bile duct and Oddi sphincter pressure before and after endoscopic papillotomy in patients with common bile duct stones.

    abstract::Pressures in the Oddi sphincter and common bile duct were determined before, immediately after and several weeks after endoscopic papillotomy. Fifteen patients were included in the study. Significant decreases in Oddi sphincter and common bile duct pressures were found and the decrease in Oddi sphincter pressure was t...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197908000-00009

    authors: Funch-Jensen P,Csendes A,Kruse A,Oster MJ,Amdrup E

    更新日期:1979-08-01 00:00:00

  • A Propensity-matched Analysis Comparing Survival After Esophagectomy Followed by Adjuvant Chemoradiation to Surgery Alone for Esophageal Squamous Cell Carcinoma.

    abstract:BACKGROUND:The role of adjuvant chemoradiation in esophageal cancer has been underestimated in the literature. This study was undertaken to determine whether adjuvant chemoradiation improves survival compared with surgery alone. METHODS:Data of 1095 esophageal squamous cell carcinoma (ESCC) patients, including 679 in ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000001410

    authors: Hwang JY,Chen HS,Hsu PK,Chao YK,Wang BY,Huang CS,Liu CC,Wu SC

    更新日期:2016-07-01 00:00:00

  • Distal pancreatectomy with en bloc celiac axis resection for locally advanced pancreatic body cancer: long-term results.

    abstract:OBJECTIVE:To analyze the long-term results of distal pancreatectomy with en bloc celiac axis resection (DP-CAR), a newly designed extended surgical procedure for locally advanced cancer of the pancreatic body. SUMMARY BACKGROUND DATA:Pancreatic body cancer often involves the common hepatic artery and/or the celiac axi...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.sla.0000258608.52615.5a

    authors: Hirano S,Kondo S,Hara T,Ambo Y,Tanaka E,Shichinohe T,Suzuki O,Hazama K

    更新日期:2007-07-01 00:00:00

  • Massive Ringer's lactate infusion: comparison with dextrose 5% and whole blood.

    abstract::The objectives of this study were to compare in dogs the effects of massive infusion of Ringer's lactate, 5% dextrose in water, and whole blood. Special interest centered upon lung function, central venous pressure, and dilutional effects upon the blood components. Three groups of 5 healthy dogs each received respecti...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197511000-00018

    authors: Hardy JD,Hardy KP,Turner MD

    更新日期:1975-11-01 00:00:00

  • An Experimental Simulation of Heat Effects on Cognition and Workload of Surgical Team Members.

    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

    authors: Ward MK,Yam CMH,Palejwala Z,Wallman K,Taggart SM,Wood FM,Parker SK

    更新日期:2020-11-13 00:00:00

  • The Clinical Utility of Molecular Testing in the Management of Thyroid Follicular Neoplasms (Bethesda IV Nodules).

    abstract:OBJECTIVE:FN present a management quandary as they are often benign but may also be aggressive TC. Consensus recommendations have historically advised thyroidectomy for definitive diagnosis. Although MT have robust benefit in hypothetical cost analyses, under current management guidelines a real-time study of their cli...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000004130

    authors: Carty SE,Ohori NP,Hilko DA,McCoy KL,French EK,Manroa P,Morariu E,Sridharan S,Seethala RR,Yip L

    更新日期:2020-10-01 00:00:00

  • Is surgical resection superior to transplantation in the treatment of hepatocellular carcinoma?

    abstract:OBJECTIVE:To compare outcomes for patients with hepatocellular carcinoma (HCC) treated with either liver resection or transplantation. METHODS:A retrospective, single-institution analysis of 413 HCC patients from 1999 to 2009. RESULTS:A total of 413 patients with HCC underwent surgical resection (n = 106) and transpl...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e31822ca66f

    authors: Koniaris LG,Levi DM,Pedroso FE,Franceschi D,Tzakis AG,Santamaria-Barria JA,Tang J,Anderson M,Misra S,Solomon NL,Jin X,DiPasco PJ,Byrne MM,Zimmers TA

    更新日期:2011-09-01 00:00:00

  • The impact of prophylactic total gastrectomy on health-related quality of life: a prospective cohort study.

    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

    authors: Worster E,Liu X,Richardson S,Hardwick RH,Dwerryhouse S,Caldas C,Fitzgerald RC

    更新日期:2014-07-01 00:00:00

  • Is there a possibility of a cure in patients with colorectal peritoneal carcinomatosis amenable to complete cytoreductive surgery and intraperitoneal chemotherapy?

    abstract:BACKGROUND:Although a randomized trial demonstrated a survival benefit of cytoreductive surgery (CRS) and intraperitoneal chemotherapy (IPC) over systemic chemotherapy alone, the treatment of peritoneal carcinomatosis from colorectal cancer (CRPC) is still a matter of debate. The aims of this study were to evaluate lon...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e31827e9289

    authors: Goéré D,Malka D,Tzanis D,Gava V,Boige V,Eveno C,Maggiori L,Dumont F,Ducreux M,Elias D

    更新日期:2013-06-01 00:00:00

  • Multicenter Canadian study of prehospital trauma care.

    abstract:OBJECTIVE:To evaluate whether the type of on-site care a trauma patient receives affects outcome. SUMMARY BACKGROUND DATA:The controversy regarding the prehospital care of trauma patients between Advanced Life Support (ALS) and Basic Life Support (BLS) is ongoing. Due to this unresolved controversy, as well as histori...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1097/01.SLA.0000048374.46952.10

    authors: Liberman M,Mulder D,Lavoie A,Denis R,Sampalis JS

    更新日期:2003-02-01 00:00:00

  • Chest Wall Resection for Recurrent Breast Cancer in the Modern Era: A Systematic Review and Meta-analysis.

    abstract:OBJECTIVE:To review the literature on chest wall resection for recurrent breast cancer and evaluate overall survival (OS) and quality-of-life (QOL) outcomes. BACKGROUND:Full-thickness chest wall resection for recurrent breast cancer is controversial, as historically these recurrences have been thought of as a harbinge...

    journal_title:Annals of surgery

    pub_type: 杂志文章,meta分析

    doi:10.1097/SLA.0000000000002310

    authors: Wakeam E,Acuna SA,Keshavjee S

    更新日期:2018-04-01 00:00:00

  • The endorectal pull-through for the management of ulcerative colitis in children and adults.

    abstract::Between June 1977 and November 1981, 26 children and adults with ulcerative colitis have undergone a total colectomy, an endorectal dissection of the rectal mucosa, and an ileoanostomy. A combined abdominoperineal approach was used to perform the operation, and the mucosal-submucosal rectal tube was dissected out inta...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:

    authors: Coran AG,Sarahan TM,Dent TL,Fiddian-Green R,Wesley JR,Jordan FT

    更新日期:1983-01-01 00:00:00

  • Effect of lymphatic mapping on diagnosis and treatment of patients with T1a, T1b favorable breast cancer.

    abstract:OBJECTIVE:To investigate the incidence of nodal metastasis in a consecutive series of patients treated at the authors' institution with highly selective criteria, and to determine the impact that lymphatic mapping and sentinel node biopsy have on the detection of nodal metastases in this carefully selected patient popu...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/01.SLA.0000071564.27229.A9

    authors: Jakub JW,Ebert MD,Diaz NM,Cantor A,Reintgen DS,Dupont EL,Shons AR,Cox CE

    更新日期:2003-06-01 00:00:00

  • Comparison of a lymph node ratio-based staging system with the 7th AJCC system for gastric cancer: analysis of 18,043 patients from the SEER database.

    abstract:OBJECTIVES:The American Joint Committee on Cancer (AJCC) staging system for gastric cancer bases N status on absolute number of metastatic nodes, regardless of the number of examined nodes. We examined a modified staging system utilizing node ratio (Nr), the ratio of metastatic to examined nodes. METHODS:A total of 18...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e31824857e2

    authors: Wang J,Dang P,Raut CP,Pandalai PK,Maduekwe UN,Rattner DW,Lauwers GY,Yoon SS

    更新日期:2012-03-01 00:00:00

  • Irrigation versus suction alone during laparoscopic appendectomy for perforated appendicitis: a prospective randomized trial.

    abstract:BACKGROUND:The efficacy of irrigating the peritoneal cavity during appendectomy for perforated appendicitis has been debated extensively. To date, prospective comparative data are lacking. Therefore, we conducted a prospective, randomized trial comparing peritoneal irrigation to suction alone during laparoscopic append...

    journal_title:Annals of surgery

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/SLA.0b013e31826a91e5

    authors: St Peter SD,Adibe OO,Iqbal CW,Fike FB,Sharp SW,Juang D,Lanning D,Murphy JP,Andrews WS,Sharp RJ,Snyder CL,Holcomb GW,Ostlie DJ

    更新日期:2012-10-01 00:00:00

  • Comparative study of portal vein embolization versus portal vein ligation for induction of hypertrophy of the future liver remnant using a mini-pig model.

    abstract:SUMMARY BACKGROUND DATA:The extent of hepatectomies is limited by the functional reserve of the remnant liver. The introduction of preoperative portal vein occlusion techniques to induce a preoperative hyperplasia of the future liver remnant has reduced the risk of postoperative liver failure. However, it has remained ...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e31816a9d7c

    authors: Wilms C,Mueller L,Lenk C,Wittkugel O,Helmke K,Krupski-Berdien G,Rogiers X,Broering DC

    更新日期:2008-05-01 00:00:00

  • Living Donor Liver Transplantation in Children: Surgical and Immunological Results in 250 Recipients at Université Catholique de Louvain.

    abstract:OBJECTIVES:To evaluate the outcome of pediatric living donor liver transplantation (LDLT) regarding portal vein (PV) reconstruction, ABO compatibility, and impact of maternal donation on graft acceptance. BACKGROUND:LDLT and ABO-mismatched transplantation constitute feasible options to alleviate organ shortage in chil...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000001094

    authors: Gurevich M,Guy-Viterbo V,Janssen M,Stephenne X,Smets F,Sokal E,Lefebvre C,Balligand JL,Pirotte T,Veyckemans F,Clapuyt P,Menten R,Dumitriu D,Danse E,Annet L,Clety SC,Detaille T,Latinne D,Sempoux C,Laterre PF,de Mag

    更新日期:2015-12-01 00:00:00

  • Utility of Adjuvant Chemotherapy After Neoadjuvant Chemoradiation and Esophagectomy for Esophageal Cancer.

    abstract:OBJECTIVE:To determine whether adjuvant chemotherapy (AC) after neoadjuvant chemoradiation and esophagectomy is associated with improved overall survival for patients with locally advanced esophageal cancer, and to evaluate how pathologic disease response to neoadjuvant treatment impacts this effect. BACKGROUND:Neoadj...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000001954

    authors: Burt BM,Groth SS,Sada YH,Farjah F,Cornwell L,Sugarbaker DJ,Massarweh NN

    更新日期:2017-08-01 00:00:00

  • Chronic Opioid Usage in Surgical Patients in a Large Academic Center.

    abstract:OBJECTIVE:The objective of this study is to investigate the prevalence and disparity of chronic opioid usage in surgical patients and the potential risk factors associated with chronic opioid usage. BACKGROUND:Chronic opioid usage is common in surgical patients; however, the characteristics of opioid usage in surgical...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0000000000001780

    authors: Jiang X,Orton M,Feng R,Hossain E,Malhotra NR,Zager EL,Liu R

    更新日期:2017-04-01 00:00:00

  • A 5-year clinical experience with single-staged repairs of infected and contaminated abdominal wall defects utilizing biologic mesh.

    abstract:OBJECTIVE:Our objective was to evaluate the safety and durability of biologic mesh for single-staged reconstruction of contaminated fields. INTRODUCTION:The presence of contamination during ventral hernia repair (VHR) poses a significant challenge. Some advocate for a multistaged reconstructive approach with delayed d...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e3182849871

    authors: Rosen MJ,Krpata DM,Ermlich B,Blatnik JA

    更新日期:2013-06-01 00:00:00

  • Defining lower limb lymphedema after inguinal or ilio-inguinal dissection in patients with melanoma using classification and regression tree analysis.

    abstract:OBJECTIVE:This study aims to objectively define the criteria for assessing the presence of lymphedema and to report the prevalence of lymphedema after inguinal and ilio-inguinal (inguinal and pelvic) lymph node dissection for metastatic melanoma. SUMMARY BACKGROUND DATA:Lymphedema of the lower limb is a common problem...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/SLA.0b013e31817ed7c3

    authors: Spillane AJ,Saw RP,Tucker M,Byth K,Thompson JF

    更新日期:2008-08-01 00:00:00

  • Chenodeoxycholic acid induced liver injury in pregnant and neonatal baboons.

    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

    authors: McSherry CK,Morrissey KP,Swarm RL,May PS,Niemann WH,Glenn F

    更新日期:1976-10-01 00:00:00

  • Sequential accumulation of K-ras mutations and p53 overexpression in the progression of pancreatic mucinous cystic neoplasms to malignancy.

    abstract:OBJECTIVE:Pancreatic mucinous cystic neoplasms (MCNs) provide a spectrum of neoplastic changes ranging from benign to malignant. The authors have correlated K-ras mutations and p53 overexpression with the evolution of these tumors. METHODS:Areas of mild, moderate, or severe dysplasia were microdissected from paraffin-...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-199910000-00006

    authors: Jimenez RE,Warshaw AL,Z'graggen K,Hartwig W,Taylor DZ,Compton CC,Fernández-del Castillo C

    更新日期:1999-10-01 00:00:00

  • Fat induced jejunal inhibition of gastric acid secretion in duodenal ulcer patients before and after truncal vagotomy.

    abstract::The effect of intrajejunal infusion of a fat solution on pentagastrin-stimulated (0.5 microgram/kg-hr) gastric acid secretion was studied in five duodenal ulcer patients before and three to five months after truncal vagotomy. Preoperatively mean acid output was reduced from 41 +/- 5.2 meq H+/hr to 15.4 +/- 1.3 meq H+/...

    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-197711000-00005

    authors: Christiansen J

    更新日期:1977-11-01 00:00:00