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 Surgjournal_title
Annals of surgeryauthors
Simien C,Holt KD,Richter TH,Whalen TV,Coburn M,Havlik RJ,Miller RSdoi
10.1097/SLA.0b013e3181e62299subject
Has Abstractpub_date
2010-08-01 00:00:00pages
383-9issue
2eissn
0003-4932issn
1528-1140journal_volume
252pub_type
杂志文章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
更新日期:2012-12-01 00:00:00
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
更新日期:2020-07-24 00:00:00
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
更新日期:1998-09-01 00:00:00
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
更新日期:1979-10-01 00:00:00
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
更新日期:2020-10-19 00:00:00
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
更新日期:2014-02-01 00:00:00
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
更新日期:1979-08-01 00:00:00
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
更新日期:2016-07-01 00:00:00
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
更新日期:2007-07-01 00:00:00
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
更新日期:1975-11-01 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: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
更新日期:2020-10-01 00:00:00
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
更新日期:2011-09-01 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: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
更新日期:2013-06-01 00:00:00
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
更新日期:2003-02-01 00:00:00
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
更新日期:2018-04-01 00:00:00
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:
更新日期:1983-01-01 00:00:00
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
更新日期:2003-06-01 00:00:00
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
更新日期:2012-03-01 00:00:00
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
更新日期:2012-10-01 00:00:00
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
更新日期:2008-05-01 00:00:00
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
更新日期:2015-12-01 00:00:00
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
更新日期:2017-08-01 00:00:00
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
更新日期:2017-04-01 00:00:00
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
更新日期:2013-06-01 00:00:00
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
更新日期:2008-08-01 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: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
更新日期:1999-10-01 00:00:00
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
更新日期:1977-11-01 00:00:00