Abstract：
BACKGROUND:It is unknown whether surgical residents who learn minimal-access surgery skills in an unstructured environment (ie, at home), will develop a technical skill set that rivals that of those trained in the more traditional, structured learning environment. METHODS:Seven surgery residents were provided structured learning through didactic and hands-on skills training sessions and consistent supervision throughout training. A second group of 7 residents participated in an unstructured learning curriculum of training without supervision. End points were determined at the end of training using a standardized simulator based on predetermined performance measures. RESULTS:Both groups achieved high task scores, with comparable scores on gesture proficiency, hand movement smoothness, instrument movement smoothness, errors, and time elapsed. There was no significant difference between group differences in final skills scores. CONCLUSIONS:Unstructured learning is equally effective in delivering quality skills training when compared with structured training.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Uccelli J,Kahol K,Ashby A,Smith M,Ferrara Jdoi
10.1016/j.amjsurg.2010.08.028subject
Has Abstractpub_date
2011-03-01 00:00:00pages
315-9; discussion 319issue
3eissn
0002-9610issn
1879-1883pii
S0002-9610(10)00765-8journal_volume
201pub_type
杂志文章abstract：:The following report illustrates a rare case of small bowel obstruction which occurred when a large phytobezoar, which had formed in a proximal jejunal diverticulum, dislodged and migrated distally. Obstruction and subsequent perforation resulted when the phytobezoar passed into the narrow terminal ileum and lodged ju...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.02.018
更新日期：2008-01-01 00:00:00
abstract：BACKGROUND:Portal hypertension is frequently associated with secondary hypersplenism, two common clinical manifestations of which are leukopenia and thrombocytopenia. Surgical portosystemic shunts alleviate portal hypertension but their effect on hypersplenism remains unpredictable. Transjugular intrahepatic portosyste...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(97)00006-8
更新日期：1997-03-01 00:00:00
abstract：BACKGROUND:Motility disturbances in the Roux loop can negatively influence the outcome of reflux gastritis; the uncut Roux loop does not have these disadvantages, but is less suitable for clinical application because of staple dehiscence. The reported "cut-closed-reconnected" Roux loop has the same physiological starti...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(00)00246-4
更新日期：2000-02-01 00:00:00
abstract：BACKGROUND:Despite recent increased indications for infrapopliteal prosthetic bypass grafts with complementary arteriovenous fistulas, objective documentation of improved perfusion to the foot is lacking. In addition, the value of post operative noninvasive testing in the prediction of bypass success remains unclear. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)80264-5
更新日期：1995-08-01 00:00:00
abstract：:A 24-year-old woman with no significant past medical or surgical history presented with diffuse abdominal pain and distention with decreased frequency of bowel movements for 1 month. A computerized tomography scan showed a massively dilated cecum suggesting obstruction. Exploratory laparotomy revealed bowel obstructio...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2009.10.030
更新日期：2012-11-01 00:00:00
abstract：BACKGROUND:Ultrasonography (USG) and technetium-99m sestamibi (MIBI) scintigraphy are commonly used imaging modalities in the era of minimally invasive parathyroidectomy (MIP) for primary hyperparathyroidism (pHPT). However, their relative importance and actual contribution to MIP have not been prospectively assessed. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.04.020
更新日期：2007-02-01 00:00:00
abstract：BACKGROUND:Work-related injuries (WRIs) represent a significant economic and logistical burden to healthcare systems. METHODS:All patients with severe WRIs (Injury Severity Score [ISS] ≥ 12) (1995 to 2013) were compared with patients with non-WRIs using standard methodology (P < .05). RESULTS:A total of 1,270 (8.5%) ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.01.023
更新日期：2015-09-01 00:00:00
abstract：BACKGROUND:A history of therapeutic irradiation to the neck complicates the management of carotid artery occlusive disease. Serious surgical concerns are raised regarding alternative incisions, difficult dissections, and adequate wound closure. Pathology may be typical atherosclerotic occlusive disease or radiation-ind...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/S0002-9610(96)00150-X
更新日期：1996-08-01 00:00:00
abstract：PURPOSE:To investigate the frequency, presentation, clinical management, and prognosis of appendiceal carcinoid tumors in children. METHOD:A review of our institution's experience over 50 years. RESULTS:Twenty-two patients below the age of 20 presented with appendiceal carcinoid tumor. The mean age at presentation wa...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)80025-7
更新日期：1995-12-01 00:00:00
abstract：BACKGROUND:Surgical energy-based devices emit energy, which can interfere with other electronic devices (eg, implanted cardiac pacemakers and/or defibrillators). The purpose of this study was to quantify the amount of unintentional energy (electromagnetic interference [EMI]) transferred to an implanted cardiac defibril...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2014.09.011
更新日期：2014-12-01 00:00:00
abstract：:The current study suggests the need for routine post-discharge surveillance to improve reliability on surgical site infection incidence rates. Surveillance only during hospitalization may not provide precise data on the incidence of surgical site infection, underestimating a true postoperative infection rate. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.05.016
更新日期：2007-02-01 00:00:00
abstract：BACKGROUND:Previous evaluations of endoscopic hernia surgery mostly are based on small prospectively documented series or on a few randomized comparative studies. In the following, results of a large single-institution experience concerning the transabdominal preperitoneal patch (TAPP) technique with regard to the deve...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(98)00074-9
更新日期：1998-06-01 00:00:00
abstract：BACKGROUND:The purpose of this study was to determine the indications and outcome of surgery in patients with Hashimoto's thyroiditis (HT). METHODS:All patients who underwent thyroidectomy from 1990 to 2009 with pathologically confirmed HT were identified. Patients whose principle diagnosis was HT were evaluated for s...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.08.021
更新日期：2011-03-01 00:00:00
abstract：BACKGROUND:Most thymectomies are performed via sternotomy. Minimally invasive thymectomy (MIT) has been described but its potential benefits and drawbacks remain unclear. METHODS:A retrospective chart review comparing thymectomies performed via sternotomy to MIT at a single institution between 2005 and 2009. RESULTS:...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.01.001
更新日期：2010-05-01 00:00:00
abstract：BACKGROUND:While percutaneous tracheostomy (PT) is becoming the procedure of choice for elective tracheostomy, there is little late complication data. This study compared incidence of, and factors contributing to, tracheal stenosis following PT or open tracheostomy (OT). METHODS:A 10-year review was conducted of traum...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2013.12.036
更新日期：2014-11-01 00:00:00
abstract：BACKGROUND:The purpose of this study was to determine the axillary recurrence rate in breast cancer patients with a negative sentinel lymph node who did not have an axillary node dissection. METHODS:Sentinel lymphadenectomy for breast cancer patients, without axillary node dissection if the node was negative, was intr...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)00956-x
更新日期：2002-10-01 00:00:00
abstract：:Part II of this two-part article (See The American Journal of Surgery 1992; 164: 85-9) reviews the current definition of the role of immunosuppressive therapy in inflammatory bowel disease (IBD) and the use of antibiotics in IBD, as well as summarizes the uses of the new agents on the horizon for the treatment of IBD....
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(05)80381-2
更新日期：1992-08-01 00:00:00
abstract：BACKGROUND:Appendiceal perforation in patients with acute appendicitis may cause a variety of potentially life-threatening complications. Escherichia coli endotoxin has been shown to impact physiological bile flow in vivo. This had led to the theory that hyperbilirubinemia in patients with appendicitis may have a predi...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/j.amjsurg.2008.08.026
更新日期：2009-08-01 00:00:00
abstract：BACKGROUND:Stress can negatively impact surgical performance, but mental skills may help. We hypothesized that a comprehensive mental skills curriculum (MSC) would minimize resident performance deterioration under stress. METHODS:Twenty-four residents were stratified then randomized to receive mental skills and FLS tr...
journal_title：American journal of surgery
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.amjsurg.2017.09.039
更新日期：2018-02-01 00:00:00
abstract：:Enhanced recovery after surgery (ERAS) is a multimodal protocol applied towards perioperative patient care. ERAS programs are implemented by a multidisciplinary team centered around the patient, incorporating outpatient clinical staff, preoperative nurses, anesthesiologists, operative nurses, postoperative recovery st...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2019.11.009
更新日期：2020-03-01 00:00:00
abstract：BACKGROUND:Gastrointestinal stromal tumors (GISTs), the specific kit-positive mesenchymal tumors of the gastrointestinal tract, are rarely found in the anorectum and account for only 0.1% of all colorectal tumors. The main stem of therapy remains surgical excision. The standard surgical approach for anorectal GISTs inc...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2005.10.013
更新日期：2006-01-01 00:00:00
abstract：:Over a 13-month period (November 1988 to December 1989), we performed our first 104 laparoscopic cholecystectomies using an intracorporeal ultrasonic lithotripsy technique. The procedure in three of these patients was converted to an open operation because of hemorrhage with unexpected findings of cirrhosis in two pat...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(91)90600-i
更新日期：1991-03-01 00:00:00
abstract：BACKGROUND:Nipple discharge occurs in 2% to 5% of women. We evaluated the effectiveness of a previously proposed treatment algorithm for these patients. METHODS:Patients with pathologic nipple discharge and a negative mammogram and subareolar ultrasound were offered follow-up from 2005 to 2011 according to the algorit...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2013.12.035
更新日期：2014-08-01 00:00:00
abstract：BACKGROUND:Rurality adversely impacts the continuum of cancer care. However, investigations of rural cancer surgery are notably absent. We examined patterns and outcomes of oncologic resections at rural US hospitals. METHODS:We identified 928,370 hospital admissions in which 1 of 20 oncologic resections was performed ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.07.012
更新日期：2012-11-01 00:00:00
abstract：:Lower esophageal sphincter (LES) effects produced by the mammalian tachykinins were evaluated in anesthetized dogs. The distribution and content of substance P (SP) and neurokinin A (NKA) in the region of the canine gastroesophageal junction was also studied. SP and NKA stimulated a linear dose-dependent contraction o...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(91)90379-r
更新日期：1991-01-01 00:00:00
abstract：BACKGROUND:Two decades since the advent of laparoscopic cholecystectomy, the rate of bile duct injuries still remains higher than in the open cholecystectomy era. METHODS:The rate and complexity of bile duct injuries was evaluated in 83,449 patients who underwent laparoscopic cholecystectomy between 1995 and 2008 in t...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2011.08.018
更新日期：2012-04-01 00:00:00
abstract：BACKGROUND:We hypothesized that team communication with unmatched grammatical form and communicative intent (mixed mode communication) would correlate with worse trauma teamwork. METHODS:Interdisciplinary trauma simulations were conducted. Team performance was rated using the TEAM tool. Team communication was coded fo...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2017.11.008
更新日期：2018-02-01 00:00:00
abstract：:A modification of the procedure of laparostomy with palisade dorsoventral lavage for treating neglected peritonitis is described. It consists of adding a polyethylene foil to cover the intestines and thus avoiding the direct contact between them from one side, and the suction drains and the palisade laparostomy screen...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/S0002-9610(96)00411-4
更新日期：1997-02-01 00:00:00
abstract：:The efficacy of photodynamic therapy tumor destruction is dependent upon both the interruption of the tumor vasculature and the resultant production of unstable oxygen species causing cellular oxidation and death. Chloroaluminum sulfonated phthalocyanine (CASP) is a recently developed photosensitizer. In order to stud...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80543-4
更新日期：1990-10-01 00:00:00
abstract：:A new break-away needle for subclavian catheter insertion has been described. This needle functions exactly as the usual 14 gauge needle, but it can be completely removed from the catheter while leaving the integral Luer adaptor intact. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90210-1
更新日期：1984-06-01 00:00:00
