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:BACKGROUND:The transformation of a trainee into a surgeon is influenced strongly by communication patterns in the operating room (OR). In the current era of limited educational opportunities, elucidation of teaching and learning strategies in this environment is critical. The aim of this study was to further understand...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2008.01.004
更新日期:2008-05-01 00:00:00
abstract::Blocking factors are small polypeptide molecules that may appear in the serum of patients with cancer. These factors block the transformation of lymphocytes in culture to nonspecific mitogens such as phytohemagglutinin or concanavalin A and, therefore, may reflect changes in the immunocompetence of the patient. Blocki...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(75)90377-3
更新日期:1975-08-01 00:00:00
abstract:BACKGROUND:Prognosis after resection for intrahepatic cholangiocarcinoma (ICC) remains unsatisfactory. There remains no effective therapy after recurrent ICC. OBJECTIVE:The current study sought to evaluate risk factors associated with recurrent ICC and possible therapies after resection. METHOD:A review of data from ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2008.12.035
更新日期:2011-02-01 00:00:00
abstract:BACKGROUND:Data concerning the long-term efficacy of laparoscopic sleeve gastrectomy in the treatment of morbid obesity remain scarce. In this retrospective, the authors present 5-year follow-up of 30 patients having undergone laparoscopic sleeve gastrectomy. METHODS:Since 2004, 30 patients underwent laparoscopic slee...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2014.04.006
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:Hypercapnia and local pressure effects unique to CO(2) base minimally invasive surgery alter renal blood flow. We have demonstrated laparoscopic antireflux surgery to have an additional impact upon hemodynamics (decreased cardiac output), potentially extending known effects upon renal blood flow. METHODS:We...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(02)00824-3
更新日期:2002-04-01 00:00:00
abstract::To determine whether the use of pedicled full-thickness gastric patches would be feasible and safe in esophageal reconstruction, studies were undertaken in eleven dogs. The results demonstrate that patches containing parietal cell mucosa are likely to produce localized adjacent esophagitis. Patches containing antral m...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90150-8
更新日期:1979-02-01 00:00:00
abstract:BACKGROUND:Current literature does not define ideal qualities of surgical mentors. We sought to define mentoring qualities desired by medical students in attending and resident surgeons. METHODS:We conducted a survey asking third-year medical students to identify the best attending surgeon and resident surgeon mentors...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2003.12.053
更新日期:2004-06-01 00:00:00
abstract:BACKGROUND:Platelet dysfunction associated with isolated traumatic brain injury (TBI) can be measured using thromboelastography-platelet mapping (TEG-PM). We hypothesized that platelet dysfunction can be detected after blunt TBI, and the degree of dysfunction is associated with increased TBI severity and in-hospital mo...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2019.09.024
更新日期:2019-12-01 00:00:00
abstract::Most series dealing with external gastrointestinal fistulas cover experience of many years and include a heterogeneous sample of fistulas. We present our experience with 117 cases of postoperative external alimentary tract fistulas treated since 1980. Only fistulas caused by anastomotic leaks and operative injury to b...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(91)91107-t
更新日期:1991-04-01 00:00:00
abstract:BACKGROUND:The Affordable Care Act (ACA) dramatically changed the healthcare system in the United States. This study aims to analyze the impact of the ACA on general surgery clinic visits and resultant procedures. METHODS:A retrospective review was conducted on new patients who presented to the elective general surger...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.11.004
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:Lymphoepithelial cyst of the pancreas is a rare but distinctive cystic lesion lined by a mature, keratinizing squamous epithelium and surrounded by lymphoid tissue. METHODS:To gain more insights into this entity, we describe 5 examples of lymphoepithelial cyst of the pancreas (2 of which were briefly descri...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)80247-5
更新日期:1995-07-01 00:00:00
abstract::One hundred thirty-six patients meeting our criteria for one or more of eight clinical conditions were prospectively observed for the development of the adult respiratory distress syndrome. A high risk population was identified, including those with sepsis syndrome (38 percent), documented aspiration of gastric conten...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(82)90612-2
更新日期:1982-07-01 00:00:00
abstract::Seven pairs of rats were simultaneously infused with a chemically formulated nutritionally complete amino acid-glucose diet which was delivered, at the same rate, into a central vein or into a feeding gastrostomy. The intragastrically infused rats showed greater weight gain than did the intravenously infused rats. Thi...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(78)90092-2
更新日期:1978-02-01 00:00:00
abstract:BACKGROUND:This study examined the impact of intraoperative myocardial acidosis and adverse postoperative outcomes on the cost of cardiac surgical care. METHODS:Myocardial tissue pH corrected to 37 degrees C (pH(37C)) was measured in 162 patients with cross-clamp (XC) duration of 119 minutes or longer. Perioperative d...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2008.01.023
更新日期:2009-02-01 00:00:00
abstract:BACKGROUND:We hypothesized that early use of external mechanical compression (EMC) reduces hemorrhage and mortality associated with pelvic fractures. METHODS:Patients with pelvic fractures and one of the following risk factors for hemorrhage were studied retrospectively: (1) unstable fracture pattern, or (2) any fract...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2007.08.040
更新日期:2007-12-01 00:00:00
abstract::1. A well defined group of patients have been studied. 2. Composite operation resulted in a 56 per cent five year disease-free survival rate. 3. Treatment of recurrent disease with irradiation increased the five year survival to 61 per cent. 4. Preoperative irradiation for squamous cell carcinoma of the intraoral cavi...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(75)90490-0
更新日期:1975-10-01 00:00:00
abstract:BACKGROUND:Patients with the best performance status have the best prognosis after resection for pancreatic adenocarcinoma. This study was undertaken to determine the impact of performance status on survival after pancreatectomy for adenocarcinoma. METHODS:Patients with a Karnofsky Performance Score (KPS) status (KPS)...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/j.amjsurg.2012.01.016
更新日期:2012-11-01 00:00:00
abstract:OBJECTIVES:The OX-40 receptor (OX-40R/CD134) is expressed primarily on activated CD4(+) ("helper") T cells. We have previously reported the presence of OX-40(+) T cells in head and neck cancer and melanoma, where they appear to be restricted to tumor compartments (primary tumor infiltrating lymphocytes [TILs] and drain...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(00)00361-5
更新日期:2000-05-01 00:00:00
abstract::The use of intraoperative autotransfusion provides a safe and cost-effective means of salvaging operative blood loss and reducing or eliminating the use of stored homologous bank blood with its inherent difficulties and risks. The risk of disease transmission or various reactions is minimized. Autotransfusion provides...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90122-3
更新日期:1979-04-01 00:00:00
abstract::Hypersplenism was not relieved by distal splenorenal shunting in 46 of 47 Japanese patients with nonalcoholic cirrhosis of the liver. However, the platelet count significantly increased by 40 percent of the preoperative value, whereas the increment in the white blood cell count was nil. Though the platelet count in 47...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(88)80164-8
更新日期:1988-07-01 00:00:00
abstract::A safe and rapid technic for internal jugular vein cannulation is described. The success rate is almost as high and the serious complication rate is much lower than subclavian vein cannulation. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(78)90148-4
更新日期:1978-05-01 00:00:00
abstract:BACKGROUND:Minor burns represent .96% to 1.5% of emergency department visits, yet burn center referral is common. Analysis of the Grady Memorial Hospital Burn Center examined the feasibility and savings if pediatric burns were managed locally with as-needed consultation. METHODS:Prospective data on 219 consecutive adm...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2011.06.036
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:Most studies of trauma deaths include non-preventable deaths, potentially limiting successful intervention efforts. In this study we aimed to compare the potentially preventable trauma deaths between 2 time periods at our institution. METHODS:Trauma patients who died in our hospital in 2005-2006 or 2012-201...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.12.022
更新日期:2019-09-01 00:00:00
abstract::A retrospective review of 28 patients with primary gastric lymphoma was performed to determine the optimal treatment modality. The presenting signs and symptoms resembled peptic ulcer disease or gastric carcinomas. The majority of the lymphomas were of the diffuse histiocytic subtype. There was a 75 percent resectabil...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(88)80268-x
更新日期:1988-01-01 00:00:00
abstract::Between 1960 and 1990, a total of 998 patients were treated at the Sydney Melanoma Unit for cutaneous melanoma of the head and neck. There were 595 male and 403 female patients, with a median age of 53 years. The most common primary lesion site was the face (47%), followed by the neck (29%), scalp (14%), and ear (10%)...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(91)90138-4
更新日期:1991-10-01 00:00:00
abstract::The effects of the intravenous bolus administration of famotidine versus the administration of Mylanta II liquid every 2 hours on the pH of the gastric antrum, body, and fundus for 24 hours were compared in 10 critically ill patients admitted to the intensive care unit with isolated cranial trauma. Patients received 3...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/s0002-9610(05)80667-1
更新日期:1993-12-01 00:00:00
abstract::DNA is the fundamental guide for the cell's processes. The alterations in DNA that can lead to abnormal or absent proteins and the role of chromosomal alterations in changing the function of the DNA are reviewed. The role of viruses in derailing a cell's normal functions, the major mechanisms of oncogene action, and t...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/s0002-9610(05)80911-0
更新日期:1992-10-01 00:00:00
abstract:BACKGROUND:The field of telemedicine has grown tremendously over the last decade. We present a systematic review of publications on telemedicine as it pertains to surgery, addressing six facets: 1) telerobotics, 2) telementoring, 3) teleconsulting, 4) telemedicine in post-operative follow-up, 5) tele-education, and 6) ...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/j.amjsurg.2019.07.018
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:One of the issues in the debate surrounding the extent of thyroid excision for localized, well-differentiated thyroid cancer is the low morbidity rate reported after all degrees of thyroid resection. This study was conducted to determine morbidity and mortality after surgical resection for thyroid cancer. M...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80085-6
更新日期:1994-11-01 00:00:00
abstract:BACKGROUND:The appropriate surgical approach of a pancreatic multifocal disease that skips the body of the gland remains unknown. We sought to analyze a parenchyma-sparing surgical technique consisting of a middle-preserving pancreatectomy (MPP) evaluating feasibility, safety, and oncological and functional outcomes. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.02.017
更新日期:2009-09-01 00:00:00