Abstract：
BACKGROUND:We conducted a national survey of general surgeons to address the association between surgeon characteristics and the tendency to recommend surgery. METHODS:We used a web-based survey with 25 hypothetical clinical scenarios with clinical equipoise regarding the decision to operate. The respondent-level tendency to operate (TTO) score was calculated as the average score over the 25 scenarios. Surgical volume was based on self-report. Linear regression models were used to evaluate the associations between TTO, other covariates of interest, and surgical volume. RESULTS:There were 907 respondents. The mean surgical TTO was 3.05 ± .43. Surgeons had significantly lower TTO scores when responding to questions within their area of practice (P < .0001). There was no association between TTO and malpractice concerns, financial incentives, or compensation structure. CONCLUSIONS:Surgeons recommend intervention far less frequently within their area of specialization. Malpractice concerns, volume, and financial compensation do not significantly affect surgical decision making.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Wilson NP,Wilson FP,Neuman M,Epstein A,Bell R,Armstrong K,Murayama Kdoi
10.1016/j.amjsurg.2013.08.018subject
Has Abstractpub_date
2013-12-01 00:00:00pages
970-7; discussion 977-8issue
6eissn
0002-9610issn
1879-1883pii
S0002-9610(13)00500-Xjournal_volume
206pub_type
杂志文章abstract：BACKGROUND:The influence of blood transfusions in the risk of postoperative infection remains controversial. We examined the association between autologous (AB) and homologous (HB) blood transfusions with postoperative infection in elective surgery. METHODS:The medical records of 991 Medicare patients aged > or =65 ye...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)00242-1
更新日期：1999-12-01 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
abstract：:Four hundred seventy-eight patients with hand burns (786 hands) were treated at the burn service of the Massachusetts General Hospital. Long-term evaluation showed that early incision and immediate autografting of deep second degree, mixed second and third degree, and third degree full-thickness hand burns resulted in...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(85)80049-0
更新日期：1985-04-01 00:00:00
abstract：:The records of more than 1,000 patients who underwent colonoscopy were reviewed. The study group consisted of 55 of these 1,000 patients who had persistent unexplained bleeding per rectum and negative radiographic examinations. Colonoscopy was helpful in defining the site of bleeding in approximately 50 per cent of th...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90332-5
更新日期：1979-11-01 00:00:00
abstract：:We performed a large single-center prospective randomized controlled study to assess the role of peritoneal drainage in simple elective cholecystectomy. In 248 patients, drains were omitted; 122 patients had closed suction drains and 124 had Penrose drains. There were no deaths, and no patient required reoperation or ...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章,随机对照试验,评审
doi：10.1016/s0002-9610(05)80271-5
更新日期：1990-02-01 00:00:00
abstract：:Since 1972, 17 patients have been surgically treated for double aortic arch at our institution. The procedure became necessary before 12 months of age in 11 patients and before 24 months in 16 patients. The major symptoms were respiratory distress, noisy breathing, and respiratory infections; four patients also had dy...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80449-0
更新日期：1993-05-01 00:00:00
abstract：:There has been a continuing evolution of the clinical spectrum of Candida infection in nonneutropenic patients. With better understanding of the predisposing factors for fungemia in critically ill patients, interest now centers on indications for early therapy, prior to the progression of colonization to fungemia. Rec...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(96)00350-9
更新日期：1996-12-01 00:00:00
abstract：BACKGROUND:Patients with cancer who undergo pancreaticoduodenectomy (PD) followed by radiation and 5-fluorouracil (5-FU) therapy have experienced median overall survival from 18 to 24 months and an actuarial 2-year overall survival from 34% to 48%. We previously reported an 84% 2-year survival using a novel adjuvant ch...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(03)00051-5
更新日期：2003-05-01 00:00:00
abstract：BACKGROUND:In this study, we explore surgical resident communication with simulated patient surrogates (SPs), in an Objective Structured Clinical Examination (OSCE). METHODS:We use discourse analysis (DA), a qualitative approach to analyzing language, to evaluate our residents' interactions with simulated patient surr...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2017.10.041
更新日期：2018-02-01 00:00:00
abstract：BACKGROUND:Laparoscopic colorectal surgery remains one of the most challenging techniques to learn. METHODS:The authors collected studies that have compared hand-assisted laparoscopic surgery (HALS) and open surgery for the treatment of colorectal disease over the past 17 years. Data of interest for HALS and open surg...
journal_title：American journal of surgery
pub_type： 杂志文章,meta分析,评审
doi：10.1016/j.amjsurg.2013.04.013
更新日期：2014-01-01 00:00:00
abstract：:Distal embolization of fragmented laminated thrombus and atheroma producing peripheral ischemia or gangrene is an underemphasized complication of arterial reconstruction. A set of techniques has been developed to minimize this important complication. To assess their effectiveness, the incidence of distal embolism in p...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90293-9
更新日期：1979-12-01 00:00:00
abstract：:Cysts of the mesothelial investment of the round ligament are rare and occur in women in their late third or fourth decades. They are relatively painless, mobile, may be perceived to be reducible, and should be included in the differential diagnosis of groin masses in women. Differentiation of these cysts from a small...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(86)90116-9
更新日期：1986-04-01 00:00:00
abstract：BACKGROUND:Parathyroid carcinoma is rare and represents 0.1% to 5% of the cases of hyperparathyroidism. New accounts are important to the understanding of these tumors. Experience in 9 cases is reported. METHODS:From 1970 to 1995, 10 patients with parathyroid carcinoma demonstrated by clinical course or pathologic fea...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(97)00228-6
更新日期：1998-01-01 00:00:00
abstract：BACKGROUND:Primary hyperparathyroidism (HPT) is an undertreated disease. This study's purpose is to determine if the calcium levels correlate with prevalence of symptoms and surgical treatment in patients with primary HPT. METHOD:Patients treated in 2006-2015 with serum calcium≥10.0 mg/dL and PTH>65 pg/mL were identif...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2018.09.010
更新日期：2019-03-01 00:00:00
abstract：BACKGROUND:Transduodenal sphincterotomy (TS) has fallen into disuse since endoscopists developed techniques to treat sphincter problems nonsurgically. However, some patients experience recurrent sphincter strictures after endoscopic sphincterotomy (ES), with the ampulla endoscopically inaccessible, and pancreas divisum...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2009.08.048
更新日期：2010-08-01 00:00:00
abstract：:In this review of 50 children with gallbladder disease in Houston, Texas, there were an equal number of patients with and without hemolytic disease and a slight predominance of males in both groups. Nearly all had been symptomatic for a prolonged period before diagnosis and cholecystectomy. Common early diagnoses were...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90428-8
更新日期：1984-12-01 00:00:00
abstract：BACKGROUND:Identifying factors associated with resident autonomy may help improve training efficiency. This study evaluates resident and procedural factors associated with level of guidance needed in the operating room. METHODS:Intraoperative performance and yearly performance on Fundamentals of Laparoscopic Surgery (...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2019.03.019
更新日期：2019-05-01 00:00:00
abstract：BACKGROUND:We hypothesize that medical centers that prioritize altruism can also deliver superior quality care. METHODS:Data were obtained from California's Office of Statewide Health Planning and Development, Medicare Hospital Compare, and the Joint Commission US Census Bureau's American Community Survey. Outcomes we...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.amjsurg.2014.10.016
更新日期：2015-03-01 00:00:00
abstract：BACKGROUND:Despite impressive results with the Lap-Band in Europe and Australia, the early Food and Drug Administration A trial in the United States showed fairly poor results. This prospective study attempts to determine if the Lap-Band can produce effective weight loss in morbidly obese Americans. METHODS:Five hundr...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2004.08.059
更新日期：2004-12-01 00:00:00
abstract：:An improved technic has been developed to predict rapidly the critical number of bacteria in tissues. This technic gave reliable and accurate measurements for wounds containing more than 2 X 10(5) organisms per gram of tissue. It is fortuitous that 10(6) bacteria is the critical number of bacteria that will induced cl...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(77)90174-x
更新日期：1977-06-01 00:00:00
abstract：:Over the last decade, significant technological advancements have occurred in cardiac surgery. One such breakthrough has been the use of robotic telemanipulation systems, which allow the surgeon to perform cardiac surgery through a minimally invasive approach. As a result, surgery for atrial fibrillation and resynchro...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2004.08.001
更新日期：2004-10-01 00:00:00
abstract：BACKGROUND:Factors that determine recurrence and complications following primary tissue repair of umbilical hernias (UHs) and the approach to repair UHs in obese patients need further analysis. METHODS:A retrospective review of UH repair (UHR) conducted at our institution was undertaken. Patients were grouped by body ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.03.014
更新日期：2016-01-01 00:00:00
abstract：BACKGROUND:Surgery is a vital component of a comprehensive health system, but there are often personnel limitations in resource constrained areas. Zambia provides post graduate surgical training through two systems to help address this shortage. However, no studies have analyzed surgical trainees' perceptions of these ...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.amjsurg.2017.07.023
更新日期：2018-04-01 00:00:00
abstract：:Fourteen operations were performed in 13 patients with total carotid artery occlusion. All patients had symptoms ranging in duration from a few hours to several months. Flow wa reestablished in 10 of the 14 arteries operated on, a success rate of 74 percent. Complication included one operative death and one permanent ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90366-9
更新日期：1980-05-01 00:00:00
abstract：:Fifty men with hernias were operated on as outpatients: 42 went home the evening after surgery. The best results were obtained in patients with unilateral indirect hernias; those with direct hernias did not do quite as well. No patient required readmission to the hospital for complications. The cost was significantly ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90161-1
更新日期：1982-05-01 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：:Hemorrhage is a major cause of trauma deaths. Coagulopathy exacerbates hemorrhage and is commonly seen during major trauma resuscitation, suggesting that current practice of coagulation factor transfusion is inadequate. Reversal of coagulopathy involves normalization of body temperature, elimination of the causes of d...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2005.03.034
更新日期：2005-09-01 00:00:00
abstract：:A new instrument for the placement of U tubes through malignant and benign biliary strictures consists of a 3 mm Bakes dilator modified by a circumferential groove and a small hole through its tip. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90082-5
更新日期：1979-03-01 00:00:00
abstract：:Over a ten year period, four patients with inflammation or perforation of non-Meckelian, small intestinal diverticula were treated on the surgical services of Bellevue Hospital. This entity remains uncommon but may be increasing in incidence. The patients presented with a short history of severe abdominal pain, usuall...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90364-0
更新日期：1976-11-01 00:00:00
abstract：BACKGROUND:Estrogen-receptor (ER)-, progesterone-receptor (PR)-, and androgen-receptor (AR)-negative breast cancer cells are unaffected by treatment with dehydroepiandrosterone-sulfate (DHEAS) and an aromatase inhibitor (AI). We hypothesized that cell growth would be inhibited with DHEAS/AI treatment after successful t...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.02.004
更新日期：2006-05-01 00:00:00
