Abstract：
BACKGROUND:Cognitive skills such as decision-making are critical to developing operative autonomy. We explored resident decision-making using a recollection of specific examples, from the attending surgeon and resident, after laparoscopic cholecystectomy. METHODS:In a separate semi-structured interview, the attending and resident both answered five questions, regarding the resident's operative roles and decisions, ways the attending helped, times when the attending operated, and the effect of the relationship between attending and resident. Themes were extracted using inductive methods. RESULTS:Thirty interviews were completed after 15 cases. Facilitators of decision-making included dialogue, safe struggle, and appreciation for retraction. Aberrant case characteristics, anatomic uncertainties, and time pressures provided barriers. Attending-resident mismatches included descriptions of transitioning control to the attending. CONCLUSIONS:Reciprocal dialogue, including concept-driven feedback, is helpful during intraoperative teaching. Unanticipated findings impede resident decision-making, and we describe differences in understanding transfers of operative control. Given these factors, we suggest that pre-operative discussions may be beneficial.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Hill KA,Dasari M,Littleton EB,Hamad GGdoi
10.1016/j.amjsurg.2017.06.006subject
Has Abstractpub_date
2017-10-01 00:00:00pages
583-588issue
4eissn
0002-9610issn
1879-1883pii
S0002-9610(17)30139-3journal_volume
214pub_type
杂志文章abstract：:The presentation, surgical management, and clinical outcome in 153 patients with biliary pancreatitis has been reviewed. Only 37 percent of our patients demonstrated any of Ranson's 11 prognostic signs of severe pancreatitis, and only 3 percent had 3 or more signs. Fourteen patients underwent emergency operation withi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(86)90028-0
更新日期：1986-01-01 00:00:00
abstract：BACKGROUND:Hepatocellular carcinoma (HCC) occur in livers with injury-remodeling, accomplished by enzymes called matrix metalloproteinases (MMP). Metastasis involves basement membrane invasion also caused by MMP activity. Alterations in MMP expression and their endogenous inhibitor (TIMP) may factor in HCC metastasis. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)00833-4
更新日期：2002-05-01 00:00:00
abstract：BACKGROUND:We previously reported on a pilot trauma multidisciplinary crisis resource course titled S.T.A.R.T.T. (Simulated Trauma and Resuscitative Team Training). Here, we study the course's evolution. METHODS:Satisfaction was evaluated by postcourse survey. Trauma teams were evaluated using the Ottawa global rating...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.07.024
更新日期：2016-07-01 00:00:00
abstract：:Recently, the role and timing of surgery for treating secondary and tertiary hyperparathyroidism (HPT) have been questioned. In order to delineate the indications for surgery in these patients, a retrospective analysis of 53 consecutive patients treated with parathyroidectomy was conducted. Subtotal thyroidectomy was ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80537-9
更新日期：1990-10-01 00:00:00
abstract：BACKGROUND:In view of the indolent nature of most cancers of the thyroid, particularly of the papillary and follicular variety, the decision to remove a segment of the upper aerodigestive tract when the cancer is either close to or invading this area is a difficult one. It was felt relevant to review the experience at ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80136-9
更新日期：1994-12-01 00:00:00
abstract：PURPOSE:The goal of this study was to evaluate the efficacy, morbidity and safety of local parastomal hernia repair using biological mesh. PATIENTS AND METHODS:A retrospective analysis of a prospectively maintained database was performed for parastomal hernia repairs. All patients who underwent local parastomal hernia...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2017.05.005
更新日期：2018-01-01 00:00:00
abstract：:Typhlitis is a neutropenic enterocolitis of varying severity. Its incidence is increasing, particularly in patients with acute myelogenous leukemia undergoing high dose cytosine arabinoside chemotherapy. The onset is heralded by prodromal fever, watery or bloody diarrhea, abdominal distension, and nausea during the ph...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(86)90547-7
更新日期：1986-05-01 00:00:00
abstract：BACKGROUND:There is disagreement regarding the preferred injection site for breast sentinel lymph node mapping. METHODS:The concordance of blue staining and radioactivity in the sentinel nodes of 730 consecutive patients was analyzed based on injection of mapping agents into the same or separate intradermal and subare...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2004.06.018
更新日期：2004-10-01 00:00:00
abstract：BACKGROUND:Anastomotic leakage (AL) after gastroesophageal resection for cancer is a serious complication. The aim was to evaluate mediastinal microdialysis in the detection of AL before clinical symptoms. METHODS:Sixty patients were included. Samples were collected every 4 hours in the 1st 8 postoperative days and an...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/j.amjsurg.2013.09.026
更新日期：2014-09-01 00:00:00
abstract：BACKGROUND:The prognostic significance of the platelet (PLR) and neutrophil (NLR) to lymphocyte ratios for patients with resectable colorectal cancer liver metastases (CLM) was evaluated. METHODS:Clinicopathologic data from patients who underwent hepatectomy for CLM at two tertiary care hospitals between 1995 and 2017...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.amjsurg.2020.05.003
更新日期：2020-12-01 00:00:00
abstract：BACKGROUND:Laparoscopic rectal cancer surgery involving rectal division with intracorporeal stapling devices is technically difficult. This study aimed to identify risk factors for anastomotic leakage associated with laparoscopic anterior resection for rectal cancer. METHODS:We studied 363 patients who underwent lapar...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.11.014
更新日期：2011-09-01 00:00:00
abstract：:Severe fasting hypoglycemia and hypoinsulinemia occurred in a sixty-six year old woman with an intrahepatic mesenchymal tumor. An extract from the tumor was potent in inhibiting the arginine-induced glucagon secretion from the isolated perfused porcine pancreas. This observation supports the theory recently advanced t...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90095-8
更新日期：1978-02-01 00:00:00
abstract：BACKGROUND:Recurrent laryngeal nerve (RLN) injury is a serious complication of thyroidectomy. The purpose of this study is to determine the predictors and consequences of RLN injury during thyroidectomy. METHODS:A retrospective analysis was conducted using the ACS-NSQIP 2016-2017 main and thyroidectomy targeted proced...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.07.023
更新日期：2021-01-01 00:00:00
abstract：BACKGROUND:Whether or not tumor response to chemotherapy-sensitized radiation therapy (CTRT) for head and neck cancer leads to an improved outcome is unknown. METHODS:Forty patients who received preoperative cisplatin plus simultaneous radiotherapy for operable stage III and IV head and neck cancer were reviewed retro...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(97)00151-7
更新日期：1997-11-01 00:00:00
abstract：INTRODUCTION:We hypothesized that the implementation of a novel mental skills curriculum (MSC) during laparoscopic simulator training would improve mental skills and performance, and decrease stress. METHODS:Sixty volunteer novices were randomized into intervention and control groups. All participants received FLS tra...
journal_title：American journal of surgery
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.amjsurg.2016.10.016
更新日期：2017-02-01 00:00:00
abstract：:A new catheter has been developed that can be accurately and precisely positioned using duplex ultrasonography alone. A piezoelectric transducer that functions as a passive, omnidirectional receiver is attached to the mid-balloon region of an angioplasty catheter. Integration to a standard duplex imaging system allows...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(91)90171-9
更新日期：1991-08-01 00:00:00
abstract：:The clinical findings and histologic features of 154 parotid gland tumors treated at the Health Sciences Centre, Winnipeg, Canada, from 1957 to 1970 were reviewed. The study illustrates a wide variation in the natural history and degree of malignancy of parotid tumors. Approximately 80 per cent were benign; among thes...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(75)90344-x
更新日期：1975-06-01 00:00:00
abstract：:The technique of regional pancreatectomy as detailed is divided into five phases. The procedure includes en bloc regional lymph node dissection, peripancreatic soft tissue resection, and resection with reconstruction of the pancreatic segment of portal vein. The pancreatic resection can be subtotal or total. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(85)90444-1
更新日期：1985-11-01 00:00:00
abstract：:Of 101 patients originally operated on, the status of 98 is known. Given the mortality and reanastomosis rates, the operation must be considered an absolute failure in 28 percent of the patients. Given the other complications that appear (or persist) late postoperatively, only 18 percent of the entire series of patien...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90165-8
更新日期：1980-09-01 00:00:00
abstract：BACKGROUND:Recently, limited abdominal computed tomography (CT) scans have been reported (Rao, New England Journal of Medicine, 1998) to have accuracy as high as 98%. We compare our hospital's CT accuracy ordered by emergency room (ER) physicians with that of experienced surgeons provided only with the ER history and p...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(02)00850-4
更新日期：2002-05-01 00:00:00
abstract：BACKGROUND:The aim of the current study was to identify predictors of pathologic complete response (pCR) following neoadjuvant therapy. METHODS:From 2000 to 2007, 518 breast cancer patients received neoadjuvant therapy. Data were compared using chi(2) and Fisher's exact tests and multivariate analysis of variance, as ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2009.06.004
更新日期：2009-10-01 00:00:00
abstract：BACKGROUND:Specific International Classification of Diseases, Ninth Revision, codes for laparoscopic procedures introduced in 2008 allow a more accurate evaluation of laparoscopic colorectal surgery. METHODS:Using the Nationwide Inpatient Sample 2009, a retrospective analysis of surgical colorectal cancer and divertic...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.07.031
更新日期：2012-12-01 00:00:00
abstract：BACKGROUND:Traditional management of symptomatic paraesophageal herniation involves hernia reduction, hiatal closure, and an antireflux procedure or gastropexy. Patients with significant comorbidities may not tolerate operative repair. A new technique, laparoscopic-assisted endoscopic reduction and fixation of the stom...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(01)00760-7
更新日期：2001-11-01 00:00:00
abstract：BACKGROUND:The purpose of this study was to determine whether lysosome-associated protein transmembrane-4 beta (LAPTM4B) overexpression is associated with the prognosis in patients with colorectal cancer. METHODS:LAPTM4B expression was evaluated in colorectal cancer patients by Western blot analysis and immunohistoche...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.02.003
更新日期：2012-11-01 00:00:00
abstract：BACKGROUND:Bloodstream infections in critically ill patients are associated with mortality as high as 60% and a prolonged hospital stay. We evaluated the impact of inappropriate antibiotic therapy (IAAT) in a critically ill surgical cohort with bacteremia. METHODS:This retrospective study evaluated adults with intensi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.10.025
更新日期：2016-03-01 00:00:00
abstract：:The accepted approach to patients with intermittent calf claudication is nonoperative unless the symptoms are truly incapacitating, in which case arteriography and either percutaneous angioplasty or operation is indicated. Arteriography is considered a preoperative procedure. However, with improvements in percutaneous...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80300-9
更新日期：1990-08-01 00:00:00
abstract：:Colonoscopic examination of the entire colon was performed on 146 patients for radiographically suspected benign polypoid disease. Of thirty-six patients who did not have a neoplastic lesion at the suspected site, seven (19 per cent) had unsuspected small benign polypoid adenomas elsewhere in the colon. Of the remaini...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90162-8
更新日期：1976-04-01 00:00:00
abstract：BACKGROUND:Changes in the surgical training landscape have sparked an interest in developing new educational models anchored on entrustment assessment. We sought to optimize the validated OpTrust entrustment assessment tool by comparing ratings from short-course video reviews to previously validated intraoperative asse...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2017.10.036
更新日期：2018-07-01 00:00:00
abstract：BACKGROUND:The aim of this study is to assess the clinical utility of routine preoperative computed tomography (CT) scanning in patients with cancer of the intraperitoneal colon. METHODS:From November 1997 to June 2001, all patients at VA Puget Sound Healthcare System with a diagnosis of colon cancer were referred for...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)00841-3
更新日期：2002-05-01 00:00:00
abstract：BACKGROUND:Intraoperative blood loss has been shown to be an important factor correlating with morbidity and mortality in liver surgery. A 5-cm long instrument with variably deployable metal electrodes using in-line radiofrequency ablation (ILRFA) energy was used for hepatic transection in an attempt to reduce bleeding...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2005.04.011
更新日期：2005-07-01 00:00:00
