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 programs. METHODS:Surgical registrars at COSECSA affiliated hospitals in Zambia were surveyed about their programs. Responses were analyzed to identify key strengths and challenges across several categories including: operative training, clinical training, educational experiences, and career plans. RESULTS:Registrars report having significant independence and receiving broad and high quality operative training. They note specific challenges including limitations in specialty training, resources, and infrastructure. CONCLUSIONS:Zambian training programs have the potential to increase number of surgeons in Zambia by a significant amount in the coming years. These programs have many strengths but also face challenges in their goal to expand surgical access in the country.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Freitas DM,Munthali J,Musowoya J,Ismail H,Herbst A,Chikoya L,Dhage S,Hopkins MAdoi
10.1016/j.amjsurg.2017.07.023subject
Has Abstractpub_date
2018-04-01 00:00:00pages
744-751issue
4eissn
0002-9610issn
1879-1883pii
S0002-9610(17)30812-7journal_volume
215pub_type
杂志文章,多中心研究abstract::Early diagnosis of esophageal perforation is critical. The importance of performing sufficient surgery at the first procedure whenever possible is emphasized. If early primary closure cannot be achieved, then the initial therapeutic method of choice is resection or diversion followed by reconstruction. Drainage of the...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90379-7
更新日期:1980-06-01 00:00:00
abstract:BACKGROUND:Training surgeons in vital decision-making skills remains unstructured. We aimed to map a process of care from the perspective of surgical decision making and test whether it could be deconstructed into an accessible format for trainees. METHODS:Semistructured interviews were conducted with 10 experienced s...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.amjsurg.2007.02.016
更新日期:2008-05-01 00:00:00
abstract:BACKGROUND:The biofragmentable anastomosis ring (BAR) was introduced by Hardy in 1985 as a simple alternative to sutured or stapled intestinal anastomosis. METHODS:The aim of this study was to analyze complications related to the use of the BAR in elective intraperitoneal intestinal anastomosis to identify technical a...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.01.005
更新日期:2006-04-01 00:00:00
abstract::Hemasite is a new device incorporated in a graft that is used for hemodialysis. A technique of thrombectomizing this device incorporated graft is described. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(84)90145-4
更新日期:1984-05-01 00:00:00
abstract::The results achieved by liver resection for metastatic cancer in more than 400 patients have been studied in a collected review. Certain conclusions seem justified: The liver is no longer the surgeon's "no-man's-land," and local excision of metastatic tumor can achieve clinical cure in some patients. The risk-benefit ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(78)90072-7
更新日期:1978-03-01 00:00:00
abstract::Between July 1973 and October 1984, we performed proctectomy either as part of a primary proctocolectomy or as a secondary staged procedure in 388 patients with ulcerative colitis and in 39 patients with Crohn's disease. The proctectomies were performed using a two-team synchronous approach. An intersphincteric or per...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(86)90026-7
更新日期:1986-01-01 00:00:00
abstract::A retrospective study of colostomy closures was prompted by recent reports detailing frequent postoperative complications. In a series of 125 intraperitoneal colostomy closures there was a low incidence of complications. There were no anastomotic breakdowns, fistulas, or deaths. We conclude that closure of a well heal...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(78)90205-2
更新日期:1978-07-01 00:00:00
abstract:BACKGROUND:It is widely accepted that mastectomy and breast-conserving surgery (BCS) with irradiation yield similar results, yet many women continue to receive mastectomy. This study evaluates factors contributing to surgical decision-making in breast cancer. Registry data were obtained on all patients treated at the S...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.05.031
更新日期:2009-12-01 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:Video broadcasting of surgical procedures is an important tool for education, training, and consultation. Current video conferencing systems are expensive and time-consuming and require preplanning. Real-time Internet video is known for its poor quality and relies on the equipment and the speed of the connec...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)00203-2
更新日期:1999-11-01 00:00:00
abstract::Consistent weight reduction by gastroplasty requires precise construction of an appropriately sized stoma that will not dilate. The technique described constructs such a stoma around a 32 French Hurst dilator with an external ring of Silastic tubing over polypropylene suture. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(81)90206-3
更新日期:1981-03-01 00:00:00
abstract:BACKGROUND:For locally advanced Siewert type II and III tumors we have performed total gastrectomy including resection of the distal 2/3 of the esophagus, through separate abdominal and right chest incisions (THX-ABD). The procedure involves wide lymphadenectomy in the abdomen/chest and a Roux-en-Y jejunostomy to the l...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.11.049
更新日期:2019-08-01 00:00:00
abstract::Small intestinal epithelium digests and absorbs nutrients. Crypt stem cell transplantation can generate neomucosa with normal morphology, but the digestive and absorptive capacities of this neomucosa are unknown. This study evaluates stem cell induced neomucosal brush border digestive enzyme activity and nutrient tran...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)80119-6
更新日期:1995-01-01 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:The optimal surgery for patients with renal hyperparathyroidism has been controversial, as either subtotal parathyroidectomy (subtotal PTX) or total parathyroidectomy with auto-transplantation (total PTX-AT) may be employed. METHODS:Adult patients having subtotal PTX or total PTX-AT for secondary hyperparat...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2017.07.018
更新日期:2017-11-01 00:00:00
abstract::The wire introducer method is a satisfactory technique for management of central venous catheters if bacteriologic monitoring of the removed catheter is used to determine whether the introduced catheter should be allowed to remain. The data indicate that when central venous catheters become infected, they do so throug...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(81)90327-5
更新日期:1981-12-01 00:00:00
abstract::Several recent reviews have suggested that aggressive surgical intervention can reduce morbidity and mortality associated with intra-abdominal crises in AIDS patients. We reviewed our experience with 57 AIDS patients with 63 emergent laparotomies performed at 4 hospitals affiliated with the University of California in...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80194-1
更新日期:1994-09-01 00:00:00
abstract:BACKGROUND:In women undergoing breast conserving surgery (BCS), up to 60% can require re-excision. Our objective is to develop an optically based technology which can differentiate benign from malignant breast tissues intraoperatively through differences in tissue composition factors. METHODS:A prospective study of op...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/j.amjsurg.2009.06.018
更新日期:2009-10-01 00:00:00
abstract::In an effort to determine the current incidence and clinical course of Buerger's disease, we reviewed the records of over 700 patients with small artery disease who were evaluated at Oregon Health Sciences University during a 15 year period. We identified 26 patients who met rigid criteria for the diagnosis of Buerger...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(87)90301-1
更新日期:1987-07-01 00:00:00
abstract::The insertion of pancreaticobiliary drains at the time of endoscopic retrograde cholangiopancreatography can provide access to the bile or pancreatic duct, decompress an obstructed biliary tree, and allow infusion of solubilizing agents to effect gallstone dissolution. Twenty-six patients underwent 32 attempts at drai...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90384-7
更新日期:1983-08-01 00:00:00
abstract::The hospital and office records of 86 patients who underwent proctectomy for cancer of inflammatory bowel disease with primary closure of the perineal wound were reviewed. Almost one fourth of all patients suffered a significant perineal wound complication, the majority of which were infections. The incidence of posto...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90187-3
更新日期:1983-01-01 00:00:00
abstract:BACKGROUND:Anorectal malformations represent a continuing challenge for the pediatric surgeon. A significant number of these children suffer from fecal incontinence, urinary incontinence, and sexual inadequacy. However, major advances in the management of these children have occurred during the last 10 years. The poste...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/s0002-9610(00)00491-8
更新日期:2000-11-01 00:00:00
abstract::Percentage and levels of circulating T-lymphocytes were studied in forty-six patients with squamous cell carcinoma of the head and neck before and/or after treatment and compared with control values obtained in fifty-one healthy volunteers. Mean percentages of circulating T-cells and mean T-cell levels in cancer patie...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(75)90481-x
更新日期:1975-10-01 00:00:00
abstract::Sixty-seven cases of neck exploration for suspected hyperparathyroidism were reviewed. Thirty-nine patients underwent removal of an adenoma with biopsy of one or more other parathyroid glands. In another group, nine patients underwent removal of the adenoma only. Both groups have had no recurrences of hyperparathyroid...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(76)90389-5
更新日期:1976-09-01 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::Tube pancreatostomy for complete external drainage of pancreatic juice following pancreatoduodenectomy and a subsequent second-stage pancreatojejunostomy were carried out in four high-risk patients without morbidity. This procedure avoids the fatal outcome associated with pancreatojejunal anastomotic leakage following...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80073-x
更新日期:1994-07-01 00:00:00
abstract:BACKGROUND:Multimodality monitoring and goal-directed therapy may not prevent blood flow and brain oxygen (Flow/BrOx) crisis. We sought to determine the impact of these events on outcome in patients with severe traumatic brain injury (sTBI). METHODS:Twenty-four patients with sTBI were treated to maintain intracranial ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2014.08.003
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:An assessment was made of the change and the effect of a histamine H(2)-receptor blocker (H(2)-blocker) or omeprazole on gastric pH after surgery. METHODS:Eighty patients who underwent colon resection for colorectal cancer were divided into groups of 20. Group I received neither H(2)-blocker nor omeprazole....
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/j.amjsurg.2002.10.002
更新日期:2004-01-01 00:00:00
abstract::Among 400 patients with adenocarcinoma of the distal large bowel, anterior resection resulted in more anastomotic leaks, postoperative urinary retention and diarrhea when used for lesions of the mid-rectum than when used for lesions of the proximal rectum or sigmoid colon. However, the operative mortality, long-term m...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90235-4
更新日期:1980-01-01 00:00:00
abstract:BACKGROUND:This study compared the surgical results of 2 localization methods-cryo-assisted localization (CAL) and needle-wire localization (NWL)-in patients undergoing breast lumpectomy for breast cancer. METHODS:A total of 310 patients were treated in an institutional review board-approved study with 18 surgeons at ...
journal_title:American journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.amjsurg.2006.06.012
更新日期:2006-10-01 00:00:00