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 (FLS) tasks from 74 general surgery residents were retrospectively reviewed. The effect of post-graduate year (PGY), procedure complexity, case difficulty, intraoperative performance, and FLS task performance were analyzed using a mixed-effects model. RESULTS:PGY level, procedure complexity, case difficulty, operative technique, and operative knowledge were significantly associated with level of intraoperative guidance. In PGY2-4 residents, ratings of medical knowledge and communication were also significantly associated with guidance. There was no significant association between FLS performance and level of guidance for any PGY level. CONCLUSIONS:The amount of intraoperative guidance is influenced by many factors, including resident performance and case characteristics. FLS tasks performance was not significantly associated with intraoperative guidance.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Hoops HE,Haley C,Cook MR,Lopez O,Dewey E,Brasel KJ,Spight D,Kiraly LNdoi
10.1016/j.amjsurg.2019.03.019subject
Has Abstractpub_date
2019-05-01 00:00:00pages
979-985issue
5eissn
0002-9610issn
1879-1883pii
S0002-9610(18)31400-4journal_volume
217pub_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:The use of biologic markers to aid in individualizing wound treatment may help improve outcomes. A biologic marker that has been demonstrated to be predictive of healing in both chronic and acute wounds is wound tissue bacterial level. The objective of this study was to determine whether tissue bacterial lev...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.09.009
更新日期：2011-08-01 00:00:00
abstract：BACKGROUND:Gallbladder inflammation and mucus hypersecretion are prominent features of cholesterol and pigment gallstones in humans and animals. The factors leading to inflammation and mucus hypersecretion are poorly understood. These studies examine the inflammatory potential of bile from dogs with pigment gallstones....
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/S0002-9610(99)80099-3
更新日期：1996-01-01 00:00:00
abstract：BACKGROUND:Studies on stress hyperglycemia in trauma patients have largely ignored diabetes, a potential confounder. The purpose of this study was to assess the relationship between diabetes and outcome in trauma patients. METHODS:Data were obtained from the National Trauma Data Bank (version 4.0). The primary outcome...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.08.031
更新日期：2006-12-01 00:00:00
abstract：:Surgeons have a history of almost 100 years of being in the forefront of efforts to standardize medical care and improve patients' health outcomes. Recently, increases in the "for-profit" sector have made it more difficult for patients to receive quality medical care. In this new era, surgeons need to stay involved in...
journal_title：American journal of surgery
pub_type： 社论
doi：10.1016/s0002-9610(97)00101-3
更新日期：1997-09-01 00:00:00
abstract：BACKGROUND:The aim of this study was to calculate and analyze the cost of treatment for stage IV pressure ulcers. METHODS:A retrospective chart analysis of patients with stage IV pressure ulcers was conducted. Hospital records and treatment outcomes of these patients were followed up for a maximum of 29 months and ana...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2009.12.021
更新日期：2010-10-01 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：:Recent advances in molecular biology have greatly accelerated knowledge relating to the significance of the enterohepatic circulation of bile salts. This review highlights the role that both oxysterols and bile salts play as ligands which, when bound to nuclear hormone receptors, activate transcription factors that se...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(02)01212-6
更新日期：2003-02-01 00:00:00
abstract：BACKGROUND:The availability and utility of public statements and policies on gender equity from professional surgical societies has not been studied. METHODS:Professional surgical society websites were searched for publicly available statements and policies related to gender equity. These were compiled and assessed fo...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.06.041
更新日期：2020-11-01 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：BACKGROUND:The purpose of this study was to evaluate the involvement of inflammatory mediators in patients undergoing Lichtenstein tension-free hernioplasty (LH) using polypropylene prosthetic materials or conventional Bassini hernia repair (BH). METHODS:Thirty patients male with unilateral inguinal hernia without com...
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/s0002-9610(00)00445-1
更新日期：2000-09-01 00:00:00
abstract：BACKGROUND:Surgery for Crohn's disease is not intended for cure, but rather to relieve symptoms and treat complications. Perioperative morbidity, the fear of creating short bowel syndrome, and the tendency of the disease to recur convinced many physicians to refer their Crohn's patients for surgery only when life-threa...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(97)00102-5
更新日期：1997-09-01 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：:Diabetic neuropathic ulcers are thought to arise from repetitive injury during normal walking in areas of high plantar pressures. It has been suggested that metatarsal head (MTH) resection alleviates elevated pressures at the site of the ulcer and, thus, expedites healing and prevents recurrence. We investigated the e...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(94)90203-8
更新日期：1994-03-01 00:00:00
abstract：BACKGROUND:The changing environment in academic medical centers has had a major effect on the recruitment and the demographic characteristics of leadership positions in academic surgery. Categorization of "cultures" from the business model has been extrapolated into the academic surgical model. METHODS:The types of cu...
journal_title：American journal of surgery
pub_type： 历史文章,杂志文章
doi：10.1016/s0002-9610(02)00814-0
更新日期：2002-04-01 00:00:00
abstract：BACKGROUND:Few data exist regarding melanoma metastasis to the adrenal gland. We reviewed our experience to determine the natural history of this condition and the appropriate role for surgical intervention. METHODS:A retrospective review of melanoma patients with adrenal metastasis was performed. Clinical presentatio...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.12.018
更新日期：2008-03-01 00:00:00
abstract：BACKGROUND:This study analyzed presentation and management of hemorrhage after pancreaticoduodenectomy (PD) to determine the respective role of surgery and embolization. METHODS:From January 1992 to March 2005, 411 patients underwent PD and were analyzed with regard to postoperative hemorrhage. RESULTS:Hemorrhage occ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.08.088
更新日期：2007-07-01 00:00:00
abstract：:Ten laryngectomees underwent esophageal motility studies to assess the effect of laryngectomy on esophageal function. When these patients are compared with controls, marked derangements in esophageal motility were noted in the upper esophageal sphincter (UES) and in the body of the esophagus. Lower esophageal sphincte...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90416-5
更新日期：1976-01-01 00:00:00
abstract：:Transplantation of adult kidneys into very small children is not performed in most centers because of concerns regarding the technical difficulty of the procedure. Advantages of the procedure include the possibility of living related donor transplantation and the increased availability of adult donor kidneys as compar...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90071-5
更新日期：1983-02-01 00:00:00
abstract：BACKGROUND:The standard paradigm for acutely injured patients involves evaluation in an emergency department (ED). Our center has employed a policy for bypassing the ED and proceeding directly to the operating room (OR) based on prehospital criteria. METHODS:This is a retrospective analysis of all trauma patients admi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.06.001
更新日期：2012-08-01 00:00:00
abstract：BACKGROUND:Predicting length of stay (LOS) is difficult for trauma and emergency general surgery (TEGS) patients. Our aim was to determine the accuracy of LOS predictions by TEGS team members and the NSQIP Risk Calculator and the patient factors associated with inaccurate predictions. METHODS:LOS for 200 TEGS patients...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.01.055
更新日期：2020-09-01 00:00:00
abstract：:Fifty-one cervical nodes from 19 patients with advanced head and neck cancer were stimulated with phorbol dibutyrate and ionomycin (PDBu + Io) to determine the effect of such stimulation on the generation of cytotoxic T cells and whether this stimulation could bypass the need for autologous tumor stimulation. Lymphocy...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80718-4
更新日期：1992-12-01 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：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：:Diabetic foot wounds affect an estimated 15% of all patients with diabetes. These wounds are typically multifactorial in origin. Neuropathy of the foot and impaired wound healing are frequently associated with peripheral arterial occlusive disease. These factors combine to contribute to the development of foot ulcers....
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/S0002-9610(03)00302-7
更新日期：2004-05-01 00:00:00
abstract：BACKGROUND:The aim of the study was to evaluate the efficacy of adjuvant chemotherapy on survival after resection for gastric cancer. METHODS:Patients were enrolled if they underwent resection of gastric cancer but had lymph node or serosal involvement or both. Surgical resection was either total or partial gastrectom...
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.2003.12.014
更新日期：2004-03-01 00:00:00
abstract：INTRODUCTION:We describe an institutional program (INR- Interval NSQIP Review), to augment NSQIP utility through structured, multidisciplinary review of surgical outcomes in order to create near 'real-time' adverse event (AE) monitoring and improve surgeon awareness. METHODS:INR is a monthly meeting of quality analyst...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.02.057
更新日期：2020-05-01 00:00:00
abstract：:The effects of cyclosporin A on the regenerating liver were studied in rats after partial hepatectomy and were compared with those of conventional immunosuppressants such as methylprednisolone and azathioprine. In Group I, a standard hepatectomy removing two thirds of the organ was performed. In Group II, an oral dose...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(88)80705-0
更新日期：1988-02-01 00:00:00
abstract：:The ability of the liver to control blood glucose levels was studied in relation to the blood ketone body ratio, which reflects the hepatic mitochondrial redox state. In partially hepatectomized rabbits, postoperative continuous administration of a hyperosmolar glucose solution revealed the following findings: (1) The...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(88)80410-0
更新日期：1988-04-01 00:00:00
abstract：:Twenty-one patients presented with pathologic interactions between the gastrointestinal tract and aortic grafts. Seventeen patients were managed by excision of the graft and axillobifemoral bypass. Six patients died. four deaths were due to disruption of the proximal aortic stump after initial therapy that appeared su...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90003-3
更新日期：1980-08-01 00:00:00
