Abstract:
OBJECTIVE:This study aims to evaluate whether graduates of integrated vascular surgery residency (IVSR) programs achieve similar surgical outcomes in clinical practice as compared to graduates of vascular surgery fellowships (VSF). SUMMARY BACKGROUND DATA:Early sub-specialization through IVSR programs decreases the total years of surgical training. However, it is unclear whether IVSR graduates achieve comparable outcomes to fellowship-trained surgeons once in clinical practice. METHODS:We identified all vascular surgeons who finished IVSR and VSF programs between 2013-2017 using American Board of Surgery data, which was linked to the Vascular Quality Initiative (VQI) registry (2013-2019) to evaluate provider-specific clinical outcomes following carotid, lower extremity, and aortic aneurysm repair procedures. The association between training models and the composite outcome of 1-year mortality, major adverse cardiac events and/or other major complications were analyzed using mixed-effects logistic regression models. RESULTS:A total of 338 surgeons (31% IVSR, 69% VSF) submitted cases into the VQI registry, including 8,155 carotid, 21,428 lower extremity, and 5,800 aortic aneurysm repair procedures. Composite 1-year outcome rates were comparable between IVSR and VSF-trained surgeons following carotid endarterectomy (8%-IVSR vs. 7%-VSF), lower extremity revascularization (19%-IVSR vs. 16%-VSF), and aortic aneurysm repair (13%-IVSR vs. 13%-VSF) procedures. These findings among IVSR-trained surgeons persisted following risk adjustment for severity of patient disease and indications for undertaking carotid [aOR:1.04 (0.84-1.28)], lower extremity [aOR:1.03 (0.84-1.26)], and aortic [aOR:0.96 (0.76-1.21)] procedures when compared to VSF-trained surgeons. CONCLUSIONS:Despite fewer total years of training, graduates of IVSR programs achieve equivalent surgical outcomes as fellowship-trained vascular surgeons once in practice. These results suggest that concerns about differential competence among integrated residency graduates are not warranted.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Smith BK,Finlayson SRG,Perler BA,Presson AP,Allen CM,Brooke BSdoi
10.1097/SLA.0000000000004706subject
Has Abstractpub_date
2020-12-18 00:00:00eissn
0003-4932issn
1528-1140pii
00000658-900000000-93840journal_volume
Publish Ahead of Printpub_type
杂志文章abstract:OBJECTIVE:The objective of this prospective, nonrandomized study was to evaluate the immediate and long-term results of first-line chemotherapy and possible surgery in locally advanced, presumably T4 squamous cell esophageal cancer. SUMMARY BACKGROUND DATA:Locally advanced esophageal cancer is rarely operable and has ...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00000658-199712000-00008
更新日期:1997-12-01 00:00:00
abstract:OBJECTIVE:To determine the efficacy of oral supplementation of the gut enzyme intestinal alkaline phosphatase (IAP) in preventing antibiotic-associated infections from Salmonella enterica serovar Typhimurium (S. Typhimurium) and Clostridium difficile. BACKGROUND:The intestinal microbiota plays a pivotal role in human ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31828fae14
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to predict recurrence in patients with grade 1 or 2 nonfunctioning pancreatic neuroendocrine tumors (NF-pNET) after curative resection. BACKGROUND:Surgical resection is the preferred treatment for NF-pNET; however, recurrence occurs frequently after curative surgery, worsening progn...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002123
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVE:To determine the optimal method of wound closure for dirty abdominal wounds. SUMMARY BACKGROUND DATA:The rate of wound infection for dirty abdominal wounds is approximately 40%, but the optimal method of wound closure remains controversial. Three randomized studies comparing delayed primary closure (DPC) wit...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-200103000-00016
更新日期:2001-03-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to compare patient outcomes between International Medical Graduate (IMG) versus US medical graduate (USMG) surgeons. SUMMARY BACKGROUND DATA:One in 7 surgeons practicing in the US graduated from a foreign medical school. However, it remains unknown whether patient outcomes differ be...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003736
更新日期:2019-12-10 00:00:00
abstract:OBJECTIVE:The authors determined the incidence of complications in 133 patients who had undergone staging laparotomy with splenectomy before treatment for Hodgkin's disease (stages I-IV). METHODS AND MATERIALS:Medical records were reviewed, and the patients or their relatives were interviewed. Median follow-up after l...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/00000658-199406000-00004
更新日期:1994-06-01 00:00:00
abstract:UNLABELLED:This population-based study evaluates the association between hospital volume and CRM (circumferential resection margin) involvement, adjusted for other confounders, in rectal cancer surgery. A low hospital volume (<20 cases/year) was independently associated with a higher risk of CRM involvement (odds ratio...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001009
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVE:This study compares outcomes following pancreaticoduodenectomy (PD) for patients treated at local, low-volume centers and those traveling to high-volume centers. BACKGROUND:Although outcomes for PD are superior at high-volume institutions, not all patients live in proximity to major medical centers. Theoreti...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001924
更新日期:2017-08-01 00:00:00
abstract::Grafting the circumflex coronary artery has been more difficult technically than the right or anterior descending because of its posterior location and the angles of its marginal branches. However, grafting this artery has been substantially simplified by a method wherein the graft is passed directly through the trans...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197606000-00012
更新日期:1976-06-01 00:00:00
abstract:OBJECTIVE:To determine overall survival and disease-free survival in selected patients with nonresectable liver-only colorectal cancer receiving liver transplantation. BACKGROUND:Patients with nonresectable colorectal cancer receiving palliative chemotherapy has a 5-year overall survival of about 10%. Liver transplant...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/SLA.0000000000003404
更新日期:2020-02-01 00:00:00
abstract::The proportion of the population of the U.S. 65 years of age and over is increasing. Biliary tract disease is estimated to involve 15% of the adult population. A review of 12,200 patients treated surgically at one medical center reveals that 2401 (20%) had acute cholecystitis. There were 93 deaths, for a mortality rat...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198101000-00009
更新日期:1981-01-01 00:00:00
abstract::Seven patients with a mean burn size of 69.6% total body-surface area underwent skin grafting with autologous cultured epidermis. They were compared with a historical group of 18 controls, with a mean burn size of 60%, who underwent grafting with conventional meshed split-thickness autograft. There were no statistical...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199006000-00005
更新日期:1990-06-01 00:00:00
abstract:OBJECTIVE:We reviewed our experience with pediatric chest wall tumors (CWTs) to identify variables associated with survival, scoliosis development, and need for corrective scoliosis surgery. BACKGROUND:Chest wall neoplasms in children or adolescents are rare. Consequently, there are few large series that detail surviv...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003495
更新日期:2019-07-25 00:00:00
abstract::This review brings the total number of biliary cysts reported in the world literature to 955. Eighty-one per cent of patients are females and 61% were discovered before age ten. The classical triad of right upper quadrant pain, right upper quandrant mass, and juandice is present in 38% of cases. The duration of sympto...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/00000658-197511000-00017
更新日期:1975-11-01 00:00:00
abstract::The results of surgical treatment in 100 patients with intrahepatic gallstones are reported including follow-up on 61 patients who survived more than three years. Nine patients died in the follow-up period, and of the remainder, 44 showed complete rehabilitation (72%). The results of follow-up examinations were best s...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198007000-00005
更新日期:1980-07-01 00:00:00
abstract:OBJECTIVE:To compare surgical safety and efficiency of 2 image guidance modalities, perfect augmented reality (AR) and side-by-side unregistered image guidance (IG), against a no guidance control (NG), when performing a simulated laparoscopic cholecystectomy (LC). BACKGROUND:Image guidance using AR offers the potentia...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0000000000002793
更新日期:2019-02-01 00:00:00
abstract::Computed tomography and, to a lesser extent, ultrasonography provide detailed anatomic localization of intra-abdominal abscesses that permit precise percutaneous placement of catheters large enough to effect drainage. Using routes similar to surgical approaches, the authors have used this technique as definitive thera...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198110000-00014
更新日期:1981-10-01 00:00:00
abstract:OBJECTIVE:To discuss the difficulties in dealing with infected or exposed ventral hernia mesh, and to illustrate one solution using an autogenous abdominal wall reconstruction technique. SUMMARY BACKGROUND DATA:The definitive treatment for any infected prosthetic material in the body is removal and substitution. When ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.SLA.0000055278.80458.D0
更新日期:2003-03-01 00:00:00
abstract:OBJECTIVE:We developed and validated a nomogram predicting the likelihood of occult lymph node metastases in surgically resectable esophageal cancers. BACKGROUND:Patients with esophageal cancer with positive lymph nodes benefit from neoadjuvant therapy, but limitations in current clinical staging techniques mean nodal...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003450
更新日期:2019-07-03 00:00:00
abstract:OBJECTIVE AND BACKGROUND:Our objective was to determine the fetal in vivo microRNA signature in hypoplastic lungs of human fetuses with severe isolated congenital diaphragmatic hernia (CDH) and changes in tracheal and amniotic fluid of fetuses undergoing fetoscopic endoluminal tracheal occlusion (FETO) to reverse sever...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001054
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:The efficacy of irrigating the peritoneal cavity during appendectomy for perforated appendicitis has been debated extensively. To date, prospective comparative data are lacking. Therefore, we conducted a prospective, randomized trial comparing peritoneal irrigation to suction alone during laparoscopic append...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0b013e31826a91e5
更新日期:2012-10-01 00:00:00
abstract:OBJECTIVE:To analyze the short- and long-term outcomes following surgical treatment for corrosive stricture of the esophagus. BACKGROUND:Surgery is a well-established treatment for corrosive strictures of the esophagus and involves either resection or bypass of the damaged esophagus and replacement by a conduit. The n...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3182125ce7
更新日期:2011-07-01 00:00:00
abstract:OBJECTIVE:To develop and validate a robust, objective mobility assessment tool, Hamlyn Mobility Score (HMS), using a wearable motion sensor. BACKGROUND:Advances in reconstructive techniques allow more limbs to be salvaged. However, evidence demonstrating superior long-term outcomes compared with amputation is unavaila...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000000711
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:Clinical coding is the translation of clinical activity into a coded language. Coded data drive hospital reimbursement and are used for audit and research, and benchmarking and outcomes management purposes. METHODS:We undertook a 2-center audit of coding accuracy across surgery. Clinician-auditor multidisci...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000000851
更新日期:2015-06-01 00:00:00
abstract:OBJECTIVE:To investigate the existence of a pathway between intraluminal products and the muscularis leukocytic infiltrate. SUMMARY BACKGROUND DATA:Mild intestinal manipulation or lipopolysaccharide initiates an intense inflammatory response within the intestinal muscularis, resulting in paralytic ileus. A major poten...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200201000-00005
更新日期:2002-01-01 00:00:00
abstract:OBJECTIVES:To determine the influence of patient depression (and anxiety) on postoperative outcome and surgeons' consideration of it. BACKGROUND:Patients' mental state influences the course of nonpsychiatric diseases. Evidence in the surgical setting comes mainly from cardiac-surgery patients and no predictive-model o...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000001448
更新日期:2015-11-01 00:00:00
abstract::This report defines the incidence of variations in the renal vascular pedicle in a group of patients with normal renal function as determined by standard laboratory criteria. The study group consisted of 166 patients undergoing renal arteriography as potential renal allograft donors. Ninety-seven patients were male an...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197807000-00014
更新日期:1978-07-01 00:00:00
abstract:OBJECTIVE:We have previously demonstrated that P. aeruginosa can have profound effects on the intestinal epithelial barrier via one of its virulence factors, the PA-I lectin/adhesin. The aims of the present study were to further characterize the interaction of P. aeruginosa and the intestinal epithelium using both in v...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000094551.88143.f8
更新日期:2003-11-01 00:00:00
abstract:OBJECTIVE:To explore the founding of the American Medical Association's Section on Surgery in 1859 and how it represented, on a national basis, the beginnings of organized surgery and the formal start of the professionalization and specialization of surgery in the United States. BACKGROUND:The broad social process of ...
journal_title:Annals of surgery
pub_type: 传,历史文章,杂志文章
doi:10.1097/SLA.0000000000001635
更新日期:2017-01-01 00:00:00
abstract::Twenty-seven patients with postoperative enterocutaneous fistulas were treated with parenteral nutrition and SMS 201-995 (100 micrograms/8 hours, subcutaneously), a long half-life somatostatin analogue. At the time SMS 201-995 was started, 11 patients had low output fistulas (less than 1000 ml/48 hours), 11 patients h...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198907000-00009
更新日期:1989-07-01 00:00:00