American journal of surgery
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Randomized Controlled Trial
The TARGIT trial: targeted intraoperative radiation therapy versus conventional postoperative whole-breast radiotherapy after breast-conserving surgery for the management of early-stage invasive breast cancer (a trial update).
The principal objective of the targeted intraoperative radiation therapy trial was to determine whether single-fraction intraoperative radiotherapy (IORT) targeted to the tumor bed provides equivalent local control compared with whole-breast irradiation in patients with early-stage invasive breast cancer. ⋯ Targeted IORT allowed the entire dose of radiotherapy to be administered in a single fraction at the time of breast-conserving surgery, thus avoiding the need for repeated radiotherapy treatments or placement of indwelling radiotherapy devices.
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Randomized Controlled Trial Multicenter Study Comparative Study
Ertapenem or ticarcillin/clavulanate for the treatment of intra-abdominal infections or acute pelvic infections in pediatric patients.
Ertapenem, a group I carbapenem antibiotic, has been shown to be safe and effective in treating adults with complicated intra-abdominal (cIAI) or acute pelvic infection (API). This study evaluated ertapenem for treating these infections in children. ⋯ This study suggests that ertapenem is generally safe and efficacious for treating cIAI or API in pediatric patients.
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Randomized Controlled Trial
Polyethylene glycol versus sodium phosphate mechanical bowel preparation in elective colorectal surgery.
The type of mechanical bowel preparation (MBP) used before elective colorectal surgery remains controversial. ⋯ SP, coupled with ertapenem antibiotic prophylaxis, may improve outcomes and reduce SSIs in patients undergoing elective colorectal surgery when compared with PEG coupled with cefotetan antibiotic prophylaxis.
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Randomized Controlled Trial
Virtual-reality training improves angled telescope skills in novice laparoscopists.
Based on prior success of virtual-reality (VR) trainers in imparting surgical skills, a randomized and controlled study was designed to determine whether VR training improves angled-telescope operative performance. ⋯ VR training in angled laparoscope use improves operative performance of novices. These data support growing evidence that VR training is highly effective in improving surgical skills outside of the clinical setting.
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Randomized Controlled Trial Comparative Study
Verbal feedback from an expert is more effective than self-accessed feedback about motion efficiency in learning new surgical skills.
Teaching of technical surgical skills to undergraduate medical students in a laboratory setting away from the patient is not common practice. Because of the large volume of students and shortage of available teaching faculty new methods of teaching must be developed for this group of trainees. In this study we examined the effectiveness of computer-based video training, different types of computer-based motion efficiency feedback (with and without expert criteria), and expert feedback on learning of a basic technical skill in medical students. ⋯ Verbal feedback from an expert instructor led to lasting improvements in technical skills performance. Providing information about motion efficiency did not lead to similar improvements.