Journal of the American College of Surgeons
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Comparative Study
AJCC Cancer Staging Manual 7th edition criteria for colon cancer: do the complex modifications improve prognostic assessment?
The 7th edition of the AJCC Cancer Staging Manual (AJCC-7) includes substantial changes for colon cancer (CC), which are particularly complex in patients with stage II and III disease. We used a national cancer database to determine if these changes improved prediction of survival. ⋯ The AJCC-7 staging of CC does not address all survival discrepancies, regardless of the number of lymph nodes examined. Consideration of other prognostic factors is critical for decisions about therapy, particularly for patients with stage II CC.
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Clinical Trial
Implementation of an interactive virtual-world simulation for structured surgeon assessment of clinical scenarios.
A novel simulation technology has emerged through the use of online 3-dimensional virtual worlds in which it is feasible to create virtual patients. This study establishes the face, content and construct validity of online 3-dimensional virtual patients in Second Life (a 3-dimensional virtual world accessible via the Internet). ⋯ This novel form of simulation demonstrated high face and content validity. Performance assessed in managing a series of virtual patients varies with different levels of surgical training. This simulation can be used to differentiate among these levels and can be implemented as a unique form of assessment.
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Comparative Study
Outcomes of hepatectomy for hepatolithiasis based on 3-dimensional reconstruction technique.
The aim of our study was to evaluate the perioperative and long-term outcomes of hepatectomy based on 3-dimensional reconstruction technique for hepatolithiasis by comparing it with traditional hepatectomy. ⋯ Hepatectomy for hepatolithiasis based on 3-dimensional reconstruction technique is feasible and safe in selected patients. Compared with traditional hepatectomy, it is more effective for diagnosis and treatment of hepatolithiasis.
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Although previous studies have shown that radiologic intussusception reduction is more likely at children's hospitals, no study to date has compared outcomes among children advancing to surgical intervention. We hypothesized that rates of bowel resection would differ between hospitals with and without pediatric surgeons. ⋯ Bowel resection during operative intussusception reduction is more likely at hospitals without pediatric surgeons, and is associated with increased complications. Improved outcomes may be achieved by efforts aimed at standardizing care and decreasing variability in the treatment of pediatric intussusception.