Journal of the American College of Surgeons
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Even after negative sentinel lymph node biopsy (SLNB) for primary melanoma, patients who develop in-transit (IT) melanoma or local recurrences (LR) can have subclinical regional lymph node involvement. ⋯ In this study, we demonstrate the technical feasibility and clinical use of repeat SLNB for recurrent melanoma. Performing SLNB cannot only optimize local, regional, and systemic treatment strategies for patients with LR or IT melanoma, but also appears to provide important prognostic information.
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Public reporting of patient and graft outcomes in a national registry and close Centers for Medicare and Medicaid Services oversight has resulted in transplantation being a highly regulated surgical discipline. Despite this, transplantation surgery lacks comprehensive tracking and reporting of perioperative quality measures. Therefore, the aim of this study was to determine the association between a kidney transplantation centers' perioperative quality benchmarking and graft and patient outcomes. ⋯ An objective index of a transplantation center's quality of perioperative care is significantly associated with patient and graft survival.
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Congenital diaphragmatic hernia (CDH) is a frequently lethal birth defect and, despite advances, extracorporeal life support (ie, extracorporeal membrane oxygenation [ECMO]) is commonly required for severely affected patients. Published data suggest that CDH survival after 2 weeks on ECMO is poor. Many centers limit duration of ECMO support. ⋯ In patients with severe CDH, improvement in pulmonary function sufficient to wean from ECMO can take 4 weeks or longer, and might require a second ECMO run. Pulmonary outcomes in these CDH patients can still be excellent, and the assignment of arbitrary ECMO treatment durations <4 weeks should be avoided.
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Comparative Study
Subscription to the Surgical Council on Resident Education web portal and qualifying examination performance.
The Surgical Council on Resident Education (SCORE) curriculum for general surgery was developed to guide surgery residents in the acquisition of knowledge for patient care. We hypothesized that residents in programs that subscribed to the SCORE web portal would perform better on the American Board of Surgery (ABS) Surgery Qualifying Examination (QE). ⋯ There was a considerable improvement in mean QE scaled scores for residents in programs that initially subscribed to the SCORE web portal. The percent passing the QE showed a trend toward improvement for subscribing programs and their residents. This association is promising and deserves additional investigation.