Journal of the American College of Surgeons
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Comparative Study
Lobectomy by Video-Assisted Thoracic Surgery vs Muscle-Sparing Thoracotomy for Stage I Lung Cancer: A Critical Evaluation of Short- and Long-Term Outcomes.
Propensity-matched studies have shown lobectomy by VATS to be superior to thoracotomy. However, these studies do not control for institution or surgeon expertise and do not compare VATS strictly with muscle-sparing thoracotomy (MST). ⋯ Our current comparison of VATS vs MST, from a single surgeon experienced with both approaches, found operative time (favoring MST) and hospital days (favoring VATS) to be the only difference between the 2 groups; and major outcomes, such as postoperative complications, disease-free survival, and overall survival, were not different. A multi-institution randomized trial should be considered before deeming any one approach to be superior.
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Computed tomography angiography (CTA) has been increasingly used in traumatic brain injury (TBI) patients to uncover vascular lesions that might have preceded the trauma and caused the bleed. This study aims to evaluate the usefulness of head CTA in the initial care of blunt TBI patients. ⋯ Head CTA is commonly used after blunt TBI but does not alter management and should be abandoned in the absence of clear indications.
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The objective of this survey was to provide a review of the American College of Surgeons (ACS) scholarship activity. ⋯ The ACS scholarship has a significant impact on the recipient's academic career, even in the setting of increasing clinical burdens. This program also appears to tangentially identify surgeons who become leaders in academic surgery.
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Clinical Trial
Educating surgeons may allow for reduced intraoperative costs for inguinal herniorrhaphy.
Our aim was to determine the impact of surgeon education regarding disposable supply costs to reduce intraoperative costs for a common procedure such as inguinal hernia repair. ⋯ Surgeon education and empowerment may significantly reduce the cost of disposable equipment in laparoscopic and open inguinal hernia repair. This simple educational technique could prove financially beneficial throughout various procedures and disciplines.
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Infants with serious congenital heart disease (CHD) appear to be at increased risk for necrotizing enterocolitis (NEC). This study aimed to quantify the incidence and mortality of NEC among very low birth weight (VLBW) neonates with serious CHD, and identify specific CHD diagnoses at the highest risk for developing NEC. ⋯ The incidence of NEC is significantly higher in VLBW neonates when CHD is present. The mortality of CHD and NEC together is substantially higher than that with each disease alone. Infants with atrioventricular canal appear to have higher risk for developing NEC than other CHD diagnoses. In addition to providing benchmark incidence and mortality data, these findings may have utility in the further study of the pathophysiology of NEC.