Journal of the American College of Surgeons
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Review Comparative Study
Bariatric Surgery Outcomes in US Accredited vs Non-Accredited Centers: A Systematic Review.
Accreditation for bariatric surgery has been scrutinized recently for its impact on surgical outcomes. This study aimed to systematically examine the medical literature to examine the impact of bariatric accreditation on surgical outcomes. ⋯ This study found that the preponderance of medical evidence supports accreditation for bariatric surgery.
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Liver resection is the most effective treatment for intrahepatic cholangiocarcinoma. Recurrent disease is frequent; however, recurrence patterns are ill-defined and prognostic models are lacking. ⋯ Recurrence patterns are time dependent. Both models as developed and validated in this study classified patients in distinct recurrence risk groups, which can guide treatment recommendations.
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Variation in use of damage control (DC) surgery across trauma centers may be partially driven by surgeon uncertainty as to when it is appropriately indicated. We sought to determine opinions of practicing surgeons on the appropriateness of published indications for trauma DC surgery. ⋯ We identified 38 indications that practicing surgeons agreed appropriately justified the use of DC surgery. Until further studies become available, these indications constitute a consensus opinion that can be used to guide practice in the current era of changing trauma resuscitation practices.
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There is a continuing debate on the best approach for endoscopically benign large polyps that are unsuitable for conventional endoscopic resection. This study aimed to estimate the cancer risk in patients with endoscopically benign unresectable colonic polyps referred for surgery. ⋯ For the majority of endoscopically benign colonic polyps, an oncologic colonic resection may be unnecessary, so advanced endoscopic resection techniques or laparoscopic-assisted polypectomy should be considered. When bowel resection is needed, the resection should be performed, obeying oncologic principles and techniques.
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Burnout is a complex syndrome of emotional distress that can disproportionately affect individuals who work in health care professions. ⋯ The high rates of burnout among general surgery residents are concerning, given the potential impact of burnout on the quality of patient care. Efforts to identify at-risk populations and to design targeted interventions to mitigate burnout in surgical trainees are warranted.