Annals of surgery
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To examine the relation between hospital teaching status and surgical outcomes for both emergency and elective general surgery cases using a national database. ⋯ Teaching status is associated with increased risk of IHM after emergency cases. POC profiles also differ by TH status. Investigation of the way in which systems-level variables that differ between TH and NTH contribute to postoperative outcomes may identify novel targets for performance improvement.
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Randomized Controlled Trial Comparative Study
Ex vivo technical skills training transfers to the operating room and enhances cognitive learning: a randomized controlled trial.
Surgical training in the operating room includes acquiring technical skills and cognitive knowledge. Technical skills training on simulated models has been shown to improve technical performance in the operating room, and may also enhance the acquisition of other skills by freeing cognitive capacity. This has yet to be investigated. ⋯ Technical skills training using a low fidelity synthetic simulator resulted in improved technical performance in the operating room, and enhanced the ability of residents to attend to cognitive components of surgical expertise.
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Comparative Study
The management of synchronous bilateral Wilms tumor: a report from the National Wilms Tumor Study Group.
To provide guidelines for future trials, we reviewed the outcomes of children with synchronous bilateral Wilms tumors (BWT) treated on National Wilms Tumor Study-4 (NWTS-4). ⋯ The current analysis of patients with BWT treated on NWTS-4 shows that preservation of renal parenchyma is possible in many patients after initial preoperative chemotherapy. The incidence of end-stage renal disease remains significantly higher in children with BWT. Future studies are warranted to address the need for earlier biopsy in nonresponsive tumors and earlier definitive surgery to recognize unfavorable histology in these high-risk patients.
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Comparative Study
Incidence and significance of Delphian node metastasis in papillary thyroid cancer.
The objective of this study was to determine the incidence and significance of Delphian node (DN) metastasis in papillary thyroid cancer. ⋯ Metastatic involvement of the DN is often associated with ETE and increased incidence of metastatic disease to the central and lateral neck compartments. If the DN is positive on intraoperative frozen section, careful evaluation of the central and lateral nodal compartments is essential.
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The purpose of this study was to characterize the clinicopathological features of invasive carcinomas arising in intraductal papillary mucinous neoplasms of the pancreas (IPMN) by histological subtype of the invasive component and to compare the outcomes of these patients to a cohort of matched patients with conventional ductal pancreatic adenocarcinoma. ⋯ In this study, the colloid carcinoma histological subtype of invasive IPMN had a more statistically favorable survival outcome than the tubular subtype. Patients with invasive tubular IPMN had no statistically significant difference in survival as matched patients with conventional ductal pancreatic carcinoma.