Annals of surgery
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Randomized Controlled Trial
Instructor feedback versus no instructor feedback on performance in a laparoscopic virtual reality simulator: a randomized trial.
To investigate the impact of instructor feedback versus no instructor feedback when training a complex operational task on a laparoscopic virtual reality simulator. ⋯ Instructor feedback increases the efficiency when training a complex operational task on a virtual reality simulator; time and repetitions used to achieve a predefined proficiency level were significantly reduced in the group that received instructor feedback compared with the control group.
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Randomized Controlled Trial Comparative Study
Effect of billroth II or Roux-en-Y reconstruction for the gastrojejunostomy on delayed gastric emptying after pancreaticoduodenectomy: a randomized controlled study.
Delayed gastric emptying (DGE) is one of the major complications after pancreaticoduodenectomy (PD), occurring in 14% to 61% of cases. There have been no studies that compare the incidence of DGE in terms of the reconstruction method of gastrojejunostomy performed in subtotal stomach-preserving pancreaticoduodenectomy (SSPPD). The objective of this study was to evaluate the superiority of Billroth II (B-II) to Roux-en Y (R-Y) reconstruction on decreasing the incidence of delayed gastric emptying DGE after SSPPD by a prospective randomized controlled trial. ⋯ It is suggested that the incidence of DGE after SSPPD can be decreased by using B-II rather than R-Y reconstruction for gastrojejunostomy.(Clinical Trials Registry, UMIN-CTR: http://www.umin.ac.jp/ctr/, ref no. UMIN000003535).
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Review Meta Analysis Comparative Study
Laparoscopic anterior 180-degree versus nissen fundoplication for gastroesophageal reflux disease: systematic review and meta-analysis of randomized clinical trials.
To compare short- and long-term outcome after 180-degree laparoscopic anterior fundoplication (180-degree LAF) with laparoscopic Nissen fundoplication (LNF). ⋯ At 1 and 5 years, dysphagia and gas-related symptoms are lower after 180-degree LAF than after LNF, and esophageal acid exposure and esophagitis are similar, with no differences in heartburn scores, patient satisfaction, dilatations, and reoperation rate. These results lend level 1a support for the use of 180-degree LAF for the surgical treatment of gastroesophageal reflux disease.
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To develop a projection model to forecast the head count and full-time equivalent supply of surgeons by age, sex, and specialty in the United States from 2009 to 2028. ⋯ The length of time it takes to train surgeons, the anticipated decrease in hours worked by surgeons in younger generations, and the potential decreases in graduate medical education funding suggest that there may be an insufficient surgeon workforce to meet population needs. Existing maldistribution patterns are likely to be exacerbated, leading to delayed or lost access to time-sensitive surgical procedures, particularly in rural areas.
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Review Meta Analysis
Decision aids for patients facing a surgical treatment decision: a systematic review and meta-analysis.
To summarize the evidence available on the effects of decision aids in surgery. ⋯ Offering a decision aid increases the number of patients who prefer conservative or less invasive treatment options. As decision aids improve patient knowledge and lower decisional conflict without raising anxiety levels, they have a place in surgery to help surgeons and patients achieve well-considered and shared treatment decisions.