Annals of surgery
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Gallstone ileus is a mechanical bowel obstruction caused by a biliary calculus originating from a bilioenteric fistula. Because of the limited number of reported cases, the optimal surgical method of treatment has been the subject of ongoing debate. ⋯ Gallstone ileus is a rare surgical disease affecting mainly the elderly female population. Mortality rates appear to be lower than previously reported in the literature. Enterotomy with stone extraction alone appears to be associated with better outcomes than more invasive techniques.
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Comparative Study
Indications and outcome of pelvic exenteration for locally advanced primary and recurrent rectal cancer.
The outcome of pelvic exenteration was compared in patients with locally advanced primary (LAP) cancer and recurrent rectal cancer (RRC). ⋯ Resection margin status is more important than primary or recurrent cancer in predicting long-term outcome.
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To assess the feasibility of developing a simulated ward environment in which to assess the ward-based care of surgical patients by clinicians of varying levels of experience (construct validation). ⋯ A high-fidelity, immersive, construct-valid ward simulator has been developed in which to observe and assess ward-based processes of surgical care.
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Observational Study
Surgical ward round quality and impact on variable patient outcomes.
To investigate the relationship between variability in surgical ward round (WR) quality and clinical outcomes. ⋯ Patient assessment during WRs is variable. Less thorough WRs result in delayed diagnoses and preventable complications, and they negatively affect outcomes. Focusing on WR quality and training may improve patient care.