Annals of surgery
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Multicenter Study Comparative Study
One-millimeter cancer-free margin is curative for colorectal liver metastases: a propensity score case-match approach.
To investigate the influence of clear surgical resection margin width on disease recurrence rate after intentionally curative resection of colorectal liver metastases. ⋯ One-mm cancer-free resection margin achieved in patients with colorectal liver metastases should now be considered the standard of care.
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Multicenter Study Comparative Study
It's big surgery: preoperative expressions of risk, responsibility, and commitment to treatment after high-risk operations.
To identify the processes, surgeons use to establish patient buy-in to postoperative treatments. ⋯ Surgeons who perform high-risk operations communicate the risks of surgery and express their commitment to the patient's survival. However, they rarely discuss prolonged life-supporting treatments explicitly and patients do not discuss their preferences. It is not possible to determine patients' desires for prolonged postoperative life support on the basis of these preoperative conversations alone.
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Multicenter Study Comparative Study
Pilot testing of a model for insurer-driven, large-scale multicenter simulation training for operating room teams.
To test the feasibility of implementing a standardized teamwork training program with full operating room teams in multiple institutions, driven by malpractice insurer support and incentives. ⋯ A standardized multicenter team training program involving full operative teams is feasible with high-fidelity simulation and modest compensation for lost time. The vast majority of the multidisciplinary participants believed the course to have had a meaningful impact on their approach to clinical practice.
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Randomized Controlled Trial Multicenter Study Comparative Study
Acute aortic dissection type A: age-related management and outcomes reported in the German Registry for Acute Aortic Dissection Type A (GERAADA) of over 2000 patients.
To determine the association between age and clinical presentation, management and surgical outcomes in a large contemporary, prospective cohort of patients with acute aortic dissection type A (AADA). ⋯ This study reflects current results after surgical treatment of AADA in relation to patient age. Current survival rates are acceptable, even in very elderly patients. The contemporary surgical mortality rate among young patients is lower than that previously reported in the literature. The postoperative stroke incidence does not increase with age.
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Multicenter Study Comparative Study
Impact of obesity on mortality and complications in trauma patients.
To examine the association between obesity and outcomes in injured patients. ⋯ Severely obese trauma patients were at least 30% more likely to die and approximately twice as likely to have a major complication compared with nonobese patients.