Annals of surgery
-
To identify predictors of positive circumferential resection margin following rectal cancer resection in the United States. ⋯ Despite advances in surgical technique and multimodality therapy, rates of positive circumferential resection margin remain high in the United States. Several tumor and treatment characteristics were identified as independent risk factors, and advances in rectal cancer care are necessary to approach the outcomes seen in other countries.
-
We aimed to investigate the optimal cutoff value of circumferential resection margin (CRM) of esophageal squamous cell carcinoma (ESCC) in patients who underwent radical esophagectomy. ⋯ In patients with ESCC, we developed new, 3-tiered CRM criteria providing more detailed prognostic information than the 2-tiered criteria.
-
Reframing healthcare delivery in terms of the principles of complex adaptive systems has practical implications for addressing the challenges in improving surgical care. In an Integrated Practice Unit (IPU) - such as a surgical service line, a surgical in-patient floor, or an acute care unit - a diverse group of caregivers must interact in a highly interdependent fashion in an environment characterized by ambiguity, uncertainty, and time constraints. Understanding of the concept of teaming and the tenets of relational coordination are crucial to the promotion of a successful patient-centric approach to surgical care.