Annals of surgery
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We describe the first successful penis transplant in the United States in a patient with a history of subtotal penectomy for penile cancer. ⋯ We have shown that it is feasible to perform penile transplantation with excellent results. Furthermore, this experience demonstrates that penile transplantation can be successfully performed with conventional immunosuppression. We propose that our successful penile transplantation pilot experience represents a proof of concept for an evolution in reconstructive transplantation.
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Multicenter Study
Effect of Preoperative Diabetes Management on Glycemic Control and Clinical Outcomes after Elective Surgery.
The aim of this study was to evaluate whether preoperative diabetes management can improve glycemic control and clinical outcomes after elective surgery. ⋯ Preoperative and inpatient diabetes management improves glycemic control on the day of surgery and postoperatively and decreases the incidence of hypoglycemia. These changes may eventually improve clinical outcomes. Although statistically significant, the decrease in LOS was of equivocal clinical significance in this study.
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Multicenter Study
Strategies for Reducing Population Surgical Costs in Medicare: Local Referrals to Low-cost Hospitals.
We sought to assess hospital cost variation for elective inpatient surgical procedures within small geographic areas. ⋯ Significant excess expenditures are incurred due to care at hospitals with substantially higher average costs than their nearby peers. This finding highlights the potential for substantial savings without the need to refer patients over long distances. Some of the procedures studied may represent appropriate targets for future Medicare bundled payment initiatives.
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To describe accurately the pattern, timing, and predictors of disease recurrence after a potentially curative resection for pancreatic ductal adenocarcinoma (PDAC). ⋯ Specific recurrence locations have different predictive factors and possess distinct RFS curves, supporting the hypothesis that unique biological differences exist among tumors leading to distinct patterns of recurrence.