Annals of surgery
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The COVID-19 pandemic has posed unique challenges for evaluating general surgery residency applicants to MATCH 2021. In the absence of away rotations, programs are likely to afford greater importance to objective data to stratify the applicant pool and medical students are likely to experience difficulty in thoroughly assessing each program. Virtual rotations, meet-and-greet events conducted before the application submission deadline, personality testing before extending interviews, standardized letters of recommendation, and skills testing can serve as valuable adjuncts for determining the best applicant-program fit. Finally, an interview limit which sets the bar for the maximum number of accepted interviews per applicant per specialty can offer a level playing field in the absence of time and cost limitations associated with travel.
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Meta Analysis
A Single Preoperative Dose of Tranexamic Acid Reduces Perioperative Blood Loss: A Meta-analysis.
To review the efficacy and safety of a single dose of intravenous tranexamic acid (TXA) given preoperatively. ⋯ While there is a growing body of evidence to support benefits of perioperative TXA use, this is the first meta-analysis to identify the efficacy and safety of a single preoperative dose of IV TXA. The potential implications for expanding the use of preoperative TXA for elective day surgery procedures is substantial. Preoperative intravenous TXA reduced perioperative blood loss and transfusion requirements in a variety of surgical disciplines without increasing the risk of thromboembolic events. Therefore, it should be considered for prophylactic use in surgery to reduce operative bleeding.
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Multicenter Study
Practice Patterns and Perioperative Outcomes of Laparoscopic Pancreaticoduodenectomy in China: A Retrospective Multicenter Analysis of 1029 Patients.
The aim of the study was to analyze the outcomes of patients who have undergone laparoscopic pancreaticoduodenectomy (LPD) in China. ⋯ LPD is technically safe and feasible, with acceptable rates of morbidity and mortality. Nonetheless, long learning curves, low-volume hospitals, and surgical inexperience are associated with higher rates of complications and mortality.
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Randomized Controlled Trial Observational Study
Identifying Naturalistic Coaching Behavior Among Practicing Surgeons in the Operating Room.
The aim of this study was to identify examples of naturalistic coaching behavior among practicing surgeons operating together by analyzing their intraoperative discussion. ⋯ In naturalistic discussions between practicing surgeons in the operating room, numerous examples of unprompted coaching behavior were identified that target intraoperative performance. Prominent coaching gaps-constructive feedback and peer learning support-were also observed. Surgical coach trainings should address these gaps.
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Trends in the Geospatial Distribution of Inpatient Adult Surgical Services across the United States.
The aim of this study was to define trends in the geographic distribution of surgical services in the United States to assess possible geographic barriers and disparities in access to surgical care. ⋯ Although the number of rural hospitals decreased over the last decade, the number of large, academic medical centers has increased; in turn, there has been an almost doubling in the number of people who live outside a 60-minute driving range to a hospital capable of performing surgery.