Annals of surgery
-
Randomized Controlled Trial
STOP signs: A Population-Based Interrupted Time Series Analysis of Antibiotic Duration for Complicated Intra-Abdominal Infection Before and After the Publication of a Landmark RCT.
To determine if the STOP-IT randomized controlled trial changed antibiotic prescribing in patients with Complicated Intraabdominal Infection (CIAI). ⋯ For appendiceal or biliary sources of CIAI, antibiotic duration was commensurate with the experimental arm of STOP-IT. For other sources, antibiotic duration was long and did not change in response to trial publication. Additional implementation science is needed to improve antibiotic stewardship.
-
Multicenter Study
Treatment and Outcomes of Congenital Ovarian Cysts: A Study by the Canadian Consortium for Research in Pediatric Surgery (CanCORPS).
We conducted a multicenter study to assess treatments and outcomes in a national cohort of infants with congenital ovarian cysts. ⋯ Most congenital ovarian cysts are asymptomatic and spontaneously resolve. Early surgical intervention does not increase ovarian preservation.
-
We expand the application of cost frontiers and introduce a novel approach using qualitative multivariable financial analyses. ⋯ In summary, we demonstrate that multivariable cost (or performance) frontiers can track a net increase in profitability associated with fellowship implementation despite diminishing returns at higher caseloads.
-
Examine feasibility and construct validity of Pictorial Fit-Frail scale (PFFS) for the first time in older surgical patients. ⋯ PFFS had good feasibility and construct validity among older surgical patients when compared to previously validated frailty measurements.
-
Multicenter Study
Controversy Over Liver Transplantation or Resection for Neuroendocrine Liver Metastasis: Tumor Biology Cuts the Deal.
In patients with neuroendocrine liver metastasis (NELM), liver transplantation (LT) is an alternative to liver resection (LR), although the choice of therapy remains controversial. In this multicenter study, we aim to provide novel insight in this dispute. ⋯ This multicentric study in patients with NELM demonstrates a survival benefit of LT over LR. This benefit depends on adherence to selection criteria, in particular low-grade tumor biology and Milan criteria, and must be balanced against potential risks of LT.