Annals of surgery
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The aim of this study was a prospective validation of the recently established ISGPS pancreas classification as a parenchymal risk classification system for pancreatic fistula after pancreatoduodenectomy. ⋯ This prospective trial shows that the ISGPS pancreas classification is valid. Patients in risk class D are prone to POPF independently of other factors. Therefore, all future publications on pancreatic surgery should report the risk class according to the ISGPS pancreas classification to allow for a better comparison of reported cohorts.
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The Impact of Low Workplace Support During Pregnancy on Surgeon Distress and Career Dissatisfaction.
To describe the impact of lack of workplace support (LOWS) for obstetric health on surgeon distress and career satisfaction. ⋯ LOWS for maternal-fetal health concerns is associated with burnout, low quality of life, and career dissatisfaction. The work environment is a modifiable factor requiring system-level interventions to limit clinical work during pregnancy and provide fair compensation for covering surgeons. Supporting surgeons during pregnancy is a short-term investment with long-term implications for improving longevity and diversity of the workforce.
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Randomized Controlled Trial Multicenter Study
The Effect of Perioperative Dexamethasone on Postoperative Complications after Pancreaticoduodenectomy: A Multicenter Randomized Controlled Trial.
To evaluate the effect of perioperative dexamethasone on postoperative complications after pancreaticoduodenectomy. ⋯ Perioperative dexamethasone did not significantly reduce postoperative complications within 30 days after pancreaticoduodenectomy.
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To critically examine the evidence-base for survival benefit of pulmonary metastasectomy (PM) for osteosarcoma (OS) in the pediatric population. ⋯ There is a weak evidence base (level IV) for a survival benefit of PM for OS in pediatric patients likely due to selection bias of "favorable cases." The included studies many of which detailed outdated treatment protocols were not designed in their reporting to specifically address the questions directly. A randomized controlled trial-while ethically challenging in a pediatric population-incorporating modern OS chemotherapy protocols is needed to crucially address any "survival benefit."
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Comparative Study
Variation in Hospital Performance for General Surgery in Younger and Older Adults: A Retrospective Cohort Study.
To compare hospital surgical performance in older and younger patients. ⋯ High surgical mortality rates in younger patients may be driven by both complication and failure-to-rescue rates. There is little overlap between low-mortality hospitals in the older and younger adult populations. Future work must delve into the root causes of this age-based difference in hospital-level surgical outcomes.