Annals of surgery
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To examine whether case managers affect patient evaluation/treatment/outcome and staffing requirements during Multiple Casualty Incidents (MCIs). ⋯ During an MCI, case managers increase surge capacity by improving efficacy (workup/treatment times and use of resources) and may improve patient care via increased personal accountability, continuity of care, and involvement in treatment decisions.
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To familiarize surgeons with the use of funnel plots as a control tool to assess quality in surgery. ⋯ More widespread application of funnel plots in surgery will help to overcome some of the existing difficulties in assessing and reporting performance and identifying evidence-based information. The assessment and changes in future healthcare delivery could be partly influenced by further development of funnel plot methodology.
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To study the impact of war on the workload/finances of a community hospital adjacent to the front. ⋯ Treatment of civilian/military casualties resulted in reorganization of hospital operations with significantly decreased accrued revenue. The bulk of the GSD workload shifts from the OR to the ED/wards while Orthopedic procedures and ICU beds become bottlenecks to patient flow during war.
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To describe the characteristics of patients undergoing multiple groin hernia repairs and to identify strategies that prevent further recurrence. ⋯ Laparoscopic preperitoneal repair provides the best surgical outcome in repeated groin hernia recurrence.
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Preoperative chemoradiotherapy (CRT) followed by esophagectomy is becoming one of the standard treatment strategies for esophageal cancer. Pathologic complete response (pCR) after CRT is the best predictor of survival in squamous cell carcinoma (SCC) of the esophagus. Although no adjuvant treatment is recommended for individuals who achieve pCR, approximately 30% of these patients develop recurrence. Herein we sought to retrospectively investigate the independent predictors of tumor recurrence in this patient group. ⋯ We have shown that up to 31.4% of patients with esophageal SCC who achieve pCR develop tumor recurrence thereafter. Pretherapy T3-4 disease was a strong and independent adverse risk factor for 5-year tumor recurrence, DSS and DFS. High-risk patients with T3-4 disease should be followed with a strict surveillance protocol.