Annals of surgery
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Synthesize the findings from individual qualitative studies about surgeons' account of their practice. ⋯ Surgeons' emphasis on technical aspects, individuality, and performance seems to impede a modern patient-centered approach to care and to act as a barrier to well-being. Our findings suggest that taking into account the relational and emotional dimensions of surgical practice (both with patients and within the institution) might improve surgical innovation, surgeons' well-being, and the attractiveness of this specialty.
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Review Meta Analysis
The effect of preservation solutions for storage of liver allografts on transplant outcomes: a systematic review and meta-analysis.
The objective of this review was to systematically evaluate the evidence comparing preservation fluids for liver allografts on transplant outcomes. ⋯ Data from included studies suggest that preservation of deceased donor livers with the University of Wisconsin or Celsior solution results in equivalent outcomes.
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Review Meta Analysis
Systematic review of learning curves for minimally invasive abdominal surgery: a review of the methodology of data collection, depiction of outcomes, and statistical analysis.
To determine how minimally invasive surgical learning curves are assessed and define an ideal framework for this assessment. ⋯ Assessment of learning curves is needed to inform surgical training and evaluate new clinical procedures. An ideal analysis would account for the degree of complexity of individual cases and the inherent differences between surgeons. There is no single proxy that best represents the success of surgery, and hence multiple outcomes should be collected.
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Review Meta Analysis
The comparison of self-gripping mesh and sutured mesh in open inguinal hernia repair: the results of meta-analysis.
The aim of this study was to compare the postoperative chronic pain and other postoperative complications after the use of the self-gripping Progrip meshes and the application of conventional suture-fixed Lichtenstein procedure. ⋯ When the self-gripping mesh compared with the conventional suture fixed Lichtenstein technique, while there was a difference in operative time, there were no differences in pain (chronic or acute) or other complications.
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Review Meta Analysis
A systematic review of the effects of resident duty hour restrictions in surgery: impact on resident wellness, training, and patient outcomes.
In 2003, the Accreditation Council for Graduate Medical Education (ACGME) mandated 80-hour resident duty limits. In 2011 the ACGME mandated 16-hour duty maximums for PGY1 (post graduate year) residents. The stated goals were to improve patient safety, resident well-being, and education. A systematic review and meta-analysis were performed to evaluate the impact of resident duty hours (RDH) on clinical and educational outcomes in surgery. ⋯ Recent RDH changes are not consistently associated with improvements in resident well-being, and have negative impacts on patient outcomes and performance on certification examinations. Greater flexibility to accommodate resident training needs is required. Further erosion of training time should be considered with great caution.