Annals of surgery
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Clinical Trial
Implementation of an Effective Strategy for Teaching Nontechnical Skills in the Operating Room: A Single-blinded Nonrandomized Trial.
To evaluate the effectiveness of debriefing and feedback on intraoperative nontechnical performance as an instructional strategy in surgical training. ⋯ Debriefing and feedback in the OR may represent an effective strategy to ensure development of nontechnical skills in competency-based education.
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Laparoscopic sleeve gastrectomy (SG) is an upcoming procedure in bariatric surgery and is currently performed worldwide. Staple line leakage, as the most frequent and most feared complication, is still a major concern. ⋯ Owing to the growing experience a constant decrease in the leakage rate after SG has been observed. Staple line disruption may still lead to sepsis, multiorgan dysfunction, and increased mortality. The results of the current study demonstrated that there are factors that increase the risk of leakage and which would enable surgeons to define risk groups, select patients more carefully, and offer closer follow-up during the postoperative course with early recognition and adequate treatment.
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Comparative Study
Live Donor Liver Transplantation With Older (≥50 Years) Versus Younger (<50 Years) Donors: Does Age Matter?
To compare the outcome of adult live donor liver transplantation (LDLT) with grafts from older versus younger donors. ⋯ Right lobe LDLT with donors aged 50 years or older results in acceptable recipient outcome without increased donor morbidity or mortality. Potential live donors should not be declined on the basis of age alone.
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To identify unplanned emergency resource utilization in the perioperative period following bariatric surgery. ⋯ Unplanned perioperative healthcare utilization is a significant burden incurred by the bariatric population. A clear opportunity is identified for improvement in healthcare delivery-particularly for high-risk and high-frequency utilizers. Presentation to nonindex hospitals has important implications to the accuracy of current patient safety and quality outcomes measures. System measures designed to capture all unplanned resource utilization, not just those to index hospitals, are crucial for accurate evaluation.
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We examined whether an early warning score (EWS) could predict inpatient complications in surgical patients. ⋯ Critical postoperative complications can be preceded by rising EWS. Interventional studies are needed to evaluate whether EWS can reduce the severity of postoperative complications and mortality for surgical patients through early identification and intervention.