World journal of surgery
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World journal of surgery · Mar 2009
Laparoscopic surgical skills assessment: can simulators replace experts?
Global Rating Scales (GRS) quantify and structure subjective expert assessment of skill. Hybrid simulators measure performance during physical laparoscopic tasks through instrument motion analysis. We assessed whether motion analysis metrics were as accurate as structured expert opinion by using GRS. ⋯ Metrics correlate well with GRS assessment, supporting concurrent validity. Metrics predict experience level as accurately as global rating and are construct valid. Hybrid simulators could provide resource-efficient feedback, freeing trainers to concentrate on teaching.
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Nonoperative management (NOM) of kidney gunshot injuries as an alternative to surgical exploration is rarely reported. The aim of this study was to assess the feasibility and safety of selective NOM of such injuries. ⋯ Selective NOM of patients with kidney gunshot injuries is a feasible, safe, effective alternative to routine exploration.
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World journal of surgery · Mar 2009
Review Meta AnalysisCarotid artery stenting versus carotid endarterectomy: systematic review and meta-analysis.
The aim of this study was to evaluate and investigate the complications of carotid endarterectomy (CEA) and carotid artery stenting (CAS) by performing a meta-analysis based on prospective randomized controlled trials (RCTs). ⋯ CAS is equal to CEA with regard to the incidence of stroke/death. These procedures may be considered complementary rather than competing modes of therapy, each of which can be optimized with careful patient selection. CAS with an EPD may be appropriate in certain patients, and in general CAS should be considered cautiously in symptomatic patients.
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World journal of surgery · Mar 2009
Randomized Controlled Trial Comparative StudyA prospective randomized trial comparing traditional and fast-track patient care in elective open infrarenal aneurysm repair.
Fast-track recovery programs have led to reduced patient morbidity and mortality after major surgery. In terms of elective open infrarenal aneurysm repair, no evidence is available about such programs. To address this issue, we have conducted a randomized prospective pilot study. ⋯ An optimized patient care program in open infrarenal aortic aneurysm repair shows favorable results concerning need for postoperative assisted mechanical ventilation, time to full enteral feeding, and incidence of medical complications. Further ranomized multicentric trials are necessary to justify broad implementation (clinical trials. gov identifier NCT 00615888).