American journal of surgery
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Randomized Controlled Trial
Evaluation of a protease inhibitor in the prevention of ischemia and reperfusion injury in hepatectomy under intermittent Pringle maneuver.
The severity of ischemia and reperfusion (I/R) injury is an important determinant of patient outcome in hepatic surgery. The aim of this study was to investigate the efficacy of a protease inhibitor in alleviating I/R injury to human liver in the setting of hepatectomy under intermittent Pringle maneuver. ⋯ This prospective randomized study demonstrated the hepatoprotective effect of a synthetic protease inhibitor in the setting of hepatectomy under the intermittent Pringle maneuver.
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Multicenter Study Comparative Study
How surgical faculty and residents assess the first year of the Accreditation Council for Graduate Medical Education duty-hour restrictions: results of a multi-institutional study.
This study examined how surgical residents and faculty assessed the first year of the Accreditation Council for Graduate Medical Education duty-hour restrictions. ⋯ Few believe that duty-hour restrictions improve patient care or resident training. Residents, especially female residents, view the restrictions more favorably than faculty.
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Although the general literature on stress and performance is extensive, little is known about specific effects of stress in surgical practice. This qualitative study explored key surgical stressors, their impact on performance, and coping strategies used by surgeons. ⋯ Although stress poses significant risks, coping strategies are not taught explicitly during surgical training. This article presents a framework for categorizing surgical stress and suggests key elements for effective coping strategies.
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Comparative Study
Efficacy of supraomohyoid neck dissection in patients with oral squamous cell carcinoma and negative neck.
Supraomohyoid neck dissection (SOHND) has been identified as an appropriate staging procedure to provide valuable pathologic information of the neck for patients with oral squamous cell carcinoma. However, the role of SOHND as a therapeutic procedure, compared with the oncologic results of radical neck dissection, remains controversial for lack of adequate data in current literature. ⋯ SOHND compares favorably with RND for the staging and treatment of patients with oral squamous cell carcinoma and negative neck.
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Rectus sheath hematoma is an uncommon cause of acute abdomen and is known to mimic various common surgical conditions. Although the management is essentially conservative, occasionally a surgical exploration is necessary.