American journal of surgery
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Acknowledging the need to improve team communication and coordination among health care providers, health care administrators and improvement officers have been quick to endorse and invest in aviation crew resource management (CRM). Despite the increased interest in CRM there exists limited data on the effectiveness of CRM to change team behavior and performance in clinical settings. ⋯ The results highlight many of the challenges the health care industry faces in its efforts to adapt CRM from aviation to medicine. Additional research is needed to develop and test new team training methods and performance feedback mechanisms for clinical teams.
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Comparative Study
Robotic-assisted adrenalectomy: what advantages compared to lateral transperitoneal laparoscopic adrenalectomy?
This study evaluates the perioperative outcomes of robotic-assisted adrenalectomy (RA) compared with lateral transperitoneal laparoscopic adrenalectomy (LA). ⋯ After a learning curve of 20 cases, RA has similar perioperative outcomes compared to lateral transperitoneal LA. Several criteria (previous laparoscopic expertise, first assistant's skill and tumor side) remain determinative on RA operative time.
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Comparative Study
Effect of systemic corticosteroids on elective left-sided colorectal resection with colorectal anastomosis.
The impact of systemic steroid therapy on surgical outcome after elective left-sided colorectal resection with rectal anastomosis is not well known. ⋯ Patients on steroids have a higher incidence of postoperative complications after elective left-sided colorectal resection with rectal anastomosis.
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Wandering spleen, a rare clinical entity with a high incidence of splenic torsion and infarction, was preoperatively diagnosed in a 28-year-old woman. Axial computed tomography showed the absence of the spleen in the left subphrenic space and a spleen-like mass in the pelvis, suggestive of a wandering spleen. A coronal contrast-enhanced computed tomography image exhibited the enlarged spleen suspended by elongated, dilated, and somewhat tortuous splenic vessels. Owing to the symptomatic splenomegaly with hypersplenism and chronic torsion, laparoscopic splenectomy was performed.
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Case presentation and literature review for intestinal malrotation presenting in an adult. Although the number of patients with this condition that escape infancy undiagnosed is not clear, it is clear that when the rare patient presents as an adult it can be a perplexing situation for surgeons not familiar with the presenting signs and anatomy. This confusion can lead to diagnostic and intraoperative errors.