American journal of surgery
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A 39-year old man was admitted to our hospital with a chest stab wound. The stab wound was approximately 3 cm long by 4 cm deep and located in the subxiphoid process area. ⋯ The patient was treated by conservative therapy, and the pneumopericardium spontaneously disappeared after 5 days. The patient was discharged on hospital day 7.
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Breast magnetic resonance imaging (MRI) has been recommended increasingly in the preoperative setting for patients newly diagnosed with malignancy to evaluate tumor extent, multicentricity, and contralateral disease. ⋯ Breast MRI is recommended for preoperative evaluation of the newly diagnosed breast cancer patient.
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The current study compared the outcome of morbidly obese patients undergoing laparoscopic versus open appendectomy. ⋯ In the morbidly obese, laparoscopic appendectomy performed for acute and perforated appendicitis is associated with a shorter length of stay and lower morbidity and costs. Laparoscopic appendectomy should be the procedure of choice for the treatment of acute appendicitis in the morbidly obese population.
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Strategies for splenic preservation for trauma patients have gained acceptance; however, meaningful outcome evaluations have not been performed. To better understand the consequences of managing patients with splenic injuries, the short-term outcomes of different types of management strategies were examined. We defined splenic preservation as observation of splenic injury, splenic embolization, and splenorrhaphy. We defined splenic salvage as splenic embolization and splenorrhaphy. ⋯ In the adult population, splenic preservation has 2-fold and splenic salvage close to 3-fold morbidity compared with immediate splenectomy in management of patients with blunt and penetrating splenic injuries.
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Recent developments in the surgical literature highlight the need for assessment of nontechnical skills in surgery. We report a revision of the NOn-TECHnical Skills (NOTECHS) scale of the aviation industry for use in surgery and detailed analysis on its reliability. ⋯ Assessment of surgical nontechnical skills is becoming a training priority. The present evidence suggests that the revised NOTECHS scale exhibits good reliability. Further empirical research should assess the validity of the scale.