American journal of surgery
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There is a pressing need for an intraoperative assessment tool that meets high standards of reliability and validity to use as an outcome measure for different training strategies. The aim of this study was to develop a tool specific for laparoscopic skills and to evaluate its reliability and validity. ⋯ These data indicate that GOALS is feasible, reliable, and valid. They also suggest that it is superior to the task checklist and VAS for evaluation of technical skill by experienced raters. The findings support the use of GOALS in the training and evaluation of laparoscopic skills.
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Comparative Study
Implementation of a Web- and simulation-based curriculum to ease the transition from medical school to surgical internship.
Starting a surgical internship is a stressful experience. We developed a web and simulation-based curriculum to ease this transition. ⋯ A web and simulation-based curriculum for incoming house staff is feasible. Studies are underway to validate this novel method and to expand its use for surgical education.
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Comparative Study
Influence of workers' compensation eligibility upon functional recovery 10 to 28 years after polytrauma.
Previous studies have shown that work-related injuries are often associated with inferior outcomes. The aim of the current study was to compare the long-term functional outcome after polytrauma between work-related and non-work-related injuries at a minimum follow-up of 10 years. ⋯ Polytrauma patients receiving workers' compensation achieve significantly inferior long-term outcomes than other patients. The obtained results demonstrate that psychosocial variables such as insurance status have a significant impact on the functional recovery following polytrauma.
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Randomized Controlled Trial Multicenter Study Clinical Trial
A controlled randomized multicenter trial of pancreatogastrostomy or pancreatojejunostomy after pancreatoduodenectomy.
Only 2 large (more than 100 patients) prospective trials comparing pancreatogastrostomy (PG) with pancreatojejunostomy (PJ) after pancreatoduodenectomy (PD) have been reported until now. One nonrandomized study showed that there were less pancreatic and digestive tract fistula with PG, whereas the other, a randomized trial from a single high-volume center, found no significant differences between the two techniques. ⋯ The type of pancreatoenteric anastomosis (PJ or PG) after PD does not significantly influence the rate of patients with one or more IAC and/or pancreatic fistula or the severity of complications.
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Case Reports
Hand-assisted laparoscopic pylorus-preserving pancreaticoduodenectomy for pancreas head disease.
Laparoscopic procedures for pancreatic surgery have been significantly improved recently; however, the number of successful laparoscopic or laparoscopy-assisted pancreaticoduodenectomies (PDs) has been limited. The limitations could be attributed to the complexity of the reconstruction procedures under laparoscopic observations and the high incidence of critical morbidity with PDs. To overcome the shortcomings, we developed the first hand-assisted laparoscopic pylorus-preserving PD and, in this report, present the case of a patient with a low-grade malignant tumor on the pancreas head.