Journal of the American College of Surgeons
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Clinical Trial
Getting a head start: high-fidelity, simulation-based operating room team training of interprofessional students.
Effective teamwork in the operating room (OR) is often undermined by the "silo mentality" of the differing professions. Such thinking is formed early in one's professional experience and is fostered by undergraduate medical and nursing curricula lacking interprofessional education. We investigated the immediate impact of conducting interprofessional student OR team training using high-fidelity simulation (HFS) on students' team-related attitudes and behaviors. ⋯ High-fidelity simulation OR interprofessional student team training improves students' team-based attitudes and behaviors. Students tend to overestimate their team-based behaviors.
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Randomized Controlled Trial Comparative Study
Reduced postoperative chronic pain after tension-free inguinal hernia repair using absorbable sutures: a single-blind randomized clinical trial.
Chronic pain after inguinal hernia repair occurs in 16% to 62% of patients. The underlying mechanism probably involves sensory nerve damage and abnormal healing that might be influenced by the materials chosen for the procedure. We hypothesize that nonabsorbable sutures used for mesh fixation to the surrounding tissues are associated with higher rates of chronic groin pain after surgery. ⋯ Nonabsorbable suture use in inguinal hernia repair is associated with a higher rate of chronic pain and a longer time to pain disappearance as compared with absorbable sutures.
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Review Meta Analysis Comparative Study
Minimally-invasive vs open pancreaticoduodenectomy: systematic review and meta-analysis.
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Traumatic brain injury (TBI) is one of the most common causes of injury-related morbidity and mortality. Access to neurosurgical services is critical to optimal outcomes through reduction of secondary injury. We sought to evaluate variations in access to neurosurgical care across a regional trauma system. ⋯ Considerable variation in delivery of initial care to TBI patients was identified. Factors such as age and injury characteristics were associated with TC access. Because early TC care in TBI confers survival benefits, the demonstrated variability necessitates improvements in access to care for patients with severe head injuries.
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Postoperative chylothorax is a rare, but potentially fatal complication after esophagectomy. Preventive measures aimed at decreasing the incidence of chyle leakage after minimally invasive esophagectomy (MIE) could potentially reduce the high postoperative mortality associated with this complication. However, previous techniques are traumatic and time consuming. We present a simple method in the prophylaxis of chylothorax after MIE. ⋯ Preoperative oral administration of milk facilitates visualization of the thoracic duct and minimizes the risk of iatrogenic injury to the thoracic duct during thoracoscopic esophagectomy. It is a simple and safe method for preventing chyle leakage after MIE. A randomized and controlled trial is required to confirm these findings.