Journal of the American College of Surgeons
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Near-infrared fluorescence cholangiography (NIRFC) improves the clinical effects of laparoscopic cholecystectomy. However, the administration of indocyanine green (ICG) remains controversial. Both the intraoperative (IS, 0.05mg) and preoperative (PS, 0.25mg/kg body weight, 1 day before operation) strategies have been shown to be superior to standard strategy (2.5mg, intraoperative). This trial was designed to determine whether IS offers non-inferior visualization of biliary ducts compared to PS. ⋯ While IS did not improve the SBR, it significantly reduced the FI of the liver background, potentially enhancing the surgeon's subjective perception and thereby increasing the visualization score. Compared to PS, IS offers greater convenience and is more effective in facilitating CVS exposure.
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Prolongation of treatment package time is strongly associated with inferior oncologic outcomes. We examine the effect of creation of a multidisciplinary head and neck clinic on treatment package times. ⋯ Colocalization of radiation oncology and otolaryngology care in multidisciplinary clinic substantially improved time to postoperative radiotherapy and treatment package times. This is likely due to the identification of patients requiring adjuvant radiation earlier in their clinical presentation which in turn allowed for advanced planning and minimization of delays in initiation of adjuvant radiation.
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Academic global surgery consists of collaborative partnerships that address surgical inequities through research, training, education, advocacy, and diplomacy. It has been characterized by increased scholastic production through global surgery publications, dedicated global surgery sessions within scientific conferences, global surgery-specific research grants, database development to support global surgery research, global surgery research fellowships, and global surgery-based academic promotion paradigms. The increased emphasis on global surgery research has been accompanied by multiple ethical challenges. This article reviews critical ethical dilemmas presented by global surgery research efforts and proposes interventions on the partnership, infrastructural, and policy levels to enhance fidelity within research partnerships.
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The Abbreviated Injury Scale (AIS) is widely used for body region-specific injury severity. The American Association for the Surgery of Trauma Organ Injury Scale (AAST-OIS) provides organ-specific injury severity but is not included in trauma databases. Previous researchers have used AIS as a surrogate for OIS. This study aims to assess AIS-abdomen concordance with AAST-OIS grade for liver and spleen injuries, hypothesizing concordance in terms of severity (grade of OIS and AIS) and patient outcomes. ⋯ AIS should not be used interchangeably with OIS due to lack of concordance. AAST-OIS should be included in trauma databases to facilitate improved organ injury research and quality improvement projects.