Annals of surgery
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Randomized Controlled Trial
Does the incorporation of motion metrics into the existing FLS metrics lead to improved skill acquisition on simulators? A single blinded, randomized controlled trial.
We hypothesized that training to expert-derived levels of speed and motion will lead to improved learning and will translate to better operating room (OR) performance of novices than training to goals of speed or motion alone. ⋯ The incorporation of motion metrics into the time/accuracy goals of the FLS laparoscopic suturing curriculum had limited impact on participant skill transfer to the OR. Given the increased training requirements for such a curriculum, further study is needed before the addition of motion metrics to the current FLS metrics can be recommended.
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The aim of this study was to identify preoperative risk factors and postoperative consequences that are associated with the occurrence of delirium after esophagectomy for malignancy. ⋯ This study demonstrates that postoperative delirium is associated with a more complicated and costly recovery after esophagectomy and that age is independently predictive of its development. Delirium has often been thought to be the sequela of other complications; however, this study demonstrates that it presents in isolation or precedes other complications in 67.4% of cases. Focused screening will likely allow targeted preventative strategies to be used in the perioperative period to reduce complications and costs associated with delirium.
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To evaluate the role of ¹⁸F-fluorodeoxyglucose-positron emission tomography (FDG-PET) in the assessment of tumor response after the completion of neoadjuvant chemoradiation (CRT) in patients with locally advanced resectable esophageal cancer. ⋯ FDG-PET does not effectively correlate with pathological response and long-term survival in patients with locally advanced esophageal cancer undergoing neoadjuvant CRT followed by surgery. (Registered on the www.e-cancer RECF0350.).
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To elucidate whether duodenal-jejunal-bypass (DJB), which improves blood glucose control, changes activity of Na-D-glucose cotransporter SGLT1 in small intestine. ⋯ The data indicate that DJB surgery decreases glucose absorption in the small intestine by downregulation of SGLT1-mediated glucose uptake. We suggest that the downregulation of SGLT1 contributes to the body-weight independent improvement of diabetes type 2.
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To determine whether the postoperative hypercoagulable state is responsible for the increase in metastases observed after surgery. ⋯ Surgery promotes the formation of fibrin and platelet clots around TCE, thereby impairing NK cell-mediated tumor cell clearance, whereas perioperative anticoagulation attenuates this effect. Therapeutic interventions aimed at reducing peritumoral clot formation and enhancing NK cell function in the perioperative period will have important clinical implications in attenuating metastatic disease after cancer surgery.