Annals of surgery
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To determine whether the Centers for Medicare & Medicaid Services (CMS) Physician Fee Schedule confers higher value for physician work in procedure and test codes than in Evaluation and Management (E/M) codes. ⋯ We did not find evidence of a systematic higher valuation of physician work in procedure/test codes than in E/M codes in the CMS RVU system.
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The purpose of this study was to explore how risk is perceived and experienced by the surgeon and how risk is actively managed in individual practice. ⋯ A framework for understanding surgeon's unique assessment of risk was elaborated. Increased awareness of the factors and strategies identified in this study can foster critical self-reflection by surgeons of their own risk assessments and those of their colleagues, and provide avenues for more explicit educational strategies for surgical training.
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To evaluate the parietal peritoneum (PP) as an autologous substitute for venous reconstruction during hepatopancreatobiliary (HPB) surgery. ⋯ A PP can be safely used as a lateral patch for venous reconstruction during HPB surgery; this could help reduce reluctance to perform vascular resection when oncologically required. Clinical trials identification: NCT02121886.
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Perioperative complications influence long- and short-term outcomes after esophagectomy. The absence of a standardized system for defining and recording complications and quality measures after esophageal resection has meant that there is wide variation in evaluating their impact on these outcomes. ⋯ The proposed system for defining and recording perioperative complications associated with esophagectomy provides an infrastructure to standardize international data collection and facilitate future comparative studies and quality improvement projects.
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To examine the clinical implications of supraclavicular (SC) lymph node (LN) metastasis in patients with esophageal squamous cell carcinoma (ESCC) who receive neoadjuvant chemotherapy, followed by surgery. ⋯ This study showed that SCLN metastasis in ESCC reflects the number of metastatic LNs. SCLN metastasis should not be considered as contraindication to curative surgery in multimodal treatment of ESCC because preoperative treatment can change SC nodal status.