Annals of surgery
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We hypothesized that disconcerting lymphedema rates in both sentinel lymph node biopsy (SLNB) and axillary lymph node dissection (ALND) may be because of unrecognized vunerable variations in arm lymphatic drainage within the axilla. Axillary reverse mapping (ARM) facilitates identification and avoidance of arm lymphatics within the axilla and its use may reduce lymphedema. ⋯ ARM allows frequent identification of arm lymphatics in the axilla, which would have been transected during routine surgery. Rates of metastases in noncrossover nodes and axillary recurrences are low. Lymphedema rates are dramatically reduced using ARM when compared with accepted standards.
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Comparative Study
Oncologic Outcomes of Single-incision Laparoscopic Surgery Compared With Conventional Laparoscopy for Colon Cancer.
The aim of this study is to document perioperative results and mid-term oncologic outcomes of single-incision laparoscopic (SIL) colectomy compared to conventional laparoscopic (CL) colectomy. ⋯ SIL colectomy for colon cancer shows probably higher, but an acceptable complication rate and can provide resection and oncologic outcomes equal to those of CL colectomy.
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Clinical Trial
Implementation of an Effective Strategy for Teaching Nontechnical Skills in the Operating Room: A Single-blinded Nonrandomized Trial.
To evaluate the effectiveness of debriefing and feedback on intraoperative nontechnical performance as an instructional strategy in surgical training. ⋯ Debriefing and feedback in the OR may represent an effective strategy to ensure development of nontechnical skills in competency-based education.
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Physicians are legally and ethically compelled to present their patients with available evidence on the potentially beneficial and harmful effects of a proposed medical or surgical treatment. This, however, is only half the story. ⋯ Explicitly stating the number of patients who will not benefit from the proposed treatment, in combination with the risk of a complication, may better inform patients and help them determine and express their treatment preference. This may also help standardize the informed consent procedure.