Annals of surgery
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Multicenter Study
The Impact of Complications and Pain on Patient Satisfaction.
To measure the association between patient-reported satisfaction and regret and clinical outcomes. ⋯ Patients who experienced postoperative complications and pain were less likely to be highly satisfied or have no regret. Notably, postoperative pain had a more significant effect on satisfaction and regret after surgery, suggesting focused postsurgical pain management is an opportunity to substantially improve patient experiences. More research and patient education are needed for managing expectations of postoperative pain, and use of adjuncts and regional anesthesia.
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Comparative Study
Outcomes of Graves' Disease Patients Following Anti-Thyroid Drugs, Radioactive Iodine or Thyroidectomy as the First-Line Treatment.
The long-term outcomes of first-line choice among ATD, RAI, and thyroidectomy for GD patients remain unclear. ⋯ GD patients who received surgery as an initial treatment appeared to have lower chances of all-cause mortality, CVD, AF, psychological disease, diabetes, and hypertension in the long-term when compared to those treated with ATD or RAI. The surgery group had the lowest relapse and direct healthcare costs among the 3 treatment modalities. This long-term cohort study suggested surgery may have a larger role to play as an initial treatment for GD patients.
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Association of a Statewide Surgical Coaching Program with Clinical Outcomes and Surgeon Perceptions.
To assess risk-adjusted outcomes and participant perceptions following a statewide coaching program for bariatric surgeons. ⋯ This statewide surgical coaching program was perceived as valuable and surgeons reported numerous practice changes. Operative times improved, but there was no significant improvement in risk-adjusted outcomes.
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Early identification of and response to barriers in telehealth settings will help patients receive optimal care. Here, the authors, based on institutional experience, provide advice on such strategies. This guidance focuses on standardizing expectations, assessing technological knowledge and resource access, evaluating understanding and comfort with telehealth, and assessing social support.
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We aim to describe the long-term follow-up data from our institution's POEM experience. ⋯ POEM provides durable symptom relief and improvement in physiologic esophagogastric junction relaxation parameters over 4.5 years postoperatively. Reinterventions are rare and effective.