Annals of surgery
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Determining the impact of county-level upward economic mobility on stage at diagnosis and receipt of treatment among Medicare beneficiaries with pancreatic adenocarcinoma. ⋯ Pancreatic adenocarcinoma patients from higher upward mobility areas were more likely to be diagnosed at an earlier stage, as well as to receive surgery or chemotherapy. The impact of county-level upward mobility was less pronounced among Black patients.
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Randomized Controlled Trial Multicenter Study
Pelvic Intraoperative Neuromonitoring Prevents Dysfunction in Patients with Rectal Cancer: Results from a Multicenter, Randomized, Controlled Clinical Trial of a NEUROmonitoring System (NEUROS).
This NEUROmonitoring System (NEUROS) trial assessed whether pelvic intraoperative neuromonitoring (pIONM) could improve urogenital and ano-(neo-)rectal functional outcomes in patients who underwent total mesorectal excisions (TMEs) for rectal cancer. ⋯ pIONM is safe and has the potential to improve functional outcomes in rectal cancer patients undergoing TME.
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To assess the effect of the Global Budget Revenue (GBR) program on outcomes after surgery. ⋯ Implementation of the GBR program is associated with improved outcomes and reductions in costs among Maryland patients who underwent surgical procedures. This is particularly salient given the increasing need to disseminate and scale population-based payment models that improve patient care while controlling health care costs.
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To evaluate the impact of axillary lymph node dissection (ALND) and sentinel lymph node biopsy (SLNB) on upper limb (UL) morbidity in breast cancer patients. ⋯ Prevalence of lymphedema after ALND was higher than previously estimated. ALND patients experienced greater rates of lymphedema, pain, reduced strength, and range of motion compared with SLNB. The findings support the continued drive to de-escalate axillary surgery.