Annals of surgery
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In this article, we seek to use a case-study discussion of a woman seeking treatment guidance for an elective, complex surgical ailment to discuss how professionalism has changed within the past century and where it may be headed with specific regard for the medical profession and surgeons. ⋯ We conducted a literature review to investigate the historical context of the physician-patient relationship with regard for the surgeon. Our work suggests that the core structure of a professional is a foundation rooted in moral excellence that merits trust from the client. In medicine, further efforts at healing from prior abuses necessitates an emphasis on ethical principles, as well as communicating this commitment not only to the patient but also to the society at large. We emphasize the importance of these changes through a case-based discussion.
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To verify an intraoperative adverse event (iAE) classification (ClassIntra grade) to evaluate quality control and to predict the prognostic performance of laparoscopic radical surgery for gastric cancer. ⋯ The ClassIntra grade is an effective prognostic and surgical quality control index for laparoscopic radical surgery for gastric cancer; therefore, it could be included in routine hospital care and surgical quality control.
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Racial and ethnic inequities in surgical care in the United States are well documented. Less is understood about evidence-based interventions that improve surgical care and reduce or eliminate inequities. In this review, we discuss effective patient, surgeon, community, health care system, policy, and multi-level interventions to reduce inequities and identifying gaps in intervention-based research. ⋯ Achieving surgical equity will require implementing evidenced-based interventions to improve quality for racial and ethnic minorities. Moving beyond description toward elimination of racial and ethnic inequities in surgical care will require prioritizing funding of intervention-based research, utilization of implementation science and community based-participatory research methodology, and principles of learning health systems.
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To examine long-term healthcare dependency outcomes of stereotactic body radiation therapy (SBRT) to surgery for older adults with stage I non-small cell lung cancer (NSCLC). ⋯ Surgery offers robust long-term dependency outcomes compared with SBRT. These are important patient-centered endpoints which may be used for counseling and shared decision-making in older adults with stage I NSCLC.
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To determine whether liver transplantation (LT) can provide long-term overall survival (OS) in selected patients with nonresectable liver-only colorectal liver metastases (nrCRLM). ⋯ LT for nrCRLM can provide long term survival and perhaps cure for selected patients. The OS is excellent compared to oncological treatment options and in line with results from studies on resectable CRLM.