Annals of surgery
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The objective of this study is to explore the patient characteristics and practice patterns of non-certified surgeons who treat Medicare patients in the United States. ⋯ For Medicare patients, non-certified surgeons treated more patients who are non-White, of lower SES, and in more rural, critical-access hospitals.
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This qualitative study aimed to explore the psychosocial experience of older adults undergoing major elective surgery from the perspective of both the patient and family caregiver. ⋯ Older adults and their caregivers described multiple overlapping challenges to emotional well-being that spanned the course of the perioperative period. Our findings highlight a critical component of perioperative care with significant implications for the recovery of older surgical patients.
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The aim of this study was to develop and test a prototype of a deep learning surgical guidance system (CASL) that can intra-operative identify peritoneal surface metastases on routine laparoscopy images. ⋯ Our findings demonstrate a pathway for an artificial intelligence system for intra-operative identification of peritoneal surface metastases, but still requires additional development and future validation in a multi-institutional clinical setting.
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To characterize malpractice trends related to active surveillance (AS) as a treatment strategy across cancers. ⋯ To date, no evidence of successful malpractice litigation for active surveillance in cancer has been identified. Given the legal precedent detailed in the identified cases and increasing support across national guidelines, active surveillance represents a sound management option in appropriate low-risk cancers, with no increased risk of medicolegal exposure.
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Randomized Controlled Trial Multicenter Study
Long-Term Outcome of Immediate Versus Postponed Intervention in Patients With Infected Necrotizing Pancreatitis (POINTER): Multicenter Randomized Trial.
To compare the long-term outcomes of immediate drainage versus the postponed-drainage approach in patients with infected necrotizing pancreatitis. ⋯ Also, during long-term follow-up, a postponed-drainage approach using antibiotics in patients with infected necrotizing pancreatitis results in fewer interventions as compared with immediate drainage and should therefore be the preferred approach.