Annals of surgery
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Comparative Study
Impact of Propofol-based Total Intravenous Anesthesia Versus Inhalation Anesthesia on Long-term Survival after Cancer Surgery in a Nationwide Cohort.
To compare the impact of propofol-based total intravenous anesthesia (TIVA) versus inhalational anesthesia (IA) on the overall survival following cancer surgery. ⋯ There is no association between the type of general anesthesia used during cancer surgery and postoperative overall, 1-, and 5-year survival.
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To describe financial toxicity (FT) in patients with resected lung cancer and identify risk factors in this population. ⋯ Patients undergoing lung cancer resection often experienced significant financial stress with several identifiable risk factors. FT should be considered early in the care of these patients to alleviate detrimental coping mechanisms and enhance their quality of survivorship.
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Observational Study
Myocardial Injury After Noncardiac Surgery in Major General Surgical Patients A Prospective Observational Cohort Study.
The objective of this study was to determine the prognostic relevance, clinical characteristics, and 30-day outcomes associated with myocardial injury after noncardiac surgery (MINS) in major general surgery patients. ⋯ Approximately 1 in 6 patients experienced MINS after major general surgery. MINS was independently associated with a nearly 5-fold increase in 30-day mortality. The vast majority of patients with MINS were asymptomatic and would have gone undetected without routine postoperative troponin measurement.
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To assess the frequency of occult metastases (OM) in patients with resected pancreatic ductal adenocarcinoma (PDAC) or ampullary adenocarcinoma (AA) discovered on detailed pathologic examination on lymph nodes (LNs) previously considered negative by conventional analysis and to examine the association between OM and overall survival (OS). ⋯ There is a 26% discordance rate between conventional and detailed LN pathologic analysis in resected PDAC and AA. The presence of OM is associated with shorter OS.
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Observational Study
Feasibility and Safety of a "Shared Care" Model in Complex Hepatopancreatobiliary Surgery: A 5-Year Observational Study of Outcomes in Pancreaticoduodenectomy.
To determine the safety of a fully functioning shared care model (SCM) in hepatopancreatobiliary surgery through evaluating outcomes in pancreaticoduodenectomy. ⋯ SCMs are feasible in complex elective surgery without compromising patient outcomes, and wider adoption may be encouraged.