Annals of surgery
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Randomized Controlled Trial Comparative Study
Bar-coding surgical sponges to improve safety: a randomized controlled trial.
A randomized, controlled trial was performed to evaluate a computer-assisted method for counting sponges using a bar-code system. ⋯ Use of automated counting using bar-coded surgical sponges improved detection of miscounted and misplaced sponges and was well tolerated by surgical staff members.
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To analyze the effects of surgical, anesthetic, and nursing teamwork skills on technical outcomes. ⋯ Detailed analysis of team interactions and dimensions is feasible and valuable, yielding important insights into relationships between nontechnical skills, technical performance, and operative duration. These results support the concept that interventions designed to improve teamwork and communication may have beneficial effects on technical performance and patient outcome.
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To analyze whether the local-regional surgical treatments (breast-conserving therapy, mastectomy) resulted in different overall survival, distant metastasis-free survival, and locoregional recurrence-free survival rates for the various molecular breast cancer subtypes. ⋯ The basal cell-like subtype is associated with a worse prognosis, a higher incidence of distant metastasis, and may be more prone to local recurrence when managed with breast-conserving therapy.
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There has been an increase in interest in endoscopic therapy (ET) for intramucosal (T1a) or submucosal (T1b) esophageal carcinoma. The objective of the present study was to determine the prevalence of nodal metastases, lymphatic vascular invasion, and multifocal neoplasia in patients with pT1 esophageal carcinoma who underwent esophagectomy without preoperative therapy and assess their potential implication for ET. ⋯ The combined high incidence of MFN, LVI, and occult nodal metastases does not support the use of ET in patients with T1 esophageal cancer regardless of depth of invasion, cell type, differentiation or extent of BE. ET may be of value in patients in whom surgical risk is considered prohibitive.
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Recent studies have described the importance of renal glomerular filtration rate (GFR) as a determinant of perioperative mortality in patients with aneurysms that involve the thoracoabdominal and abdominal aorta. We studied the impact of GFR on mortality following repair of ascending and arch aneurysms. ⋯ Preoperative renal function as defined by GFR was the most significant predictor of mortality during repairs of the ascending and transverse aortic arch. The use of GFR provides better preoperative risk stratification during these repairs than creatinine alone.