Annals of surgery
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To establish whether Accreditation Council for Graduate Medical Education Milestones predict future performance of general surgery trainees. ⋯ The Milestones features that were most predictive of better patient outcomes related to intraoperative skills, ethical principles, and patient navigation and safety, measured 12-18 months prior to graduation. The development of a parsimonious set of evidence-based Milestones that better correlate with surgeon experience could enhance surgical education.
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The objective of this work was to estimate the association between surgeon sex with surgical postponements or cancellations. ⋯ There may be sex-bias in the decision about which surgical cases to postpone or cancel to accommodate emergency surgeries in our setting. This bias may contribute to compensation inequality in a fee-for-service setting.
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To examine the association between surgeon gender and early postoperative complications, including 30-day death and readmission, in elective surgery. ⋯ These results support that surgeon gender is not associated with early postoperative outcomes, including mortality, readmission, or other complications in elective surgery. These findings encourage patients, healthcare providers, and stakeholders not to consider surgeon gender as a risk factor for postoperative complications.
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We evaluated the efficacy of risk-based, protocol-driven management versus (vs) usual management after elective major cancer surgery to reduce 30-day rates of postoperative death or serious complications (DSC) . ⋯ Risk-based, protocol-driven management did not reduce 30-day rate of DSC after elective major cancer surgery compared to usual management, nor improve postoperative health care utilization, HRQOL, or cancer outcomes. Trials are needed to identify cost-effective, tailored perioperative strategies to optimize outcomes after major cancer surgery.
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This study investigated the correlation between positive resection margins and outcomes in patients with pancreatic ductal adenocarcinoma who underwent surgery and adjuvant chemotherapy according to the pivotal trial PRODIGE 24-CCTG PA-6. ⋯ All efforts should be made to evaluate the three margins of the highest prognostic value, with the others being secondary. A key finding of this study is the likely effect of mFOLFIRINOX on local invasion in operated patients, which seems to correct the impairment related to margin involvement, probably explaining the improvements in DFS and OS.