The Journal of surgical research
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Mentorship is a key component in preventing burnout and attrition in surgical training, yet many residencies lack a formal program, one method used to establish successful mentor relationships. We aimed to measure the difference in resident perceptions and experience after the implementation of a mentorship program. ⋯ Implementation of a formal mentorship program resulted in an improvement in resident perception of faculty involvement and support. Meeting with a mentor resulted in a significant improvement in resident perception. Implementation of a mentorship program can improve resident experience, and few interactions are needed to affect the change.
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Meta Analysis Comparative Study
Segmentectomy Versus Wedge Resection for Stage I Non-Small Cell Lung Cancer: A Meta-analysis.
Segmentectomy and wedge resection have been recommended as appropriate surgical treatments for patients with poor pulmonary function or major comorbidities. However, for stage I non-small cell lung cancer (NSCLC), it is still undecided whether survival is better with segmentectomy or with wedge resection. ⋯ Survival after lobar resection for stage I NSCLC is significantly better with segmentectomy than with wedge resection.
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Meta Analysis Comparative Study
Stereotactic Body Radiotherapy Versus Surgery for Early-Stage Non-Small-Cell Lung Cancer.
Surgery is the gold standard therapy for patients with early-stage non-small-cell lung cancer (NSCLC). However, stereotactic body radiotherapy (SBRT) may provide as an alternative for patients who are medically inoperable or refuse surgical resection. The optimal treatment (SBRT or surgery) for patients with early-stage NSCLC is not clear. ⋯ Our results found a superior OS and long-term DC for early-stage NSCLC after surgery compared with SBRT after propensity score matching.
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Comparative Study
Heparin-Sparing Anticoagulation Strategies Are Viable Options for Patients on Veno-Venous ECMO.
Extracorporeal membrane oxygenation (ECMO), a rescue therapy for pulmonary failure, has traditionally been limited by anticoagulation requirements. Recent practice has challenged the absolute need for anticoagulation, expanding the role of ECMO to patients with higher bleeding risk. We hypothesize that mortality, bleeding, thrombotic events, and transfusions do not differ between heparin-sparing and full therapeutic anticoagulation strategies in veno-venous (VV) ECMO management. ⋯ Survival, bleeding, thrombotic complications, and transfusion requirements did not differ between heparin-sparing and full therapeutic heparin strategies for management of VV ECMO. VV ECMO can be a safe option in patients with traditional contraindications to anticoagulation.
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Nonoperative management (NOM) has become more common in hemodynamically stable patients with high-grade blunt splenic injury. However, there are no widely accepted guidelines for an optimal and safe timeframe for the initiation of venous thromboembolism (VTE) prophylaxis. The purpose of this study was to explore the association between the timing of VTE prophylaxis initiation and NOM failure rate in isolated high-grade blunt splenic injury. ⋯ The results of our study suggest that early initiation of VTE prophylaxis (<48 h) does not increase the risk of NOM failure in patients with isolated high-grade blunt splenic injury.