Surgery
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Recurrent laryngeal nerve injuries remain a complication that is a source of concern to both surgeons and patients. RLN monitoring has gained popularity in recent years despite a lack of evidence showing decreased rates of recurrent laryngeal nerve injury when nerve monitoring is used. We sought to explore malpractice litigation in thyroid surgery with respect to recurrent laryngeal nerve monitoring. With increased public awareness and surgeon use of recurrent laryngeal nerve monitoring, we hypothesize an increase in its use in malpractice litigation in the area of thyroid surgery. ⋯ Although recurrent laryngeal nerve monitoring has become more widely available and used, there is no evidence that its use or nonuse has played a role in malpractice litigation in the last 20 years. recurrent laryngeal nerve injury remains a cause of malpractice litigation.
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The dichotomy between clinical and hospital revenue generation for trauma care is well established. Many trauma programs require hospital support for fiscal survival. We evaluated the impact of standardized clinical documentation to the hospital's bottom line at our trauma center. ⋯ An effective standardized documentation strategy for trauma care results in significant fiscal gains in hospital reimbursement.
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The effect of patient complications on physicians is not well understood. Our objective was to determine the impact of a surgeon's complication(s) on his/her emotional state and job performance. ⋯ The majority of surgeons agreed that it was difficult to handle the emotional effects of complications throughout their careers. Efforts should be made to increase awareness of unrecognized emotional effects of patient complications and improve access to support systems for surgeons.
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For patients with severe chronic pancreatitis, total or completion pancreatectomy with islet cell autotransplantation (IAT) can alleviate pain and avoid the complications of diabetes. Several genetic mutations, specifically, PRSS1, CFTR, and SPINK1, are associated with chronic pancreatitis. Few reports have focused on the benefit of this operation for this subset of patients. ⋯ In patients who suffer from genetically linked chronic pancreatitis, pancreatic resection with IAT should be considered as an early therapeutic option to decrease chronic abdominal pain while preserving endogenous endocrine function.