Surgery
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Comparative Study
Clinimetric properties of 3 instruments measuring postoperative recovery in a gynecologic surgical population.
General, health-related quality-of-life questionnaires and recovery-specific questionnaires have been used to measure recovery in surgical patients. The aim of this study was to evaluate the clinimetric properties of 3 recovery instruments and to examine whether recovery-specific instruments are useful. ⋯ Because construct validity and responsiveness were greatest in the RI-10, we conclude that this short recovery-specific instrument is useful in studies evaluating postoperative recovery. We recommend the use of the RI-10, unless the immediate postoperative days are of interest in which the QoR-40 was valid.
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The combination of hepatic ischemia and cholestasis, both identified as risk factors for oxidative stress, potentially enhances postischemic reperfusion (I/R) injury. Preoperative biliary drainage relieves oxidative stress and therefore seems a worthwhile intervention in cholestatic patients undergoing major liver resection. ⋯ The cholestatic rat is more susceptible to postischemic liver injury and these injurious effects were significantly attenuated by biliary decompression.
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Most surgeons still perform T2 or T2-3 sympathectomy for palmar hyperhidrosis (PH), but both of these treatments can cause severe side effects. Some recent articles advocating T4 sympathectomy have obtained satisfactory results. The aim of this study was to compare the outcomes of 3 different levels of sympathectomy. ⋯ About 40% of ETS2 groups and 25% of ETS3 group patients were unsatisfied with their operation. All patients of the ETS4 group were satisfied with the outcome. In conclusion, ETS4 sympathectomy is an effective method for treating PH and it decreases the rate of compensatory hydrosis (CH).
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Bilateral thoracoscopic splanchnicectomy is a minimally invasive method of treating pain in patients with chronic pancreatitis. It offers good, short-term pain relief, but long-term success is difficult to predict. We analyze long-term results and identify factors predicting success of splanchnicectomy. ⋯ Splanchnicectomy offers prolonged (>4 years) benefit in 1 of 4 patients with severe chronic pancreatitis pain. Prior opioid use may adversely impact pain relief after splanchnicectomy.
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Randomized Controlled Trial Comparative Study
Comparison of expert instruction and computer-based video training in teaching fundamental surgical skills to medical students.
Practice using computer-based video instruction (CBVI) leads to improvements in surgical skills proficiency. This study investigated the benefits of the introduction of (a) learner-directed, interactive video training and (b) the addition of expert instruction on the learning and retention of the basic surgical skills of suturing and knot-tying in medical students. ⋯ This study shows that in surgical novices, neither the inclusion of expert instruction nor the addition of self-directed interaction with video leads to further improvements in skill development or retention. These findings further support the possible implementation of CBVI within surgical skills curricula.