Variation in the Practice of Central Venous Catheter and Chest Tube Insertions among Surgery Residents.

Objectives: Central venous catheter (CVC) and chest tube (CT) insertions are common bedside procedures frequently performed by surgery residents. Despite published guidelines, variability in the practice exists. We sought to characterize the surgery residents' practice patterns surrounding these two bedside procedures.

Surgeon-Authored Virtual Laparoscopic Adrenalectomy Module Is Judged Effective and Preferred Over Traditional Teaching Tools.

Objective: The study assesses user acceptance and effectiveness of a surgeon-authored virtual reality (VR) training module authored by surgeons using the Toolkit for Illustration of Procedures in Surgery (TIPS).

Methods: Laparoscopic adrenalectomy was selected to test the TIPS framework on an unusual and complex procedure. No commercial simulation module exists to teach this procedure.

Development and validation of a composite scoring system for robot-assisted surgical training--the Robotic Skills Assessment Score.

Background: A standardized scoring system does not exist in virtual reality-based assessment metrics to describe safe and crucial surgical skills in robot-assisted surgery. This study aims to develop an assessment score along with its construct validation.

Materials And Methods: All subjects performed key tasks on previously validated Fundamental Skills of Robotic Surgery curriculum, which were recorded, and metrics were stored.

Fundamental skills of robotic surgery: a multi-institutional randomized controlled trial for validation of a simulation-based curriculum.

Objective: To develop and establish effectiveness of simulation-based robotic curriculum--fundamental skills of robotic surgery (FSRS).

Methods: FSRS curriculum was developed and incorporated into a virtual reality simulator, Robotic Surgical Simulator (RoSS). Fifty-three participants were randomized into an experimental group (EG) or control group (CG).

Should total number of lymph nodes be used as a quality of care measure for stage III colon cancer?

Objective: To assess whether TNODS is an independent prognostic factor after adjusting for the lymph node ratio (LNR).

Summary Background Data: The medical literature has suggested that the TNODS is associated with better survival in stage II and III colon cancer. Thus TNODS was endorsed as a quality measure for patient care by American College of Surgeons, National Quality Forum.

Young surgeons' attitudes regarding surgery and professional organizations.

Background: Attitudes of young surgeons regarding professional organizations are unclear. We surveyed young surgeons to assess their opinions regarding the role of The American College of Surgeons in the future of surgery.

Methods: A 21-question on-line survey was distributed to all young (age <45 years) ACS members.

The prognostic superiority of log odds of positive lymph nodes in stage III colon cancer.

Background: Literature showed that lymph node ratio (LNR) and total number of lymph nodes (TNODS) are independent prognostic factors in node-positive colon cancer. Our study assesses the prognostic superiority of the log odds of positive lymph nodes (LODDS) in the same patient population.

Material And Methods: A total of 24,477 stage III colon cancer cases from the SEER registry were reviewed.

Lymph node ratio: role in the staging of node-positive colon cancer.

Background: Recent literature has shown that lymph node ratio (LNR) is superior to the number of positive lymph nodes (pLNs) in predicting the prognosis in several malignances other than colon cancer. We hypothesize that LNR may play a similar role in stage III colon cancer.

Methods: We included 24,477 stage III colon cancer cases from the Surveillance, Epidemiology, and End Results cancer registry.

Utilization of standardized patients to evaluate clinical and interpersonal skills of surgical residents.

Background: This project was designed to determine the growth of interpersonal skills during the first year of a surgical residency.

Methods: All categorical surgical residents were given a clinical skills examination of abdominal pain using standardized patients during their orientation (T1). The categorical residents were retested after 11 months (T2).

Outcomes of patients with atherosclerotic upper extremity tissue loss.

Severe ischemia of the upper extremity causing tissue necrosis occurs much less frequently than in the lower extremity. The clinical outcome of patients diagnosed with digital nonhealing ulcer or gangrene is largely unknown. A retrospective review of patients with upper extremity tissue loss was performed.

Application of geostatistics to risk assessment.

Geostatistics offers two fundamental contributions to environmental contaminant exposure assessment: (1) a group of methods to quantitatively describe the spatial distribution of a pollutant and (2) the ability to improve estimates of the exposure point concentration by exploiting the geospatial information present in the data. The second contribution is particularly valuable when exposure estimates must be derived from small data sets, which is often the case in environmental risk assessment. This article addresses two topics related to the use of geostatistics in human and ecological risk assessments performed at hazardous waste sites: (1) the importance of assessing model assumptions when using geostatistics and (2) the use of geostatistics to improve estimates of the exposure point concentration (EPC) in the limited data scenario.

Hospital costs for endovascular and open repair of abdominal aortic aneurysm.

Background: To evaluate hospital costs and reimbursement for open (OAAA) and endovascular (EVAAA) repair of abdominal aortic aneurysm.

Study Design: Review of all patients who underwent OAAA or EVAAA in two teaching hospitals during the period January 1, 2000, to December 31, 2000, was completed for the following: demographics, Diagnosis Related Group (DRG), resource use, length of stay, hospital costs, and reimbursement data.

Results: There were 130 abdominal aortic aneurysm procedures performed.

Maintaining outcomes in a surgical residency while complying with resident working hour regulations.

Background: Regulatory requirements for resident working hours were designed to improve patient care. Compliance challenges a training program to meet procedural and clinical requirements. This is a retrospective study of a 5-year experience in addressing the challenges and studying the impact of compliance on resident caseload and board performance.

Ertapenem monotherapy versus combination therapy with ceftriaxone plus metronidazole for treatment of complicated intra-abdominal infections in adults.

The efficacy and safety of intravenous (IV) ertapenem, 1 and 1.5 g once a day, for treatment of adults with complicated intra-abdominal infection were compared with those of IV ceftriaxone 2 g once a day plus IV metronidazole 500 mg every 8 h. After at least 3 days of IV therapy and satisfactory clinical response, patients could be switched to oral ciprofloxacin plus metronidazole.