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Associations between intraoperative factors and surgeons' self-assessed operative satisfaction.

https://arctichealth.org/en/permalink/ahliterature309612
Source
Surg Endosc. 2020 01; 34(1):61-68
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
01-2020
Author
Sofia Erestam
David Bock
Annette Erichsen Andersson
Anders Bjartell
Stefan Carlsson
Karin Stinesen Kollberg
Daniel Sjoberg
Gunnar Steineck
Johan Stranne
Thordis Thorsteinsdottir
Stavros Tyritzis
Anna Wallerstedt Lantz
Peter Wiklund
Eva Angenete
Eva Haglind
Author Affiliation
Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, SSORG - Scandinavian Surgical Outcomes Research Group, Östra Campus, Gothenburg, Sweden. sofia.erestam@vgregion.se.
Source
Surg Endosc. 2020 01; 34(1):61-68
Date
01-2020
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Attitude of Health Personnel
Humans
Intraoperative Complications
Laparoscopy - methods
Male
Personal Satisfaction
Prostatectomy - adverse effects - methods
Prostatic Neoplasms - surgery
Robotic Surgical Procedures - adverse effects - methods
Self-Assessment
Surgeons - psychology - standards
Sweden
Work Performance
Abstract
Little is known concerning what may influence surgeon satisfaction with a surgical procedure and its associations with intraoperative factors. The objective was to explore the relationships between surgeons' self-assessed satisfaction with performed radical prostatectomies and intraoperative factors such as technical difficulties and intraoperative complications as reported by the surgeon subsequent to the operation.
We utilized prospectively collected data from the controlled LAPPRO trial where 4003 patients with prostate cancer underwent open (ORP) or robot-assisted laparoscopic (RALP) radical prostatectomy. Patients were included from fourteen centers in Sweden during 2008-2011. Surgeon satisfaction was assessed by questionnaires at the end of each operation. Intraoperative factors included time for the surgical procedure as well as difficulties and complications in various steps of the operation. To model surgeon satisfaction, a mixed effect logistic regression was used. Results were presented as odds ratios (OR) with 95% confidence intervals (CI).
The surgeons were satisfied in 2905 (81%) and dissatisfied in 702 (19%) of the surgical procedures. Surgeon satisfaction was not statistically associated with type of surgical technique (ORP vs. RALP) (OR 1.36, CI 0.76; 2.43). Intraoperative factors such as technical difficulties or complications, for example, suturing of the anastomosis was negatively associated with surgeon satisfaction (OR 0.24, CI 0.19; 0.30).
Our data indicate that technical difficulties and/or intraoperative complications were associated with a surgeon's level of satisfaction with an operation.
PubMed ID
30887183 View in PubMed
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Barber-Surgeons in Military Surgery and Occupational Health in Finland, 1324-1944.

https://arctichealth.org/en/permalink/ahliterature301943
Source
Mil Med. 2019 01 01; 184(1-2):14-21
Publication Type
Historical Article
Journal Article
Date
01-01-2019
Author
Jarmo Kuronen
Jarmo Heikkinen
Author Affiliation
Etelä-Savon Työterveys Oy, Maaherrankatu 13, Mikkeli, Finland.
Source
Mil Med. 2019 01 01; 184(1-2):14-21
Date
01-01-2019
Language
English
Publication Type
Historical Article
Journal Article
Keywords
Amputation - methods
Barber Surgeons - history
Finland
General Surgery - history - methods
History, 15th Century
History, 16th Century
History, 17th Century
History, 18th Century
History, 19th Century
History, 20th Century
History, Medieval
Humans
Prostheses and Implants - history
Abstract
Barber-surgeons have existed as a medical profession in multiple countries for centuries. This article outlines the exciting history of the barber-surgeons in Finland, focusing on a time frame covering over 600 years, from the Middle Ages until the last barber-surgeon in Finland finished his practice during the Second World War. The barber-surgeons were the first healthcare professionals who focused on the healthcare of soldiers during times of both peace and war. They were able to treat wounds, conduct minor and even major surgeries and perform amputations. The development of the profession and the education and skills of the barber-surgeons are summed up and illuminated. New genealogical sources are also reviewed to profile the barber-surgeons as men, married and of multinational origin. This review summarizes the history of the profession, who the barber-surgeons in Finland were and where they came from. It concludes by noting that the barber-surgeons had a remarkable impact on the development of the professions of surgeons and physicians as well as on the development of occupational healthcare as a whole. However, these impacts are not sufficiently appreciated today.
PubMed ID
30137595 View in PubMed
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Better survival for patients with colon cancer operated on by specialized colorectal surgeons - a nationwide population-based study in Sweden 2007-2010.

https://arctichealth.org/en/permalink/ahliterature309370
Source
Colorectal Dis. 2019 Dec; 21(12):1379-1386
Publication Type
Evaluation Study
Journal Article
Date
Dec-2019
Author
M Bergvall
S Skullman
K Kodeda
P-A Larsson
Author Affiliation
Department of Surgery, Skaraborgs Sjukhus Research Centre, Skaraborgs Sjukhus Skövde, Skövde, Sweden.
Source
Colorectal Dis. 2019 Dec; 21(12):1379-1386
Date
Dec-2019
Language
English
Publication Type
Evaluation Study
Journal Article
Keywords
Adult
Aged
Colectomy - mortality
Colonic Neoplasms - mortality - surgery
Colorectal Surgery - statistics & numerical data
Female
General Surgery - statistics & numerical data
Humans
Male
Middle Aged
Postoperative Complications - etiology - mortality
Registries
Surgeons - statistics & numerical data
Survival Rate
Sweden
Treatment Outcome
Abstract
Mortality and complication rates after surgery for colon cancer are high, especially after emergency procedures. The aim of the present study was to evaluate the importance of the formal competence of surgeons for survival and morbidity.
The Swedish Colorectal Cancer Registry prospectively records data on patients diagnosed with cancer within the colon and rectum. A cohort of patients operated on for colon cancer between 2007 and 2010 were followed 5 years after surgery. Data on postoperative morbidity, mortality and long-term survival were compared with regard to formal competency of the most senior surgeon attending the procedure.
This analysis includes 13 365 patients operated on for colon cancer, including 10 434 elective procedures and 2931 emergency cases. The overall 5-year survival was higher for those operated on by subspecialist colorectal surgeons compared with general surgeons (60% vs 48%; P 
PubMed ID
31293019 View in PubMed
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Bored? Not with our parallel universes.

https://arctichealth.org/en/permalink/ahliterature264740
Source
Alaska Med. 2013 Sep;54:3
Publication Type
Article
Date
Sep-2013
Author
Dave Rush
Source
Alaska Med. 2013 Sep;54:3
Date
Sep-2013
Language
English
Publication Type
Article
Keywords
Alaska
Hobbies
Humans
Medicine in Art
Physicians
Singing
Surgeons
PubMed ID
26043480 View in PubMed
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Cerebrospinal fluid levels of neopterin are elevated in delirium after hip fracture.

https://arctichealth.org/en/permalink/ahliterature286018
Source
J Neuroinflammation. 2016 Jun 29;13(1):170
Publication Type
Article
Date
Jun-29-2016
Author
Roanna J Hall
Leiv Otto Watne
Ane-Victoria Idland
Johan Raeder
Frede Frihagen
Alasdair M J MacLullich
Anne Cathrine Staff
Torgeir Bruun Wyller
Durk Fekkes
Source
J Neuroinflammation. 2016 Jun 29;13(1):170
Date
Jun-29-2016
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Chromatography, High Pressure Liquid
Cohort Studies
Delirium - blood - cerebrospinal fluid - etiology
Female
Hip Fractures - complications - epidemiology - surgery
Humans
Male
Middle Aged
Neopterin - blood - cerebrospinal fluid
Norway - epidemiology
Orthopedic Surgeons
Retrospective Studies
Scotland - epidemiology
Abstract
The inflammatory cell product neopterin is elevated in serum before and during delirium. This suggests a role for disordered cell-mediated immunity or oxidative stress. Cerebrospinal fluid (CSF) neopterin levels reflect brain neopterin levels more closely than serum levels. Here we hypothesized that CSF neopterin levels would be higher in delirium.
In this prospective cohort study, 139 elderly patients with acute hip fracture were recruited in Oslo and Edinburgh. Delirium was diagnosed with the confusion assessment method performed daily pre-operatively and on the first 5 days post-operatively. Paired CSF and blood samples were collected at the onset of spinal anaesthesia. Neopterin levels were measured using high-performance liquid chromatography.
Sixty-four (46 %) of 139 hip fracture patients developed delirium perioperatively. CSF neopterin levels were higher in delirium compared to controls (median 29.6 vs 24.7 nmol/mL, p?=?0.003), with highest levels in patients who developed delirium post-operatively. Serum neopterin levels were also higher in delirium (median 37.0 vs 27.1 nmol/mL, p?=?0.003). CSF neopterin remained significantly associated with delirium after controlling for relevant risk factors. Higher neopterin levels were associated with poorer outcomes (death or new institutionalization) 1 year after surgery (p?=?0.02 for CSF and p?=?0.03 for serum).
This study is the first to examine neopterin in CSF from patients with delirium. Our findings suggest potential roles for activation of cell-mediated immune responses or oxidative stress in the delirium process. High levels of serum or CSF neopterin in hip fracture patients may also be useful in predicting poor outcomes.
Notes
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PubMed ID
27357281 View in PubMed
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[Composite authors Corresponding member of Russian Academy of Sciences Lev Vasil'evich Potashov (to his 85th birthday) (Collective of authors)].

https://arctichealth.org/en/permalink/ahliterature266603
Source
Vestn Khir Im I I Grek. 2015;174(3):113-4
Publication Type
Article
Date
2015

[Contribution of military surgeons participants of the great patriotic war to solving the problem of rendering medical care to the wounded with lesions of blood vessels].

https://arctichealth.org/en/permalink/ahliterature260737
Source
Angiol Sosud Khir. 2014;20(4):159-67
Publication Type
Article
Date
2014
Author
E P Kokhan
S P Gliantsev
N I Galik
Source
Angiol Sosud Khir. 2014;20(4):159-67
Date
2014
Language
Russian
Publication Type
Article
Keywords
History, 20th Century
Humans
Military Medicine - history - methods
Russia
Surgeons - history
Vascular Surgical Procedures - history - methods
Vascular System Injuries - etiology - surgery
World War II
Wounds, Gunshot - complications
Abstract
review in the article are opinions and experience of outstanding academic military surgeons, participants of the Great Patriotic war: Burdenko N N., Kupriyanov P.A., Akhutin M.N., Banaitis A.I., Elansky N.N, Petrovsky B.V., and others. The methods they worked out and practically implemented made it possible to substantially improve the outcomes of gunshot wounds and vascular lesions.
PubMed ID
25646546 View in PubMed
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Danish surgeons' views on minimally invasive surgery.

https://arctichealth.org/en/permalink/ahliterature260151
Source
J Laparoendosc Adv Surg Tech A. 2014 Jan;24(1):1-7
Publication Type
Article
Date
Jan-2014
Author
Hellen Edwards
Lars Nannestad Jørgensen
Source
J Laparoendosc Adv Surg Tech A. 2014 Jan;24(1):1-7
Date
Jan-2014
Language
English
Publication Type
Article
Keywords
Adult
Attitude of Health Personnel
Cholecystectomy - methods
Denmark
Endoscopy, Gastrointestinal - utilization
Female
Humans
Laparoscopy - methods
Male
Middle Aged
Minimally Invasive Surgical Procedures - utilization
Natural Orifice Endoscopic Surgery - utilization
Population Surveillance
Questionnaires
Risk assessment
Surgeons - statistics & numerical data
Abstract
Advancements in minimally invasive surgery have led to increases in popularity of single-incision laparoscopic surgery (SILS) and natural orifice translumenal surgery (NOTES(®); American Society for Gastrointestinal Endoscopy [Oak Brook, IL] and Society of American Gastrointestinal and Endoscopic Surgeons [Los Angeles, CA]) due to their postulated benefits of better cosmesis, less pain, and quicker recovery. This questionnaire-based study investigated Danish surgeons' attitudes toward these new procedures.
A 26-item questionnaire was developed and distributed electronically via e-mail to a total of 1253 members of The Danish Society of Surgeons and The Danish Society of Young Surgeons.
In total, 352 (approximately 30%) surgeons completed the questionnaire, 54.4% were over 50 years of age, and 76.6% were men. When choosing surgery, the most important factors taken into consideration were the risk of complication and short convalescence, whereas the least important factors were cosmesis and option of local anaesthesia. If the surgeons themselves were to undergo cholecystectomy, 35.5% would choose SILS, and 14.5% would choose NOTES provided that the risk was equal to traditional laparoscopy (3%). The fraction of surgeons willing to learn SILS and NOTES was 44.6% and 32.7%, respectively. The desire to learn was higher among less experienced and surgically active surgeons. Of the responders, 68.8% considered SILS and 43.2% considered NOTES would become standard techniques for cholecystectomy within 6 years.
The importance of risk of complications has not surprisingly a high priority among surgeons in this questionnaire. Why this is has to be investigated further before implementing SILS and NOTES as standard of care.
PubMed ID
24131341 View in PubMed
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Description and analysis of clinical pathways for oesophago-gastric adenocarcinoma, in 10 European countries (the EURECCA upper gastro intestinal group - European Registration of Cancer Care).

https://arctichealth.org/en/permalink/ahliterature281765
Source
Eur J Surg Oncol. 2016 Sep;42(9):1432-47
Publication Type
Article
Date
Sep-2016
Author
M. Messager
W. de Steur
P G Boelens
L S Jensen
C. Mariette
J V Reynolds
J. Osorio
M. Pera
J. Johansson
P. Kolodziejczyk
F. Roviello
G. De Manzoni
S P Mönig
W H Allum
Source
Eur J Surg Oncol. 2016 Sep;42(9):1432-47
Date
Sep-2016
Language
English
Publication Type
Article
Keywords
Adenocarcinoma - diagnosis - pathology - therapy
Animals
Critical Pathways
Denmark
Esophageal Neoplasms - diagnosis - pathology - therapy
Europe
France
Gastroenterologists
Germany
Health Policy
Humans
Ireland
Italy
Neoplasm Staging
Netherlands
Oncologists
Patient care team
Poland
Quality of Health Care
Registries
Spain
Stomach Neoplasms - diagnosis - pathology - therapy
Surgeons
Surveys and Questionnaires
Sweden
Time Factors
United Kingdom
Abstract
Outcomes for patients with oesophago-gastric cancer are variable across Europe. The reasons for this variability are not clear. The aim of this study was to describe and analyse clinical pathways to understand differences in service provision for oesophageal and gastric cancer in the countries participating in the EURECCA Upper GI group.
A questionnaire was devised to assess clinical presentation, diagnosis, staging, treatment, pathology, follow-up and service frameworks across Europe for patients with oesophageal and gastric cancer. The questionnaire was issued to experts from 14 countries. The responses were analysed quantitatively and qualitatively and compared.
The response rate was (10/14) 71.4%. The approach to diagnosis was similar. Most countries established a diagnosis within 3 weeks of presentation. However, there were different approaches to staging with variable use of endoscopic ultrasound reflecting availability. There has been centralisation of treatments in most countries for oesophageal surgery. The most consistent area was the approach to pathology. There were variations in access to specialist nurse and dietitian support. Although most countries have multidisciplinary teams, their composition and frequency of meetings varied. The two main areas of significant difference were research and audit and overall service provision. Observations on service framework indicated that limited resources restricted many of the services.
The principle approaches to diagnosis, treatment and pathology were similar. Factors affecting the quality of patient experience were variable. This may reflect availability of resources. Standard pathways of care may enhance both the quality of treatment and patient experience.
PubMed ID
26898839 View in PubMed
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Factors that Can Promote or Impede the Advancement of Women as Leaders in Surgery: Results from an International Survey.

https://arctichealth.org/en/permalink/ahliterature275772
Source
World J Surg. 2016 Feb;40(2):258-66
Publication Type
Article
Date
Feb-2016
Author
Kazumi Kawase
Monika Carpelan-Holmström
Ava Kwong
Hilary Sanfey
Source
World J Surg. 2016 Feb;40(2):258-66
Date
Feb-2016
Language
English
Publication Type
Article
Keywords
Adult
Attitude of Health Personnel
Career Mobility
China
Female
Finland
Humans
Japan
Leadership
Male
Motivation
Physicians, Women - psychology
Sexism
Surgeons - psychology
Surveys and Questionnaires
United States
Abstract
Compared with male surgeons, women have less success advancing their careers and are underrepresented in leadership positions in surgery. The purpose of this study is to identify the qualifications necessary to become leaders in surgery and the career barriers faced by women surgeons in various cultural environments.
A survey was performed with women surgeons in Japan, USA, Finland, and Hong Kong, China, to assess various barriers faced by women surgeons in the respective countries. To develop appropriate survey tool, a preliminary questionnaire was distributed to leaders in surgery and also in various organizations worldwide.
The response rate was 23 % with 225 of 964 survey returned. Japanese women surgeons identify lacked family support as impeding a successful surgical career. US women surgeons feel more latent gender discrimination. Finnish women surgeons are less likely to need to sacrifice work-life balance, when holding leadership positions. Women surgeons worldwide are highly motivated to develop their career and agree the percentage of women surgeons in leadership positions should be increased.
Women surgeons in different countries perceive different challenges. We must develop strategies and should not hesitate to negotiate to overcome these issues to reach leadership positions in surgery. This may be accomplished through networking worldwide to improve current conditions and obstacles.
PubMed ID
26578316 View in PubMed
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44 records – page 1 of 5.