Discrepancies in Thyroidectomy Outcomes Between General Surgeons and Otolaryngologists

2021 ◽  
Author(s):  
Stephen Stopenski ◽  
Areg Grigorian ◽  
Rachel Roditi ◽  
Zeljka Jutric ◽  
Maki Yamamoto ◽  
...  
Keyword(s):  
General Surgeons

Residency Training and Hand Surgery Practice Patterns: A National Surgical Quality Improvement Program Database Analysis

2020 ◽  
Author(s):  
James J. Drinane ◽  
Brian Drolet ◽  
Ashit Patel ◽  
Joseph A. Ricci
Keyword(s):  
Quality Improvement ◽  
Residency Training ◽  
Practice Patterns ◽  
Hand Surgery ◽  
Soft Tissue Coverage ◽  
Improvement Program ◽  
Surgical Quality ◽  
Orthopedic Surgeons ◽  
Procedural Volume ◽  
General Surgeons

Abstract Introduction Fellowship-trained hand surgeons may have residency training in either orthopedic, plastic, or general surgery, generating significant variability in education background. To study the effect of different training backgrounds on practice pattern variations, we utilized the NSQIP (National Surgical Quality Improvement Database) database to assess hand surgery volumes and case variety by specialty. Materials and Methods NSQIP years 2008 to 2017 was queried with hand surgery current procedural terminology codes defined by the American Board of Orthopedic Surgery. Procedures were grouped according to type and specialty, and relative rates calculated. Hand society membership data were used to determine if procedural volume for each specialty in each category and overall contribution to the volume of hand surgery performed nationally was distributed in accordance with membership data. Results A total of 145,015 hand surgeries were performed; 13,267 (9.1%) by general surgeons, 28,402 (19.6%) by plastic surgeons, and 103,346 (71.3%) by orthopedic surgeons. Orthopedic surgeons performed significantly more bone, fracture, joint, and tendon cases. General surgeons and plastic surgeons performed higher than expected numbers of soft tissue coverage and cases overall with respective excesses of 183 and 22%. Conclusion Hand surgery is an available fellowship pathway from multiple residencies. Fellowship training does not level the field of real-world practice patterns. Residency training experiences significantly impact practice.

An Uncommon An Uncommon Cause of Acute Abdomen in Underprivileged Communities

2019 ◽  
Vol 8 (2) ◽  
Author(s):  
David Muchuweti ◽  
Hopewell Mungani ◽  
Hopewell Mungani ◽  
Farai Mahomva ◽  
Edwin Gamba Muguti ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Acute Abdomen ◽  
Bowel Obstruction ◽  
Bowel Wall ◽  
Haemodynamic Instability ◽  
Small Bowel Volvulus ◽  
General Surgeons ◽  
Heavy Infestation ◽  
Emergency Abdominal Surgery

Oftentimes general surgeons working in poorly resourced communities carry out emergency abdominal surgery in patients with acute abdomen with no definitive preoperative diagnosis. The definitive diagnosis is made at laparotomy. Perforated small bowel obstruction secondary to heavy Infestation with Ascaris Lumbricoides brings a number of intraoperative challenges requiring correct intraoperative surgical management decisions. We present a case of a 17 year-old patient who was admitted with a diagnosis of small bowel obstruction who at laparotomy was found to have perforated gangrenous small bowel volvulus with heavy worm load visible through the bowel wall. Because of faecal peritoneal contamination and haemodynamic instability she underwent a two staged procedure with good outcome.

scholarly journals Emergency cricothyrotomy during the COVID-19 pandemic: how to suppress aerosolization

2020 ◽  
Vol 5 (1) ◽  
pp. e000542
Author(s):  
Nabil Issa ◽  
Whitney E Liddy ◽  
Sandeep Samant ◽  
David B Conley ◽  
Robert C Kern ◽  
...  
Keyword(s):  
Potential Risk ◽  
Healthcare Providers ◽  
Healthcare Setting ◽  
Healthcare Systems ◽  
Financial Resources ◽  
Risk Of Infection ◽  
X Ray ◽  
General Surgeons ◽  
Fluorescein Dye ◽  
Nose And Throat

BackgroundCricothyrotomy is associated with significant aerosolization that increases the potential risk of infection among healthcare providers. It is important to identify simple yet effective methods to suppress aerosolization and improve the safety of healthcare providers.Methods5 ear, nose and throat and general surgeons used a locally developed hybrid cricothyrotomy simulator with a porcine trachea to test three draping methods to suppress aerosolization during the procedure: an X-ray cassette drape, dry operating room (OR) towels and wet OR towels. The three methods were judged based on three categories: effectiveness of suppression, availability in all healthcare systems and ease of handling.ResultsAll five surgeons performed the procedure independently using each of the three suppression methods. The wet OR towel drape was found to be an effective method to suppress aerosolization, and it did not hinder the surgeons from performing the procedure accurately. This finding was confirmed by using an atomized fluorescein dye injection into the porcine trachea, representing aerosolized material while performing the procedure.ConclusionsWe present a novel intervention using wet towels to suppress aerosolization during cricothyrotomy. Wet towels are cheap and readily available within any healthcare setting regardless of the financial resources available.

scholarly journals Prevalence and associated factors for burnout among attending general surgeons: a national cross-sectional survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Suleyman Utku Celik ◽  
Alperen Aslan ◽  
Eylul Coskun ◽  
Beyza Nur Coban ◽  
Zeynep Haner ◽  
...  
Keyword(s):  
Associated Factors ◽  
Multivariable Analysis ◽  
Workplace Stress ◽  
Personal Accomplishment ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Practice Characteristics ◽  
Training And Research ◽  
General Surgeons ◽  
At Risk Populations

Abstract Background Burnout resulting from long-term and unmanaged workplace stress is high among healthcare professionals, especially surgeons, and affects both individuals and the quality of patient care. The objective of this study was to determine the prevalence and associated factors for burnout among attending general surgeons and to identify possible preventive strategies. Methods A national cross-sectional survey using a 35-item questionnaire was conducted among members of the Turkish Surgical Society. The survey evaluated demographics, professional and practice characteristics, social participation, and burnout as well as interventions to deal with burnout. Burnout was defined as a high score on the emotional exhaustion (EE) and/or depersonalization (DP) subscales. Surgeons with high scores on both the EE and DP and a low score on personal accomplishment (PA) were considered to have severe burnout. Results Six hundred fifteen general surgeons completed the survey. The median EE, DP, and PA scores were 34 (IQR, 20–43), 9 (IQR, 4–16), and 36 (IQR, 30–42), respectively. Overall, the prevalence of burnout and severe burnout were 69.1 and 22.0%, respectively. On multivariable analysis, factors independently associated with burnout were working in a training and research hospital (OR = 3.34; P < 0.001) or state hospital (OR = 2.77; P = 0.001), working ≥ 60 h per week (OR = 1.57; P = 0.046), and less frequent participation in social activities (OR = 3.65; P < 0.001). Conclusions Burnout is an important problem among general surgeons with impacts and consequences for professionals, patients, and society. Considering that burnout is a preventable condition, systematic efforts to identify at-risk populations and to develop strategies to address burnout in surgeons are needed.

scholarly journals Hand Surgery in Thailand

2021 ◽  
Vol 13 (01) ◽  
pp. 35-41
Author(s):  
Sunyarn Niempoog ◽  
Kiat Witoonchart ◽  
Woraphon Jaroenporn
Keyword(s):  
World War Ii ◽  
Traffic Accidents ◽  
Hand Surgery ◽  
Vital Role ◽  
Second Phase ◽  
World War ◽  
Third Phase ◽  
Foreign Countries ◽  
General Surgeons ◽  
Set Up

AbstractModern hand surgery in Thailand started after the end of World War II. It is divided into 4 phases. In the initial phase (1950-1965), the surgery of the hand was mainly performed by general surgeons. In 1965-1975, which was the second phase, many plastic surgeons and orthopaedic surgeons graduated from foreign countries and came back to Thailand. They played a vital role in the treatment of the surgery of the hand and set up hand units in many centers. They also contributed to the establishment of the “Thai Society for Surgery of the Hand,” which still continues to operate. In the third phase (1975-2000), there was a dramatic development of microsurgery because of the rapid economic expansion. There were many replantation, free tissue transfers, and brachial plexus surgeries in traffic and factory-related accidents. The first hand-fellow training program began in 1993. In the fourth phase (since 2000), the number of hand injuries from factory-related accidents began declining. But the injury from traffic accidents had been increasing both in severity and number. Moreover, the diseases of hand that relate to aging and degeneration had been on the rise. Thai hand surgeons have been using several state-of-the-art technologies such as arthroscopic and endoscopic surgery. They are continuing to invent innovations, generating international publications, and frequently being invited as speakers in foreign countries.

scholarly journals Colorectal cancer screening behaviors of general surgeons and first-degree family members: a survey-based study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Suleyman Utku Celik ◽  
Hasan Gorkem Cay ◽  
Ersin Bayrakdar ◽  
Aysima Ince ◽  
Esra Nur Ince ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Family Members ◽  
High Volume ◽  
Routine Screening ◽  
Care Providers ◽  
Crc Screening ◽  
First Degree Relatives ◽  
General Surgeons ◽  
Low Volume ◽  
Screening Behaviors

Abstract Background Colorectal cancer (CRC) screening rates are low in the general population and among health care providers. The aim of this study was to evaluate the CRC screening practices of general surgeons who provide specialized diagnostic testing and CRC treatment and to examine the CRC screening behaviors of their first-degree family members. Methods A cross-sectional survey was conducted among general surgeons who attended the 21st National Surgical Congress in Turkey held from April 11th to 15th, 2018. The survey included items on demographics, screening-related attitude, CRC screening options, barriers to CRC screening, and surgeons’ annual volumes of CRC cases. Results A total of 530 respondents completed the survey. Almost one-third of the responding surgeons (29.4%, n = 156) were aged over 50 years, among whom approximately half (47.1%, n = 74) reported having undergone CRC screening and preferring a colonoscopy as the screening modality (78.4%). Among general surgeons aged 50 years and older, high-volume surgeons (≥25 CRC cases per year) were more likely to undergo screening compared with low-volume surgeons (< 25 CRC cases per year). The respondents aged below 50 years reported that 56.1% (n = 210) of their first-degree relatives were up-to-date with CRC screening, mostly with colonoscopy. Compared to low-volume surgeons aged below 50 years, high-volume surgeons’ first-degree relatives were more likely to be up-to-date with CRC screening. Conclusion The survey results demonstrated that routine screening for CRC among surgeons and/or their first-degree relatives is currently not performed at the desired level. However, high-volume surgeons are more likely to participate in routine screening.

scholarly journals Colonoscopy and Flexible Sigmoidoscopy Practice Patterns in Ontario: A Population-Based Study

2007 ◽  
Vol 21 (7) ◽  
pp. 431-434 ◽  
Author(s):  
Susan E Schultz ◽  
Chris Vinden ◽  
Linda Rabeneck
Keyword(s):  
Flexible Sigmoidoscopy ◽  
Practice Patterns ◽  
Age Groups ◽  
Population Based ◽  
Insurance Plan ◽  
Ontario Health Insurance Plan ◽  
Population Based Study ◽  
The North ◽  
General Surgeons ◽  
Statistics Canada

OBJECTIVE: To conduct a population-based study on the provision of large bowel endoscopic services in Ontario.METHODS: Data from the following databases were analyzed: the Ontario Health Insurance Plan, the Institute for Clinical Evaluative Sciences Physicians Database and Statistics Canada. The flexible sigmoidoscopy and colonoscopy rates per 10,000 persons (50 to 74 years of age) by region between April 1, 2001, and March 31, 2002, were calculated, as well as the numbers and types of physicians who performed each procedure.RESULTS: In 2001/2002, a total of 172,108 colonoscopies and 43,400 flexible sigmoidoscopies were performed in Ontario for all age groups. The colonoscopy rate was approximately five times that of flexible sigmoidoscopy; rates varied from 463.1 colonoscopies per 10,000 people in the north to 286.8 colonoscopies per 10,000 people in the east. Gastroenterologists in all regions tended to perform more procedures per physician, but because of the large number of general surgeons, the total number of procedures performed by each group was almost the same.CONCLUSION: Population-based rates of colonoscopies and flexible sigmoidoscopies are low in Ontario, as are the procedure volumes of approximately one-quarter of physicians.

New Concept for a Thoracic Drainage System Using Magnetic Actuation

2019 ◽  
Vol 26 (6) ◽  
pp. 705-711
Author(s):  
Daisuke Taniguchi ◽  
Keitaro Matsumoto ◽  
Yoshihiro Kondo ◽  
Tomoshi Tsuchiya ◽  
Ikuo Yamamoto ◽  
...  
Keyword(s):  
Abdominal Cavity ◽  
Drainage System ◽  
Magnetic Actuation ◽  
Thoracic Cavity ◽  
Common Procedure ◽  
Thoracic Drainage ◽  
Drain Fluid ◽  
Laboratory Trial ◽  
General Surgeons ◽  
Effective Drainage

Objectives. Thoracic drainage is a common procedure to drain fluid, blood, or air from the pleural cavity. Some attempts to develop approaches to new thoracic drainage systems have been made; however, a simple tube is often currently used. The existing drain presupposes that it is placed correctly and that the tip does not require moving after insertion into the thoracic cavity. However, in some cases, the drain is not correctly placed and reinsertion of an additional drain is required, resulting in significant invasiveness to the patient. Therefore, a more effective drainage system is needed. This study aimed to develop and assess a new thoracic drain via a collaboration between medical and engineering personnel. Methods. We developed the concept of a controllable drain system using magnetic actuation. A dry laboratory trial and accompanying questionnaire assessment were performed by a group of thoracic and general surgeons. Objective mechanical measurements were obtained. Porcine experiments were also carried out. Results. In a dry laboratory trial, use of the controllable drain required significantly less time than that required by replacing the drain. The average satisfaction score of the new drainage system was 4.07 out of 5, indicating that most of the research participants were satisfied with the quality of the drain with a magnetic actuation. During the porcine experiment, the transfer of the tip of the drain was possible inside the thoracic cavity and abdominal cavity. Conclusion. This controllable thoracic drain could reduce the invasiveness for patients requiring thoracic or abdominal cavity drainage.

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