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  • 1.
    Brauckhoff, Michael
    et al.
    Department of General, Visceral, and Vascular Surgery, Halle/Saale, Germany.
    Meinicke, Anja
    Department of General, Visceral, and Vascular Surgery, Halle/Saale, Germany.
    Bilkenroth, Udo
    Institute for Pathology, Martin-Luther-University of Halle-Wittenberg, Halle/Saale, Germany.
    Lorenz, Kerstin
    Department of General, Visceral, and Vascular Surgery, Halle/Saale, Germany.
    Brauckhoff, Katrin
    Department of General, Visceral, and Vascular Surgery, Halle/Saale, Germany.
    Gimm, Oliver
    Department of General, Visceral, and Vascular Surgery, Halle/Saale, Germany.
    Thanh, Phuong Nguyen
    Department of General, Visceral, and Vascular Surgery, Halle/Saale, Germany.
    Dralle, Henning
    Department of General, Visceral, and Vascular Surgery, Halle/Saale, Germany.
    Long-term results and functional outcome after cervical evisceration in patients with thyroid cancer.2006Ingår i: Surgery, ISSN 0039-6060, E-ISSN 1532-7361, Vol. 140, nr 6, s. 953-9Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Surgical strategy in patients with thyroid cancer (TC) infiltrating the aerodigestive system is controversial. This study was undertaken to examine the long-term results of cervical evisceration (CE).

    PATIENTS AND METHODS: Since 1995, 14 consecutive patients with advanced TC underwent total laryngectomy (LE, n = 6) or esophagolaryngectomy (ELR, n = 8). Patients with unusual thyroid neoplasms or metastases to the thyroid (n = 3) were excluded. For esophageal reconstruction, free jejunal grafts (n = 6) and gastric tubes (n = 2) were used.

    RESULTS: Procedure-related morbidity and mortality were 42% and 14%, respectively. ELR was associated with a significant higher frequency of complications and reoperations compared with LE. Twelve-month and 30-month survival rates were 73% and 55%, respectively; 85% of the patients were satisfied with the surgical results. There were no long-term problems concerning food intake in the ELR patients. Two ELR patients were able to learn a substitutive voice.

    CONCLUSIONS: Cervical evisceration in patients with TC is associated with significant perioperative morbidity and mortality requiring careful patient selection. Regarding long-term survival, local tumor control, and patient's satisfaction, however, CE should be taken into account in suitable patients with advanced TC.

  • 2.
    Britt, Rebecca C
    et al.
    Department of Surgery, Eastern Virginia Medical School, Norfolk, VA, USA.
    Scerbo, Mark W
    Department of Psychology, Old Dominion University, Norfolk, VA, USA.
    Montano, Michael
    Department of Psychology, Old Dominion University, Norfolk, VA, USA.
    Kennedy, Rebecca A
    Department of Psychology, Old Dominion University, Norfolk, VA, USA.
    Prytz, Erik
    the Department of Psychology, Old Dominion University, Norfolk, VA, USA.
    Stefanidis, Dimitrios
    Carolinas Medical Center, Charlotte, NC, USA.
    Intracorporeal suturing: Transfer from Fundamentals of Laparoscopic Surgery to cadavers results in substantial increase in mental workload2015Ingår i: Surgery, ISSN 0039-6060, E-ISSN 1532-7361, Vol. 158, nr 5, s. 1428-1433Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    INTRODUCTION:

    A spatial secondary task developed by the authors was used to measure the mental workload of the participant when transferring suturing skills from a box simulator to more realistic surgical conditions using a fresh cadaver. We hypothesized that laparoscopic suturing on genuine bowel would be more challenging than on the Fundamentals of Laparoscopic Surgery (FLS)-simulated bowel as reflected in differences on both suturing and secondary task scores.

    METHODS:

    We trained 14 surgical assistant students to FLS proficiency in intracorporeal suturing. Participants practiced suturing on the FLS box for 30 minutes and then were tested on both the FLS box and the bowel of a fresh cadaver using the spatial, secondary dual-task conditions developed by the authors.

    RESULTS:

    Suturing times increased by >333% when moving from the FLS platform to the cadaver F(1,13) = 44.04, P < .001. The increased completion times were accompanied by a 70% decrease in secondary task scores, F(1,13) = 21.21, P < .001.

    CONCLUSION:

    The mental workload associated with intracorporeal suturing increases dramatically when trainees transfer from the FLS platform to human tissue under more realistic conditions of suturing. The increase in mental workload is indexed by both an increase in suturing times and a decrease in the ability to attend to the secondary task.

  • 3.
    Escobar Kvitting, John-Peder
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Klinisk fysiologi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Kirurgiska kliniken i Östergötland med verksamhet i Linköping, Norrköping och Motala.
    Sandström, Per
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för biomedicin och kirurgi, Avdelningen för kirurgi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Kirurgiska kliniken i Östergötland med verksamhet i Linköping, Norrköping och Motala.
    Thorelius, Lars
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Medicinsk radiologi.
    Kullman, Eric
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för biomedicin och kirurgi, Avdelningen för kirurgi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Kirurgiska kliniken i Östergötland med verksamhet i Linköping, Norrköping och Motala.
    Borch, Kurt
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för biomedicin och kirurgi, Avdelningen för kirurgi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Kirurgiska kliniken i Östergötland med verksamhet i Linköping, Norrköping och Motala.
    Svanvik, Joar
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för biomedicin och kirurgi, Avdelningen för kirurgi. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Kirurgiska kliniken i Östergötland med verksamhet i Linköping, Norrköping och Motala.
    Radiofrequency ablation of a liver metastasis complicated by extensive liver necrosis and sepsis caused by gas gangrene2006Ingår i: Surgery, ISSN 0039-6060, E-ISSN 1532-7361, Vol. 139, nr 1, s. 123-125Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    [No abstract available]

  • 4.
    Fransén, Karin
    et al.
    Linköpings universitet, Institutionen för biomedicin och kirurgi, Cellbiologi. Linköpings universitet, Hälsouniversitetet.
    Dimberg, Jan
    Österström, Anna
    Linköpings universitet, Institutionen för biomedicin och kirurgi, Cellbiologi. Linköpings universitet, Hälsouniversitetet.
    Olsson, Anneli
    Söderkvist, Peter
    Linköpings universitet, Institutionen för biomedicin och kirurgi, Cellbiologi. Linköpings universitet, Hälsouniversitetet.
    Sirsjö, Allan
    Nitric oxide synthase 2 mRNA expression in relation to p53 and adenomatous polyposis coli mutations in primary colorectal adenocarcinomas2002Ingår i: Surgery, ISSN 0039-6060, E-ISSN 1532-7361, Vol. 131, nr 4, s. 384-392Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background. The inducible nitric (NO) synthase 2 (NOS2) is upregulated in breast, brain, colon, and gynecological tumors, which indicate that NO may have a role in tumorigenesis. However, little is known about the role and regulation of NOS2 in colorectal carcinomas. Recent in vitro experiments have implicated that NOS2 is downregulated by p53 accumulation. Virtual analysis of the NOS2 promoter showed putative TCF-4/Lef-1 response elements, which indicate a potential regulation of NOS2 expression by activation of the adenomatous polyposis coli (APC)/β-catenin pathway.

    Methods. NOS2 mRNA expression was investigated in 59 colorectal carcinomas by reverse transcriptase/real-time polymerase chain reaction and related to mutations in the p53, APC, and β-catenin genes. Presence of NOS2 protein was studied by Western blot, and the localization was studied by immunohistochemistry. Loss of heterozygosity was studied in the region of the NOS2 gene.

    Results. The NOS2 mRNA and protein expression were significantly higher in tumors than in control tissue. Immunohistochemistry revealed extensive NOS2 staining in the epithelial cells and, to a minor degree, in leukocytes. Increased NOS2 mRNA expression was found in Dukes' stages A and B compared with the C and D stages. No relationship was found between elevated NOS2 expression and loss of heterozygosity in the later stages according to Dukes' classification or mutations in the p53, APC, or β-catenin genes.

    Conclusions. Inactivating mutations in the p53 and APC pathways are not the main explanation for the increased NOS2 expression found in colorectal tumors.

  • 5.
    Hasselgren, Kristina
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Kirurgiska kliniken US.
    Malago, Massimo
    UCL, England.
    Vyas, Soumil
    UCL, England.
    Robles Campos, Ricardo
    Vizgen De La Arrixaca University Hospital, Spain.
    Brusadin, Roberto
    Vizgen De La Arrixaca University Hospital, Spain.
    Linecker, Michael
    University of Zurich Hospital, Switzerland.
    Petrowsky, Henrik
    University of Zurich Hospital, Switzerland.
    Clavien, Pierre Alain
    University of Zurich Hospital, Switzerland.
    Machado, Marcel Autran
    University of Sao Paulo, Brazil.
    Hernandez-Alejandro, Roberto
    University of Rochester, NY USA.
    Wanis, Kerollos
    Western University, Canada.
    Walter, Lars
    Region Östergötland, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland.
    Sandström, Per
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Kirurgiska kliniken US.
    Björnsson, Bergthor
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Kirurgiska kliniken US.
    Neoadjuvant chemotherapy does not affect future liver remnant growth and outcomes of associating liver partition and portal vein ligation for staged hepatectomy2017Ingår i: Surgery, ISSN 0039-6060, E-ISSN 1532-7361, Vol. 161, nr 5, s. 1255-1265Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background. The only potentially curative treatment for patients with colorectal liver metastases is hepatectomy. Associating liver partition and portal vein ligation for staged hepatectomy has emerged as a method of treatment for patients with inadequate future liver remnant. One concern about associating liver partition and portal vein ligation for staged hepatectomy is that preoperative chemotherapy may negatively affect the volume increase of the future liver remnant and outcomes. Methods. This study from the International Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy Registry (NCT01924741) includes 442 patients with colorectal liver metastases registered from 2012-2016. Future liver remnant hypertrophy (absolute increase, percent increase, and kinetic growth rate) and clinical outcome were analyzed retrospectively in relation to type and amount of chemotherapy. The analyzed groups included patients with no chemotherapy, 1 regimen of chemotherapy, amp;gt; 1 regimen, and a group that received monoclonal antibodies in addition to chemotherapy. Results. Ninety percent of the patients received neoadjuvant oncologic therapy including 42% with 1 regimen of chemotherapy, 44% with monoclonal antibodies, and 4% with amp;gt; 1 regimen. Future liver remnant increased between 74-92% with the largest increase in the group with 1 regimen of chemotherapy. The increase in milliliters was between 241 mL (amp;gt; 1 regimen) and 306 mL (1 regimen). Kinetic growth rate was between 14-18% per week and was greatest for the group with 1 regimen of chemotherapy. No statistical significance was found between the groups with any of the measurements of future liver remnant hypertrophy. Conclusion. Neoadjuvant chemotherapy, including monoclonal antibodies, does not negatively affect future liver remnant growth. Patients with colorectal liver metastases who might be potential candidates for associating liver partition and portal vein ligation for staged hepatectomy should be considered for neoadjuvant chemotherapy. (Surgery 2017;161:1255-65.)

  • 6.
    Linecker, Michael
    et al.
    University of Zurich Hospital, Switzerland.
    Kambakamba, Patryk
    University of Zurich Hospital, Switzerland.
    Reiner, Cacilia S.
    University of Zurich Hospital, Switzerland.
    Linh, Thi Dan Linh Nguyen-Kim
    Univ Zurich Hosp, Inst Diagnost & Intervent Radiol, Zurich, Switzerland.
    Stavrou, Gregor A
    Asklepios Hosp Barmbek Hamburg, Dept Gen & Abdominal Surg, Hamburg, Germany; Semmelweis Univ Budapest, Campus Hamburg, Hamburg, Germany .
    Jenner, Robert M.
    Asklepios Hospital Barmbek Hamburg, Germany.
    Oldhafer, Karl J.
    Asklepios Hospital Barmbek Hamburg, Germany; Semmelweis University of Budapest, Germany.
    Björnsson, Bergthor
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Kirurgiska kliniken US.
    Schlegel, Andrea
    University of Zurich Hospital, Switzerland.
    Gyori, Georg
    University of Zurich Hospital, Switzerland.
    Schneider, Marcel André
    University of Zurich Hospital, Switzerland.
    Lesurtel, Mickael
    University of Zurich Hospital, Switzerland; University of Lyon, France.
    Clavien, Pierre-Alain
    University of Zurich Hospital, Switzerland.
    Petrowsky, Henrik
    University of Zurich Hospital, Switzerland.
    How much liver needs to be transected in ALPPS? A translational study investigating the concept of less invasiveness2017Ingår i: Surgery, ISSN 0039-6060, E-ISSN 1532-7361, Vol. 161, nr 2, s. 453-464Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background. ALPPS induces rapid liver hypertrophy after stage-1 operation, enabling safe, extended resections (stage-2) after a short period. Recent studies have suggested that partial transection at stage-1 might be associated with a better safety profile. The aim of this study was to assess the amount of liver parenchyma that needs to be divided to achieve sufficient liver hypertrophy in ALPPS. Methods. In a bi-institutional, prospective cohort study, nonfibrotic patients who underwent ALPPS with complete (n = 22) or partial (n = 23) transection for colorectal liver metastases were analyzed and compared with an external ALPPS cohort (n = 23). A radiologic tool was developed to quantify the amount of parenchymal transection. Liver hypertrophy and clinical outcome were compared between both techniques. The relationship of partial transection and hypertrophy was investigated further in an experimental murine model of partial ALPPS. Result. The median amount of parenchymal transection in partial ALPPS was 61 % (range, 34-86%). The radiologic method correlated poorly with the intraoperative surgeons estimation (r(s) = 0.258). Liver hypertrophy was equivalent for the partial ALPPS, ALPPS, and external ALPPS cohort (64% vs 60% vs. 64%). Experimental data demonstrated that partial transection of at least 50% induced comparable hypertrophy (137% vs 156%) and hepatocyte proliferation compared to complete transection. Conclusion. The study provides clinical and experimental evidence that partial liver partition of at least 50% seems to be equally effective in triggering volume hypertrophy as observed with complete transection and can be re recommended as less invasive alternative to ALPPS.

  • 7.
    Lorenz, Kerstin
    et al.
    Martin-Luther University of Halle-Wittenberg, Germany.
    Brauckhoff, Michael
    Martin-Luther University of Halle-Wittenberg, Germany.
    Behrmann, Curd
    Martin-Luther University of Halle-Wittenberg, Germany.
    Sekulla, Carsten
    Martin-Luther University of Halle-Wittenberg, Germany.
    Ukkat, Jörg
    Martin-Luther University of Halle-Wittenberg, Germany.
    Brauckhoff, Katrin
    Martin-Luther University of Halle-Wittenberg, Germany.
    Gimm, Oliver
    Martin-Luther University of Halle-Wittenberg, Germany.
    Dralle, Henning
    Martin-Luther University of Halle-Wittenberg, Germany.
    Selective arterial chemoembolization for hepatic metastases from medullary thyroid carcinoma2005Ingår i: Surgery, ISSN 0039-6060, E-ISSN 1532-7361, Vol. 138, nr 6, s. 986-993Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Hepatic metastases from medullary thyroid carcinoma (MTC) may impair quality of life by hypercalcitonemia-associated diarrhea and pain. In this prospective study, the effect of selective arterial chemoembolization (SACE) was evaluated.

    METHODS: Eleven patients with hepatic metastases from MTC received 1 to 9 courses of SACE using epirubicine. Symptomatic, biochemical, and morphologic responses on SACE were recorded.

    RESULTS: Symptomatic response was observed in all symptomatic patients. However, biochemical and radiologic response occurred only in 6 patients. Liver function was not affected by SACE. One patient with unexpected concurrent pheochromocytoma metastases died after the first course. Development of side effects in the course was observed in 8 patients but were only World Health Organization grade 1. Patients' satisfaction with SACE was excellent. Long-term follow-up found 7 patients alive (1-72 months). Three patients died with tumor 6, 12, and 24 months after SACE, respectively.

    CONCLUSION: SACE provided good symptom palliation for the majority of patients with hepatic metastases from MTC. However, transient remission or stabilization of hepatic metastases resulted in only 60%. Further studies using a randomized protocol are required.

  • 8.
    Muszynska, Carolina
    et al.
    Lund University, Sweden.
    Lundgren, Linda
    Lund University, Sweden; Skåne University Hospital, Sweden.
    Lindell, Gert
    Lund University, Sweden.
    Andersson, Roland
    Lund University, Sweden.
    Nilsson, Johan
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Kirurgiska kliniken US.
    Sandstrom, Per
    Lund University, Sweden; Skåne University Hospital, Sweden.
    Andersson, Bodil
    Lund University, Sweden.
    Predictors of incidental gallbladder cancer in patients undergoing cholecystectomy for benign gallbladder disease: Results from a population-based gallstone surgery registry2017Ingår i: Surgery, ISSN 0039-6060, E-ISSN 1532-7361, Vol. 162, nr 2, s. 256-263Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background. Gallbladder cancer is a rare neoplasm with a poor prognosis. Early diagnosis and correct treatment strategy is important. The aim of this study was to identify predictors for incidental gallbladder cancer. Methods. Data from cholecystectomies registered in the nationwide Swedish Register for Gallstone Surgery between 2007 and 2014 were analyzed for incidental gallbladder cancer. Exclusion criteria were patients with a gallbladder not sent for histopathology, preoperative suspicion of polyps/gallbladder cancer, and indication for operation for other reasons than gallstone disease. Predictive factors for incidental gallbladder cancer were identified using multivariable logistic regression. Results. A total of 86,154 procedures were registered in the Swedish Register for Gallstone Surgery. Of these, 36,355 patients were included in the analysis, and 215 of the included patients had incidental gallbladder cancer (0.59%). Mean age was 70 11 years for index cases and 54 16 years for the control group, and 80% of cases and 60% of controls were female. Predictors for incidental gallbladder cancer were older age (odds ratio = 1.08; P amp;lt; .001), female sex (odds ratio = 3.58; P amp;lt; .001), previous cholecystitis (odds ratio = 1.37; P = .045), and the combination of acute cholecystitis without jaundice (odds ratio = 1.39; P = .041) and jaundice without acute cholecystitis (odds ratio = 2.02; P = .009). A preoperative risk model including these factors gave an area under receiver operating characteristic curve of 0.82. By adding macroscopic evaluation of the gallbladder by the surgeon, the area under receiver operating characteristic curve increased to 0.87. Intraoperatively suspected gallbladder cancer was confirmed as cancer in 31 % of the cases. Conclusion. Incidental gallbladder cancer is more likely to be diagnosed in older patients, women, and after previous cholecystitis. Jaundice and acute cholecystitis were also shown to be important risk factors. Intraoperative inspection of the gallbladder improved the risk model.

  • 9.
    Røsok, Bård I
    et al.
    Department of Hepato-Pancreato-Biliary Surgery, Oslo University Hospital, Oslo, Norway.
    Björnsson, Bergthor
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Kirurgiska kliniken US.
    Sparrelid, Ernesto
    Department of Clinical Science, Intervention and Technology, Division of Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
    Hasselgren, Kristina
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Kirurgiska kliniken US.
    Pomianowska, Ewa
    Oslo University Hospital, Oslo, Norway.
    Gasslander, Thomas
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Kirurgiska kliniken US.
    Bjørnbeth, Bjørn Atle
    Oslo University Hospital, Oslo, Norway.
    Isaksson, Bengt
    Department of Clinical Science, Intervention and Technology, Division of Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
    Sandström, Per
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Kirurgiska kliniken US.
    Scandinavian multicenter study on the safety and feasibility of the associating liver partition and portal vein ligation for staged hepatectomy procedure.2016Ingår i: Surgery, ISSN 0039-6060, E-ISSN 1532-7361, Vol. 159, nr 5, s. 1279-1286Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has emerged as an additional tool to increase the size of the future liver remnant (FLR) in the settings of advanced tumor burden in the liver. Initial reports have indicated high feasibility but also high mortality and morbidity. The aim of this study was to assess the initial experience with ALPPS in Scandinavia regarding feasibility, morbidity, and mortality.

    MATERIALS AND METHODS: We conducted a retrospective analysis of all patients who underwent ALPPS since its introduction at 3 Scandinavian hepatobiliary centers.

    RESULTS: Thirty-six patients were identified, 21 male and 15 female. Median age was 67 years (22-83). Colorectal liver metastases (n = 25) were the most common indication for ALPPS followed by hepatocellular carcinoma (n = 4), cholangiocarcinoma (n = 4), and other (n = 3). Median growth of the FLR between the operations was 67% (-17 to 238) in 6 (5-13) days. All patients completed the second operation, and 71% of the resections were R0. Although the total percentage of patients with complication(s) was 92%, only 4 patients (11%) had a grade 3b complication according to the Clavien-Dindo classification, and no other severe complications were noted. There was no in-hospital mortality, but 1 (2.8%) patient died within 90 days of operation.

    CONCLUSION: ALPPS is a highly feasible method to stimulate FLR growth in patients with colorectal liver metastases as well as primary hepatobiliary malignancies. The treatment can be carried out with relative safety.

  • 10.
    Scerbo, Mark
    et al.
    Department of Psychology, Old Dominion University, Norfolk, VA.
    Britt, Rebecca
    Department of Surgery, Eastern Virginia Medical School, Norfolk, VA.
    Montano, Michael
    Department of Psychology, Old Dominion University, Norfolk, VA.
    Kennedy, Rebecca
    Department of Psychology, Old Dominion University, Norfolk, VA.
    Prytz, Erik
    Department of Psychology, Old Dominion University, Norfolk, VA.
    Stefanidis, Dimitri
    Bariatric Surgery Center, Indiana University, Bloomington, IN.
    The Effects of a retention interval and refresher session on intracorporeal suturing and knot tying skill and mental workload2017Ingår i: Surgery, ISSN 0039-6060, E-ISSN 1532-7361, Vol. 161, nr 5, s. 1209-1214Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background. The effects of refraining from practice for different intervals on laparoscopic suturing and mental workload was assessed with a secondary task developed by the authors. We expected the inability to practice to produce a decrease in performance on the suturing, knot tying, and secondary task and skills to rebound after a single refresher session.

    Methods. In total, 22 surgical assistant and premedical students trained to Fundamentals of Laparoscopic Surgery proficiency in intracorporeal suturing and knot tying were assessed on that task using a secondary task. Participants refrained from practicing any Fundamentals of Laparoscopic Surgery tasks for 1 or 5 months. At the time of their return, they were assessed immediately on suturing and knot tying with the secondary task, practiced suturing and knot tying for 40 minutes, and then were reassessed.

    Results. The mean suture times from the initial reassessment were greater than the proficiency times but returned to proficiency levels after one practice session, F(2, 40) = 14.5, P < .001, partial h2 = .420. Secondary task scores mirrored the results of suturing time, F(2, 40) = 6.128, P < .005, partial h2 = .235, and were moderated by retention interval.

    Conclusion. When participants who reached proficiency in suturing and knot tying were reassessed after either 1or 5 months without practice, their performance times increased by 35% and secondary task scores decreased by 30%. These deficits, however, were nearly reversed after a single refresher session.

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