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This Month in
March 01, 2005

This Month in Archives of Surgery

Arch Surg. 2005;140(3):223. doi:10.1001/archsurg.140.3.223

Moore et al reviewed a liver transplant series at Vanderbilt University (Nashville, Tenn) totaling 483 patients, trying to provide some insight into the reason for success in these endeavors. They found that the risk factors included age (older than 60 years), urgency status, and prolonged cold ischemia time and that the cumulative effects of these risk factors can be modeled to predict posttransplant survival.

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From Tel Aviv, Israel, comes this study of 329 patients, half of whom had mechanical bowel preparation and half of whom did not. The groups were otherwise similar. The results suggested that no advantage was gained by the mechanical bowel preparation in elective colorectal surgery.

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Dosis et al from St Mary’s Hospital in London, England, combined the use of dexterity- based and video systems to produce a comprehensive surgical assessment tool. Dexterity analysis was performed using objective parameters of time, path length, number of movements, and velocities and trajectories and was synchronized into the platform with video analysis leading to greater efficiency during the assessment of surgical skills. The ultimate goal is to completely automate assessment in surgery, and the mathematic modeling has produced encouraging preliminary results.

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Theme Issue: Cultural Changes in Surgery

Surgery is an evolving profession. Surgeons in current practice need to reevaluate their interactions with their medical colleagues. The surgical residency program has changed to a more collaborative disease-based system, states Dr Aurora D. Pryor of Duke University Medical Center, Durham, NC.

The surgical curriculum needs changes to be more education oriented, including the 6 competencies, declares Dr L. D. Britt of Eastern Virginia Medical School, Norfolk.

Joel T. Allison and associates have outlined how the Baylor Health Care System in Dallas, Tex, has evolved over the years.

Dr Jo Buyske, chief of surgery at one of the University of Pennsylvania hospitals in Philadelphia, reviews the role of women in the history of surgery, stressing that although women have not blended seamlessly into the world of surgery, it will happen and probably sooner than one imagines.

Dr Erik D. Van Eaton and colleagues from the University of Washington, Seattle, provide us with an article relating to the team concept of patient care. Hopefully, we will have residents who say “that is our patient” rather than “that is not my patient” and will provide better care than ever.

The young surgeon’s perspective is provided by Dr Richard J. Bold of the University of California Davis Medical Center, Sacramento, who not long ago was a resident himself.

The surgical chief’s perspective is provided by Dr R. Daniel Beauchamp of Vanderbilt University.

Finally, Dr Ajit K. Sachdeva, director of the Division of Education of the American College of Surgeons, Chicago, Ill, has proposed a “new paradigm of continuing education in surgery.”

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Medical and Surgical Management of Chronic Ulcerative Colitis

This article by Cima and Pemberton of the Mayo Clinic, Rochester, Minn, reviews the status of patients with this disease and the treatment modalities.

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