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In This Issue of JAMA Surgery
September 2017

Highlights

JAMA Surg. 2017;152(9):809. doi:10.1001/jamasurg.2016.3447

Research

This study asked “Does the presence/absence of a simulated surgical task affect the acquisition of teamwork skills among midlevel surgical residents?” Fifteen residents and 6 practicing surgeons participated in a pre-post educational intervention pilot study. The results showed that including a surgical task in operating room team training significantly enhanced the acquisition of teamwork skills among midlevel surgical residents and that medium-fidelity synthetic anatomy was as effective as high-fidelity anatomy from deceased donors for promoting teamwork skills.

Invited Commentary

CME

This randomized clinical trial examines the effects of a modified Hospital Elder Life Program that include oral and nutritional assistance, early mobilization, and oriented communication. Chen and colleagues randomized 377 patients who were undergoing abdominal surgery to the modified Hospital Elder Life Program or control groups and found that helping older patients in the hospital stay well-fed, mobile, and oriented prevents delirium by 51% and reduces their length of stay by 2 days.

Invited Commentary

Using recursive partitioning and contemporary national data for 3315 patients from the Surveillance, Epidemiology, and End Results program cohort and the National Cancer Database, Adam and colleagues propose a staging revision for medullary thyroid cancer. The current American Joint Committee on Cancer system upstages many patients to stage IV. By reclassifying some patients with better survival rates into earlier stages, the proposed staging model better predicts survival, with important implications for treatment and surveillance strategies.

Invited Commentary

Author Audio Interview CME

Consolidation of hospital markets has been linked to higher costs of care, though this variation remains unexplored for complex surgery. Using the 2003-2011 Nationwide Inpatient Sample, Cerullo and colleagues examined the relationship between regional hospital market concentration and the costs of complex hepatic and pancreatic resections. They found that market concentration was associated with lower overall charges and lower costs.

Invited Commentary

Clinical Review & Education

Most patients with primary hyperparathyroidism have a mild form of the disease. In this article, Stephen and colleagues review the literature on the indications for surgery in primary hyperparathyroidism. The reviewed literature suggests that improved outcomes in patients with asymptomatic primary hyperparathyroidism who undergo curative surgery.

CME

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