Therapeutic, V.

Supplemental Digital Content is available in the text.

Therapeutic, III.

The ERAS protocol for alloplastic breast reconstruction is safe, without increased readmission or complication rates compared to TRAS, and significantly decreased length of stay.

Purpose To examine common themes and synthesize data surrounding pregnancy and parenthood during surgical residency training. Method The authors conducted a systematic search of the literature in March 2019. They searched MEDLINE, EMBASE, and Scopus, seeking articles published from 2003 to 2018 that focused on pregnancy, parenthood, and the experience of surgical residents. They excluded articles that examined nonsurgical programs, as well as editorials, abstracts, and commentaries. Two investigators independently reviewed all citations, selected articles for full-text review, and extracted data from the selected articles. Results Of 523 titles and abstracts screened, 27 were included. Overall, female surgical residents had fewer children during residency training than their male counterparts (18%–28% vs 32%–54%). As compared with the general population, surgical residents had their first child later in life (30–34 vs 25 years old), and had fewer children overall (0.6–2.1 vs 2.7). Infertility rates were higher among female surgeons than in the general population (30%–32% vs 11%), as were assisted reproductive technology rates (8%–13% vs 1.7%). Pregnant surgical residents experienced a high rate of obstetrical complications; working more than 6 overnight calls shifts per month or 60 hours per week were predictors of increased complication rates. The authors noted no differences in attrition, caseload, or exam pass rates amongst female surgical residents who had become pregnant as compared with other residents. Despite these similar academic outcomes, negative attitudes and perceptions toward pregnancy during residency were consistently identified. Conclusions Female surgical residents experience high rates of infertility and obstetrical complications, contend with negative attitudes and stigma during their pregnancies, and voluntarily delay childbearing. Formal maternity policies, a shift in surgical culture, and ongoing discussion with all stakeholders are needed to attract and retain female surgical residents.

Introduction Survival in uveal melanoma has remained unchanged since the early 1970s. Because outcomes are

The purpose of this study was to examine the perceived satisfaction and barriers to care for transgender patients after they decide to undergo gender-affirming surgery (GAS). Method: A survey consisting of 21 multiple-choice and short-answer questions was distributed to transgender organizations and online forums across Canada and the United States. The data were then analyzed using descriptive statistics. Results: There were 32 participants, 12 who identified as female to male and 20 as male to female. The mean age was 36 years, with a range of 18 to 81 years. The mean age of their first GAS was 33 years, and the range of wait time was 6 months to 7 years. Most of the participants received information about GAS from transgender websites and transgender surgery clinics (91% and 50%, respectively). Most participants (74%) felt like they had access to appropriate care and 89% felt like their surgeons provided enough information about GAS. There were 38% of participants who would change their experience with GAS. Participants stated several barriers toward receiving GAS: financial (73%), finding a physician (65%), and access to information (63%). Surgical transition was important to the quality of life for 91% of participants and 100% were happy with their decision to undergo GAS. Conclusions: Transgender participants demonstrated that GAS is important to their quality of life and this study showed significant barriers to GAS. Résumé Objectif : La présenteétude visait à examiner la perception de satisfaction et d'obstacles aux soins de la part des patients transgenres après qu'ils ont décidé de subir une opération de réassignation de genre (ORG). Méthodologie : Les chercheurs ont distribué un sondage composé de 21 questions à choix multiple et à réponse courte aux organisations transgenres et aux forums en ligne du Canada et des États-Unis. Ils ont ensuite analysé les données à l'aide de statistiques descriptives. Résultats : Au total, 32 personnes ont participé au sondage. Douze se sont identifiés comme hommes trans et 20, comme femmes trans. Ils avaient un âge moyen de 36 ans (plage de 18 à 81 ans). Ils avaient un âge moyen de 33 ans lors de leur première ORG et avaient dû attendre de six mois à sept ans pour la subir. La plupart des participants avaient reçu de l'information au sujet de l'ORG dans des sites pour les personnes transgenres et des cliniques chirurgicales de réassignation de genre (91 % et 50 %, respectivement). La plupart des participants (74 %) trouvaient qu'ils avaient eu accès à des soins appropriés et 89 % trouvaient que leur chirurgien leur avait fourni assez d'information sur l'ORG. Cependant, 38 % des participants auraient modifié leur expérience de l'ORG. Les participants ont souligné plusieurs obstacles à l'ORG : la question financière (73 %), la quête d'un médecin (65 %) et l'accès à l'information (63 %). La transition chirurgicaleétait importante pour la qualité de vie de 91 % des participants et ilsétaient tous heureux d'avoir subi une ORG. Conclusions : Les participants transgenres ont ...

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