International journal of surgery
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Herniorrhaphy is one of the most frequently performed general surgical operations worldwide. However, most low- and middle-income countries (LMICs) are unable to provide this essential surgery to the general public, resulting in considerable morbidity and mortality. This study aimed to estimate the prevalence, barriers to care and disability of untreated hernias in Nepal. ⋯ Despite the lower than expected prevalence of inguinal hernias, hundreds of thousands of people in Nepal are currently in need of surgical evaluation. Given that essential surgery is a necessary component in health systems, the prevalence of inguinal hernias and the cost-effectiveness of herniorrhaphy, this disease is an important target for LMICs planning surgical capacity improvements.
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Developing countries without established surgical capacity face heightened morbidity and mortality from poorly understood, untreated thoracic surgical impairments. This study sought to estimate the prevalence of thoracic surgical need in a low-income country and consider contributing factors involved. ⋯ The study provides data on the prevalence of thoracic surgical conditions and factors affecting prevalence in one of the world's poorest countries. The results speak to the need for further work to enhance health systems strengthening while offering the opportunity for future training and research in resource-limited settings--an area of thoracic surgery that is not well understood.
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Review Meta Analysis
Allogeneic blood transfusion and the prognosis of gastric cancer patients: systematic review and meta-analysis.
Perioperative allogeneic blood transfusion (ABT) may be a deleterious predictor on the prognosis of gastric cancer (GC) for subjects who had undergone curative surgeries. In this article we proposed to figure out the effect of ABT with a systematic review and meta-analysis. ⋯ In GC patients undergoing curative surgeries, ABTs are associated with a worse prognosis, including all-cause mortality, cancer-related mortality and recurrence. Patient blood management should be investigated further to minimize use of ABT.
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The majority of evidence for use of gentamicin-containing collagen implants (GCCI) demonstrates a positive impact on infection prophylaxis despite the equivocal results of a recently published large-scale study. The primary aim of the study was to evaluate the impact of prophylactic use of GCCI on SWI following cardiac surgery in a routine clinical setting. A secondary aim was to identify the risk factors for SWI among the patient cohort. ⋯ In routine clinical practice the addition of GCCI to standard infection prophylaxis reduces the risk of both SSWI and DSWI in high-risk patients undergoing cardiac surgery.