International journal of surgery
-
Acute appendicitis is among the most common indications for emergency abdominal surgery. The risk of perforation might increase with a delay in treatment. Therefore, appendicitis is considered a surgical emergency, leading to appendectomies being frequently performed off-hours. However, numerous studies from other medical specialties have shown less favourable outcomes in patients admitted or treated off-hours than in those treated during regular working hours. The purpose of this study was to determine whether the time of day of the procedure and preoperative delay in appendectomy have significant impacts on morbidity and mortality rates. ⋯ The time of day of performing an appendectomy does not seem have any significant effect on complication and mortality rates. However, a longer length of preoperative stay significantly increases the risk of complications and mortality. Night-time operations should be preferred over next-day surgery considering the equal perioperative risks observed in this study.
-
Percutaneous endoscopic transforaminal lumbar interbody fusion (PETLIF) has been used in the treatment of lumbar degenerative diseases, as a novel minimally invasive technique. ⋯ The study indicated that PETLIF had advantages of less surgical trauma, less postoperative low-back pain, less hidden blood loss, and faster recovery, compared with MIS-TLIF. There was no significant difference in medium-short term surgical outcomes between the 2 techniques. However, the indications of PETLIF is relatively limited, and the learning curve of PETLIF is deep, surgeons need to select indications strictly. Further study with big sample size and long-term follow-up is needed.
-
Patients with multi-vessel coronary artery disease and poor left ventricular (LV) function (ejection fraction [EF] < 30%) requiring revascularization are considered 'high-risk'. Limited long-term survival data exists comparing percutaneous coronary intervention (PCI) with second-generation drug-eluting stents (DES) versus surgery for this cohort of patients. ⋯ Surgical revascularization, preferably off-pump CABG, results in better long-term survival compared with PCI using second generation DES for patients with multi-vessel coronary artery disease and poor left ventricular function. Randomized controlled trials in this patient group should be undertaken.