International journal of surgery
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Enhanced recovery programmes (ERAS) are safe and have been shown to decrease the length of the hospital stay and complications following colorectal surgery. However implementation of ERAS requires dedicated resources. In addition, the practice of ERAS still varies between different surgeons and in different centres. ⋯ Adherence to ERAS among colorectal surgeons is relatively high. Certain aspects of perioperative practice have potential for improvement. Practice of ERAS should be encouraged in both laparoscopic and open surgery.
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Over the past decade there has been considerable change to surgical training such as modernising medical careers which have raised concerns over exposure to operative experience. With the National Health Service (NHS) plan aiming for the majority of elective surgical cases to be performed as day cases we sought to assess the level of exposure modern day surgical trainees obtain in day case surgery. ⋯ The survey reveals that the modern surgical trainee is gaining a low and inconsistent level of exposure to day case surgery despite being aware of the importance of this modality of training. An urgent review is required to ensure trainees become actively involved in day case surgery and are not missing on this vital training opportunity.
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The aim of this study was to assess the role of adding gabapentin (Neurontin) to the prescription of patients with opiate resistant pain as a result of critical limb ischaemia (CLI). ⋯ The study has demonstrated that gabapentin is a useful adjuvant in the management of CLI and leads to significant reductions in pain scores and improves night pain for most patients.
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To evaluate the risk-adjusted perioperative outcome of colorectal cancer surgery, applying the Colorectal Physiological and Operative Severity Score for the enumeration of Mortality and morbidity (CR-POSSUM). ⋯ Perioperative outcome of colorectal surgery in Trinidad and Tobago is comparable to the developed countries as evaluated by the CR-POSSUM. Patients presenting for emergency surgery and those with advanced stages of cancer had higher perioperative mortality.
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To compare the traditional anatomic landmark technique with the ultrasound-guided method for central venous catheterization. ⋯ The ultrasound-guided method is faster, more efficient, and less morbid procedure compared with the classical anatomic landmark technique. Therefore, it should be preferred over the classical landmark method, especially in high-risk patients for the development of complications.