World journal of surgery
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World journal of surgery · Aug 2001
Randomized Controlled Trial Comparative Study Clinical TrialLactate metabolism during laparoscopic cholecystectomy: comparison between CO2 pneumoperitoneum and abdominal wall retraction.
Recent reports have implicated CO2 pneumoperitoneum for laparoscopic surgery in the occurrence of postoperative mesenteric ischemia. With this kind of surgery, the increase in blood lactate levels has been attributed to anaerobic metabolism, probably due to tissue ischemia induced by high intraabdominal pressure (IAP). The aim of this study was to evaluate the metabolic repercussion of CO2 pneumoperitoneum during laparoscopic cholecystectomy (LC). ⋯ Lactate concentration, expressed as mean (SD), went from 25.4 (14.4) mg/dl at baseline to 18.9 (13.6) mg/dl 4 hours after surgery in the PP group and from 19.4 (6.1) mg/dl at baseline to 17.8 (14.7) mg/dl in the AWR group. No significant differences were found between groups intraoperatively (p = 0.116) or postoperatively (p = 0.99). Our study did not show significant differences in blood lactate levels during LC with CO2 pneumoperitoneum compared to the same procedure with abdominal wall retraction.
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World journal of surgery · Aug 2001
ReviewCervical pharyngoesophageal and laryngotracheal injuries.
Aerodigestive tract injuries in the neck are found in about 7% of penetrating neck injuries and are very rare in blunt trauma. A combination of a good physical examination with endoscopy and esophagography can reliably diagnose all significant injuries. Airway control in laryngotracheal trauma is the most urgent priority and is often a difficult procedure. Although selected small pharyngeal and laryngotracheal injuries may be managed nonoperatively, all other aerodigestive tract injuries should be managed with early operation.
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World journal of surgery · Aug 2001
Biography Historical ArticleErnst Ferdinand Sauerbruch: rise and fall of the pioneer of thoracic surgery.
Ferdinand Sauerbruch (1875-1951) was a pioneer of thoracic and cardiac surgery and is undoubtedly one of the twentieth century's most outstanding surgeons. Before 1904 operations on the thorax met with fatal complications due to pneumothorax. Sauerbruch developed a pressure-differential chamber that maintained normal respiration and enabled safe operations to be undertaken on the thorax. ⋯ He died at the age of 76 in Berlin. After almost a century since the advent of the first safe thoracic surgery, the advances in technique and technology have been enormous. A great deal is owed to the inspiration and contributions of Ferdinand Sauerbruch.
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World journal of surgery · Aug 2001
Evaluation of cervical spine in intensive care patients following blunt trauma.
The aim of this study was to review a Level 1 trauma center's use of early (< 72 hours from injury) limited MRI to "clear" cervical spine extradural soft tissue injuries in ICU patients sustaining blunt trauma. A retrospective review of the records of patients meeting entry criteria during 1997 was performed. Demographic data, cervical spine radiographic and imaging evaluation, results, and follow-up information were gathered. ⋯ MRI is a noninvasive imaging technique that allows evaluation of extradural soft tissue injury with potentially less patient risk and with fewer personnel. MRI allows early liberation of cervical spine precautions in those patients with negative studies. Further studies are needed to compare specific ligamentous injury patterns by MRI with dynamic studies of the C-spine to further define MRI injury patterns indicating risk of acute spinal instability.