World journal of surgery
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World journal of surgery · Sep 2009
Combined lumbar spinal and thoracic high-epidural regional anesthesia as an alternative to general anesthesia for high-risk patients undergoing gastrointestinal and colorectal surgery.
A prospective study was undertaken to review the use of combined lumbar spinal and thoracic high-epidural regional anesthesia in high-risk patients who underwent gastrointestinal/colorectal surgery from 2004 to 2006. ⋯ This study supports the role of regional anesthetic techniques, combined with targeted, minimally invasive surgery--particularly for the management of high-risk patients presenting in the emergency setting.
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World journal of surgery · Sep 2009
Use of a trauma service clinical pathway to improve patient outcomes for retained traumatic hemothorax.
Early evacuation of retained hemothorax (RHTX) has been shown to improve clinical outcomes. In 2006, our trauma surgery service instituted a clinical pathway for management of RHTX that was designed to decrease time to operation and improve patient outcomes. We report our experience with early evacuation of posttraumatic RHTX after instituting a service-wide clinical pathway. ⋯ Implementation of a clinical pathway for early evacuation of retained hemothorax can significantly improve patient outcomes and decrease hospital costs. Furthermore, trauma surgeons are capable of safely performing thoracic surgery for evacuation of retained hemothorax.