World journal of surgery
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World journal of surgery · Sep 2011
Risk factors influencing postoperative outcomes of major hepatic resection of hepatocellular carcinoma for patients with underlying liver diseases.
Major hepatic resection of more than three segments in patients with hepatocellular carcinoma (HCC) is a high-risk operation, especially in patients with co-existing underlying liver diseases. The present study evaluated risk factors for postoperative morbidity and mortality after major hepatic resection in HCC patients with underlying liver diseases. ⋯ Careful preoperative selection of patients in terms of the Child-Pugh classification and decrease of intraoperative blood loss are important measures to reduce postoperative morbidity after major hepatic resection in HCC patients with underlying liver diseases. Moreover, we should be aware that preoperative platelet count is independently associated with postoperative morbidity and mortality for those patients following major hepatic resection.
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World journal of surgery · Sep 2011
Comparative StudyLearning curve of transumbilical single incision laparoscopic cholecystectomy (SILS): a preliminary study of 80 selected patients with benign gallbladder diseases.
Transumbilical single incision laparoscopic surgery (SILS) is a new laparoscopic procedure in which only one transumbilical incision is made, demonstrated as a scarless procedure. Here we report a single-center preliminary experience of transumbilical single incision laparoscopic cholecystectomy (SILC) in the treatment of benign gallbladder diseases, defining a single surgeon's learning curve. ⋯ For experienced laparoscopic surgeons, SILC is an easy and safe procedure. Patients benefit from milder pain, a lower incidence of port-related complications, better cosmesis, and fast recovery. The SILC procedure may become another option for the treatment of benign gallbladder diseases for selected patients.
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World journal of surgery · Sep 2011
Thoracoscopic simultaneous bilateral bullectomy through apicoposterior transmediastinal access for bilateral spontaneous pneumothorax: a challenging approach.
Video-assisted thoracoscopic surgery (VATS) through transmediastinal access (TMA) for contralateral thoracic cavity is an operative alternative for bilateral pulmonary lesions. Recently, we introduced a novel method of apicoposterior TMA to perform simultaneous VATS bilateral bullectomy (BB) for bilateral spontaneous pneumothorax (BPTX). We retrospectively analyzed ten patients on whom this procedure was performed and evaluated the effectiveness of this approach. ⋯ A VATS apicoposterior transmediastinal approach is relatively safe and technically reliable for highly selective BPTX patients who have localized blebs or bullae on the left apical lung. Pleural reinforcement procedures may also be required for the prevention of postoperative recurrence.
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World journal of surgery · Sep 2011
Changes in metabolic profile and adipoinsular axis in morbidly obese premenopausal females treated with restrictive bariatric surgery.
The aim of the present study was to evaluate the effects of surgically induced weight loss on the metabolic profile and adipocytokine levels in premenopausal morbidly obese females. ⋯ The results of this study suggest that weight loss through restrictive bariatric surgery results in a significant reduction in leptin, resistin, and IL-6 levels, and an increase in adiponectin levels, in addition to improving insulin sensitivity and glucose and lipid homeostasis in young morbidly obese female patients. These changes were significantly correlated with the magnitude of weight loss.
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World journal of surgery · Sep 2011
Noninvasive positive pressure ventilation in the management of post-thyroidectomy tracheomalacia.
Post-thyroidectomy tracheomalacia is a rare but complicated problem. It has often been treated with tracheostomy or prolonged endotracheal intubation. However, noninvasive positive pressure ventilation (NPPV) has been successfully employed with increasing frequency in patients with respiratory failure from other causes. In the present study we describe the use of NPPV in the management of respiratory distress in patients with post-thyroidectomy tracheomalacia. ⋯ Noninvasive positive pressure ventilation is effective and appears safe in the management of stridor and airway compromise following early extubation in patients with post-thyroidectomy tracheomalacia.