World journal of surgery
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World journal of surgery · May 2012
Review Meta AnalysisSomatostatin analogues for the treatment of enterocutaneous fistulas: a systematic review and meta-analysis.
Enterocutaneous fistulas are abnormal connections between the skin and gastrointestinal tract that most commonly occur after surgery. Somatostatin analogues have been used in their treatment. The objective of the present study was to determine if somatostatin analogues shorten the time to closure of postoperative enterocutaneous fistulas compared to placebo. ⋯ Somatostatin analogues appear to decrease the duration of enterocutaneous fistulas and duration of hospital stay, but no mortality benefit was identified. The quality of evidence for outcomes in this review ranged from low to moderate. Future large, blinded, RCT would be useful in improving the confidence in the treatment effects identified in this systematic review and meta-analysis.
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World journal of surgery · May 2012
Risk associated with bilobectomy after neoadjuvant concurrent chemoradiotherapy for stage IIIA-N2 non-small-cell lung cancer.
The aim of the present study was to evaluate the outcomes of surgical resection, especially bilobectomy, after chemoradiation therapy to treat stage IIIA-N2 non-small-cell lung cancer. ⋯ Bilobectomy is associated with high operative mortality and poor long-term survival after neoadjuvant concurrent chemoradiotherapy for stage IIIA-N2 non-small-cell lung cancer. The outcomes of bilobectomy were similar to those of pneumonectomy in terms of overall survival, disease-free survival, and postoperative mortality.
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World journal of surgery · May 2012
Challenges of surgery in developing countries: a survey of surgical and anesthesia capacity in Uganda's public hospitals.
There are large disparities in access to surgical services due to a multitude of factors, including insufficient health human resources, infrastructure, medicines, equipment, financing, logistics, and information reporting. This study aimed to assess these important factors in Uganda's government hospitals as part of a larger study examining surgical and anesthesia capacity in low-income countries in Africa. ⋯ There is a lack of vital human resources and infrastructure to provide adequate, safe surgery at many of the government hospitals in Uganda. A large number of surgical procedures are undertaken despite these austere conditions. Many areas that need policy development and international collaboration are evident. Surgical services need to become a greater priority in health care provision in Uganda as they could promise a significant reduction in morbidity and mortality.
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World journal of surgery · May 2012
An estimate of the number of lives that could be saved through improvements in trauma care globally.
Reducing the global burden of injury requires both injury prevention and improved trauma care. We sought to provide an estimate of the number of lives that could be saved by improvements in trauma care, especially in low income and middle income countries. ⋯ A significant number of lives could be saved by improvements in trauma care globally. This is another piece of evidence in support of investment in and greater attention to strengthening trauma care services globally.
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World journal of surgery · May 2012
Randomized Controlled Trial Multicenter Study Comparative StudyDesarda versus Lichtenstein technique for primary inguinal hernia treatment: 3-year results of a randomized clinical trial.
The Shouldice method and other tissue-based techniques are still acknowledged to be acceptable for primary inguinal hernia repair according to the European Hernia Society guidelines. Desarda's technique, presented in 2001, is an original hernia repair method using an undetached strip of external oblique aponeurosis. This randomized trial compared outcomes after hernia repair with Desarda (D) and mesh-based Lichtenstein (L) techniques. ⋯ The results of primary inguinal hernia repair with the Desarda and Lichtenstein techniques are comparable at the 3-year follow-up. The technique may potentially increase the number of tissue-based methods available for treating groin hernias.