World journal of surgery
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World journal of surgery · Oct 2013
Comparative Study Clinical TrialInitial experiences of an enhanced recovery protocol in esophageal surgery.
A recent development in gastrointestinal surgery is the implementation of enhanced recovery after surgery (ERAS) programs. Evidence regarding the benefit of these programs in patients undergoing esophageal surgery is scarce. We investigated the feasibility and possible benefit of a perioperative ERAS program in patients undergoing esophagectomy for malignant disease. ⋯ The implementation of an ERAS program in esophageal surgery was feasible and resulted in a small but significant reduction in overall hospital stay, whereas overall morbidity was not affected.
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World journal of surgery · Oct 2013
Clinical TrialIdentification of hepatoma-derived growth factor as a potential prognostic and diagnostic marker for extrahepatic cholangiocarcinoma.
Hepatoma-derived growth factor (HDGF) has been reported to play a pivotal role in the development and progression of several tumors. The aim of the present study was to analyze whether HDGF is a potential prognostic and diagnostic marker for extrahepatic cholangiocarcinoma (EHCC). ⋯ HDGF was a valuable independent prognostic factor after curative resection in EHCC, and it provided an important basis for screening/treating high-risk patients. Meanwhile, our study indicated that serum HDGF levels can be used as a noninvasive and potential diagnostic marker for EHCC.
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World journal of surgery · Oct 2013
Observational StudyEvaluation of trauma care in a mature level I trauma center in the Netherlands: outcomes in a Dutch mature level I trauma center.
Trauma centers are associated with improved survival rates and outcomes in trauma patients. In 2000 our hospital officially became a level I trauma center. The implementation of the trauma center model showed a significant reduction in mortality and hospital length of stay in our hospital and throughout the trauma region. The aim of the present prospective database study was to present the outcomes of patients treated during the course of further maturation of a level I trauma center. ⋯ Maturation of the trauma center and the trauma system resulted in improved patient outcomes. A significant increase in unexpected survivors was noted, and shorter hospital stay and ICU stay were achieved. Of note, population-based studies on trauma system and trauma center performance with statistical analysis by logistic regression are considered strong class III evidence.
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World journal of surgery · Oct 2013
Comparative Study Clinical TrialOutcomes after emergency versus elective ventral hernia repair: a prospective nationwide study.
Early surgical results after emergency repairs for the most frequent ventral hernias (epigastric, umbilical, and incisional) are not well described. Thus, the aim of present study was to investigate early results and risk factors for poor 30-day outcome after emergency versus elective repair for ventral hernias. ⋯ Emergency umbilical/epigastric or incisional hernia repair was beset with up to 15-fold higher mortality, reoperation, and readmission rates than elective repair. Older age, female gender, and umbilical hernia defects between 2 and 7 cm or incisional hernia defects up to 7 cm were important risk factors for emergency repair.
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World journal of surgery · Oct 2013
Randomized Controlled Trial Comparative StudyEarly oral feeding versus traditional postoperative care after abdominal emergency surgery: a randomized controlled trial.
Early oral feeding (EOF) has been demonstrated to be safe and beneficial after abdominal elective surgery. The aim of this randomized controlled trial is to assess the safety and benefits of EOF compared to traditional postoperative care (TPC) after abdominal emergency surgery. ⋯ EOF was safe after abdominal emergency surgery. EOF was associated with more vomiting (treated easily and without patient discomfort) and less hunger than with TPC. No other EOF-related benefits could be demonstrated during this trial.