World journal of surgery
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World journal of surgery · Aug 2013
Review Meta AnalysisSystematic review and meta-analysis of enhanced recovery after pancreatic surgery with particular emphasis on pancreaticoduodenectomies.
In the past decade, Enhanced Recovery after Surgery (ERAS) protocols have been implemented in several fields of surgery. With these protocols, a faster recovery and shorter hospital stay can be accomplished without an increase in morbidity or mortality. The purpose of this study was to review systematically the evidence for implementation of an ERAS protocol in pancreatic resections, with particular emphasis on pancreaticoduodenectomies (PDs). ⋯ This systematic review suggests that using an ERAS protocol in pancreatic resections may help to shorten hospital length of stay without compromising morbidity and mortality. This seemed to apply to distal pancreatectomy, total pancreatectomy, and PD. Meta-analysis was performed for those studies focusing on PD and showed that there were no differences in readmission or mortality. Morbidity rates were significantly lower for patients managed according ERAS principles.
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World journal of surgery · Aug 2013
Long-term outcome and quality of life after laparoscopic treatment of large paraesophageal hernia.
Laparoscopy has been widely used for surgical repair of large paraesophageal hernias (PEHs). The technique, however, entails substantial technical difficulties, such as repositioning the stomach in the abdominal cavity, sac excision, closure of the hiatal gap, and fundoplication. Knowledge of the long-term outcome (>10 years) is scarce. The aim of this article was to evaluate the long-term results of this approach, primarily the anatomic hernia recurrence rate and the impact of the repair on quality of life. ⋯ Long-term follow-up (up to 160 months) in our study showed that laparoscopic PEH repair is clinically efficacious but is associated with small anatomic recurrences in ≤50 % of patients. Further studies are needed to identify the anatomic, pathologic, and physiological factors that may impair outcome, allowing the procedure to be tailored to each patient.
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World journal of surgery · Aug 2013
Nationally representative household survey of surgery and mortality in Sierra Leone.
There is limited evidence to characterize the burden of unmet need of surgical diseases in low- and middle-income countries. The purpose of this study was to determine rate of deaths attributable to a surgical condition and reasons for not seeking surgical care in Sierra Leone. ⋯ A large proportion of deaths in Sierra Leone was associated with surgical conditions, the majority of which did not undergo surgical intervention. Our results indicate that to remove barriers to effective surgical care in Sierra Leone policymakers should first focus on relieving financial burdens and increasing access to timely surgical care.
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World journal of surgery · Aug 2013
Biography Historical Article"Anatomy lesson of Frederik Ruysch" of 1670: a tribute to Ruysch's contributions to lymphatic anatomy.
Frederick Ruysch was one of the most prominent Dutch physicians of the seventeenth and eighteenth centuries. For more than 65 years, he was the Praelector Anatomiae (Lecturer of Anatomy) of the Amsterdam Guild of Surgeons. During his career, he conducted many dissections at the guild's theatre to teach anatomy. Ruysch was internationally renowned for his great dissection skills and his innovative techniques for preserving anatomical specimens. The "Anatomy Lesson of Dr. Frederik Ruysch" painted in 1670, is thought to be a group portrait undertaken to commemorate the officials of the Guild of Surgeons. Ruysch was portrayed performing an anatomical dissection of inguinal lymph nodes on the corpse of an executed criminal. This portrait is one of the earliest paintings focusing on the "lymphatic system." ⋯ Frederik Ruysch should be considered one of the pioneers contributing to the early knowledge of the lymphatic system. He succeeded in dissecting the lymphatic vessels and valves with the aid of his innovative dissection and preservation techniques. The famous group portrait of the Amsterdam Guild of Surgeons with Ruysch demonstrating the lymph nodes pays tribute to his work on which we still rely today.