World journal of surgery
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World journal of surgery · Nov 2014
First 100 laparoscopic surgeries in a predominantly rural Nigerian population: a template for future growth.
Minimal access surgery has revolutionized surgery practice. Its proven advantages, such as reduced postoperative pain, early return to unrestricted activities, and better cosmesis, have become important drivers for its rapid development. In sub-Saharan Africa this development has been slow. The aim of the current study was to describe the challenges and outcomes of laparoscopic procedures in a public hospital that caters to a predominantly rural population. ⋯ Our study suggests that basic laparoscopic procedures could be offered safely to our resource-poor rural population. It is a platform on which we can hopefully introduce advanced laparoscopic surgical operations.
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World journal of surgery · Nov 2014
Early postoperative small bowel obstruction is an independent risk factor for subsequent adhesive small bowel obstruction in patients undergoing open colectomy.
This prospective study was performed to investigate whether postoperative ileus (POI) or early postoperative small bowel obstruction (EPSBO) affects the development of adhesive small bowel obstruction (SBO) in patients undergoing colectomy. ⋯ The development of adhesive SBO after colectomy is more frequent in patients with EPSBO and colostomy; however, POI does not increase the risk of adhesive SBO.
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World journal of surgery · Nov 2014
Enhanced recovery after surgery pathway in patients undergoing pancreaticoduodenectomy.
Enhanced recovery after surgery (ERAS(®)) pathways have reduced morbidity and length of hospital stay (LOS) in orthopedics, bariatric, and colorectal surgery. New perioperative care protocols have been tested in patients undergoing pancreaticoduodenectomy (PD), with controversial results on morbidity. Incomplete data about ERAS items compliance have been reported. The aim of this study was to assess compliance with an ERAS protocol and its impact on short-term outcome in patients undergoing PD. ⋯ The ERAS pathway was feasible and safe, yielding an earlier postoperative recovery. An ERAS protocol should be implemented in patients undergoing PD; however, patients with early postoperative low compliance should be carefully managed.
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World journal of surgery · Nov 2014
Sensitivity and specificity of red cell distribution width in diagnosing acute mesenteric ischemia in patients with abdominal pain.
We investigated the utility of the red cell distribution width (RDW) in diagnosing acute mesenteric ischemia (AMI) in patients with abdominal pain. ⋯ The RDW on admission is of marginal help to diagnose AMI among patients with abdominal pain.
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World journal of surgery · Nov 2014
Preoperative biliary drainage of severely jaundiced patients increases morbidity of pancreaticoduodenectomy: results of a case-control study.
Recent studies have indicated that preoperative biliary drainage (PBD) should not be routinely performed in patients suffering from obstructive jaundice before surgery. The severity of jaundice that mandates PBD has yet to be defined. Our aim was to investigate whether PBD is truly justified in severely jaundiced patients before pancreaticoduodenectomy. The parameters evaluated were overall morbidity, length of hospital stay, and total in-hospital mortality. ⋯ Even severe jaundice should not be considered as an indication for PBD before pancreaticoduodenectomy, as PBD increases infections and postoperative morbidity, therefore delaying definite treatment.