World journal of surgery
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World journal of surgery · Apr 2014
Surgical conditions account for the majority of admissions to three primary referral hospitals in rural Mozambique.
The World Health Organization has identified the primary referral hospital as its priority site for improving surgical care in low- and middle-income countries. Little is known about the relative burden surgical patients place on health care facilities at this level. This research estimates the fraction of admissions due to surgical conditions at three hospitals in rural Mozambique. ⋯ Surgical conditions are the most common reason for admissions at three primary referral hospitals in rural Mozambique. These data suggest that surgical care is a major component of health care delivered at primary referral hospitals in Mozambique and likely other sub-Saharan African countries.
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World journal of surgery · Apr 2014
Randomized Controlled TrialPerioperative immunonutrition in surgical cancer patients: a summary of a decade of research.
Immunonutrition is assumed to enhance immune system function. In surgical patients, it is supposed to reduce postoperative complications. However, results of recent clinical trials have been puzzling and have not supported this theory. ⋯ The type of postoperative nutrition was of no importance in well-nourished patients. However, in malnourished patients, enteral immunonutrition helped to improve treatment outcome. These findings suggest its use as a method of choice during the postoperative period.
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World journal of surgery · Apr 2014
Observational StudyImpact of intraoperative distractions on patient safety: a prospective descriptive study using validated instruments.
There is emerging evidence indicating that distractions in the operating room (OR) are prevalent. Studies have shown a negative impact of distractions, but they have been conducted mostly with residents in simulated environments. We tested the hypothesis that intraoperative distractions are associated with deterioration in patient safety checks in the OR. ⋯ Distractions are prevalent in ORs and in this study were linked to deterioration in intraoperative patient safety checks. Surgeons should be mindful of their tolerance to distractions. Surgical leadership can help control distractions and reduce their potential impact on patient safety and performance.
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World journal of surgery · Apr 2014
Multicenter StudyManagement of anastomotic leak: lessons learned from a large colon and rectal surgery training program.
Anastomotic leak is a dreaded surgical complication that can lead to significant morbidity and mortality. Despite its prevalence, there is no consensus on the management of anastomotic leak. This study aimed to review the management of anastomotic leak in the Division of Colon and Rectal Surgery at two institutions. ⋯ Anastomotic leak continues to result in patient morbidity and mortality. Its diverse presentation requires tailoring management to the patient. Nonoperative and operative treatments are viable options for intraperitoneal and extraperitoneal leaks based on patient presentation.
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World journal of surgery · Apr 2014
Comparative Study Clinical TrialA case-matched series of immediate total-body CT scanning versus the standard radiological work-up in trauma patients.
In recent years computed tomography (CT) has become faster and more available in the acute trauma care setting. The aim of the present study was to compare injured patients who underwent immediate total-body CT (TBCT) scanning with patients who underwent the standard radiological work-up with respect to 30-day mortality. ⋯ Trauma patients who underwent immediate TBCT scanning had similar absolute 30-day mortality rates compared to patients who underwent conventional imaging and selective CT scanning. However, immediate TBCT scanning was associated with a decreased 30-day mortality after correction for the impact of differences in raw ISS and in-hospital GCS.