World journal of surgery
-
World journal of surgery · May 2014
Randomized Controlled Trial Comparative StudyContinuous absorbable intradermal sutures yield better cosmetic results than nonabsorbable interrupted sutures in open appendectomy wounds: a prospective, randomized trial.
Acute appendicitis is the most common reason for abdominal surgery in young adults and children. Open appendectomy is still the treatment often chosen because it is simple, safe, and effective. Our aim was to study whether cosmetic results of appendectomy wounds are better after using continuous absorbable intradermal (A) sutures compared with wound closure with interrupted nonabsorbable (NA) sutures. ⋯ Continuous intradermal absorbable suturing yields a better cosmetic result than interrupted nonabsorbable suturing in lower abdominal transverse appendectomy.
-
World journal of surgery · May 2014
Randomized Controlled Trial Comparative StudyWide resection of inguinal nerves versus simple section to prevent postoperative pain after prosthetic inguinal hernioplasty: our experience.
In the literature, chronic groin pain (i.e. lasting >3 months) occurs in about 10 % of patients who undergo inguinal hernioplasty with prosthesis; it is characterized by a broad range of symptoms, and is relative to individual perceptions of pain. In 2-5 % of cases, the painful symptomatology is so intense that it interferes with daily activities, and can be debilitating in 0.5-6 % of cases. The best known cause of inguinodynia is neuropathy, due to implication of one or more inguinal nerves (iliohypogastric, ilioinguinal, and genitofemoral nerves) into fibroblastic processes; or from nervous stimulation caused by prosthetic material on adjacent nervous trunks. Many therapeutic strategies have been proposed to treat chronic groin pain, including intra-operative prophylactic neurectomy. ⋯ The prophylactic wide resection of selected segments of inguinal nerves, despite the apparent paradox of greater tissue damage, appears more effective than simple section at preventing postoperative inguinodynia, given both the lower incidence and the faster resolution of painful symptomatology.
-
World journal of surgery · May 2014
Multicenter StudyIs current perioperative practice in hepatic surgery based on enhanced recovery after surgery (ERAS) principles?
The worldwide introduction of multimodal enhanced recovery programs has also changed perioperative care in patients who undergo liver resection. This study was performed to assess current perioperative practice in liver surgery in 11 European HPB centers and compare it to enhanced recovery after surgery (ERAS) principles. ⋯ Perioperative care among centers that perform liver resections varied substantially. In current HPB surgical practice, some elements of the ERAS program, e.g., preoperative counselling and minimal fasting, have already been implemented. Elements in the perioperative phase (avoidance of drains and nasogastric tube) and postoperative phase (early resumption of oral intake, early mobilization, and use of recovery criteria) should be further optimized.
-
World journal of surgery · May 2014
Comparative StudyMorbidity of chemotherapy administration and satisfaction in breast cancer patients: a comparative study of totally implantable venous access device (TIVAD) versus peripheral venous access usage.
This prospective, non-randomized, comparative study evaluated morbidity of chemotherapy administration via a totally implantable venous access device (TIVAD) versus peripheral intravenous access (PIVA), and satisfaction in breast cancer patients in a limited-resource setting. ⋯ Breast cancer chemotherapy via TIVAD is safe and convenient and results in high satisfaction levels, although it involves additional expenditure. Chemotherapy via PIVA is acceptable, albeit with lower satisfaction, more so in those receiving more than six chemotherapy cycles.
-
World journal of surgery · May 2014
Improved outcomes in the management of high-risk incisional hernias utilizing biological mesh and soft-tissue reconstruction: a single center experience.
Repair of incisional hernias is complex in the setting of previous/current infection, loss of domain and bowel involvement, and is often on the background of significant co-morbidities. Reported repair techniques are associated with significant morbidity and led our unit to develop a novel technique for complex incisional hernia repair. ⋯ This technique was associated with a low risk of surgical site occurrences and hernia recurrence, with no requirements for mesh explantation. Repair of such complex incisional hernias remains challenging, and further randomized controlled trials are required to elucidate the optimal method of closure and mesh type.