World journal of surgery
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World journal of surgery · May 2015
Tracheobronchial fistula during the perioperative period of esophagectomy for esophageal cancer.
Tracheobronchial (TB) injury and fistula formation during the perioperative period of esophagectomy is a rare but life-threatening complication. ⋯ Careful dissection with direct vision of the esophagus, as well as oversewing of the staplers on the gastric tube, is mandatory for preventing TB injury and fistula formation. Appropriate drainage is effective in cases with peri-tracheal abscesses. If the TB fistula fails to heal within a 4- to 6-week period, conservative management should be abandoned. Direct surgical intervention with coverage by a muscle flap is important for TB fistulas.
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World journal of surgery · May 2015
B-type natriuretic peptide-guided risk assessment for postoperative complications in lung cancer surgery.
Since lung cancer surgery is still associated with a high complication rate, it is important to efficiently identify patients at high risk for postoperative complications following lung cancer surgery. We previously reported that elderly patients with elevated preoperative B-type natriuretic peptide (BNP) levels (>30 pg/mL) have an increased risk for postoperative atrial fibrillation and cardiopulmonary complications following lung cancer surgery. The objective of this study was to evaluate the clinical utility of BNP-guided risk classification for postoperative complications after lung cancer surgery. ⋯ Risk assessment using preoperative BNP levels was clinically useful for the identification of patients at high risk for postoperative complications.
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World journal of surgery · May 2015
Risk factors for incisional and organ space surgical site infections after liver resection are different.
Surgical site infection (SSI) is a common cause of major morbidity after liver resection. This study aimed to identify the risk factors for incisional and organ/space SSIs after liver resection. ⋯ High ASA scores, anemia, chronic hepatitis or liver cirrhosis, and prolonged operations increased the risk of incisional SSIs; concomitant bowel surgery increased the risk of organ/space SSI. Specific precautions to prevent organ/space and incisional SSIs may shorten hospital stays.
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World journal of surgery · May 2015
Long-term outcomes of open and video-assisted thoracoscopic lung lobectomy for the treatment of early stage non-small cell lung cancer are similar: a propensity-matched study.
Generally, in retrospective studies, favourable short- and long-term outcomes for patients after lung lobectomy for early stage non-small cell lung cancer (NSCLC) using video-assisted thoracoscopic surgery (VATS) have been reported. However, the interpretation of lung lobectomy outcomes may be biased in retrospective settings. ⋯ VATS lobectomy is less invasive than open lobectomy, but in terms of survival outcomes, VATS lobectomy was oncologically equivalent to open lobectomy. The oncological benefit of VATS reported by retrospective studies might be overestimated.
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World journal of surgery · May 2015
Postoperative hyperbilirubinemia suggests the occurrence of complications after esophagectomy for esophageal cancer.
Serum bilirubin levels frequently increase after esophagectomy for esophageal cancer. Several studies have reported hyperbilirubinemia in patients with postoperative complications. We aimed to perform a detailed large-scale analysis to clarify this association. ⋯ Although various factors impact postoperative hyperbilirubinemia, postoperative complications were most significantly associated with postoperative hyperbilirubinemia. Patients with postoperative hyperbilirubinemia after esophagectomy must be managed more carefully because unnoticed complications may be associated with hyperbilirubinemia.