World journal of surgery
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World journal of surgery · Mar 2012
Multivariable analysis of cholecystectomy after gastrectomy: laparoscopy is a feasible initial approach even in the presence of common bile duct stones or acute cholecystitis.
When performing cholecystectomy after gastrectomy, we often encounter problems, such as adhesions, nutritional insufficiency, and bowel reconstruction. The purpose of this study was to identify the factors related to surgical outcome of these associated procedures, with emphasis on the use of a laparoscopic approach. ⋯ The laparoscopic approach is feasible for cholecystectomy after gastrectomy, even in cases with CBD stones or acute cholecystitis. This approach does not appear to increase operation time or complication rate and was shown to decrease the length of postoperative hospital stay.
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Since the mid-1990s the surgical community has seen a surge in the prevalence of open abdomens (OAs) reported in the surgical literature and in clinical practice. The OA has proven to be effective in decreasing mortality and immediate postoperative complications; however, it may come at the cost of delayed morbidity and the need for further surgical procedures. Indications for leaving the abdomen open have broadened to include damage control surgery, abdominal compartment syndrome, and abdominal sepsis. ⋯ Additionally, critical care strategies for optimization of the patient with an OA are still being developed. Review of the literature suggests a bimodal distribution of primary closure rates, with early closure dependent on postoperative intensive care management and delayed closure more affected by the choice of the temporary abdominal closure technique. Invariably, a small fraction of patients requiring OA management fail to have primary fascial closure and require some form of biologic fascial bridge with delayed ventral hernia repair in the future.
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World journal of surgery · Feb 2012
Randomized Controlled Trial Comparative StudyComparison of Limberg flap and tension-free primary closure during pilonidal sinus surgery.
Pilonidal disease is an inflammatory disease seen in the intergluteal region. In this study, our aim was to compare the efficacy of the Limberg flap versus a tension-free primary closure. ⋯ The lower rates of wound infection and recurrence associated with the Limberg flap reported elsewhere may be associated with healing of the tension-free procedure. In this study, tension-free primary closure was found to be as effective as the Limberg flap reconstruction.
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World journal of surgery · Feb 2012
Randomized Controlled Trial Comparative StudyEnhanced Recovery After Surgery (ERAS) program attenuates stress and accelerates recovery in patients after radical resection for colorectal cancer: a prospective randomized controlled trial.
The aim of this trial was to compare the Enhanced Recovery After Surgery (ERAS) program with conventional perioperative management in patients who underwent radical resection for colorectal cancer. ⋯ The ERAS protocol attenuates the surgical stress response and accelerates postoperative recovery without compromising patient safety.
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World journal of surgery · Feb 2012
Value of the metastatic lymph node ratio for predicting the prognosis of non-small-cell lung cancer patients.
The aim of this study was to investigate the relation between the metastatic lymph node ratio (LNR) and the prognosis of non-small-cell lung cancer (NSCLC). ⋯ The combination of the LNR and pN status provides a valuable help with prognosis. However, these results must be evaluated further in a large prospective randomized clinical trial.