World journal of surgery
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World journal of surgery · Dec 2011
Comparative StudyComparison of the survival difference between AJCC 6th and 7th editions for gastric cancer patients.
The AJCC 7th edition changes the classification of T- and N-factors and the TNM stage of gastric cancer. We evaluated its prognostic impact. ⋯ The AJCC 7th edition provides a more stratified survival difference in staging of gastric cancer. Future division of N3a and N3b in the classification of the TNM stage is recommended.
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World journal of surgery · Dec 2011
Comparative StudyElevation of liver function tests after laparoscopic gastrectomy using a Nathanson liver retractor.
Although pneumoperitoneum has been suspected as a possible cause of transient elevation of liver function tests (LFTs) after laparoscopic surgery, liver damage by direct retraction could also influence postoperative LFTs. The aim of this study was to clarify whether laparoscopic gastrectomy (LG) using a Nathanson retractor was associated with the postoperative elevation of LFTs compared with open gastrectomy (OG). ⋯ LG resulted in frequent elevation of LFTs. Care should be taken to minimize intraoperative liver damage when performing LG using a Nathanson retractor.
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World journal of surgery · Dec 2011
Comparative StudyRobotic versus open pancreaticoduodenectomy: a comparative study at a single institution.
Minimally invasive pancreaticoduodenectomy (PD) remains one of the most challenging abdominal procedures, and its application is poorly reported in the literature so far. To date, few data are available comparing a minimally invasive approach to open PD. The aim of the present study is to compare the robotic and open approaches for PD at a single institution. ⋯ The authors present one of the first studies comparing open and robotic PD. While it is too early to draw definitive conclusions concerning the long-term outcomes, short-term results show a positive trend in favor of the robotic approach without compromising the oncological principles associated with the open approach.
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Laparoscopic intersphincteric resection (ISR) after neoadjuvant chemoradiation is helpful in the management of patients with low rectal cancer. With the advent of this technique, the need for performance of abdominoperineal resection seems to have decreased in patients with very low rectal tumors. The aim of the present study was to evaluate the feasibility, the functional outcome, and the short-term oncologic outcomes of laparoscopic ISR for low rectal adenocarcinoma at our institution. ⋯ Laparoscopic ISR after neoadjuvant chemoradiation can be recommended as a technically feasible, minimally invasive, and a sphincter-saving procedure with acceptable functional and short-term oncologic outcomes in patients with very low rectal cancer.
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World journal of surgery · Dec 2011
Is there still a role for preoperative 12-lead electrocardiography?
Twelve-lead electrocardiography is a standard preoperative investigation for patients undergoing major surgery. There is uncertainty and debate over the usefulness of this test for stratifying postoperative cardiac risk. The aim of this study was to investigate the correlation between an abnormal electrocardiogram (ECG) and the postoperative cardiac event rate. ⋯ Preoperative electrocardiography is a useful screening test for predicting perioperative cardiac events. Patients with an abnormal ECG but without a prior history of heart disease are a high-risk group potentially amenable to intervention and risk reduction.