World journal of surgery
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World journal of surgery · Mar 2011
Comparative StudyAngiointervention: high rates of failure following blunt renal injuries.
Nonoperative management (NOM) of solid organ injury after blunt trauma is now standard. Recently, angioembolization (AE) has been used to extend NOM. Few data exist on evaluating NOM of blunt renal injuries (BRIs). We sought to determine the overall efficacy of NOM as well as the outcome of AE in patients with BRI. ⋯ NOM of BRI is safe and effective, with an overall failure rate of 3.1%. However, angiography with or without AE has substantial failure rates. Patients with higher-grade injuries and active vascular extravasation on admission computed tomography scan also fail NOM regardless of therapy. The blood transfusion requirement during the first 24 h may indicate who will require operative intervention following angiography. Close observation and/or early laparotomy are wise for these high-risk patients.
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World journal of surgery · Mar 2011
Gunshot injuries in the elderly: patterns and outcomes. A national trauma databank analysis.
Trauma in the elderly (≥ 55 years) accounts for a significant proportion of admissions to trauma centers. Our understanding of the epidemiology and outcomes associated with penetrating injury in this age segment of the population, however, is severely limited. The aim of the present study therefore was to investigate the incidence and type of injuries sustained by elderly patients from firearms and the impact of age on outcomes. ⋯ Injury from firearms is not uncommon in the elderly patient population and is primarily a result of self-inflicted gunshot wounds to the head. These patients sustain a high burden of injury and a high rate of mortality, which increases with advancing age.
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World journal of surgery · Mar 2011
Simplified alternative to the TRISS method for resource-constrained settings.
We developed simple methods of risk adjustment for evaluating the quality of injury care (predicting survival probabilities of the injured) by fully utilizing routinely collected data in injury surveillance and clinical practices. Widely used methods of risk adjustment require additional data that are difficult to collect in resource-constrained settings. ⋯ Simplified methods of risk adjustment that require only routinely collected data will facilitate evaluation and improvement in the quality of injury care in resource-constrained low- and middle-income countries, where injuries are a growing public health concern.
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World journal of surgery · Mar 2011
Laparoscopic repeat resection of recurrent hepatocellular carcinoma.
The present study was designed to explore the safety and feasibility of laparoscopic re-resection of recurrent liver tumors. ⋯ Our experience with carefully selected cases meeting specific criteria suggests that laparoscopic hepatic re-resection is a safe, feasible procedure that may offer multiple benefits for treating recurrent hepatocellular carcinoma.
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World journal of surgery · Mar 2011
Comment Letter Comparative StudyTwo-stage breast cancer screening in the developing world.