World journal of surgery
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World journal of surgery · Jun 2019
Nationwide Propensity-Score Matched Study of Mesh Versus Suture Repair of Primary Ventral Hernias in Women with a Subsequent Pregnancy.
Mesh reinforcement is recommended for repair of primary ventral hernias; however, this recommendation does not consider a potential subsequent pregnancy. The aim of this prospective cohort study was to compare mesh and suture repair of a primary ventral hernia in women with a subsequent pregnancy. ⋯ Mesh repair was associated with a decreased risk of recurrence, but an increased risk of chronic pain, compared with suture repair in women with a subsequent pregnancy.
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World journal of surgery · May 2019
High-Dose RAI Therapy Justified by Pathological N1a Disease Revealed by Prophylactic Central Neck Dissection for cN0 Papillary Thyroid Cancer Patients: Is it Superior to Low-Dose RAI Therapy?
One of the presumed advantages of prophylactic central neck dissection (pCND) is offering staging basis for more aggressive radioactive iodine (RAI) therapy, which postulates the necessity of high dose for treatment efficacy. The present study aims to compare the effectiveness between low-dose and high-dose RAI in a select cohort of cN0 papillary thyroid cancer (PTC) patients with pathological N1a (pN1a) disease revealed by pCND in terms of ablation rate and response to therapy. The frequency of short-term adverse effects between the two groups was also compared. ⋯ High-dose RAI therapy, with higher frequency of short-term adverse effects, appears to be not superior to low-dose RAI therapy for cN0 PTC patients with pN1a disease revealed by pCND to achieve better response to therapy. Further randomized studies with larger series of patients and longer follow-up duration, especially with the low-dose group, are needed to validate our results.
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World journal of surgery · May 2019
Impact of Tumor Location on Postoperative Outcome of Intraductal Papillary Neoplasm of the Bile Duct.
The concept of intraductal papillary neoplasm of the bile duct (IPNB) has been proposed to be the biliary equivalent of intraductal papillary mucinous neoplasm (IPMN) of the pancreas. While the classification of IPMNs is based on their location of duct involvement, such classification has not been fully evaluated for IPNBs. The aim of this study is to investigate the value of IPNB classification based on its location. ⋯ Patients with intrahepatic IPNB show more favorable pathological characteristics and postoperative survival outcomes than those with extrahepatic IPNB.
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World journal of surgery · Apr 2019
The Hybrid Electronic Medical Registry Allows Benchmarking of Quality of Trauma Care: A Five-Year Temporal Overview of the Trauma Burden at a Major Trauma Centre in South Africa.
This study is a five-year follow-up of previously published review of the trauma workload at our institution. It aims to provide evidence about the quality of trauma care delivered by a major academic trauma service in South Africa to provide a temporal analysis of trauma trends in the city of Pietermaritzburg. ⋯ The HEMR has allowed us to track the burden of trauma presenting to our institution over a five-year period. This confirms previous studies over shorter time periods from our institution. The pattern of trauma has remained consistent, and the previously described high levels show no sign of decreasing. Interventions to try and reduce this burden are urgently required.
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World journal of surgery · Apr 2019
Morbid Obesity's Silver Lining: An Armor for Hollow Viscus in Blunt Abdominal Trauma.
Morbid obesity is usually accompanied by both subcutaneous and visceral fat accumulation. Fat can mimic an air bag, absorbing the force of a collision. We hypothesized that morbid obesity is mechanically protective for hollow viscus organs in blunt abdominal trauma (BAT). ⋯ Obesity is protective in BAT. This translates into lower rates of GI tract injury and operation in morbidly obese patients. In contrast, underweight patients appear to suffer a higher rate of GI tract injury and associated GI operations.