World journal of surgery
-
World journal of surgery · Feb 2009
Randomized Controlled Trial Comparative StudyRandomized controlled trial of Roux-en-Y versus rho-shaped-Roux-en-Y reconstruction after distal gastrectomy for gastric cancer.
The main advantage of the Roux-en-Y (RY) operation is that it prevents bile and pancreatic juice from reaching the gastric mucosa, although the gastrojejunostomy may cause functional delayed gastric emptying (DGE), known as RY stasis syndrome. Rho-shaped Roux-en-Y reconstruction (rRY), an RY reconstruction with a rho-shaped anastomosis, is an established operation that has been found to be effective in preventing DGE. ⋯ Our findings showed that RY reconstruction after gastrectomy may be as simple and sufficient as conventional reconstruction.
-
World journal of surgery · Feb 2009
Continuous monitoring of adverse events: influence on the quality of care and the incidence of errors in general surgery.
This study was designed to determine the incidence of adverse events and errors in the care of surgical patients and to demonstrate that continuous prospective collection of data on adverse events can improve quality of care and reduce the number of errors. Retrospective studies find adverse events in approximately 5% of patients admitted. Prospective studies publish figures of approximately 30%. No studies to date have tried to use continuous collection of data on adverse events to reduce the incidence of errors. ⋯ This is the first attempt to determine the prevalence of errors in surgery. Introducing systematic programs for recording adverse events can reduce error rates and promote a culture of patient safety in a General Surgery Department.
-
World journal of surgery · Feb 2009
Preoperative biliary drainage increases infectious complications after hepatectomy for proximal bile duct tumor obstruction.
The role of preoperative biliary drainage before liver resection in jaundiced patients remains controversial. The objective of this study is to compare the perioperative outcome of liver resection for carcinoma involving the proximal bile duct in jaundiced patients with and without preoperative biliary drainage. ⋯ Overall mortality and morbidity after liver resection are not improved by preoperative biliary drainage in jaundiced patients. Prehepatectomy biliary drainage increases the incidence of infectious complications.
-
World journal of surgery · Jan 2009
Prognostic factors in critically ill patients suffering from secondary peritonitis: a retrospective, observational, survival time analysis.
Acute mortality of unselected critically ill patients has improved during the last 15 years. Whether these benefits also affect survival of critically ill patients with secondary peritonitis is unclear as is the relevance of specific prognostic factors, such as source control. ⋯ Four-month prognosis of critically ill, surgical patients with secondary peritonitis is poor and mostly determined by the ability to obtain source control. Outcome has improved since 2002, and after successful surgical and intensive care therapy long-term survival seems to be good.