World journal of surgery
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World journal of surgery · Apr 2006
Comparative StudyWhich octogenarians do poorly after major open abdominal surgery in our Asian population?
As the elderly population grows and surgeons are faced with more octogenarians, there is a need to know how our Asian patients fair after major surgery. ⋯ Efforts to improve outcome in geriatric surgery patients should emphasize a shift of attitude towards elective surgery rather than doing emergency operations when complications occur and also target the optimization of predictors of adverse outcome. Octogenarians should not be denied elective surgery.
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World journal of surgery · Apr 2006
Effect of temporary abdominal closure on colonic anastomosis and postoperative adhesions in experimental secondary peritonitis.
The effect of relaparotomies and temporary abdominal closure on colonic anastomoses and postoperative adhesions is under debate. ⋯ Relaparotomy and the type of temporary closure have no negative effect on anastomotic healing in rats with peritonitis. Temporary abdominal closure with a Bogota bag caused a significantly high rate of adhesions.
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World journal of surgery · Mar 2006
Comparative StudyVideo-assisted thoracoscopic surgery for recurrent spontaneous pneumothorax: the long-term benefit.
Management of recurrent primary spontaneous pneumothorax by open surgery was considered the treatment of choice until recently. The major drawbacks of this management are the prolonged postoperative pain and cosmetic results. In the last decade, video-assisted thoracoscopic surgery (VATS) has replaced the routine use of open surgery. Most papers that compared limited open surgery to VATS addressed the early postoperative results, and studies that assessed the long-term results focused primarily on the rate of recurrence and pulmonary function tests. The aim of this study was to compare the outcome of minithoracotomy and VATS with emphasis on patients' long-term, subjective perspective and satisfaction. ⋯ We recommend video-assisted surgery as the first-line surgical treatment for patients with recurrent primary spontaneous pneumothorax. This recommendation is based on its somewhat favorable early postoperative course, the superior long-term outcome, and patient satisfaction.
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World journal of surgery · Mar 2006
Preoperative nutritional risk assessment in predicting postoperative outcome in patients undergoing major surgery.
Although a variety of nutritional indices have been found to be valuable in predicting patient outcome when used alone, there is no consensus on the best method for assessing the nutritional status of hospitalized patients. Therefore, the aim of this study was to assess the nutritional status of a cohort of patients who underwent major elective surgery using the Nutritional Risk Index (NRI), Maastricht Index (MI), Subjective Global Assessment (SGA), and Mini Nutritional Assessment (MNA) to determine the best possible nutrition screening system in surgical practice. ⋯ Our findings revealed that all nutritional assessment techniques can be safely applied to the clinical setting with no significant difference in predictive value. We therefore strongly recommend the use of any of these techniques to improve the outcome of surgical care. Meanwhile, further investigations are needed, and much effort must be given to find the best method for assessing nutritional status.
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World journal of surgery · Mar 2006
Tissue oxygen saturation during colorectal surgery measured by near-infrared spectroscopy: pilot study to predict anastomotic complications.
We investigated the relation between tissue oxygen saturation measured by near-infrared spectroscopy (NIRS) and anastomotic complications associated with colorectal surgery. ⋯ The StO2 of the anastomotic site can be safely and reliably measured by NIRS during colorectal surgery. Low StO2 on both sides of the anastomosis may indicate an increased risk of anastomotic complications. Further study is needed to determine the cutoff value for StO2 required to prevent serious complications.