World journal of surgery
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World journal of surgery · Mar 2006
Comparative StudySurgical outcomes research based on administrative data: inferior or complementary to prospective randomized clinical trials?
The importance of surgical research has gained new prominence over the past decades as the relevance of well designed and well conducted studies has become increasingly evident. There are two basic but diametrically different methods of conducting research: the prospective randomized clinical trial and the retrospective surgical outcomes study based on administrative data. Administrative databases contain data that were initially collected for purposes other than scientific research. ⋯ In the present article, the strengths and weaknesses of both prospective randomized clinical trials and retrospective surgical outcomes research are discussed. Specifically, the advantages and limitations of investigations based on large administrative databases are outlined. Because both study designs play an important role in surgical research, carefully designed and implemented surgical outcomes research based on administrative data should be viewed as being complementary and not inferior to prospective randomized clinical trials.
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World journal of surgery · Mar 2006
Perforation of the gastrointestinal tract secondary to ingestion of foreign bodies.
Ingesting a foreign body (FB) is not an uncommon occurrence. Most pass through the gastrointestinal (GI) tract uneventfully, and perforation is rare. The aim of this study was to report our experience with ingested FB perforations of the GI tract treated surgically at our institution. ⋯ Ingested FB perforation in the adult population is most commonly secondary to unconscious accidental ingestion and is frequently caused by dietary FBs especially fish bones. A preoperative history of FB ingestion is thus rarely obtained, although wearing dentures is a common risk factor. FB perforations of the stomach, duodenum, and large intestine tend to present with a longer, more innocuous clinical picture than perforations in the jejunum or ileum.
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World journal of surgery · Mar 2006
Interval appendectomy after conservative treatment of an appendiceal mass.
The purpose of this study was to clarify the role of interval appendectomy after conservative treatment of an appendiceal mass. ⋯ Patients who recovered from conservative treatment of an appendiceal mass should undergo colonoscopy or barium enema to detect any underlying diseases and to rule out coexistent colorectal cancer. Routine interval appendectomy benefits less than 20% of patients.
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World journal of surgery · Feb 2006
Comparative StudyUsefulness of multidetector computed tomography for the initial assessment of blunt abdominal trauma patients.
The prompt detection and accurate localization of abdominal injuries are difficult. Some diagnostic modalities, including laboratory tests, ultrasound, and diagnostic peritoneal lavage (DPL) were used to evaluate patients with blunt abdominal trauma, with various advantages and pitfalls. We aimed to evaluate the risk and benefit of using multidetector computed tomography (MDCT) as an initial assessment tool for proper diagnosis and treatment planning of patients with blunt abdominal trauma. ⋯ Multidetector computed tomography was useful as a second line initial assessment tool to identify injuries and determine treatment planning in blunt abdominal trauma patients. No increased risk was found if the facility is readily available, the protocol is well designed, and the patient is well prepared.
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World journal of surgery · Feb 2006
Identification of prognostic factors associated with early mortality after surgical resection for pancreatic cancer--under-analysis of cumulative survival curve.
The cumulative survival curve after surgery for advanced pancreatic cancer is characterized by a steep downward slope in the early postoperative period. The aim of this investigation was to identify the characteristics associated with early mortality in patients undergoing pancreatic resection for pancreatic cancer. ⋯ The high hazard rate in the early postoperative period was closely linked with death due to liver metastases. The preoperative presence of local pain was a prognostic factor associated with early mortality.