World journal of surgery
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World journal of surgery · Jul 2005
Case ReportsDopamine-secreting pheochromocytomas: in search of a syndrome.
Pheochromocytomas rarely produce dopamine as the only catecholamine. Two cases are reported here, and a review of the literature was conducted. Unlike norepinephrine-and epinephrine-secreting tumors, dopamine-secreting pheochromocytomas lack a classic clinical presentation and are often asymptomatic. ⋯ This medication is an option for controlling symptoms but should not be used routinely in these patients. The prognosis for patients with these tumors is worse than for those with an epinephrine- and norepinephrine-secreting tumor. Because of their asymptomatic nature, dopamine-secreting pheochromocytomas tend to be detected later and are more likely to be malignant at the time of diagnosis.
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World journal of surgery · Jul 2005
Perforated peptic ulcer treated by simple closure and Helicobacter pylori eradication.
Simple closure followed by Helicobacter pylori (Hp) eradication has become the most used procedure in perforated ulcer treatment. However, its efficacy and safety are still to be determined. To assess recurrence and re-perforation rates, and as a secondary objective, to analyze Hp infection rates in perforated ulcer patients and controls, we conducted a prospective study. ⋯ Overall relapse and re-perforation 1-year crude rates were 6.1% and 4.1%, respectively. Crude rates for non-gastric ulcer recurrence were 0 at 1 year and 2.6% at 2 years and for non-gastric ulcer re-perforation rates were 0 at 1 and 2 years. This therapeutic strategy is associated with a low rate of recurrence and no re-perforations in case of duodenal, pyloric, or pre-pyloric perforated ulcers, but it is not acceptable for perforated gastric ulcers.
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World journal of surgery · Jun 2005
Safety and effectiveness of left hepatic trisegmentectomy for hilar cholangiocarcinoma.
Left hepatic trisegmentectomy has been performed for huge malignant tumors, but it is rarely applied in patients with hilar cholangiocarcinoma. Twelve consecutive patients (7 men and 5 women; mean age, 64 years) underwent left hepatic trisegmentectomy in our institution between January 2000 and December 2003. The preoperative management and postoperative outcomes of this surgical procedure were presented and retrospectively analyzed. ⋯ There was no hospital death or postoperative hepatic failure. The incidence of positive resectional margin was 25%. With biliary decompression and preoperative portal embolization techniques, left hepatic trisegmentectomy was a safe and curative resectional option for hilar cholangiocarcinoma.
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World journal of surgery · Jun 2005
Adult surgical emergencies in a developing country: the experience of Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria.
The goal of this study was to examine the adult surgical emergencies seen at the Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, with a view to proffering preventive solutions where appropriate and improving outcome. From the register of patients seen at the Casualty department and from the operations register in the main operation room of NAUTH, names and hospital numbers of adult patients treated as emergencies over a 5-year period, from 7 September 1998 to 6 September 2003, were obtained. The hospital folders were then retrieved from the Records Department. ⋯ Good roads and adequate security should be provided for the people. The need for Pre-Hospital Care for the efficient evacuation of accident victims is emphasized. These measures will help to improve the management and outcome of surgical emergencies, and decrease the number of surgical emergencies resulting from RTAs and gunshot wounds.