World journal of surgery
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World journal of surgery · Jul 2018
Multicenter StudyBlunt Cerebrovascular Artery Injury and Stroke in Severely Injured Patients: An International Multicenter Analysis.
Blunt cerebrovascular injury (BCVI) is considered to be a rare entity in patients with high-energy trauma and is a potentially preventable cause of secondary brain damage. If it occurs, it may be fatal or associated with poor outcomes related to devastating complications. We hypothesized that analyses of epidemiology and concomitant injuries may predict the development of BCVI and associated complications. ⋯ Our data validated cervical spine injuries as a major predictor, but the predictive value of BSF must be scrutinized. Patient age appears to play a contradictory role in BCVI risk and BCVI-associated mortality. Predicting which patients will develop BCVI remains an ongoing challenge, especially since many patients do not present with concomitant injuries of the head or spine and therefore might not be captured by standard screening criteria.
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World journal of surgery · Jul 2018
The Benefit of Ultrasound in Deciding Between Tube Thoracostomy and Observative Management in Hemothorax Resulting from Blunt Chest Trauma.
Hemothorax is most commonly resulted from a closed chest trauma, while a tube thoracostomy (TT) is usually the first procedure attempted to treat it. However, TT may lead to unexpected results and complications in some cases. The advantage of thoracic ultrasound (TUS) over a physical examination combined with chest radiograph (CXR) for diagnosing hemothorax1 has been proposed previously. However, its benefits in terms of avoiding non-therapeutic TT have not yet been confirmed. Therefore, this study is aimed to evaluate the severity of hemothorax in blunt chest trauma patients by using TUS in order to avoid non-therapeutic TT in stable cases. ⋯ In the case of blunt trauma, TUS can rapidly and accurately evaluate hemothorax to avoid TT in patients who may not benefit much from it. As a result, the rate of non-therapeutic TT can be decreased, and the influence on shortening hospital length of stay may be further evaluated with prospective controlled study.
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World journal of surgery · Jul 2018
A Nomogram to Predict Prognosis in Malignant Pleural Mesothelioma.
Malignant pleural mesothelioma (MPM) is a rare malignancy with heterogeneous outcomes. This study was aimed to develop a nomogram to precisely and visually predict survival of MPM patients. ⋯ We developed a nomogram to accurately predict clinical outcomes of MPM patients based on individual characteristics. Risk stratification by the survival nomogram could optimize individual therapies and follow-up.
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World journal of surgery · Jul 2018
Observational StudyEarly Management of Retained Hemothorax in Blunt Head and Chest Trauma.
Major blunt chest injury usually leads to the development of retained hemothorax and pneumothorax, and needs further intervention. However, since blunt chest injury may be combined with blunt head injury that typically requires patient observation for 3-4 days, other critical surgical interventions may be delayed. The purpose of this study is to analyze the outcomes of head injury patients who received early, versus delayed thoracic surgeries. ⋯ In this study, early VATS could be performed safely in brain hemorrhage patients without indication of surgical decompression. The clinical outcomes were much better in patients receiving early intervention within 4 days after trauma.
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World journal of surgery · Jul 2018
Changes in Clinical Practice Reduce the Rate of Anastomotic Leakage After Colorectal Resections.
Anastomotic leakage is a serious clinical problem after colorectal resections and is associated with a significantly increased length of stay, morbidity and mortality. The aim of the present study was to evaluate the effect of changes in clinical practice on anastomotic leakage rate after colorectal resections. ⋯ Implementing a structured change of clinical practice can significantly reduce the anastomotic leakage rate after colorectal resections.