World journal of surgery
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World journal of surgery · Jun 2015
The SF-36 and 6-Minute Walk Test are Significant Predictors of Complications After Major Surgery.
Major surgeries are associated with postoperative morbidity and mortality. Current preoperative evaluation fails to identify patients at increased risk of postoperative complications. This study is aimed to determine whether the Short Form-36 health survey (SF-36) and the 6-minute walk test (6-MWT) are useful predictors of postoperative complications after major surgery. ⋯ SF-36 (Physical Functioning) and 6-MWT are useful indicators for predicting postoperative complications and LOS. Patients undergoing major surgery answered SF-36 and performed 6-MWT. Physical Functioning as a component of the SF-36 correlated with LOS. The 6-MWT had a negative correlation with LOS and with complication grade. SF-36 and 6-MWT are useful predictors of postoperative complications.
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World journal of surgery · Jun 2015
Repeat Cytoreductive Surgery and HIPEC for Peritoneal Surface Malignancy and Peritoneal Carcinomatosis.
Peritoneal-based malignancy (PBM), especially peritoneal carcinomatosis from gastrointestinal malignancies traditionally carries a poor prognosis. Cytoreductive surgery (CRS) and hyperthermic intra-peritoneal chemotherapy (HIPEC) have been shown to attain long median survival of 34-92 months and 5 year survival of 29-59% in patients with favorable histopathological subtypes. Recurrence after CRS and HIPEC poses a management dilemma. This paper evaluates our institution's experience with repeat CRS and HIPEC, its associated morbidity and outcomes. ⋯ Repeat CRS and HIPEC can achieve prolonged survival in selected patients with peritoneal-based malignancies, and can be performed with acceptable morbidity and mortality.
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World journal of surgery · May 2015
Role of gadoxetic acid-enhanced magnetic resonance imaging in the preoperative evaluation of small hepatic lesions in patients with colorectal cancer.
The initial abdominal computed tomography (CT) scans of patients with colorectal cancer (CRC) sometimes reveal equivocal hepatic lesions. In this study, we evaluated the outcomes of equivocal hepatic lesions found by abdominal CT and the diagnostic accuracy of subsequent liver magnetic resonance imaging (MRI). ⋯ Gadoxetic acid-enhanced MRI is a useful diagnostic tool for assessing equivocal hepatic lesions on preoperative CT of CRC patients that allows increased diagnostic accuracy and detection of additional colorectal liver metastasis lesions.
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World journal of surgery · May 2015
Observational StudyChanging operative strategy from abdominoperineal resection to sphincter preservation in T3 low rectal cancer after downstaging by neoadjuvant chemoradiation: a preliminary report.
The objective of this study is to assess oncological outcome after changing operative strategy from abdominoperineal resection (APR) to sphincter preservation (SP) in T3 low rectal carcinomas downstaged by neoadjuvant chemoradiation (nCRT). ⋯ For selected patients of T3 low rectal cancer, changing operative strategy from APR to SP after downstaging by nCRT can be done in motivated patients with good sphincter function. Disease-free survival rates and continence are comparable to patients had APR and to previous publications with decision made before nCRT. With strict follow-up, early diagnosis of recurrence and salvage surgery with free resection margins can be achieved.
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World journal of surgery · May 2015
Randomized Controlled Trial Comparative StudyClamshell incision versus left anterolateral thoracotomy. Which one is faster when performing a resuscitative thoracotomy? The tortoise and the hare revisited.
The clamshell incision (CI) offers a better exposure than the left anterolateral thoracotomy (LAT) as a resuscitative thoracotomy. Most surgeons will have to manage a heart wound only once or twice in their career. The patient's survival depends on how fast the surgeon can control the heart wound; however, it is unclear which of the two incisions allows for faster control in the hands of inexperienced surgeons. The aim of this study was to compare the time needed to access and control a standardized stab wound to the right ventricle, by inexperienced surgical trainees, by LAT or CI; we hypothesized that the CI does not take longer than the LAT. ⋯ The time needed from skin incision until cardiac wound control via CI was not longer than via LAT and the easier control of the cardiac wound when using CI was confirmed.