World journal of surgery
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World journal of surgery · Jan 2015
Global public health impact of recovered supplies from operating rooms: a critical analysis with national implications.
In modern operating rooms, clean and unused medical supplies are routinely discarded and can be effectively recovered and redistributed abroad to alleviate the environmental burden of donor hospitals and to generate substantial health benefits at resource-poor recipient institutions. ⋯ Hospital operating rooms continue to represent a large source of recoverable surgical supplies that have demonstrable health benefits in the recipient communities. Cost-effective recovery and need-based donation programs can significantly alleviate the global burden of surgical diseases.
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World journal of surgery · Jan 2015
Effect of antiplatelet therapy on patients undergoing gastroenterological surgery: thromboembolic risks versus bleeding risks during its perioperative withdrawal.
Antiplatelet agents given to prevent thromboembolic disease are frequently withdrawn prior to surgical procedures to reduce bleeding complications. This action may expose patients to increased thromboembolic morbidity and mortality. ⋯ Satisfactory outcomes were obtained during gastroenterologic surgery under rigorous perioperative management, including single-agent APT continuation in patients at high thromboembolic risk. Patients treated with multidrug APT still represent a challenging group, however, and need to be carefully managed to prevent perioperative complications.
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World journal of surgery · Jan 2015
Implementing an enhanced recovery program after pancreaticoduodenectomy in elderly patients: is it feasible?
An enhanced recovery after surgery (ERAS) program aims to reduce the stress response to surgery and thereby accelerate recovery. It is unclear whether these programs can be safely implemented for elderly patients, especially in highly complex surgery such as pancreaticoduodenectomy (PD). The objective of this study was to evaluate the feasibility of an ERAS program in elderly patients undergoing PD. ⋯ An ERAS program seems feasible and safe for patients ≥ 70 years of age undergoing PD.
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World journal of surgery · Jan 2015
Long-term follow-up after non-operative management of biloma due to blunt liver injury.
Some case series have reported that hepatectomy was used to treat major bile leakage and biloma. However, it is unknown whether non-operative management (NOM) can be used to treat these complications. Our hospital uses NOM primarily for blunt liver injuries. This study describes the incidence and treatment of newly developed biloma in hemodynamically stable patients with blunt liver trauma and investigates NOM as a treatment option. ⋯ Our data suggest that biloma after NOM of blunt liver injury is common (36 %), but infected biloma is rare. All patients with bilomas were treated using NOM. Most bilomas are self-limited, and NOM is feasible.
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World journal of surgery · Jan 2015
Sutured repair of primary small umbilical and epigastric hernias: concomitant rectus diastasis is a significant risk factor for recurrence.
Umbilical and epigastric hernias are common in the adult population and prompt repair is advised. We aimed to evaluate the impact of concomitant rectus diastasis on the outcome of patients who underwent primary sutured fascia closure of a hernia without mesh. ⋯ We strongly recommend preoperatively checking for rectus diastasis and using nonabsorbable sutures as an alternative to mesh repair only when repairing small umbilical or epigastric hernias (<2 cm) and there is no concomitant rectus diastasis. Patients with coexistent rectus diastasis definitely benefit from mesh-based repair of the midline to decrease the recurrence rate.