World journal of surgery
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World journal of surgery · Sep 2014
Inter-rater reliability of the PIPES tool: validation of a surgical capacity index for use in resource-limited settings.
In response to the need for simple, rapid means of quantifying surgical capacity in low resource settings, Surgeons OverSeas (SOS) developed the personnel, infrastructure, procedures, equipment and supplies (PIPES) tool. The present investigation assessed the inter-rater reliability of the PIPES tool. ⋯ Reliability of the PIPES tool was moderate for the infrastructure and procedures sections, fair for the equipment section, and poor for supplies section when comparing surgeons' responses to nurses' responses-an extremely rigorous test of reliability. These results indicate that the PIPES tool is an effective measure of surgical capacity but that the equipment and supplies sections may need to be revised.
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World journal of surgery · Sep 2014
Randomized Controlled TrialPrevention of incisional hernia in midline laparotomy with an onlay mesh: a randomized clinical trial.
Our objective was to evaluate the prevention of incisional hernia (IH) during the postoperative period of a midline laparotomy during elective surgery. ⋯ Fitting a prophylactic supra-aponeurotic mesh prevents IH independently of other factors.
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World journal of surgery · Sep 2014
Surgical treatment of endemic goiter in a nonhospital setting without general anesthesia in Africa.
Endemic goiter remains a serious public health problem and 75 % of people affected live in underdeveloped countries where treatment is difficult for various reasons. The aim of this article is to report our experience in African countries with the management and surgical treatment of endemic goiter, performed in a nonhospital setting and without general anesthesia in the context of a collaborative development project by experienced endocrine surgeons. ⋯ Surgery without general anesthesia performed in a nonhospital setting in underdeveloped countries in patients with goiter is a viable option with good results and low morbidity.
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World journal of surgery · Sep 2014
Review Meta Analysis Comparative StudyLaparoscopic versus open incisional and ventral hernia repair: a systematic review and meta-analysis.
Laparoscopic incisional and ventral hernia repair (LIVHR) is an alternative approach to conventional open incisional and ventral hernia repair (OIVHR). A consensus on outcomes of LIVHR when compared with OIVHR has not been reached. ⋯ Laparoscopic incisional and ventral hernia repair is a feasible and effective alternative to the open technique. It is associated with lower incidences of wound infection and shorter length of hospital stay. However, caution is required because it is associated with an increased risk of bowel injury compared with the open technique. Given the relatively short follow-up duration of trials included in the systematic review, trials with long-term follow-up are needed to compare the durability of laparoscopic and open repair.
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World journal of surgery · Sep 2014
Review Meta AnalysisPostoperative nonsteroidal anti-inflammatory drugs and risk of anastomotic leak: meta-analysis of clinical and experimental studies.
Enhanced recovery programs following colorectal resection recommend the use of nonsteroidal anti-inflammatory drugs (NSAIDs) as part of multimodal analgesia. The present study aimed to assess whether postoperative NSAID use increased the risk of anastomotic leak. ⋯ Emerging data strongly suggest that postoperative NSAIDs are linked to anastomotic leak, although most studies are flawed and may be describing pre-existing selection bias. However, when combined with experimental data, these increasing concerns suggest caution is needed when prescribing NSAIDs to patients with pre-existing risk factors for leak, until more definitive evidence emerges.