Journal of investigative surgery : the official journal of the Academy of Surgical Research
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Comparative Study
Liver Regeneration After Major Liver Resection for Hepatocellular Carcinoma in the Elderly.
Background: With an aging population, more elderly patients are being considered for hepatic resection for hepatocellular carcinoma (HCC). This study aimed to evaluate postoperative outcomes including liver regeneration after major hepatectomy for HCC in the elderly. Methods: We assessed 41 patients who underwent major hepatectomy (≥3 segments) at our institute between 2000 and 2013. ⋯ Age was not correlated with liver regeneration rate (R2 = 0.00537, p = 0.695). Conclusions: Liver regeneration after major hepatectomy for HCC was not affected by age and that resected liver volume is an important factor for liver regeneration. Short- and long-term outcomes after major hepatectomy were similar in elderly and younger patients.
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Background: Transthoracic hybrid minimally invasive esophagectomy (HMIE) is frequently performed in patients with esophageal cancer. However, no conclusive benefit has been defined for HMIE compared with open esophagectomy (OE) or totally MIE (TMIE). The aim of this meta-analysis is to evaluate the effectiveness of HMIE compared with OE and TMIE. ⋯ No statistical differences were observed for other surgical outcomes. Conclusions: In our opinion, HMIE is a promising surgical technique. But further RCTs are still needed to confirm the advantages and disadvantages of HMIE mentioned above.
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Purpose: The aim of this research is to perform a literature review of the treatments available for the anterior iliac spines avulsion fracture on the young subjects. Material and Methods: We performed a systematic literature search for studies on spines avulsion fractures in young subjects from January 1, 2013, to February 2018; abstracts were screened by a single reviewer. ⋯ All the studies belonged to level IV of scientific evidence. 64 patients suffered an anterior inferior iliac spine fracture while patients 36% patients suffered an anterior superior iliac spine fracture. 93.2% underwent conservative treatment and 6.8% underwent surgery. Conclusions: The anterior iliac spine avulsions fractures are rare injuries that occur in young male athletes and the conservative option is the most selected treatment modality.
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Backgrounds: Appendiceal cancers are usually diagnosed after appendectomy accidentally. The need for subsequent right hemicolectomy in these patients was determined by the potential risk of regional lymph node (LN) metastasis. Establishing a nomogram to forecast the potential risk of lymph node metastasis of appendiceal cancer could help in the next step of treatment. ⋯ All of them showed excellent performance of the nomogram in our study. Conclusion: A new nomogram was created to assess the potential risk of LN metastasis in patients of appendiceal cancer by utilizing age, tumor histology, tumor pathologic grade, tumor size, T-stage, and M-stage. The nomogram could provide a strong reference for the right hemicolectomy and facilitate clinic decision.
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Objective: The objectives of this study were to examine the clinical profile of critically ill patients with septic acute kidney injury (AKI) and to investigate clinical characteristics associated with the outcome of patients. Methods: Data from 582 critically ill patients were collected and retrospectively reviewed. Patients were divided into two groups: without AKI development and with AKI development. ⋯ Multivariate logistic regression analysis revealed that the outcome of patients was associated with lung infection, coagulation system dysfunction, staphylococcus aureus infection, and use of various treatments (epinephrine, norepinephrine, and the use of mechanical ventilation) after AKI development. Conclusion: AKI occurred in approximately half of the critically ill patients admitted to ICU. The site and type of infections, as well as the use of vasopressor agents, were associated with the outcome.