Surgery today
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Randomized Controlled Trial Clinical Trial
Perioperative prostaglandin E1 treatment for the prevention of postoperative complications after esophagectomy: a randomized clinical trial.
We conducted a prospective randomized clinical study to examine whether perioperative prostaglandin E1 (PGE1) could help in the prevention of postoperative complications after esophagectomy for esophageal cancer. ⋯ The perioperative administration of PGE1 helps maintain adequate portal blood flow, improves hyperbilirubinemia, and attenuates the duration of SIRS, thereby reducing the risk of postoperative complications after esophagectomy and lymphadenectomy for esophageal cancer.
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Randomized Controlled Trial Clinical Trial
Jugular venous oxygen saturation during mild hypothermic versus normothermic cardiopulmonary bypass in elderly patients.
Age is known to be a major risk factor for adverse postoperative cognitive dysfunction after cardiac surgery. We conducted this study to determine if jugular venous oxygen saturation (SjvO(2)) differed during mild hypothermic (32 degrees C) and normothermic cardiopulmonary bypass (CPB) in elderly patients. ⋯ The SjvO(2) value was better during mild hypothermic CPB than during normothermic CPB in elderly patients.
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Comparative Study
Postoperative renal function after elective abdominal aortic aneurysm repair requiring suprarenal aortic cross-clamping.
To examine postoperative renal function after suprarenal aortic cross-clamping performed without renal hypothermia in patients undergoing elective abdominal aortic aneurysm (AAA) surgery. ⋯ Suprarenal aortic cross-clamp without performing renal hypothermia is safe and able to be tolerated well by the patient during elective AAA surgery, although careful attention must be paid to limiting the period of renal ischemia.
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Case Reports
Emergency celiac revascularization for supramesocolic ischemia during pancreaticoduodenectomy: report of a case.
Occlusive atherosclerotic disease of the celiac artery may be diagnosed late during pancreatic resection, inducing a sudden ischemic threat to the liver, stomach, pancreas, and new anastomoses. Failure to identify and correct the insufficient supramesocolic flow can result in serious morbidity. ⋯ We describe this technique as an alternative treatment for acute supramesocolic ischemia caused by celiac axis occlusion. It is important that surgeons performing pancreatic surgery are aware of the possibility of this complication because the test occlusion of the gastroduodenal artery, which must always precede its ligation, can be negative.
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Comparative Study
Preoperative spirometry versus expired gas analysis during exercise testing as predictors of cardiopulmonary complications after lung resection.
As cardiopulmonary load increases with the amount of lung resected, to perform surgery safely it is important to be able to predict cardiopulmonary insufficiency. However, lung function testing with spirometry and blood gas analysis does not accurately measure cardiopulmonary reserve. We conducted this study to evaluate expired gas analysis during exercise testing for predicting postoperative complications after lung resection. ⋯ The combination of expired gas analysis during exercise and conventional pulmonary function tests identified patients at risk for postoperative cardiopulmonary complications following pulmonary resection.