Surgery today
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Case Reports
Ruptured hepatic abscess caused by fish bone penetration of the duodenal wall: report of a case.
The accidental ingestion of a foreign body into the gastrointestinal tract is not uncommon; however, the development of a hepatic abscess secondary to foreign body perforation is extremely rare. We report the case of a ruptured hepatic abscess caused by fish bone penetration of the duodenal bulb, resulting in generalized peritonitis. ⋯ We diagnosed a ruptured hepatic abscess caused by a calcified foreign body, which was managed by peritoneal lavage, drainage of the hepatic abscess, and removal of the fish bone, followed by simple closure of the hepatoduodenal fistula. The patient's postoperative course was complicated by systemic inflammatory response syndrome, but he recovered eventually.
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Randomized Controlled Trial Multicenter Study Comparative Study
Randomized clinical trial comparing intravenous antimicrobial prophylaxis alone with oral and intravenous antimicrobial prophylaxis for the prevention of a surgical site infection in colorectal cancer surgery.
The use of preoperative oral antibiotics during preparation for elective colorectal surgery remains controversial. This was a prospective randomized clinical trial to compare the efficacy of intravenous antimicrobial prophylaxis alone with combined oral and intravenous antimicrobial prophylaxis for surgical site infection (SSI) in patients undergoing elective colorectal surgery. ⋯ The addition of oral antibiotics to intravenous antimicrobial prophylaxis showed no advantage in the prevention of SSI.
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Randomized Controlled Trial Comparative Study
A placebo-controlled comparison of bupivacaine and ropivacaine instillation for preventing postoperative pain after laparoscopic cholecystectomy.
The aim of this study was to determine the effect of local anesthetic instillation, to compare bupivacaine and ropivacaine in patients undergoing a laparoscopic cholecystectomy. ⋯ We herein showed that the intraperitoneal instillation of local anesthetic during laparoscopic cholecystectomy is a noninvasive, rapid, safe and simple analgesic technique that reduces the total morphine consumption during first 24 h.
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Randomized Controlled Trial
Neutrophil elastase inhibitor (sivelestat) preserves antitumor immunity and reduces the inflammatory mediators associated with major surgery.
To examine the effects of the administration of perioperative sivelestat, a selective neutrophil elastase inhibitor, on tumor immunity and inflammatory mediators in patients who undergo major surgery. ⋯ In this preliminary study, the perioperative administration of sivelestat was thus suggested to reduce surgical stress by decreasing the cytokine release and preserving the antitumor immunity.
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Gastrointestinal (GI) motility dysfunction is a common complication of any abdominal surgical procedure. During fasting, the upper GI tract undergoes a cyclic change in motor activity, called the interdigestive migrating motor contraction (IMC). The IMC is divided into four phases, with phase III having the most characteristic activity. ⋯ For nervous dysfunction, an inhibitory sympathetic reflux is likely to be important in postoperative motility disorders. Until recently, treatment for gut dysmotility has consisted of nasogastric suction, intravenous fluids, and observation; however, more effective treatment methods are being reported. Recent discoveries have the potential to decrease postoperative gut dysmotility remarkably after surgery.