Surgery today
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Combined pulmonary fibrosis and emphysema (CPFE) has recently been reported as a prognostic factor that may increase the risk of lung cancer for patients with respiratory disorders; however, there have been no reports published on mortality and morbidity following major lung resection for patients with CPFE. ⋯ The postoperative outcome of patients with CPFE in this study was poor with respect to morbidity and mortality. The high rate of complications and poor survival warrants further investigation of the indications for surgery in patients with CPFE.
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Comparative Study
Gasless transumbilical laparoscopic-assisted appendectomy as a safe and cost-effective alternative surgical procedure for mild acute appendicitis.
Several reports have demonstrated the effectiveness and feasibility of single incisional transumbilical laparoscopic-assisted appendectomy (TULAA). We developed a modified TULAA technique, gasless-TULAA, which involves lifting the abdominal wall with a retractor, without pneumoperitoneum or another incision. ⋯ Gasless-TULAA is a cost-effective, safe, and readily available surgical technique for mild appendicitis, which can obviate the need for specialized equipment.
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Comparative Study
Comparison of pain management after laparoscopic distal gastrectomy with and without epidural analgesia.
The optimal analgesia following laparoscopic distal gastrectomy (LDG) has not been determined; moreover, it has been unclear whether epidural anesthesia has benefits for laparoscopic surgery. In this study, we evaluated the effectiveness of epidural analgesia after LDG. ⋯ Epidural anesthesia may reduce the need for additional analgesics after LDG, but increases the risk of urinary retention.
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Managing postoperative pain is important to ensure a good quality of life and fast recovery after surgery. We examined the feasibility of peroral management for the postoperative pain after laparoscopic-assisted distal gastrectomy (LADG). ⋯ Postoperative pain management using oral analgesics after LADG is feasible and safe, and is an ideal pain treatment associated with few adverse events while providing pain relief not inferior to epidural anesthesia.
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The National Clinical Database (NCD) of Japan was established in April, 2010 with ten surgical subspecialty societies on the platform of the Japan Surgical Society. Registrations began in 2011 and over 4,000,000 cases from more than 4100 facilities were registered over a 3-year period. ⋯ The outcome measures of this study were 30-day mortality and operative mortality. In this review, we examine the eight risk models, compare the procedural outcomes, outline the feedback reporting, and discuss the future evolution of the NCD.