American journal of surgery
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Randomized Controlled Trial Comparative Study Clinical Trial
A prospective, randomized trial of short versus long tubes in adhesive small-bowel obstruction.
Many cases of acute adhesive small-bowel obstruction (SBO) can be successfully treated with intestinal tube decompression. There is considerable controversy, however, regarding whether a short nasogastric tube (NGT) or a long nasointestinal tube (LT) is the best method of intestinal tube decompression. ⋯ Patients with adhesive SBO can safely be given a trial of tube decompression upon hospital admission. There was no advantage of one type of tube over the other in patients with adhesive SBO.
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The American College of Surgeons recommends minimum patient volumes for trauma centers and surgeons. Those numbers, however, are largely based on results from studies of surgical (but not trauma) relationships between volume and outcome. ⋯ These results support the regionalization of trauma care by affirming that increased per-surgeon experience in the treatment of seriously injured patients is associated with improved outcomes and help define the minimum experience needed to achieve normative survival. Prospective study of the relationship between volume and survival and other outcomes is required.