American journal of surgery
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Microvascular hyperpermeability that occurs in hemorrhagic shock and burn trauma is regulated by the apoptotic signaling pathway. We hypothesized that tumor necrosis factor-α (TNF-α)-related apoptosis-inducing ligand (TRAIL) would promote hyperpermeability directly or by interacting with other signaling pathways. ⋯ TRAIL-induced microvascular hyperpermeability is phosphatidylinositol 3-kinase (PI3K)-dependent and may be mediated by caspase-3 cleavage of the endothelial adherens junctional complex.
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Multicenter Study Comparative Study
Compression anastomosis ring device in colorectal anastomosis: a review of 1,180 patients.
The nickel-titanium compression anastomosis ring device (ColonRing, NiTi Surgical Solutions, Netanya, Israel) has been cleared by the Food and Drug Administration in 2006 to construct gastrointestinal anastomoses. We evaluated the anastomotic leak rate after end-to-end anastomosis using the ColonRing device. ⋯ The use of the ColonRing device is feasible and safe and could be considered an alternative technology for end-to-end colorectal anastomosis.
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We sought to identify differences among black and white Medicare-insured patients with colorectal cancer who underwent resection. ⋯ Black patients with colorectal cancer demonstrated increased risk of mortality and readmission after controlling for age, sex, and comorbidities. Although black vs white differences in perioperative mortality decreased over time, disparities in readmission and long-term survival persisted.
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Comparative Study
Accuracy of magnetic resonance cholangiopancreatography for diagnosing stones in the common bile duct in patients with abnormal intraoperative cholangiograms.
Magnetic resonance cholangiopancreatography (MRCP) is a noninvasive method for diagnosing choledocholithiasis. It is said to be as accurate as the gold standard endoscopic retrograde cholangiopancreatography (ERCP) for detecting common bile duct (CBD) stones. A study was needed to look at the accuracy of MRCP compared with intraoperative cholangiography (IOC) for detecting stones in the CBD. The aim of this study was to evaluate the diagnostic accuracy of MRCP in patients with choledocholithiasis diagnosed with IOC. ⋯ MRCP has a high rate of false normal results compared with IOC and is not as accurate as more invasive techniques. There is no need for preoperative MRCP in patients with suspected choledocholithiasis caused by stones.
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The Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) model and its Portsmouth modification (P-POSSUM) are used extensively to predict postoperative mortality and morbidity in general surgery. The aim of this study was to undertake the first systematic review of the predictive value of these models in patients undergoing pancreatic surgery. ⋯ POSSUM overpredicted postoperative morbidity in patients undergoing pancreatic surgery. Both POSSUM and P-POSSUM failed to offer significant predictive value for mortality in pancreatic surgery, and more data collection in large populations undergoing pancreatic surgery are needed.