American journal of surgery
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Review Meta Analysis Comparative Study
Low-pressure versus standard-pressure pneumoperitoneum for laparoscopic cholecystectomy: a systematic review and meta-analysis.
The feasibility and safety of low-pressure pneumoperitoneum in laparoscopic cholecystectomy remain unclear. ⋯ Low-pressure pneumoperitoneum is feasible and safe and results in reduced postoperative pain and near-equal operative time compared with standard-pressure pneumoperitoneum. More studies are required to investigate the potential benefits of the reduced length of hospital stay.
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Multicenter Study
Natural history of retained surgical items supports the need for team training, early recognition, and prompt retrieval.
Unintentionally retained items feature prominently among surgical "never events." Our knowledge of these rare occurrences, including natural history and intraoperative safety omission or variance (SOV) profile, is limited. We sought to bridge existing knowledge gaps by presenting a secondary analysis of a multicenter study focused on these important aspects of retained surgical items (RSIs). ⋯ The finding that most operations complicated by RSIs were found to involve team/system errors and 2 or more SOVs emphasizes the importance of team safety training. The observation that early RSI removal minimizes patient morbidity and symptoms highlights the need for prompt RSI identification and treatment. The incidence of inflammation-related findings increases significantly with longer retention periods.
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Rural surgeons have unique learning needs not easily met by traditional continuing medical education courses. ⋯ This course was successful, from participants' perspectives, in providing hands-on mentored training for a variety of skills that reflect the broad scope of practice of surgeons in rural areas. Attendees felt that their participation resulted in important behavior and practice changes.
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Observational Study
Incidence and risk factors of delirium in the elderly general surgical patient.
This study evaluates the incidence of delirium and risk factors associated with delirium in elderly patients admitted to a general surgical ward. ⋯ The incidence of delirium is high in elderly patients, especially after an acute admission, leading to an increase in length of hospital stay. To minimize delirium, associated risk factors must be identified and, if possible, treated.
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Comparative Study Observational Study
Improved perioperative and short-term outcomes of robotic versus conventional laparoscopic colorectal operations.
Robotic assistance may offer unique advantages over conventional laparoscopy in colorectal operations. ⋯ Compared with conventional laparoscopy, some types of robotic-assisted colorectal operations may offer advantages regarding postoperative length of stay and perioperative complications.