American journal of surgery
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Inguinal nerve entrapment is a debilitating postoperative problem. ⋯ Five percent of patients had minor complications. There was abnormal nerve histopathology in 18%. Total pain relief was attained in 72% of patients, partial relief in 25%, and no relief in 3%. Two patients complained of numbness postoperatively. Multifactorial analysis showed recurrent hernia repair as a significant predictive factor.
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Despite blood-conservation techniques, hemorrhage during burn excision remains substantial. It is difficult to predict the blood loss that will occur per operation and how many units the patient will require during surgery. This may result in high cross-match-to-transfusion ratios (CMTRs). ⋯ Estimation of excision area can predict transfusion need, which at our institution yields a low CMTR.
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Randomized Controlled Trial Comparative Study Clinical Trial
Randomized controlled trial comparing the controlled rehabilitation with early ambulation and diet pathway versus the controlled rehabilitation with early ambulation and diet with preemptive epidural anesthesia/analgesia after laparotomy and intestinal resection.
Multimodal postoperative care regimens accelerate recovery after abdominal surgery. The benefit of thoracic epidural (TE) analgesia over patient-controlled analgesia (PCA) remains unproven when used with a fast-track postoperative care plan. ⋯ TE offers no advantage over PCA for patients undergoing major intestinal resections who are on a fast-track postoperative care plan using PCA.
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Review Comparative Study
A comparison of the adverse reactions associated with isosulfan blue versus methylene blue dye in sentinel lymph node biopsy for breast cancer.
Sentinel lymph node biopsy (SLNB) is an established means of staging the axilla in patients with breast cancer. Recently, methylene blue dye has been shown to be an efficacious and cost-effective alternative to isosulfan blue. With the increasing popularity of SLNB, the potential complications of isosulfan blue use must be appreciated. ⋯ The use of isosulfan blue due for SLNB is associated with a significant number of allergic reactions, some of which are life-threatening. Because methylene blue dye has been shown to be equally effective and does not pose a serious risk of serious allergic reactions, it offers an improved technique above isosulfan blue dye for SLNB.
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Case Reports
A secure technique of intracorporeal Roux-Y reconstruction after laparoscopic distal gastrectomy.
Laparoscopic distal gastrectomy [LDG] is a minimally invasive surgery for gastric carcinoma. The Billroth I method has been commonly employed to reconstruct alimentary tract after LDG. Conversely, Roux-Y reconstruction is employed far less commonly despite its merits. Technical difficulties, including a risk of twisting the Roux loop under limited vision through a laparoscope, have hampered Roux-Y reconstruction after LDG. ⋯ By using the present technique, intracorporeal Roux-Y reconstruction after LDG can be accomplished without a risk of twisting the jejunal loop.