American journal of surgery
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Diabetes mellitus is postulated to be both a risk factor and manifestation of pancreatic adenocarcinoma. This study evaluated the effects of preoperative glycemic control as determined by hemoglobin A1c (HbA1c) on outcomes following pancreaticoduodenectomy (PD). ⋯ PD can be safely performed in patients with HbA1c levels suggestive of poor long-term preoperative glycemic control. Medical efforts to optimize HbA1c should not delay resection.
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There are limited data regarding the effects of ascites on outcome of patients undergoing colorectal resection. We sought to identify complications related to ascites. ⋯ The presence of ascites in CHF patients is associated with increased mortality in patients undergoing colorectal surgery. There is no correlation between ascites and surgical site infection but wound disruption increases in the presence of ascites.
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The American Board of Surgery In-Training Examination (ABSITE) offers annual assessment of resident medical knowledge. We sought to determine if ongoing end-of-rotation evaluations by faculty of residents' medical knowledge correlate with ABSITE performance. ⋯ Faculty evaluations of resident medical knowledge correlate poorly with resident ABSITE performance, and should not be used as an ongoing predictive tool.
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Preventing surgical site infection is perhaps the most direct method of decreasing medical expenses. The following is an attempt at comprehensive ways of decreasing surgical site infection as well as decreasing patient discomfort.
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It is unclear whether transumbilical incision for laparoscopic colectomy has a risk of incisional hernia at the extraction site similar to left lower incision. ⋯ Extraction site for transumbilical incision may not affect the risk of incisional hernia.