Journal of the American College of Surgeons
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Comparative Study
Laparoscopic colorectal resection: a safe option for elderly patients.
Open colorectal surgery in the elderly has been associated with higher morbidity and mortality rates. The favorable short-term outcomes of laparosocopic colorectal resection might reduce the morbidity in elderly patients. This study compares results of elderly patients (aged 70 and above) who underwent laparoscopic colorectal resection with those having open surgery. ⋯ Laparoscopic colorectal resection is a safe option for elderly patients and is associated with more favorable short-term outcomes in terms of earlier return of bowel function, earlier resumption of diet, and shorter hospital stay. It is also associated with less cardiopulmonary morbidity, which is an important complication after colorectal surgery in the elderly.
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Comparative Study
Portal versus systemic drainage of small bowel allografts: comparative assessment of survival, function, rejection, and bacterial translocation.
Portal venous drainage of small bowel grafts is theoretically more physiologic than systemic drainage, but is technically more demanding. Comparisons in animal models have not demonstrated a clear advantage of one technique over the other, but clinical data are lacking. ⋯ Systemic venous drainage of small bowel transplants is a dependable technique, associated with similar results as portal venous drainage, in terms of overall mortality, morbidity, rejection, function, and patient and graft survival. But attention should be paid to an impaired clearance of intestinal bacterial translocation after systemic drainage.
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The clinicopathologic characteristics and the expression of apomucin (MUC) in intrahepatic cholangiocarcinoma (ICC) with respect to gross morphology have not been comprehensively examined. ⋯ It is apparent that the IG type of ICC should be distinguished from the other types of ICC because a favorable prognosis can be expected after complete surgical resection.