Journal of the American College of Surgeons
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Inadvertent passage of a nasoenteric feeding tube into the tracheobronchial tree can result in pneumothorax. Measures requiring feeding tube passage to 35 cm only followed by a radiograph to verify intraesophageal placement and creation of a specialized placement team were implemented to decrease the incidence of procedure-related pneumothorax. This study evaluates the effectiveness of our safety measures. ⋯ Creating a specialized placement team, and initiating the safety measure of limiting feeding tube placement to 35 cm and obtaining a radiograph before full advancement reduced the incidence of procedure-related pneumothorax.
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Comparative Study
Off-pump versus on-pump coronary artery bypass surgery: does the pump influence outcome?
This study assessed hospitalization outcome differences for patients undergoing off-pump coronary artery bypass (OPCAB) grafting compared with patients having coronary artery bypass grafting with cardiopulmonary bypass. ⋯ Patients undergoing OPCAB had a considerably shorter length of hospitalization, had fewer pulmonary and intraoperative complications, and received a lower volume of blood products.
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Dwindling operative opportunities in trauma care may have a detrimental impact on career satisfaction among trauma surgeons and on career attractiveness to surgical trainees. Addition of emergency general surgery may alleviate some of these concerns. ⋯ The combined trauma and nontrauma surgery service increased operative caseloads and improved satisfaction of trauma surgeons. A comprehensive trauma and emergency general surgery service may be an attractive model for the future of trauma surgery and provide logistical and medical advantages to the emergency general surgery patient population.
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Hepatic resection is increasingly performed for primary and metastatic tumors. Reports from tertiary care centers show improved outcomes over time with lower operative mortality rates. The objective of this investigation was to characterize trends in the use and outcomes of hepatic resection in the US during a recent 13-year period. ⋯ The number of hepatic resections performed in the US has increased significantly. Short-term outcomes have also improved over the same time period, with more improvement seen at higher volume centers than in lower volume centers.