Journal of the American College of Surgeons
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Randomized Controlled Trial Multicenter Study Comparative Study
Surgeon vs Pathologist for the Prediction of Pancreatic Fistula: Results from the Randomized Multicenter RECOPANC Study.
Surgically assessed pancreatic texture has been identified as the strongest predictor of postoperative pancreatic fistula. However, texture is a subjective parameter with no proven reliability or validity. Therefore, a more objective parameter is needed. In this study, we evaluated the fibrosis level at the pancreatic neck resection margin and correlated fibrosis and all clinico-pathologic parameters collected over the course of the Pancreatogastrostomy vs Pancreatojejunostomy for RECOnstruction (RECOPANC) study. ⋯ Histologically evaluated pancreatic fibrosis is an easily applicable and highly reproducible POPF predictor and superior to surgically evaluated pancreatic texture. Future studies might use fibrosis grade for risk stratification in pancreatoduodenectomy.
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Observational Study
Incidence and Risk Factors for Long-Term Mesh Explantation Due to Infection in over 100,000 Hernia Surgery Patients.
Infectious complications after hernia operation are potentially disastrous, often requiring long-term antibiotic administration, debridement, and mesh explantation. Our objective was to describe the long-term incidence and risk factors for synthetic mesh explantation due to infection after hernia operation in a large cohort. ⋯ Mesh explantation for infection is most common after ventral hernia repair. Risk factor optimization is crucial to minimize such an end point.