Journal of the American College of Surgeons
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Comparative Study
Peritoneal cytokines predict mortality after surgical treatment of secondary peritonitis in the rat.
The study aimed to analyze if peritoneal cytokine levels can predict survival in an experimental model for peritonitis. Early identification of patients most at risk for adverse outcomes would facilitate the decision for aggressive therapy in order to maximally exploit their chance for survival. ⋯ These data should generate renewed interest to examine the peritoneal cytokines as early markers for adverse outcomes in patients with secondary peritonitis. Possibly, combinations of peritoneal cytokines with other markers can lead to much needed, reliable early prediction of disease severity.
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Comment Letter
Radiofrequency ablation use in hepatocellular carcinoma.
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Historical Article
Wherever the dart lands: toward the ideal trauma system.
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Knowledge of the factors associated with longer-term reduced capacity to work (RCW) is lacking in patients after polytrauma. ⋯ In this cohort of patients surviving polytrauma, approximately 50% of patients sustained longer-term RCW. Several characteristics, such as level of education or trauma severity, showed an independent association with patients' capacity to work, which was significantly associated with patients' self-rated scorings of well-being.
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Predictors of major complications after laparoscopic cholecystectomy: surgeon, hospital, or patient?
Regionalization of care has been proposed for complex operations based on hospital/surgeon volume-mortality relationships. Controversy exists about whether more common procedures should be performed at high-volume centers. Using mortality alone to assess routine operations is hampered by relatively low perioperative mortality. We used a large national database to analyze the risk of major in-hospital complications after laparoscopic cholecystectomy (LC). ⋯ Major in-hospital complications after LC are associated with individual patient characteristics rather than surgeon or hospital operative volumes. These results suggest regionalization of general surgical procedures might be unnecessary. Rather, careful patient selection and preoperative preparation can diminish overall complication rates.