Annals of surgery
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To evaluate a single center's 10-year experience with emergency endovascular aneurysm repair (eEVAR) in 102 patients with ruptured abdominal aortoiliac aneurysms (RAAA). ⋯ In this 102 patient contemporary series of eEVAR for RAAA, endografting proved to be safe with a 30-day mortality of 13%. Key components of this favorable outcome result were adequate preoperative diagnostic imaging, hypotensive hemostasis, selective transfemoral supraceliac aortic balloon occlusion, predominantly local anesthesia, detection and treatment of ACS, and attention to logistics. Widespread adoption of these treatment components is recommended.
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To analyze the impact of body mass indices on postbariatric reconstructive surgery complications. ⋯ Body mass indices influence complications in postbariatric reconstructive surgery. Current BMI may impact complications in single-procedure cases, but appears to play less of a role in larger cases. Careful patient selection, assessment of surgical complexity, and recognition of the particular risks increased by residual obesity can help to optimize outcomes in this patient population.
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To describe the characteristics of patients undergoing multiple groin hernia repairs and to identify strategies that prevent further recurrence. ⋯ Laparoscopic preperitoneal repair provides the best surgical outcome in repeated groin hernia recurrence.
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To study the impact of war on the workload/finances of a community hospital adjacent to the front. ⋯ Treatment of civilian/military casualties resulted in reorganization of hospital operations with significantly decreased accrued revenue. The bulk of the GSD workload shifts from the OR to the ED/wards while Orthopedic procedures and ICU beds become bottlenecks to patient flow during war.
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Preoperative chemoradiotherapy (CRT) followed by esophagectomy is becoming one of the standard treatment strategies for esophageal cancer. Pathologic complete response (pCR) after CRT is the best predictor of survival in squamous cell carcinoma (SCC) of the esophagus. Although no adjuvant treatment is recommended for individuals who achieve pCR, approximately 30% of these patients develop recurrence. Herein we sought to retrospectively investigate the independent predictors of tumor recurrence in this patient group. ⋯ We have shown that up to 31.4% of patients with esophageal SCC who achieve pCR develop tumor recurrence thereafter. Pretherapy T3-4 disease was a strong and independent adverse risk factor for 5-year tumor recurrence, DSS and DFS. High-risk patients with T3-4 disease should be followed with a strict surveillance protocol.