Annals of surgery
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Routine preoperative laboratory testing for ambulatory surgery is not recommended. ⋯ Preoperative testing is overused in patients undergoing low-risk, ambulatory surgery. Neither testing nor abnormal results were associated with postoperative outcomes. On the basis of high rates of testing in healthy patients, physician and/or facility preference and not only patient condition currently dictate use. Involvement from surgical societies is necessary to establish guidelines for preoperative testing.
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This study aims to examine trends of utilization and rates of conversion to open procedure for patients undergoing laparoscopic colon resections (LCR). ⋯ There is a trend of increasing utilization of LCR, with acceptable conversion rates, across hospitals in the United States over the recent years. When feasible, attempted LCR had better outcomes than open colectomy in the immediate perioperative period.
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Comparative Study
Impact of resident participation in surgical operations on postoperative outcomes: National Surgical Quality Improvement Program.
To evaluate whether resident participation in operations influences postoperative outcomes. ⋯ Resident involvement in surgical procedures is safe. The small overall increase in mild surgical complications is mostly caused by superficial wound infections. Reasons for this are likely multifactorial but may be related to prolonged operative time.
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To identify all trauma patients with diabetes and compare diabetic hyperglycemia (DH) patients with those with stress-induced hyperglycemia (SIH). ⋯ DM is common in patients with hyperglycemia after trauma. As opposed to DH, SIH is associated with higher mortality after trauma. Further research is warranted to identify mechanisms causing hyperglycemia and subsequent worse outcomes after trauma.
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To investigate the association between time from admission to appendectomy (TTA) and the incidence of perforation and infectious complications. ⋯ In this series, appendectomy delay did not increase the risk of perforation but was associated with a significantly increased risk of SSI in patients with nonperforated appendicitis. Prompt surgical intervention is warranted to avoid additional morbidity in this population.