Annals of surgery
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Gastroesophageal reflux is the main risk factor for esophageal adenocarcinoma, but there is no strong support for any cancer-protective effect after antireflux surgery. We hypothesized that recurrent reflux or high exposure to other established risk factors, that is, obesity and tobacco smoking, are overrepresented among patients who despite antireflux surgery develop esophageal adenocarcinoma. ⋯ Recurrence of reflux might explain the lack of protective effect of antireflux surgery regarding risk of developing esophageal adenocarcinoma.
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Urinary and sexual dysfunctions are recognized complications of rectal cancer surgery. Their incidence after robotic surgery is as yet unknown. The aim of this study was to prospectively evaluate the impact of robotic surgery for rectal cancer on sexual and urinary functions in male and female patients. ⋯ RTME allows for preservation of urinary and sexual functions. This is probably due to the superior movements of the wristed instruments that facilitate fine dissection, coupled with a stable and magnified view that helps in recognizing the inferior hypogastric plexus.
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To evaluate the influence of the anatomy of the right posterior bile duct (RPBD) of the donor on biliary complications in the recipients after living-donor liver transplantation (LDLT) using right hemi-liver grafts. ⋯ The anatomy of the RPBD of the donor influenced the biliary outcome in the recipients. A short RBD and a long caudal segment of the RPBD of the donor were significant risk factors for biliary complications in LDLT.
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To identify risk factors associated with readmission for children treated with appendicitis, and to characterize variation in risk-adjusted readmission rates between children's hospitals. ⋯ Significant variation in risk-adjusted readmission rates exists among children's hospitals after treatment of appendicitis, and outliers can be identified at both ends of the performance spectrum. These findings may have important implications for the identification and dissemination of "best practices" from exemplar hospitals.
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To evaluate the effect of laparoscopic sleeve gastrectomy (LSG) on fasting and meal-stimulated release of the gut hormones ghrelin, pancreatic polypeptide (PP), peptide-YY (PYY), glucagon-like peptide-1 (GLP-1), and amylin and of the adipocytokine leptin. ⋯ LSG markedly improved glucose homeostasis and generated significant changes in ghrelin, PP, PYY, GLP-1, amylin, and leptin levels. These multiple hormonal actions may have several beneficial effects on the underlying mechanism of weight loss, demonstrating that LSG could be more than just a restrictive bariatric operation.