Annals of surgery
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To determine predictors of metabolic syndrome and its resolution in a large, ethnically diverse adult population undergoing bariatric surgery. ⋯ On the basis of our findings, bariatric surgery may be most effective for younger, less obese patients who are early in the course of their cardiometabolic disease. Future research should investigate the factors that lead to lower rates of disease resolution after bariatric surgery for racial/ethnic minority groups.
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To clarify the recurrence pattern after resection of main duct intraductal papillary mucinous neoplasms (MD-IPMNs) using molecular analyses and determine the most adequate treatment strategy. ⋯ One-step total pancreatectomy can be avoided, and remnant total pancreatectomy would lead to favorable outcomes even in patients with pancreatic recurrence, some cases of which seem to involve residual lesions. Postoperative surveillance of high-grade dysplasia should be performed as if malignant, and close attention should be paid to the occurrence of concomitant pancreatic ductal adenocarcinomas in patients with MD-IPMNs.
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To determine the impact of length of stay upon 30-day outcomes. ⋯ In this large, prospective, clinical database, LOS of 1 day or less for LRYGB patients was significantly associated with an increased risk of 30-day mortality and a trend toward increased risk of 30-day serious complications.
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To evaluate the influence of preoperative dysplasia grade, appearance, and site on risk and location of cancer in patients with colitis. ⋯ Risk of cancer for patients with HGD or DALM is substantial. Despite low risk of cancer in patients with flat LGD, threshold for surgery should be low given the high prevalence of postoperative pathologic findings. Only in selected cases, colonoscopic surveillance after discussion of associated risks may be acceptable, provided high patient compliance can be assured. Surgery should be considered in all other cases, because it is the only modality that can eliminate the risk of cancer. The location of preoperative dysplasia may allow for the clarification of the need for proctectomy especially in the poor risk surgical patient.
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Comparative Study
Indications and outcome of pelvic exenteration for locally advanced primary and recurrent rectal cancer.
The outcome of pelvic exenteration was compared in patients with locally advanced primary (LAP) cancer and recurrent rectal cancer (RRC). ⋯ Resection margin status is more important than primary or recurrent cancer in predicting long-term outcome.