Annals of surgery
-
Randomized Controlled Trial Multicenter Study Comparative Study
Decreased Morbidity of Laparoscopic Distal Gastrectomy Compared With Open Distal Gastrectomy for Stage I Gastric Cancer: Short-term Outcomes From a Multicenter Randomized Controlled Trial (KLASS-01).
To determine the safety of laparoscopy-assisted distal gastrectomy (LADG) compared with open distal gastrectomy (ODG) in patients with clinical stage I gastric cancer in Korea. ⋯ LADG for patients with clinical stage I gastric cancer is safe and has a benefit of lower occurrence of wound complication compared with conventional ODG.
-
To study the association between ketorolac use and postoperative complications. ⋯ Use of intravenous ketorolac was associated with greater odds of reintervention, ED visit, and readmission in both colorectal and noncolorectal GI surgery. Given this confirmatory evaluation of other reports of a negative association and the large size of this cohort, clinicians should exercise caution when using ketorolac in patients undergoing GI surgery.
-
Review
A Systematic Review of the Impact of Dedicated Emergency Surgical Services on Patient Outcomes.
This review aims to assess the impact of implementing dedicated emergency surgical services, in particular acute care surgery, on clinical outcomes. ⋯ ACS models as well as centralized units and hospitals with dedicated emergency operating rooms, access to radiology and intensive care facilities (ITU) are all factors associated with improved clinical and financial outcomes in the delivery of emergency general surgery. There is, however, no consensus on the elements that constitute an ideal ACS model and how it can be implemented into current surgical practice.
-
Randomized Controlled Trial
Evaluating a Novel 3D Stereoscopic Visual Display for Transanal Endoscopic Surgery: A Randomized Controlled Crossover Study.
To compare surgical performance with transanal endoscopic surgery (TES) using a novel 3-dimensional (3D) stereoscopic viewer against the current modalities of a 3D stereoendoscope, 3D, and 2-dimensional (2D) high-definition monitors. ⋯ This novel 3D stereoscopic viewer allows surgical performance in TES equivalent to that achieved using the current stereoendoscope and superior to standard 2D and 3D displays, but with lower physical and mental demands for the surgeon. Participants expressed a preference for this system, ranking it more highly on a questionnaire. Clinical translation of this work has begun with the novel viewer being used in 5 TES patients.
-
To provide a comprehensive review of recent epidemiologic data on the burden of adhesion-related complications and adhesion prevention. Second, we elaborate on economic considerations for the application of antiadhesion barriers. ⋯ Adhesions are an important cause for long-term complications in both open and laparoscopic surgery. Adhesiolysis during reoperations seems to impact adhesion-related morbidity most. Routine application of antiadhesion barriers in open surgery is safe and cost-effective. Application of antiadhesion barriers can be cost-effective in selected cases of laparoscopy. More research is needed to develop barriers suitable for laparoscopic use.