Annals of surgery
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To develop parsimonious prediction models for postoperative mortality, overall morbidity, and 6 complication clusters applicable to a broad range of surgical operations in adult patients. ⋯ Our results suggest that it will be possible to develop parsimonious models to predict 8 important postoperative outcomes for a broad surgical population, without the need for surgeon specialty-specific models or inclusion of laboratory variables.
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Comparative Study
Alvimopan Provides Additional Improvement in Outcomes and Cost Savings in Enhanced Recovery Colorectal Surgery.
To examine the impact of alvimopan on outcomes and costs in a rigorous enhanced recovery colorectal surgery protocol. ⋯ Alvimopan administration as an element of enhanced recovery colorectal surgery is associated with faster return of bowel function, lower incidence of postoperative ileus, shorter hospitalization, and a significant cost savings. These results suggest that alvimopan is cost-effective in the setting of enhanced recovery colorectal surgery protocols, and should therefore be considered in these programs.
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To develop accurate preoperative risk prediction models for multiple adverse postoperative outcomes applicable to a broad surgical population using a parsimonious common set of risk variables and outcomes. ⋯ Accurate preoperative risk assessment of postoperative mortality, overall morbidity, and 6 complication clusters in a broad surgical population can be achieved with as few as 8 preoperative predictor variables, improving feasibility of routine preoperative risk assessment for surgical patients.
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The aim of the study was to establish whether an inguinal neurectomy at the time of hernia repair would reduce the risk of postoperative pain for open tension-free sutured mesh repair. ⋯ Routine ilioinguinal neurectomy during Lichtenstein-type herniorrhaphy seems to be a safe and effective method to reduce pain in the short and midterm, but may have little long-term impact. Iliohypogastric neurectomy seems to reduce pain in at least the short term.
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To evaluate the impact of a laparoscopic resection on postoperative mortality after colorectal cancer surgery. ⋯ LR reduces the risk of postoperative mortality compared with OR in elective setting in patients with nonlocally advanced, nonmetastasized colorectal cancer. Especially elderly frail patients seem to benefit because of reduced cardiopulmonary complications. These findings support widespread implementation of LR for colorectal cancer also in patients at high operative risk.