Annals of surgery
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To define the potential influences of donor brain death on organs used for transplantation. ⋯ Donor brain death is a significant risk factor for peripheral organs used for transplantation. The activated state of such organs appears to trigger host immune mechanisms that accelerate the process of acute rejection. The effects of this central injury may explain in part the less satisfactory performance of cadaver organs in human transplantation compared with those from living sources.
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To determine whether ischemic preconditioning protects the human liver against a subsequent period of ischemia in patients undergoing hemihepatectomy, and to identify possible underlying protective mechanisms of ischemic preconditioning, such as inhibition of hepatocellular apoptosis. ⋯ Ischemic preconditioning is a simple and effective modality protecting the liver against subsequent prolonged periods of ischemia. This strategy may be a more attractive technique than intermittent inflow occlusion, which is associated with increased blood loss during each period of reperfusion.
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To determine the incidence of tracheal stenosis, voice and breathing changes, and stomal complications after percutaneous dilatational tracheostomy (PDT). ⋯ Subjective voice changes and tracheal abnormalities are common after endotracheal intubation followed by PDT. Long-term follow-up of critically ill patients identified a 31% rate of more than 10% tracheal stenosis after PDT. Symptomatic stenosis manifested by subjective respiratory symptoms after decannulation was found in 3 of 48 (6%) patients.
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Comparative Study Clinical Trial
Patterns of recurrence and survival after laparoscopic and conventional resections for colorectal carcinoma.
To determine whether survival and recurrence after laparoscopic-assisted surgery for colorectal cancer is compromised by an initial laparoscopic approach. ⋯ Oncologic outcome at a minimum of 2 years is not compromised by the laparoscopic approach. Wound recurrences are a feature of laparoscopic and conventional surgery for advanced disease.
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To discuss the diagnosis and treatment of meralgia paresthetica as reported in the literature and as experienced by the author. ⋯ Surgical management of meralgia paresthetica is a viable option for patients in whom medical management fails. Based on the published literature and the author's experience, a rationale is presented for determining the appropriate surgical management of these patients.