Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
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J. Gastrointest. Surg. · Sep 2009
Multicenter Study Comparative StudySmall pancreatic and periampullary neuroendocrine tumors: resect or enucleate?
The aim of this study was to compare the outcomes of enucleation versus resection in patients with small pancreatic, ampullary, and duodenal neuroendocrine tumors (NETs). ⋯ These data suggest that most outcomes of enucleation and resection for small pancreatic and peri-pancreatic NETs are comparable. However, enucleation has better outcomes than pancreaticoduodenectomy for head lesions and the advantage of preserving splenic function for tail lesions.
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J. Gastrointest. Surg. · Sep 2009
Comparative StudyNegative impact of blood transfusion on recurrence and prognosis of hepatocellular carcinoma after hepatic resection.
In perioperative management of hepatic resection for hepatocellular carcinoma, excessive blood loss and blood transfusion greatly influence postoperative complications and prognosis of the patients. We evaluated the influence of blood products use on postoperative recurrence and prognosis of patients with hepatocellular carcinoma. ⋯ Transfusion of blood products is associated with increased recurrence rate and worse survival after elective hepatic resection for patients with hepatocellular carcinoma.
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J. Gastrointest. Surg. · Sep 2009
Comparative StudyLong-term outcomes and prognostic factors of elderly patients with hepatocellular carcinoma undergoing hepatectomy.
The present study aimed to evaluate the long-term outcomes and prognostic factors of elderly patients with hepatocellular carcinoma (HCC) undergoing hepatectomy. ⋯ HCC in the elderly was less HBV-associated, less advanced, and less aggressive. Hepatectomy for selected elderly patients with HCC possibly have a better curative effect compared with younger patients. For the elderly patients without preoperative comorbidities or with controlled comorbidities, hepatectomy is a safe and effective treatment. pTNM staging is the only independent predictor of postoperative overall survival in elderly HCC patients.
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J. Gastrointest. Surg. · Sep 2009
Diagnostic accuracy of C-reactive protein for intraabdominal infections after colorectal resections.
Intraabdominal infections are caused mainly by anastomotic leaks and represent a serious complication. Diagnosis is usually made when patients become critically ill. Though inflammatory markers, including C-reactive protein (CRP) and white blood count (WBC), may contribute to an early diagnosis, their clinical roles remain unclear. The diagnostic accuracy of continuous tests depends on the choice of cut-off values. We analyzed the diagnostic accuracy of serial CRP and WBC measurements to detect infectious complications after colorectal resections. ⋯ Serial CRP measurements are helpful for detecting intraabdominal infections after colorectal resection. Persistently elevated CRP values after POD 3 should be investigated for intraabdominal infection.
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J. Gastrointest. Surg. · Sep 2009
Comparative StudyShort-term outcomes of laparoscopic rectal surgery for primary rectal cancer in elderly patients: is it safe and beneficial?
The role of laparoscopic resection in management of rectal cancer is still controversial. The purpose of this study was to evaluate whether laparoscopic rectal resection for rectal cancer could be safely performed in elderly patients. ⋯ Laparoscopic rectal resection for elderly patients can be safely performed with similar postoperative outcomes as in younger patients and may have advantages in terms of faster gastrointestinal recovery and shorter length of hospital stay compared with open surgery.