Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
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J. Gastrointest. Surg. · Nov 2011
Comparative StudyManagement of gastrointestinal leaks after minimally invasive esophagectomy: conventional treatments vs. endoscopic stenting.
Gastrointestinal leak is a dreaded complication after esophagectomy. Conventional treatments for leak include conservative therapy, surgical reoperation, and even complete gastrointestinal (GI) diversion. The aim of this study was to evaluate the impact of endoluminal stenting in the management of esophagogastric leak after esophagectomy. ⋯ In our clinical practice, there has been a shift in the management of esophagogastric anastomotic leaks to nonsurgical therapy using endoscopic esophageal covered stenting. Endoluminal stenting is a safe and effective alternative in the management of GI leaks.
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J. Gastrointest. Surg. · Nov 2011
MELD-based indices as predictors of mortality in chronic liver disease patients who undergo emergency surgery with general anesthesia.
Underlying chronic liver disease is associated with high morbidity and mortality after emergency surgery, which complicates clinical decisions over performing such surgery. In addition, the Child-Turcotte-Pugh (CTP) score is limited in its ability to predict postoperative residual liver function. This study was designed to determine whether the scores of the Model for End-stage Liver Disease (MELD)-based indices are effective predictors of mortality following emergency surgery in patients with chronic liver disease. ⋯ iMELD reflects underlying liver function and predicts overall mortality more accurately than CTP and other MELD-based indices scores do in chronic liver disease patients after emergency surgery with general anesthesia.
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J. Gastrointest. Surg. · Nov 2011
Comparative StudySignificance of thoracoscopy-assisted surgery with a minithoracotomy and hand-assisted laparoscopic surgery for esophageal cancer: the experience of a single surgeon.
This retrospective study evaluated the surgical learning curve and outcomes of thoracolaparoscopic esophagectomy. ⋯ Thoracolaparoscopic esophagectomy for esophageal cancer was technically feasible and oncologically satisfactory, according to the surgical learning curve.
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J. Gastrointest. Surg. · Nov 2011
Perioperative outcomes for open distal pancreatectomy: current benchmarks for comparison.
Open distal pancreatectomy (ODP) outcomes have largely relied on single-institution data from high-volume, tertiary centers. To provide contemporary, national benchmarks of ODP outcomes, we examined the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. ⋯ ODP remains the gold standard for lesions of the pancreatic body or tail. The current analysis reflects nationwide data that may serve as current benchmarks for both open and laparoscopic techniques.