Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
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Rapunzel syndrome is a rare entity comprising of a large gastroduodenal trichobezoar due to trichotillomania. Its treatment is often surgical. ⋯ A 27-year-old patient was investigated after an upper gastro-intestinal tract obstruction. Computed tomography and endoscopy showed a large gastric trichobezoar with a duodenojejunal tail. Conservative treatments failed to remove the bezoar. We performed a short laparotomy which allowed the removal of the bezoar through a longitudinal gastrotomy. Postoperative course was uneventful.
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J. Gastrointest. Surg. · Aug 2011
Epidural analgesia in open resection of colorectal cancer: is there a clinical benefit? a retrospective study on 1,470 patients.
Epidural analgesia (EA) is effective for postoperative pain relief and results in an earlier recovery from postoperative paralytic ileus. This study evaluated the influence of epidural analgesia on the postoperative 30-day mortality and morbidity after open colorectal cancer resection. ⋯ For patients with open colorectal cancer surgery, the application of EA leads to a reduction in pneumonia. Although this is only a retrospective study, it strongly supports the use of EA.
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J. Gastrointest. Surg. · Aug 2011
Diagnosis and management of anastomotic leaks after esophagectomy.
Complications following esophagectomy significantly affect outcomes, including perioperative mortality, costs, and survival. Anastomotic leak remains one of the most serious complications, and early recognition and appropriate initial treatment are essential. ⋯ It is critically important to differentiate between leaks and conduit necrosis. Endoscopic examination is the best method for making this assessment. Surgeons should become familiar with the expanding options for endoscopic assessment and treatment of esophageal anastomotic leaks.