Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
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J. Gastrointest. Surg. · Oct 2012
Randomized Controlled Trial Comparative StudyPreliminary experience of fast-track surgery combined with laparoscopy-assisted radical distal gastrectomy for gastric cancer.
The aim of this study was to evaluate the safety and effectiveness of fast-track surgery combined with laparoscopy-assisted radical distal gastrectomy for gastric cancer. ⋯ Combination of FTS and LADG in gastric cancer is safe, feasible, and efficient and can improve nutritional status, lessen postoperative stress, and accelerate postoperative rehabilitation. Compared with FTS + ODG and LADG, its advantages were limited in short-term follow-up.
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J. Gastrointest. Surg. · Oct 2012
Review Meta Analysis Comparative StudyLaparoscopic versus open appendectomy for complicated and uncomplicated appendicitis in children.
Appendectomy is one of the most common emergency operations performed in the pediatric population. The aim of this pooled analysis is to compare the outcome from complicated appendicitis (CA) and uncomplicated appendicitis (UA) following laparoscopic appendectomy (LA) and open appendectomy (OA) in children. ⋯ Pooled analysis demonstrates that, in children with uncomplicated acute appendicitis, LA is associated with a reduced hospital stay but broad equivalence in postoperative morbidity when compared with the conventional approach. Although overall morbidity is reduced when the laparoscopic approach is utilized, in cases of CA, the risk of intra-abdominal abscess is increased.
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J. Gastrointest. Surg. · Oct 2012
Risk factors for postoperative pancreatic fistulization subsequent to enucleation.
Pancreatectomies increase the risk of postoperative pancreatic fistula (POPF) and pancreatic insufficiency. Pancreatic enucleation preserves pancreatic parenchyma, lowers the risk of pancreatic insufficiency, but may induce specific complications (tumor recurrence or pancreatic fistulization). The aim of this study was to determine the risk factors for POPF following a pancreatic enucleation. ⋯ Enucleation for resection of pancreatic tumors located at less than or equal to two 2 mm from the main pancreatic duct is a risk factor for POPF. Enucleation is a safe and effective treatment for benign or borderline pancreatic tumors.
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J. Gastrointest. Surg. · Oct 2012
Comparative StudyPostoperative intra-abdominal complications assessed by the Clavien-Dindo classification following open and laparoscopy-assisted distal gastrectomy for early gastric cancer.
Laparoscopy-assisted gastrectomy (LAG) has been increasingly used for the treatment of early gastric cancer, and many advantages over open gastrectomy (OG) have been reported. However, only a few reports have assessed postoperative complications following LAG using the Clavien-Dindo classification. ⋯ There was no significant difference in postoperative complication rates between the LAG and the OG groups. The more severe Clavien-Dindo grade III complications, which required surgical interventions, were observed at similar rates between the two groups. Laparoscopic gastrectomy for early gastric cancer is therefore feasible in terms of the incidence and severity of intra-abdominal complications.
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Acute appendicitis in patients with end-stage renal disease (ESRD) poses a diagnostic challenge. Delayed surgery can contribute to higher morbidity and mortality rates. However, few studies have evaluated this disease among ESRD patients. Our study focused on the lack of data on the incidence and risk factors of acute appendicitis among ESRD patients and compared the outcomes in patients who underwent different dialysis modalities. ⋯ ESRD patients had a higher risk for acute appendicitis and poorer outcomes than non-dialysis populations. A careful examination of ESRD patients presenting with atypical abdominal pain to avoid misdiagnosis is extremely important to prevent delayed surgery.