Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
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J. Gastrointest. Surg. · Feb 2014
Review Meta AnalysisAlcohol drinking does not affect postoperative surgical site infection or anastomotic leakage: a systematic review and meta-analysis.
Alcohol abuse appears to increase postoperative complications, but clinical trials have reported conflicting results. The objective of this systematic review and meta-analysis is to clarify how alcohol drinking affects postoperative surgical site infection and anastomotic leakage and to determine the impact of perioperative alcohol intervention. ⋯ Alcohol drinking is not an independent risk factor for surgical site infection and anastomotic leakage. Interventions which aim to make patients quit alcohol or treat withdrawal symptoms do not seem to affect the surgical outcomes of interest.
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J. Gastrointest. Surg. · Feb 2014
Meta Analysis Comparative StudySingle-incision versus conventional laparoscopic appendectomy: a meta-analysis of randomized controlled trials.
Single-incision laparoscopic appendectomy (SILA) has gained enormous popularity worldwide. We conducted a meta-analysis to assess feasibility, safety, and benefits of SILA as compared with conventional laparoscopic appendectomy (CLA). ⋯ SILA is feasible and safe with no obvious advantages over CLA. Therefore, it may be considered as an alternative to CLA.
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J. Gastrointest. Surg. · Feb 2014
Planned delay of oral intake after esophagectomy reduces the cervical anastomotic leak rate and hospital length of stay.
Cervical anastomotic leak rates are high after esophagectomy. We examined the effect of a purposeful delay in institution of oral diet after esophagectomy on the leak rate and hospital length of stay. A retrospective analysis of 120 patients submitted to esophagectomy with cervical esophagogastric anastomosis was conducted. ⋯ Anastomotic leak was significantly associated with increased length of stay (p < 0.001), adding an average of 7.6 days to hospital stay. Respiratory complications (p < 0.001) and delayed gastric emptying (p = 0.014) were also independent predictors of increased length of stay, but early eater status was not. Delayed resumption of oral diet after esophagectomy significantly reduces cervical anastomotic leak rate and avoids the increased length of stay associated with leak.
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J. Gastrointest. Surg. · Feb 2014
Postoperative serum amylase predicts pancreatic fistula formation following pancreaticoduodenectomy.
Early identification of patients at risk for developing pancreatic fistula (PF) after pancreaticoduodenectomy (PD) may facilitate prevention or treatment strategies aimed at reducing its associated morbidity. ⋯ An elevated serum amylase on POD1 may be used, in addition to other prognostic factors, to help stratify risk for developing PF following PD.