Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
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J. Gastrointest. Surg. · May 2015
Pre-surgical Geriatric Syndromes, Frailty, and Risks for Postoperative Delirium in Older Patients Undergoing Gastrointestinal Surgery: Prevalence and Red Flags.
We sought to identify and evaluate red flags for pre-surgical geriatric conditions (geriatric syndromes, frailty, and risks for postoperative delirium) in older patients undergoing gastrointestinal surgery. ⋯ Eight red flags covered as part of history and physical examination are well suited to screen patients for geriatric conditions indicating the need for preoperative geriatric assessments and optimization.
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J. Gastrointest. Surg. · May 2015
Randomized Controlled TrialImplementation of a surgical safety checklist and postoperative outcomes: a prospective randomized controlled study.
The implementation of a surgical safety checklist is said to minimize postoperative surgical complications. However, to our knowledge, no randomized controlled study has been done on the influence of checklists on postoperative outcomes in a developing country. We conducted a prospective randomized controlled study with parallel group study design of the implementation of WHO surgical safety checklist involving 700 consecutive patients undergoing operations in our hospital between February 2012 and April 2013. ⋯ A significant reduction in mortality was noted in the Rc arm as compared to the Rn arm (p = 0.04). In a subgroup analysis, the number of overall and higher-grade complications per patient with incomplete checklists was higher than that with fully completed checklist group. Implementation of WHO surgical safety checklist results in a reduction in mortality as well as improved postoperative outcomes in a tertiary care hospital in a developing country.
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J. Gastrointest. Surg. · May 2015
Multicenter StudyMinimally invasive resection of choledochal cyst: a feasible and safe surgical option.
The use of minimally invasive surgery (MIS) for choledochal cyst (CC) has not been well documented. We sought to define the overall utilization and outcomes associated with the use of the open versus MIS approach for CC. We examined the factors associated with receipt of MIS for CC, as well as characterized perioperative and long-term outcomes following open versus MIS for CC. ⋯ MIS resection of CC was demonstrated to be a feasible and safe approach with acceptable short-term outcomes in the pediatric population. MIS for benign CC disease was associated with similar perioperative morbidity but a shorter length of stay and a lower blood loss when compared with open resection.
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J. Gastrointest. Surg. · May 2015
Impact of blood transfusions and transfusion practices on long-term outcome following hepatopancreaticobiliary surgery.
The long-term impact of transfusions with packed red blood cells (PRBC) among patients undergoing hepatopancreaticobiliary (HPB) surgery remains ill-defined. We sought to determine the impact of overall blood utilization, as well as a restrictive transfusion strategy, on long-term outcomes among patients undergoing an HPB resection for a malignancy. ⋯ Adoption of a more restrictive transfusion strategy in patients undergoing resection for cancer may preserve a limited resource, reduce costs, as well as avoid exposing oncology patients to the unnecessary risks associated with a transfusion.
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J. Gastrointest. Surg. · May 2015
Oversewing staple lines to prevent anastomotic complications in primary ileocolic resections for Crohn's disease.
Oversewing staple lines may be a novel way to reduce anastomotic complications after primary ileocolic resections for Crohn's disease (CD). ⋯ After controlling for clinical and surgical factors, oversewing staple lines in primary ICRs for CD is correlated with reduced MACs.