Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
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J. Gastrointest. Surg. · Oct 2017
Meta AnalysisThe Impact of Surgeon Volume on Outcomes After Pancreaticoduodenectomy: a Meta-analysis.
Despite significant improvement in operative mortality rates following pancreaticoduodenectomy (PD), morbidity remains high. Outcomes following PD may be improved in high-volume centers and with high-volume surgeons. We sought to evaluate the association between surgeon experience and postoperative outcomes after PD. ⋯ HVS performing PD have significantly better outcomes than LVS in terms of decreased mortality, morbidity, LOS, and hospital costs. Efforts toward increased regionalization of care should be discussed. Consensus regarding definition of HVS needs to be undertaken.
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J. Gastrointest. Surg. · Oct 2017
Effect of Multimodal Analgesia on Opioid Use After Open Ventral Hernia Repair.
There is limited data on enhanced recovery after surgery (ERAS) protocols after ventral hernia repair (VHR). This study reports the impact of multimodal analgesia on opioid use after open VHR. ⋯ Implementation of multimodal analgesia in the perioperative and postoperative setting significantly reduced opioid use after VHR.
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J. Gastrointest. Surg. · Oct 2017
The Effect of Neoadjuvant Chemoradiation on Anastomotic Leak and Additional 30-Day Morbidity and Mortality in Patients Undergoing Total Gastrectomy for Gastric Cancer.
In addition to increased perioperative morbidity, anastomotic leak following gastric resection for gastric cancer can have detrimental effects on overall and disease-free survival. The risk of anastomotic leak following neoadjuvant therapy remains unknown. The purpose of this study is to investigate the association of preoperative chemotherapy and radiation therapy with postoperative anastomotic leak and additional 30-day morbidity and mortality outcomes following total gastrectomy with reconstruction for gastric cancer using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP). ⋯ Neoadjuvant therapy prior to gastric resection for gastric cancer is not associated with an increased risk of anastomotic leak or other additional short-term morbidity or mortality.