Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
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J. Gastrointest. Surg. · Jan 2015
Randomized Controlled Trial Multicenter StudyRoutine drainage of the operative bed following elective distal pancreatectomy does not reduce the occurrence of complications.
Routine drainage of the operative bed following elective pancreatectomy remains controversial. Data specific to distal pancreatectomy (DP) have not been examined in a multi-institutional collaborative. ⋯ Placement of drains following elective distal pancreatectomy was associated with a higher overall morbidity and pancreatic fistulas. Drains did not reduce intra-abdominal septic morbidity, clinically relevant pancreatic fistulas, nor the need for postoperative therapeutic intervention.
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J. Gastrointest. Surg. · Jan 2015
Laparoscopic versus open low anterior resection for rectal cancer: results from the national cancer data base.
While the use of laparoscopy has increased among patients undergoing colorectal surgery, there is ongoing debate regarding the oncologic equivalence of laparoscopy compared to open low anterior resection (LAR) for rectal cancer. ⋯ Laparoscopic LAR appears to result in equivalent short-term oncologic outcomes compared to the traditional open approach as measured via surrogate endpoints in the NCDB. While these results support the increasing use of laparoscopy in rectal surgery, further data are necessary to assess long-term outcomes.
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J. Gastrointest. Surg. · Jan 2015
Peroral endoscopic myotomy (POEM) for esophageal primary motility disorders: analysis of 100 consecutive patients.
Peroral endoscopic myotomy (POEM) is a flexible endoscopic approach to the lower esophageal sphincter (LES) providing access for a myotomy to relieve dysphagia. The technique has been adopted worldwide due to reports of excellent short-term clinical outcomes. We report on a consecutive patient cohort with clinical and objective outcomes representing the establishment of a POEM program within a busy esophageal surgical practice. ⋯ This study represents the largest POEM series to date that includes objective data. Despite reflux in one/three of patients, POEM provides excellent relief of dysphagia (97%) and chest pain (91.5%) for patients with esophageal spastic disorders with acceptable procedural morbidity.
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J. Gastrointest. Surg. · Dec 2014
Randomized Controlled TrialEffects of intravenous versus epidural lidocaine infusion on pain intensity and bowel function after major large bowel surgery: a double-blind randomized controlled trial.
We compared the effects of intravenous lidocaine (IVL) with lumbar epidural lidocaine analgesia (LEA) on pain and ileus after open colonic surgery. ⋯ Compared with LEA-lidocaine or placebo, intravenous lidocaine offered no clinically significant benefit in terms of analgesia and bowel function.
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J. Gastrointest. Surg. · Dec 2014
Multicenter StudyA nationwide analysis of postoperative deep vein thrombosis and pulmonary embolism in colon and rectal surgery.
There are limited data regarding predictive factors of postoperative venous thromboembolism (VTE) in patients undergoing colorectal resection. We sought to identify associations between patient comorbidities and postoperative VTE in colorectal resection. The National Surgical Quality Improvement Program (NSQIP) database was used to examine clinical data of patients experiencing postoperative VTE after colorectal resection from 2005 to 2011. ⋯ Prophylactic treatment of VTE after discharge may have benefits in high-risk patients. Thirteen and eleven perioperative risk factors have associations with DVT and PE, respectively. Emergent admission, open procedures, ulcerative colitis, and stage 4 cancer patients have increased risk of DVT.