Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
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J. Gastrointest. Surg. · Jan 2013
The impact of MRSA colonization on surgical site infection following major gastrointestinal surgery.
The purpose of this study is to determine whether methicillin-resistant Staphylococcus aureus (MRSA) colonization affects surgical site infections (SSI) after major gastrointestinal (GI) operations. ⋯ MRSA colonization is not an independent risk factor for SSI following major GI operations; however, it is strongly predictive of MRSA-associated SSI in these patients. Preoperative MRSA nasal swab test with decolonization may reduce the incidence of MRSA-associated SSI after major GI surgery.
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J. Gastrointest. Surg. · Jan 2013
Visceral obesity and colorectal cancer: are we missing the boat with BMI?
Compared to subcutaneous fat, visceral fat is more metabolically active, leading to chronic inflammation and tumorigenesis. The aim of this study is to describe the effect of visceral obesity on colorectal cancer outcomes using computed tomography (CT) imaging to measure visceral fat. ⋯ This study shows that viscerally obese patients with stage II colorectal cancer are at higher risk for poor outcomes and should be increasingly considered for adjuvant chemotherapy.
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J. Gastrointest. Surg. · Jan 2013
High-grade dysplasia and adenocarcinoma are frequent in side-branch intraductal papillary mucinous neoplasm measuring less than 3 cm on endoscopic ultrasound.
Surgical resection for intraductal papillary mucinous neoplasm (IPMN) of the pancreas has increased over the last decade. While IPMN with main duct communication are generally recommended for resection, indications for resection of side-branch IPMN (SDIPMN) have been less clear. We reviewed our single institutional experience with SDIPMN and indications for resection. ⋯ EUS is a helpful modality for the diagnostic evaluation of SDIPMN. Considering the high incidence of malignancy as well as high-grade dysplasia in SDIPMN greater than 2 cm, EUS features should be used in conjunction with other clinical criteria to guide management decisions. Patients with SDIPMN greater than 2 cm that do not undergo surgical resection may benefit from more intensive surveillance.
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J. Gastrointest. Surg. · Jan 2013
Quality assessment in pancreatic surgery: what might tomorrow require?
The Institute of Medicine (IOM) defines healthcare quality across six domains: safety, timeliness, effectiveness, patient centeredness, efficiency, and equitability. We asked experts in pancreatic surgery (PS) whether improved quality metrics are needed, and how they could align to contemporary IOM healthcare quality domains. ⋯ Experts in pancreatic surgery have significant consensus on 12 proposed metrics of quality that they view as both highly important and aligned with more than one IOM healthcare quality domain.