Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
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J. Gastrointest. Surg. · Jan 2013
Multicenter Study Comparative Study Clinical TrialShort-term outcomes of laparoscopy combined with enhanced recovery pathway after ileocecal resection for Crohn's disease: a case-matched analysis.
Laparoscopy combined with an enhanced recovery pathway (ERP) is widely considered to be the first-choice option for patients with colorectal cancer. However, no previous reports have focused on patients with Crohn's disease (CD) treated by laparoscopy and ERP. ⋯ This is the first reported experience of laparoscopy with ERP in CD patients and suggests that optimized perioperative care combined with minimally invasive techniques may lead to further improvements in surgical outcomes for CD patients.
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J. Gastrointest. Surg. · Jan 2012
Multicenter StudyGastrointestinal metabolic surgery for the treatment of diabetic patients: a multi-institutional international study.
Gastrointestinal metabolic surgery has been proposed for the treatment of not well-controlled type 2 diabetes mellitus (T2DM) patients with a body mass index (BMI) <35 kg/m(2). This study aims to describe recent experience with surgical treatment of T2DM in Asian centers. ⋯ Gastrointestinal metabolic surgery is an effective treatment for not well-controlled T2DM treatment. Diabetes remission is significantly higher in those with duration of diabetes less than 5 years and BMI > 30 kg/m(2).
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J. Gastrointest. Surg. · Feb 2011
Multicenter StudyRisk stratification for distal pancreatectomy utilizing ACS-NSQIP: preoperative factors predict morbidity and mortality.
Evaluation of risk factors for adverse outcomes following distal pancreatectomy (DP) has been limited to data collected from retrospective, primarily single-institution studies. Using a large, multi-institutional prospectively collected dataset, we sought to define the incidence of complications after DP, identify the preoperative and operative risk factors for the development of complications, and develop a risk score that can be utilized preoperatively. ⋯ The rate of serious complication after DP is 22%. The DP-specific preoperative risk scoring system described in this paper may be utilized for patient counseling and informed consent discussions, identifying high-risk patients who would benefit from disease optimization, and risk adjustment when comparing outcomes between institutions.
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J. Gastrointest. Surg. · Jul 2010
Multicenter StudyInfection rates in a large investigational trial of sacral nerve stimulation for fecal incontinence.
Treatment options for patients with fecal incontinence (FI) are limited, and surgical treatments can be associated with high rates of infection and other complications. One treatment, sacral nerve stimulation (SNS), is approved for FI in Europe. A large multicenter trial was conducted in North America and Australia to assess the efficacy of SNS in patients with chronic fecal incontinence. The aim of this report was to analyze the infectious complication rates in that trial. ⋯ SNS for FI resulted in a relatively low infection rate. This finding is especially important because the only other Food and Drug Administration-approved treatment for end-stage FI, the artificial bowel sphincter, reports a much higher rate. Combined with its published high therapeutic success rate, this treatment has a positive risk/benefit profile.
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J. Gastrointest. Surg. · Sep 2009
Multicenter Study Comparative StudySmall pancreatic and periampullary neuroendocrine tumors: resect or enucleate?
The aim of this study was to compare the outcomes of enucleation versus resection in patients with small pancreatic, ampullary, and duodenal neuroendocrine tumors (NETs). ⋯ These data suggest that most outcomes of enucleation and resection for small pancreatic and peri-pancreatic NETs are comparable. However, enucleation has better outcomes than pancreaticoduodenectomy for head lesions and the advantage of preserving splenic function for tail lesions.