Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
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J. Gastrointest. Surg. · Nov 2011
MELD-based indices as predictors of mortality in chronic liver disease patients who undergo emergency surgery with general anesthesia.
Underlying chronic liver disease is associated with high morbidity and mortality after emergency surgery, which complicates clinical decisions over performing such surgery. In addition, the Child-Turcotte-Pugh (CTP) score is limited in its ability to predict postoperative residual liver function. This study was designed to determine whether the scores of the Model for End-stage Liver Disease (MELD)-based indices are effective predictors of mortality following emergency surgery in patients with chronic liver disease. ⋯ iMELD reflects underlying liver function and predicts overall mortality more accurately than CTP and other MELD-based indices scores do in chronic liver disease patients after emergency surgery with general anesthesia.
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J. Gastrointest. Surg. · Nov 2011
Comparative StudySignificance of thoracoscopy-assisted surgery with a minithoracotomy and hand-assisted laparoscopic surgery for esophageal cancer: the experience of a single surgeon.
This retrospective study evaluated the surgical learning curve and outcomes of thoracolaparoscopic esophagectomy. ⋯ Thoracolaparoscopic esophagectomy for esophageal cancer was technically feasible and oncologically satisfactory, according to the surgical learning curve.
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J. Gastrointest. Surg. · Nov 2011
Perioperative outcomes for open distal pancreatectomy: current benchmarks for comparison.
Open distal pancreatectomy (ODP) outcomes have largely relied on single-institution data from high-volume, tertiary centers. To provide contemporary, national benchmarks of ODP outcomes, we examined the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. ⋯ ODP remains the gold standard for lesions of the pancreatic body or tail. The current analysis reflects nationwide data that may serve as current benchmarks for both open and laparoscopic techniques.
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J. Gastrointest. Surg. · Oct 2011
Depression is associated with prolonged and complicated recovery following colorectal surgery.
There are little data regarding the impact of depression on outcomes after gastrointestinal surgery. We hypothesize that depression would be associated with prolonged hospital stay and changes in discharge disposition for patients undergoing colon and rectal surgery. ⋯ Among patients undergoing colorectal surgery, depression is associated with a significantly prolonged hospital stay and higher likelihood of requiring skilled nursing assistance after discharge. Further research into the mechanism underlying these differences and potential treatment strategies among depressed patients is warranted.
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J. Gastrointest. Surg. · Oct 2011
Analysis of risk factors for delayed gastric emptying (DGE) after 387 pancreaticoduodenectomies with usage of 70 stapled reconstructions.
Delayed gastric emptying (DGE) is one of the most troublesome complications after pancreaticoduodenectomy (PD). ⋯ The method of alimentary reconstruction affected the occurrence of DGE. The incidence of DGE was less in stapled reconstruction than in hand-sewn reconstruction.