Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
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J. Gastrointest. Surg. · May 2008
Effect of BioGlue on the incidence of pancreatic fistula following pancreas resection.
Despite numerous modifications of surgical technique, pancreatic fistula remains a serious problem and occurs in about 10% of patients following pancreas resection. BioGlue is a new sealant that creates a flexible mechanical seal within minutes independent of the body's clotting mechanism. ⋯ Application of BioGlue sealant probably does not reduce the incidence of pancreatic fistula following pancreas resection.
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J. Gastrointest. Surg. · May 2008
Meta Analysis Comparative StudyComparison of stapled versus handsewn loop ileostomy closure: a meta-analysis.
The purpose of this study was to compare the rates of small bowel obstruction, anastomotic complications, and wound infections between stapled and handsewn closures of loop ileostomies. A literature search in Embase, PubMed, and Cochrane Database for Clinical Trials using search terms "closure," "loop ileostomy," and "stapled" was performed. All abstracts were reviewed to identify relevant articles, and their references were hand searched for additional studies. ⋯ Two studies showed shorter operative times favoring stapled anastomoses. No difference was seen in length of stay. Current literature suggests no statistically significant differences between stapled and hand-sewn loop ileostomy closures, but there may be a trend favoring stapled closures with regard to lower small bowel obstruction rates and shorter operative time.
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J. Gastrointest. Surg. · May 2008
Efficacy of laparoscopic mesh-augmented hiatoplasty in GERD and symptomatic hiatal hernia. Study using combined impedance-pH monitoring.
Laparoscopic fundoplication is the standard antireflux procedure. However, side effects such as gas bloating indicate that the procedure is not unproblematic. Laparoscopic mesh-augmented hiatoplasty (LMAH) might be an alternative operation aimed at restoring the intra-abdominal part of the esophagus and reducing the size of the diaphragmatic hiatus. ⋯ LMAH significantly reduces reflux symptoms and esophageal acid exposure without interfering with the ability to vent gas from the stomach documented by an unchanged number of gas reflux episodes before and after LMAH.
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J. Gastrointest. Surg. · Apr 2008
Review Meta Analysis Comparative StudyEnteral versus parenteral nutrition after gastrointestinal surgery: a systematic review and meta-analysis of randomized controlled trials in the English literature.
Although previous studies recommend the use of enteral nutrition (EN), the benefit of EN after elective gastrointestinal surgery has not been comprehensively demonstrated as through a meta-analysis. Our aim is to determine whether enteral nutrition is more beneficial than parenteral nutrition. ⋯ The present findings would lead us to recommend the use of EN rather than PN when possible and indicated.
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J. Gastrointest. Surg. · Mar 2008
Frequency with which surgeons undertake pancreaticoduodenectomy continues to determine length of stay, hospital charges, and in-hospital mortality.
This study was undertaken to determine changes in the frequency of, volume of, and outcomes after pancreaticoduodenectomy 6 years after a study denoted that, in Florida, the frequency and volume of pancreaticoduodenectomy impacted outcome. ⋯ In Florida, more pancreaticoduodenectomies are carried out by fewer surgeons. Mortality has not decreased because of surgeons infrequently performing pancreaticoduodenectomy. Most pancreaticoduodenectomies are still undertaken by surgeons who conduct pancreaticoduodenectomy infrequently with greater lengths of stay, hospital costs, and in-hospital mortality rates. To an even greater extent than previously documented, patients are best served by surgeons frequently performing pancreaticoduodenectomy.