Langenbeck's archives of surgery
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Langenbecks Arch Surg · Jun 2010
Face, content and construct validity of a new realistic trainer for conventional techniques in digestive surgery.
Surgical simulation modules for "open" surgery are limited in contrast to well-studied and validated laparoscopic trainers. In this study, face, content and construct validity of a devised simulation module (Berlin Operation Trainer, BOPT) for handsewn anastomoses in digestive surgery were analysed. ⋯ The BOPT is a suitable instrument for advanced surgical training for novices and experienced colleagues creating a realistic and demanding situation. Further studies have to evaluate if a more realistic preoperative training will support an effective transfer of learned techniques to the operating room.
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Early appropriate therapy in terms of early fluid resuscitation and early antibiotic therapy is beneficial in patients with severe sepsis and septic shock. The purpose of this review is to address the role of early source control in the management of patients with severe sepsis. ⋯ Source control is considered an essential element in the management of sepsis and should be considered and performed early after the diagnosis is established in most if not all patients.
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Langenbecks Arch Surg · Jun 2010
Multicenter StudyRisk of death after emergency repair of abdominal wall hernias. Still waiting for improvement.
The precise importance of factors affecting morbidity and mortality in patients with complicated abdominal wall hernias undergoing emergency surgical repair has been not completely elucidated. ⋯ Using multivariate logistic regression analysis, probabilities of death after complicated abdominal wall hernia surgery are increased in patients with: age over 70 years, high ASA class, and associated intestinal resection. Guidelines should be developed to improve prognosis in these patients.
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Langenbecks Arch Surg · Jun 2010
Comparative StudyTransinguinal preperitoneal memory ring patch versus Lichtenstein repair for unilateral inguinal hernias.
The aim of this study was to compare the transinguinal preperitoneal technique (TIPP) using a memory ring patch versus the Lichtenstein technique in relation to acute and chronic pain, post-operative complications and recurrence rates. ⋯ For surgeons performing the Lichtenstein repair but looking for modifications concerning pain relief and a quicker procedure, the TIPP approach is a feasible alternative that seems to be associated with less post-operative pain.
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Langenbecks Arch Surg · Jun 2010
Preoperative risk factors for mortality after relaparotomy: analysis of 254 patients.
The aim of this work was to analyze preoperative mortality risk factors after relaparotomy for abdominal surgery in a unit of General Surgery at a University Hospital. ⋯ Advanced age, the presence of either fever or hypothermia, and the need of mechanical ventilation are preoperative risk factors associated with mortality after relaparotomy and should be considered when planning reintervention.