Langenbeck's archives of surgery
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Langenbecks Arch Surg · Jun 2014
Review Comparative StudyManagement of persistent postsurgical inguinal pain.
Severe persistent pain is a major postsurgical complication affecting 2-4 % of patients following inguinal hernia repair and may cause critical physical and socioeconomic disability. This review introduces relevant criteria and analyses the current evidence base underlying recommended management strategies. ⋯ There is a need for improved study designs and, launching of large multicenter collaborative studies supplying the necessary long-term data for recommendation of future management strategies.
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Langenbecks Arch Surg · Jun 2014
Comparative StudyInfluence of preoperative biliary drainage on surgical outcome after pancreaticoduodenectomy: single centre experience.
Controversy prevails on the impact of preoperative biliary drainage (PBD) on postoperative complications and clinical outcome of pancreatic cancer. We determined whether PBD is associated with increased morbidity and mortality rates after pancreaticoduodenectomy. ⋯ With the exception of the classical indications, PBD should be carefully evaluated in patients with resectable pancreatic cancer.
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Langenbecks Arch Surg · Jun 2014
Surgery for incarcerated hernia: short-term outcome with or without mesh.
Incarcerated hernias represent about 5-15 % of all operated hernias. Tension-free mesh is the preferred technique for elective surgery due to low recurrence rates. There is however currently no consensus on the use of mesh for the treatment of incarcerated hernias, especially in case of bowel resection. ⋯ Morbidity after surgery for incarcerated hernia remains high and depends on comorbidities and surgical presentation. The use of mesh could become current practice even in case of bowel resection.
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Langenbecks Arch Surg · Apr 2014
Indication for the use of an interposed graft during portal vein and/or superior mesenteric vein reconstruction in pancreatic resection based on perioperative outcomes.
Combined portal vein and/or superior mesenteric vein (PV/SMV) resection with pancreatic resection sometimes leads to prolonged survival for patients with pancreatic cancer. In this study, we evaluated perioperative outcomes of patients with PV/SMV reconstruction and considered indications for the use of a graft during this procedure. ⋯ Depending on the length and/or position of the removed PV/SMV segment, interposed graft may be required for reconstruction in some patients, and the use of graft vein, particularly using IJV, is an appropriate procedure that is not associated with any complications.
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Surgery remains the only potential curative therapy for pancreatic cancer, but compromised physiological reserve and comorbidities may deny pancreatic resection from elderly patients. ⋯ Elderly patients are at higher risk of mortality after pancreatic resection than usually reported case series. Nonetheless, elderly patients can undergo pancreatic resection with acceptable 5-year survival results. Our results contribute for a better, informed decision-making for elderly patients and their family.