Langenbeck's archives of surgery
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Langenbecks Arch Surg · Dec 2012
ReviewSurgical evaluation and knowledge transfer--methods of clinical research in surgery.
This article aims to outline the framework of surgical evaluation and knowledge transfer. Therefore, special design issues affecting surgical clinical research will be discussed. Moreover, principles and challenges of knowledge transfer from research into practice will be addressed. ⋯ For a rigorous evaluation of surgical procedures, a basic understanding of research methodology is urgently needed, and to improve methodological expertise, collaboration between surgeons and methodologists is encouraged.
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Langenbecks Arch Surg · Oct 2012
Sex differences in the epidemiology, seasonal variation, and trends in the management of patients with acute appendicitis.
Acute appendicitis is the most common indication for acute surgical abdominal intervention. In this study, we analyzed the gender correlation with demographic, epidemiologic, diurnal, and seasonal trends in relation to the incidence and management of patients with acute appendicitis in our medical center. ⋯ We found distinct gender, epidemiological, seasonal, and diurnal trends influencing the incidence of acute appendicitis. The incidence rate of false-positive surgery has been gradually declining, probably due to the increased use of preoperative abdominal CT and ultrasound. Acute appendicitis was more common in males and during the summer months.
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Langenbecks Arch Surg · Oct 2012
Randomized Controlled TrialReduction of wound infections in laparoscopic-assisted colorectal resections by plastic wound ring drapes (REDWIL)?--A randomized controlled trial.
Surgical site infections (SSIs) are frequent complications in colorectal surgery and may lead to burst abdomen, incisional hernia, and increased perioperative costs. Plastic wound ring drapes (RD) were introduced some decades ago to protect the abdominal wound from bacteria and reduce SSIs. There have been no controlled trials examining the benefit of RD in laparoscopic colorectal surgery. The Reduction of wound infections in laparoscopic assisted colorectal resections by plastic wound ring drapes (REDWIL) trial was thus designed to assess their effectiveness in preventing SSIs after elective laparoscopic colorectal resections. ⋯ RD do not reduce the rate of SSIs in laparoscopic colorectal surgery. The inpatient costs are similar with and without RD.
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Langenbecks Arch Surg · Oct 2012
Second surgery or chemotherapy for relapse after radical resection of colorectal cancer metastases.
Limited data suggest that second resections for colorectal cancer metastases may improve survival, but no study has compared surgery with chemotherapy in this setting. Therefore, we retrospectively compared the clinical outcome of potentially resectable patients who received a second metastasectomy with those who did not in our single-centre experience. ⋯ Our study suggests that in highly selected metastatic colorectal cancer patients, a multimodal treatment plan, including a second resection, can achieve longer survival with respect to medical therapy.
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Langenbecks Arch Surg · Aug 2012
Comparative StudyCentral pancreatectomy with inframesocolic pancreatojejunostomy.
Pancreatic fistula (PF) occurs frequently after central pancreatectomy (CP), but it is not clear from which pancreatic stump it arises and, consequently, which interventions can reduce its incidence and severity. The information could be obtained if the two pancreatic remnants were segregated into different body compartments. ⋯ In CP, interposing an anatomic barrier, such as the transverse mesocolon, between the two pancreatic remnants is a simple maneuver that, if on one hand, adds little to the complexity of the operation, on the other, provides insights into the origin of PF after CP.