Langenbeck's archives of surgery
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Langenbecks Arch Surg · Mar 2019
Observational StudyDislocation of intra-abdominal drains after pancreatic surgery: results of a prospective observational study.
The use of intra-abdominal drains after major surgical procedures represents a well-established but controversial practice. No data are available regarding both the occurrence and the potential impact of their postoperative accidental dislocation. The aim of this study is to assess the actual rate of dislocation of intra-abdominal drains postoperatively and to evaluate its clinical impact. ⋯ Dislocation of intra-abdominal drains is an early and frequent event after major pancreatic resection. Its occurrence might protect against the negative effects of maintaining drainage, eventually leading to better postoperative outcomes. This data reinforces the knowledge that surgical drains might be detrimental in selected cases.
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Langenbecks Arch Surg · Feb 2019
Stringent fluid management might help to prevent postoperative ileus after loop ileostomy closure.
The present study aimed to analyze the impact of perioperative fluid management on postoperative ileus (POI) after loop ileostomy closure. ⋯ Perioperative fluid administration of > 1.7 L and POD 2 weight gain of > 1.2 kg represent critical thresholds for POI after loop ileostomy closure.
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Langenbecks Arch Surg · Feb 2019
Comparative StudyComparison of double-flap and OrVil techniques of laparoscopy-assisted proximal gastrectomy in preventing gastroesophageal reflux: a retrospective cohort study.
Laparoscopy-assisted proximal gastrectomy (LAPG) with esophagogastrostomy using the double-flap technique has been reported to rarely cause gastroesophageal reflux. However, quantitative evaluation of the reflux has hardly been performed. The aim of this study was to clarify the superiority of the double-flap technique of LAPG with esophagogastrostomy compared with the OrVil technique in terms of preventing gastroesophageal reflux. ⋯ Despite its longer operative time and still relatively high anastomotic stricture rate, the double-flap technique would be better than the OrVil technique in terms of preventing gastroesophageal reflux in patients who underwent LAPG with esophagogastrostomy.
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Langenbecks Arch Surg · Feb 2019
Can preoperative vitamin D deficiency predict postoperative hypoparathyroidism following thyroid surgery?
Postoperative hypoparathyroidism remains a relevant problem after thyroid surgery. Although the roles of vitamin D deficiency and other risk factors have been discussed in previous studies, variable results have been reported. ⋯ Postoperative PTH levels accurately identified patients at risk for hypoparathyroidism. Decreased preoperative vitamin D levels could not predict hypocalcemia, and high vitamin D levels could not prevent permanent hypoparathyroidism.
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Langenbecks Arch Surg · Nov 2018
Prognostic factors of disease-free and overall survival in patients with hepatocellular carcinoma undergoing partial hepatectomy in curative intent.
Tumor recurrence after liver resection continues to pose a major problem in hepatocellular carcinoma (HCC). Here we aimed to evaluate prognostic markers for disease-free (DFS) and overall survival (OS) in HCC-patients who underwent liver resection in curative intent. Additionally, we investigated the effects of HCC-recurrence in a subgroup of patients. ⋯ Tumor recurrence alone is not associated with poor oncological outcome and repeat liver resections as well as local-ablative procedures may help to improve OS in HCC.