Acta Chir Belg
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The purpose of this study was to analyse the outcomes of patients readmitted to ICU following initial recovery after oesophagectomy. ⋯ Although ICU readmission following elective oesophagectomy is associated with significant mortality, the overall long-term survival rate for these patients, particularly those who do not require renal support is encouraging.
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With reduction in surgical training, surgical trainees may find it difficult deal with local anaesthetic agents because of lack of exposure and knowledge. We have summarised the common usage of local anaesthetics in various situation. The trainees need to gain competence by understanding the basics and practising them under supervision.
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As a minimal invasive procedure, a standard threeportal videothoracoscopy may have complications such as chronic and residual pain. However, a single incision thoracoscopic surgery is a less invasive procedure with minimal complications. We present our series of patients who had single incision thoracoscopic surgical procedures. ⋯ In selected patients, single incision thoracoscopic surgery is an effective and a safe procedure with lower levels of pain and shorter hospital stay. A wide spectrum of thoracic surgical procedures can be performed with the use of single incision thoracoscopic surgery.
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Enhanced recovery after surgery (ERAS) protocol: prospective study of outcome in colorectal surgery.
Fast-track programs (ERAS) have been shown to improve postoperative recovery in colorectal surgery, combining newer anesthetic and minimally invasive surgery with evidence-based adjustments to facilitate revalidation. This prospective study evaluated the outcome of an ERAS protocol implementation in a university colorectal unit. ⋯ These results of length of stay, morbidity and readmission-rates have important implications for the organization of health care, waiting lists and costs. Therefore the ERAS principles should be more wide-spread implemented.
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The unspecific non-steroidal anti-inflammatory drug (NSAID) ketorolac is used during surgery as a single dose regimen to reduce immediate postoperative pain. Many studies have shown an increased risk of bleeding in patients treated with NSAIDs. We wanted to investigate whether intraoperative ketorolac administered at the end of surgery resulted in increased bleeding assessed by reduction in haemoglobin and need for blood transfusion. ⋯ Ketorolac given during surgery may increase the risk of postoperative haemorrhage after laparoscopic Roux-en-Y gastric by-pass.