Arch Surg Chicago
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Comparative Study
Use of computed tomography in anterior abdominal stab wounds: results of a prospective study.
Computed tomography (CT) can be used to evaluate patients with anterior abdominal stab wounds (AASWs). ⋯ In patients with AASWs, CT can be used to identify visceral injuries. It is a promising tool that may identify patients who can be discharged after a shorter period of observation. Further evaluation of its use in patients with AASWs is warranted.
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Comparative Study
Alarming surge in nonsurvivable urban trauma and the case for violence prevention.
A growing proportion of urban trauma mortality is characterized by devastating and likely nonsurvivable injuries. ⋯ While in-hospital mortality has remained the same, the proportion of nonsurvivable traumatic injuries has increased. In a mature trauma system, this provides a compelling argument for violence prevention strategies to reduce urban trauma mortality.
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Comparative Study
Resection of pancreatic neuroendocrine tumors: results of 70 cases.
Neuroendocrine tumors of the pancreas can be managed surgically with excellent outcomes. ⋯ This single-institutional case series demonstrates that pancreatic neuroendocrine tumors can be safely resected without mortality and with minimal morbidity. The presence of lymphovascular invasion can be used to classify neuroendocrine tumors as malignant, and this appears to predict survival. Patients with malignant tumors can expect long-term survival even in the setting of metastatic disease.
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Comparative Study
Predictors of single-gland vs multigland parathyroid disease in primary hyperparathyroidism: a simple and accurate scoring model.
Preoperative clinical, biochemical, and imaging studies could be used to reliably select patients with single-gland primary hyperparathyroidism who could undergo minimally invasive parathyroidectomy and to determine whether additional perioperative testing is necessary. ⋯ Preoperative biochemical and imaging study results reliably distinguished single-gland vs multigland parathyroid disease in primary hyperparathyroidism. Our findings suggest that patients with a score of 3 or higher can undergo a minimally invasive parathyroidectomy without the routine use of intraoperative parathyroid hormone or additional imaging studies, and those with a score of less than 3 should have additional testing to ensure that multigland disease is not overlooked.
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Comparative Study
Trends in laparoscopic splenectomy for massive splenomegaly.
During the past 10 years, expertise with minimally invasive techniques has grown, leading to an increase in successful laparoscopic splenectomy (LS) even in the setting of massive and supramassive spleens. ⋯ Despite conflicting reports regarding the safety of LS for massive splenomegaly, our data indicate that with increasing institutional experience, the laparoscopic approach is safe, shortens the length of stay, and improves mortality.