Arch Surg Chicago
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Comparative Study
Hospital teaching status and outcomes of complex surgical procedures in the United States.
Complex operations performed in teaching hospitals have similar outcomes as those performed in nonteaching hospitals. ⋯ Teaching hospitals have lower operative mortality rates for complex surgical procedures. However, the lower mortality rates at teaching hospitals can be explained by higher procedural volume.
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Randomized Controlled Trial Comparative Study Clinical Trial
The advantage of total thyroidectomy to avoid reoperation for incidental thyroid cancer in multinodular goiter.
To investigate the impact of total thyroidectomy on the rate of completion thyroidectomy for incidentally found thyroid cancer in euthyroid multinodular goiter. ⋯ We recommend total or near-total thyroidectomy in multinodular goiter to eliminate the necessity for early completion thyroidectomy in case of a final diagnosis of thyroid cancer.
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Comparative Study
Has evolution in awareness of guidelines for institution of damage control improved outcome in the management of the posttraumatic open abdomen?
Awareness of guidelines for damage control can improve patient outcomes after postraumatic open abdomen. ⋯ We recommend close monitoring of intraoperative outcome predictors as validated within our guidelines and recommend following our model for early institution of damage control.
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Comparative Study
Postoperative rhabdomyolysis following laparoscopic gastric bypass in the morbidly obese.
Laparoscopic approaches for weight reduction in the morbidly obese have become common with more than 50,000 bariatric surgical procedures being performed in 2001. The objective of this article is to raise awareness among surgeons of a new complication of rhabdomyolysis from this frequent procedure. ⋯ We hypothesized that morbidly obese patients develop critical surface and deep tissue pressures during bariatric surgery, increasing their risk for tissue injury and rhabdomyolysis. Unexplained elevations in the serum creatinine level or reports of buttock, hip, or shoulder pain in the postoperative period should raise the possibility of rhabdomyolysis and prompt clinical investigation. We recommend routine preoperative and postoperative measurements of the serum creatine kinase and serum creatinine levels to aid detection. Surgeons need to keep a low index of suspicion because early diagnosis and treatment are the cornerstones of successful management of rhabdomyolysis.