The Journal of surgical research
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Foreign body ingestion remains a common reason for emergency room visits and operative interventions in the pediatric population. Rare earth magnet ingestion represents a low percentage of all foreign bodies swallowed by children; however, magnets swallowed in multiplicity can result in severe injuries. ⋯ These results demonstrated the increasing need for magnet regulations and public awareness to prevent potentially serious complications.
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Comparative Study
Utilization and costs associated with robotic surgery in children.
To evaluate utilization and costs associated with robotic surgery in children. ⋯ Use of robotic surgery in pediatrics is increasing especially in the management of urologic conditions. Costs of robotic surgery-associated hospitalizations were higher than nonrobotic surgery-associated hospitalizations.
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The single best diagnostic and staging test for pancreatic cancer remains a contrast-enhanced computed tomography scan. It is frequently the only imaging test required before surgical resection for solid pancreatic lesions. Unfortunately, many patients undergo additional testing that often delays definitive care. ⋯ Despite a relatively simple algorithm for the investigation of solid pancreatic lesions, considerable heterogeneity remains in how these patients are evaluated before referral to HPB surgery. As the number of investigations increases after the index imaging test, there is increasing delay to both surgical consultation and definitive intervention. Education is required to expedite care and mitigate excess diagnostic tests.
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Computed tomographic angiography (CTA) tends to be overused in patients with traumatic subarachnoid hemorrhage (tSAH) to rule out intracranial aneurysmal disease. We hypothesized that there are two exclusive subsets of patients with tSAH that maybe at increased risk for aneurysm and thus should undergo CTA, those "found down" with an unknown mechanism of injury and those with "central subarachnoid hemorrhage" (CSH, in the subarachnoid cisterns and Sylvian fissures). This pilot study was performed to provide more information on the validity of our hypothesis. ⋯ These preliminary data support a more selective approach to screening CTAs in patients with tSAH. CTA should be used in those patients with CSH regardless of mechanism of injury. A more restrictive approach should be used in patients with only peripheral subarachnoid hemorrhage.
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Recent single-institutional data point to the feasibility of same-day discharge (SDD) after appendectomy for nonperforated appendicitis and its potential as a quality-of-care indicator. Opportunities for SDD are greatest the sooner the appendectomy is performed after admission. We examine a national database to assess the pattern of SDD utilization among children who underwent appendectomy on the day of admission and potential limitations to SDD. ⋯ SDD is increasingly used for children with nonperforated appendicitis, but there is significant variability in the utilization of SDD for different ethnicities and hospital regions. These variations need to be further investigated to better delineate its potential role as a quality-of-care indicator.