The Journal of surgical research
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Comparative Study Clinical Trial
Ultrasonographic measurements of the inferior vena cava variation as a predictor of fluid responsiveness in patients undergoing anesthesia for surgery.
Both hypovolemia and hypervolemia are connected with increased morbidity and mortality in the treatment and prognosis of patients. An accurate assessment of volume state allows the optimization of organ perfusion and oxygen supply. Recently, ultrasonography has been used to detect hypovolemia in critically ill patients and perioperative patients. The objective of our study was to assess the correlation between inferior vena cava (IVC) variation obtained with ultrasound and stroke volume variation (SVV) measured by the Vigileo/FloTrac monitor, as fluid responsiveness indicators, in patients undergoing anesthesia for surgery. ⋯ Our data show that IVC variation and SVV proved to be reliable predictors of fluid responsiveness in patients undergoing anesthesia for surgery with mechanical ventilation.
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Comparative Study Observational Study
Short-term outcomes of minimally invasive versus open colectomy for colon cancer.
Laparoscopic and open approaches to colon resection have equivalent long-term outcomes and oncologic integrity for the treatment of colon cancer. Differences in short-term outcomes should therefore help to guide surgeons in their choice of operation. We hypothesized that minimally invasive colectomy is associated with superior short-term outcomes compared to traditional open colectomy in the setting of colon cancer. ⋯ This retrospective study of patients undergoing colectomy for colon cancer demonstrates significantly improved outcomes associated with a MIS approach, even when controlling for baseline differences in illness severity. When feasible, minimally invasive colectomy should be considered gold standard for the surgical treatment of colon cancer.
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The Modified Hernia Grading System (MHGS) was developed to risk stratify complex ventral hernia repairs (VHRs). MHGS grade 3 patients have mesh infections, dirty or contaminated fields, and/or violation of the alimentary tract. Reported surgical site infection (SSI) rates are over 40% after single-stage VHR in contaminated fields. In an attempt to decrease the SSI rate in MHGS grade 3 patients, we developed a dual-stage VHR (DSVHR) approach. ⋯ DSVHR in MHGS grade 3 patients is associated with a lower SSI rate than previously reported for those undergoing single-stage repairs.
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Biography Historical Article
Vacca pox to pexa vec: John Hunter's and Edward Jenner's contribution to oncolytic virotherapy.
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This study describes risk factors leading to the development of various postoperative complications and recurrence after the Karydakis procedure. ⋯ Patients with no history of previous pilonidal surgery, a short length of extracted part, and long distance of caudal pit from anal verge are best candidates for the Karydakis flap procedure.