Archives of surgery (Chicago, Ill. : 1960)
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Multicenter Study Comparative Study
Indwelling urinary catheter use in the postoperative period: analysis of the national surgical infection prevention project data.
To describe the frequency and duration of perioperative catheter use and to determine the relationship between catheter use and postoperative outcomes. ⋯ Indwelling urinary catheters are routinely in place longer than 2 days postoperatively and may result in excess nosocomial infections. The association with adverse outcomes makes postoperative catheter duration a reasonable target of infection control and surgical quality-improvement initiatives.
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Multicenter Study Comparative Study
Invasion vs insurgency: US Navy/Marine Corps forward surgical care during Operation Iraqi Freedom.
The transition from maneuver warfare to insurgency warfare has changed the mechanism and severity of combat wounds treated by US Marine Corps forward surgical units in Iraq. ⋯ The transition from maneuver to insurgency warfare has changed the type and severity of casualties treated by US Marine Corps forward surgical units in Iraq. Improvised explosive devices, severity and number of injuries per casualty, longer transport times, and higher KIA and DOW rates represent major differences between periods. Further data collection is necessary to determine the association between transport times and mortality rates.
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Comparative Study
Early laparoscopic cholecystectomy is the preferred management of acute cholecystitis.
Early laparoscopic cholecystectomy (LC) results in a shorter length of stay and acceptable conversion and complication rates when compared with antibiotic therapy plus interval LC or percutaneous cholecystostomy in patients admitted to a surgical service because of acute cholecystitis. However, actual practice does not conform to current evidence. ⋯ Early laparoscopic cholecystectomy resulted in a significantly reduced length of stay, no major complications, and no significant difference in conversion rates when compared with initial antibiotic treatment and interval LC. Despite these advantages, early LC is not the most common treatment for acute cholecystitis in practice.
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Randomized Controlled Trial
Spinal vs general anesthesia for laparoscopic cholecystectomy: interim analysis of a controlled randomized trial.
To compare spinal anesthesia with the gold standard general anesthesia for elective laparoscopic cholecystectomy in healthy patients. ⋯ Spinal anesthesia is adequate and safe for laparoscopic cholecystectomy in otherwise healthy patients and offers better postoperative pain control than general anesthesia without limiting recovery.