Archives of surgery (Chicago, Ill. : 1960)
-
Multicenter Study
Long-term and perioperative corticosteroids in anastomotic leakage: a prospective study of 259 left-sided colorectal anastomoses.
To determine the risk factors for symptomatic anastomotic leakage (AL) after colorectal resection. ⋯ We found a significantly increased incidence of AL in patients treated with long-term corticosteroids and perioperative corticosteroids for pulmonary comorbidity. Therefore, we recommend that in this patient category, anastomoses should be protected by a diverting stoma or a Hartmann procedure should be considered to avoid AL.
-
Multicenter Study
Successful nonoperative management of the most severe blunt liver injuries: a multicenter study of the research consortium of new England centers for trauma.
Grade 4 and grade 5 blunt liver injuries can be safely treated by nonoperative management (NOM). ⋯ Nonoperative management was offered safely in two-thirds of grade 4 and grade 5 blunt liver injuries, with a 91.3% success rate. Only 6.5% of patients with NOM required a delayed operation because of liver-specific issues, and none experienced life-threatening complications because of the delay.
-
To investigate which residents develop successful collegial relationships with attending physicians and to determine how social interactions affect residency satisfaction. ⋯ Collegial interactions between residents and attendings are important because they are associated with residency satisfaction. Efforts should be made to expand such interactions to junior and female residents.
-
Review Meta Analysis
Wound healing and infection in surgery. The clinical impact of smoking and smoking cessation: a systematic review and meta-analysis.
To clarify the evidence on smoking and postoperative healing complications across surgical specialties and to determine the impact of perioperative smoking cessation intervention. ⋯ Postoperative healing complications occur significantly more often in smokers compared with nonsmokers and in former smokers compared with those who never smoked. Perioperative smoking cessation intervention reduces surgical site infections, but not other healing complications.