Swiss surgery = Schweizer Chirurgie = Chirurgie suisse = Chirurgia svizzera
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Randomized Controlled Trial Comparative Study Clinical Trial
Laparoscopic colectomy for colon cancer--a trial update.
A prospective randomized trial was designed to test the hypothesis that disease-free survival and overall survival are equivalent regardless of whether patients receive laparoscopic assisted colectomy (LAC) or open colectomy. Secondary and tertiary aims will test the safety of LAC and the impact of LAC on quality of life and costs, respectively. ⋯ Although this study is ongoing; preliminary results suggest that open and LAC provide for the same extent of resection. The quality of life portion of the study is now complete and data will soon be available.
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Review Case Reports
Streptococcal toxic shock syndrome revealed by a peritonitis. Case report and review of the literature.
Group A streptococcus (GAS) or Streptococcus pyogenes cause a variety of life-threatening infectious complications including necrotizing fasciitis, purpura fulminans and streptococcal toxic shock syndrome (STSS). Exotoxins that act as superantigens are felt to be responsible for STSS. These exotoxins are highly destructive to skin, muscle and soft tissue. ⋯ Several studies have shown that mortality was dramatically reduced in STSS patients treated with immunoglobulin G given intravenously (IVIG). Early recognition of this most rapidly progressive infection and prompt operative debridement are required for successful management. This report presents a female patient at two month post-partum with a peritonitis and multi-organ failure.
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Pancreatic pseudocysts are rare in children. Traumatic injury accounts for 80% of the cases. We present the case of a pancreatic injury with pseudocyst formation in a child and discuss the initial management of pancreatic injury as well as the treatment of pseudocyst formation in children.
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The intercostal nerve syndrome is caused by an impingement of the intercostals nerve at the level of the anterior rectus sheath. It may lead to acute or chronic abdominal pain, it should therefore be considered in the differential diagnosis of the acute or chronic abdomen. ⋯ In our retrospective study 14 patients with 15 entrapment syndromes are described. If, sometimes after a few diagnostic and therapeutic detours, the diagnosis is established, surgical intervention with resection of the altered nerve at it's exit of the anterior rectus sheath can usually abolish the pain with little side effects.
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We analysed the ATLS courses organized in Switzerland since 1998. At the students courses the surgeons exceed the participants with a percentage of 45.7%, followed by the anaesthesiologist with 36.3%. ⋯ The statistics of the instructors show about the same pattern, the percentage of senior residents is even more impressive. The aim of ATLS is the same concept, the idea of ATLS in all emergency units throughout the whole country of Switzerland.