Articles: cations.
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Nearly 30% of patients with newly formed ileostomies require hospital readmission from severe dehydration or associated complications. This contributes to significant morbidity and rising healthcare costs associated with this procedure. Our aim was to design and pilot a novel program to decrease readmissions in this patient population. ⋯ Implementation of a novel program reduced the 30-day readmission rate by 58% and cost of readmissions per patient by >80% in a high risk for readmission patient population with newly created ileostomies. Future efforts will expand this program to a greater number of patients, both institutionally and systemically, to reduce the readmission-rate and healthcare costs for this high-risk patient population.
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Comparative Study
Comparative Efficacy of Bilateral Thoracoscopic Splanchnicectomy for Intractable Pain Secondary to Pancreatic Cancer vs Chronic Pancreatitis.
Splanchnicectomy has been evaluated for treatment of chronic pain in both pancreatic cancer and chronic pancreatitis patients, although its efficacy has not been compared in these 2 patient populations. This study aimed to compare bilateral thoracoscopic splanchnicectomy in treatment of abdominal pain secondary with pancreatic cancer and chronic pancreatitis. ⋯ Bilateral thoracoscopic splanchnicectomy safely, effectively, and durably relieves abdominal pain in patients with both pancreatic cancer and chronic pancreatitis. However, it is more effective in providing pain relief and preventing pain-related hospitalizations in patients with pancreatic cancer compared with those with chronic pancreatitis.
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Case Reports
Application of far-lateral approach to sub-axial spine-Application, technical difficulties and results.
The far-lateral approach has traditionally been used as an approach to ventral foramen magnum pathologies. Ventral pathologies in the cervical spine and cervicodorsal regions also provide unique surgical challenges. Traditional posterior surgical approaches to the ventral cervical pathologies require significant cord retraction, and anterior approaches require significant bone removal with implant stabilization. We approached these lesions using a modification of the far-lateral approach for lesions in the subaxial spine. ⋯ We propose extension of far-lateral approach to ventral intradural extramedullary lesions in the subaxial spine up to the cervicothoracic junction. The far-lateral approach can be extended safely to the ventral and ventrolateral lesions of the subaxial cervical spine, especially for recurrent or residual lesions previously approached from the midline posteriorly.
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Multicenter Study Comparative Study
Predictors of In-hospital Postoperative Opioid Overdose After Major Elective Operations: A Nationally Representative Cohort Study.
The aim of this study was to describe national trends and outcomes of in-hospital postoperative opioid overdose (OD) and identify predictors of postoperative OD. ⋯ Postoperative OD is a rare, but potentially lethal complication, with increasing incidence. Postoperative monitoring and treatment safety interventions should be thoughtfully employed to target high-risk patients and avoid this potentially fatal complication.