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Pim B Olthof, Michal Heger, Krijn P van Lienden, Kora de Bruin, Roelof J Bennink, Thomas M van Gulik
BACKGROUND: Portal vein embolization is the gold standard approach to preoperatively enhance the future liver remnant before liver resection. Portal vein embolization is studied in several experimental animal models; however, clinical translation of results is often difficult. We aimed to examine the translational value of the portal vein embolization response in a standardized rabbit model by comparing the volume and function increase with the response seen in patients. METHODS: Six rabbits were subjected to embolization of the cranial liver lobes, and the hypertrophy response of the caudal liver lobe was studied using computed tomography volumetry and Technetium-99m-labeled-mebrofenin hepatobiliary scintigraphy...
October 18, 2016: Surgery
Michael G White, Marc A Ward, Megan K Applewhite, Harry Wong, Vivek Prachand, Peter Angelos, Edwin L Kaplan, Raymon H Grogan
BACKGROUND: With over 110,000 bariatric operations performed in the United States annually, it is important to understand the biochemical abnormalities causing endocrine dysfunction associated with these procedures. Here we compare 2 malabsorptive procedures, duodenal switch and Roux-en-Y gastric bypass, to determine the role malabsorption plays in secondary hyperparathyroidism in this population. METHODS: Data from all super-obese patients undergoing duodenal switch or Roux-en-Y gastric bypass between August 2002 and October 2005 were prospectively collected...
October 18, 2016: Surgery
Shara I Feld, Sarah E Tevis, Alexander G Cobian, Mark W Craven, Gregory D Kennedy
BACKGROUND: Many studies have evaluated predictors of postoperative complications, yet little is known about the development of multiple complications. The goal of this study was to assess complication timing in cascades of multiple complications and the risk of future complications given a patient's first complication. METHODS: This study includes 30-day, postoperative complications from the American College of Surgeons National Surgical Quality Improvement Program for all patients who underwent major inpatient and outpatient operative procedures from 2005-2013...
October 18, 2016: Surgery
Henry A Pitt, Amy J Goldberg, Abhijit S Pathak, Jonathan A Shinefeld, Sally M Hinkle, Selwyn O Rogers, Verdi J DiSesa, Larry R Kaiser
BACKGROUND: Survival of surgical inpatients is a key quality metric. Patient, surgeon, and system factors all contribute to inpatient mortality, and sophisticated risk adjustment is required to assess outcomes. When the mortality of general surgery patients was determined to be high at a safety-net hospital, a comprehensive approach was undertaken to improve patient survival. METHODS: General surgical service line mortality was measured in the database of the University HealthSystem Consortium from January 2013 through June 2015...
October 18, 2016: Surgery
Jürgen Böhm, Frank Pianka, Nina Stüttgen, Junghyun Rho, Biljana Gigic, Yuzheng Zhang, Nina Habermann, Petra Schrotz-King, Clare Abbenhardt-Martin, Lin Zielske, Paul D Lampe, Alexis Ulrich, Markus K Diener, Cornelia M Ulrich
BACKGROUND: Ventral incisional hernia is the most common long-term complication after an abdominal operation. Among newly diagnosed colorectal cancer patients, we screened the preoperative plasma proteome to explore predictive markers for the development of an incisional hernia. METHODS: We utilized preoperative plasma samples of 72 newly diagnosed colorectal cancer patients who underwent midline incision for tumor resection between 2010 and 2013. A total of 21 patients with incisional hernia occurrence were matched with 51 patients with at least 18 months follow-up without an incisional hernia by sex, age, and body mass index...
October 13, 2016: Surgery
Antonio Sitges-Serra, Lander Gallego-Otaegui, Sergio Suárez, Leyre Lorente-Poch, Assumpta Munné, Juan J Sancho
BACKGROUND: The main drawback of central neck lymph node dissection is postoperative parathyroid failure. Little information is available concerning inadvertent resection of the parathyroid glands in this setting and its relationship to postoperative hypoparathyroidism. Our aim was to determine the prevalence of inadvertent parathyroidectomy during total thyroidectomy and central neck dissection for papillary thyroid cancer and its impact on short-and long-term parathyroid function. METHODS: This was a prospective observational study of consecutive patients undergoing first-time total thyroidectomy with a central neck dissection for papillary carcinoma >10 mm...
October 13, 2016: Surgery
David Berger-Richardson, Tyler R Chesney, Marina Englesakis, Anand Govindarajan, Sean P Cleary, Carol J Swallow
BACKGROUND: The risk of port-site metastasis after laparoscopic removal of incidental gallbladder cancer was previously estimated to be 14-30%. The present study was designed to determine the incidence of port-site metastasis in incidental gallbladder cancer in the modern era (2000-2014) versus the historic era (1991-1999). We also investigated the site of port-site metastasis. METHODS: Using PRISMA, a systematic review was conducted to identify papers that addressed the development of port-site metastasis after laparoscopic resection of incidental gallbladder cancer...
October 13, 2016: Surgery
Theoneste Nkurunziza, Gabriel Toma, Jackline Odhiambo, Rebecca Maine, Robert Riviello, Neil Gupta, Caste Habiyakare, Tharcisse Mpunga, Alex Bonane, Bethany Hedt-Gauthier
BACKGROUND: In developing countries, 9 out of 10 patients lack access to timely operative care. Most patients seek care at district hospitals that often lack operative capacity, creating a need for referral. Delays in referrals contribute to substantial disability and death. This study assessed the predictors of delayed referrals for injured patients. METHODS: This retrospective cohort study included injured patients, recommended for referral between January 1, 2013, and December 31, 2013, from 3 rural district hospitals in Rwanda...
October 12, 2016: Surgery
Mehr Z Qureshi, John T Gorczyca, Adam J Doyle, Mark L Gestring
No abstract text is available yet for this article.
October 12, 2016: Surgery
Max Bolun Liu, Thuy Bui Huong, Xuyen Hoang, Lan Doan, Shauna Trinh, Hoa Pham Anh Nguyen, Hai Thanh Le, Ai-Xuan Holterman
BACKGROUND: Biliary atresia is an idiopathic, neonatal liver disease of the bile ducts. The natural evolution of biliary atresia is known in developed countries. This study describes the clinical course of biliary atresia in Vietnam, a developing country. METHODS: Chart reviews were undertaken of patients treated with or without the Kasai procedure between January 2010 and July 2013 at a children's hospital in Vietnam. RESULTS: Of 287 children with biliary atresia, 149 (52%) were treated without the Kasai procedure and 138 (48%) were treated with the Kasai procedure...
October 12, 2016: Surgery
Ines G Alamo, Kolenkode B Kannan, Harry Ramos, Tyler J Loftus, Philip A Efron, Alicia M Mohr
BACKGROUND: Propranolol has been shown previously to restore bone marrow function and improve anemia after lung contusion/hemorrhagic shock. We hypothesized that daily clonidine administration would inhibit central sympathetic outflow and restore bone marrow function in our rodent model of lung contusion/hemorrhagic shock with chronic stress. METHODS: Male Sprague-Dawley rats underwent 6 days of restraint stress after lung contusion/hemorrhagic shock during which the animals received clonidine (75 μg/kg) after the restraint stress...
October 11, 2016: Surgery
David H Ballard, Jeffery A Weisman, Udayabhanu Jammalamadaka, Karthik Tappa, J Steven Alexander, F Dean Griffen
No abstract text is available yet for this article.
October 7, 2016: Surgery
Masaki Yamamoto, Nobuhisa Akamatsu, Taku Aoki, Yoshihiro Sakamoto, Sumihito Tamura, Kiyoshi Hasegawa, Norihiro Kokudo
BACKGROUND: There are several techniques for reconstructing the portal vein-superior mesenteric vein during pancreatoduodenectomy. The aim of the present study was to present our results with portal vein-superior mesenteric vein reconstruction using cryopreserved homologous veins during pancreatoduodenectomy for patients with pancreatic head cancer. METHODS: Patients who underwent pancreatoduodenectomy for pancreatic head cancer were reviewed retrospectively. In patients with portal vein-superior mesenteric vein resection, the detailed method of reconstruction and clinical outcomes were reviewed...
October 7, 2016: Surgery
Naohito Beppu, Ayako Kakuno, Hiroshi Doi, Norihiko Kamikonya, Nagahide Matsubara, Naohiro Tomita, Hidenori Yanagi, Naoki Yamanaka
BACKGROUND: Although preoperative chemoradiotherapy exerts a destructive effect on positive lymph nodes, microscopic examination reveals different degrees of tumor regression. The aim of the present study is to investigate the impact of the radiation-induced regression of positive nodes on survival in patients with rectal cancer treated with preoperative chemoradiotherapy. METHODS: From 2001 to 2015, 229 patients with T3 rectal cancer underwent total mesorectal excision after preoperative chemoradiotherapy...
October 7, 2016: Surgery
Christopher J Pannucci, Matthew T Rondina
No abstract text is available yet for this article.
October 3, 2016: Surgery
Leonard Ndayizeye, Christian Ngarambe, Blair Smart, Robert Riviello, Jean Paul Majyambere, Jennifer Rickard
BACKGROUND: Few studies discuss causes and outcomes of peritonitis in low-income settings. This study describes epidemiology of patients with peritonitis at a Rwandan referral hospital. Identification of risk factors associated with mortality and unplanned reoperation could improve management of peritonitis. METHODS: Data were collected on demographics, clinical presentation, operative findings, and outcomes for all patients with peritonitis. Multivariate regression analysis identified factors associated with in-hospital mortality and unplanned reoperation...
October 3, 2016: Surgery
Mahsa Javid, Glenda Callender, Courtney Quinn, Tobias Carling, Patricia Donovan, Robert Udelsman
BACKGROUND: Patients with primary hyperparathyroidism and baseline intraoperative parathyroid hormone levels in the normal range are challenging. This study compares the predictive value of a commonly used intraoperative parathyroid hormone algorithm, a software model for cure prediction, and surgeon judgment in this population. METHODS: This was a retrospective review of consecutive patients who underwent parathyroidectomy for primary hyperparathyroidism at a single institution from March 2013 to October 2014...
October 3, 2016: Surgery
Demetrios Moris, Timothy M Pawlik
No abstract text is available yet for this article.
October 3, 2016: Surgery
Janelle Rekman, Christopher Wherrett, Sean Bennett, Miso Gostimir, Sara Saeed, Kristina Lemon, Richard Mimeault, Fady K Balaa, Guillaume Martel
BACKGROUND: Liver resection can be associated with significant blood loss and transfusion. Whole blood phlebotomy is an under-reported technique, distinct from acute normovolemic hemodilution, the goal of which is to minimize blood loss in liver operation. This work sought to report on its safety and feasibility and to describe technical considerations. METHODS: Consecutive patients who had an elective liver resection and concurrent phlebotomy between 2013 and 2016 were examined prospectively...
October 3, 2016: Surgery
Yun Zhang, Jian Zhang, Tao Xu, Wei Wu, Fang-Fang Huang, Wen-Qiao Yu, Shao-Yang Zhang, Ting-Bo Liang
BACKGROUND: Intestinal dendritic cells play important roles in regulating the function of the intestinal immune barrier and the intestinal bacterial translocation. In this study, we aim to investigate the effects of allicin on the function of mesenteric lymph node-dendritic cells after trauma/hemorrhagic shock. METHODS: One hundred and eight-four Sprague-Dawley rats were randomly assigned into a sham group (n = 46), sham + allicin group (n = 46), trauma/hemorrhagic shock group (n = 46), and trauma/hemorrhagic shock + allicin group (n = 46)...
October 3, 2016: Surgery
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