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Langenbeck's Archives of Surgery

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https://www.readbyqxmd.com/read/28889185/statistical-approach-to-quality-assessment-in-liver-transplantation
#1
Harald Schrem, Sophia Volz, Hans-Friedrich Koch, Jill Gwiasda, Priscila Kürsch, Alon Goldis, Daniel Pöhnert, Markus Winny, Jürgen Klempnauer, Alexander Kaltenborn
PURPOSE: This study investigated the utility of retrospective two one-sided cumulative sum (CUSUM) charts combined with multivariable regression analysis in liver transplantation for transplant center benchmarking. METHODS: One thousand seven hundred and forty-nine consecutive adult primary liver transplants (January 1, 1983 to December 31, 2012) were analyzed retrospectively with two one-sided CUSUM chart analysis of 90-day mortality. RESULTS: Three eras and two subseries in latest era 3 were identified due to graphically delineated relevant shifts in mean 90-day mortality...
September 9, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28875312/indication-of-extrahepatic-bile-duct-resection-for-gallbladder-cancer
#2
Hiroshi Kurahara, Kosei Maemura, Yuko Mataki, Masahiko Sakoda, Satoshi Iino, Yota Kawasaki, Shinichiro Mori, Takaaki Arigami, Yuko Kijima, Hiroyuki Shinchi, Shoji Natsugoe
PURPOSE: Extrahepatic bile duct (EHBD) resection is performed as part of radical cholecystectomy for gallbladder (GB) cancer. However, the indication for EHBD resection is still controversial. The aim of the present study was to evaluate the prognostic value of this procedure. METHODS: Patients who underwent surgical resection for GB cancer with curative intent were enrolled. We divided GB cancer into two categories based on the tumor location: proximal-type and distal-type tumors...
September 5, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28875302/laparoscopic-approaches-to-complicated-diverticulitis
#3
REVIEW
M Gachabayov, R Essani, R Bergamaschi
BACKGROUND: The objective of this article is to review the evolving role of laparoscopic surgery in the treatment of complicated diverticulitis. PURPOSE: The authors attempted to give readers a concise insight into the evidence available in the English language literature. This study does not offer a systematic review of the topic, rather it highlights the role of laparoscopy in the treatment of complicated diverticulitis. CONCLUSIONS: New level 1 evidence suggest that observation rather than elective resection following nonoperative management of diverticulitis with abscess and/or extraluminal air is not below the standard of care...
September 5, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28840372/persistent-perineal-sinus-after-abdominoperineal-resection
#4
Amélie Chau, Mathieu Prodeau, Hélène Sarter, Corinne Gower, Moshe Rogosnitzky, Yves Panis, Philippe Zerbib
BACKGROUND AND AIMS: Persistent perineal sinus (PPS) defined as a perineal wound remaining unhealed more than 6 months after abdominoperineal resection (APR) is a well-known complication. The aim of our study was (1) to evaluate the incidence of PPS after APR for Crohn's disease (CD) in the era of biotherapy, (2) to determine long-term outcome of PPS, (3) to study risk factors associated with delayed perineal healing, and (4) to compare the results in this CD patient group with patients without CD...
August 25, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28831565/systemic-inflammatory-response-after-hernia-repair-a-systematic-review
#5
REVIEW
Dunja Kokotovic, Jakob Burcharth, Frederik Helgstrand, Ismail Gögenur
PURPOSE: All surgical procedures elicit a complex systemic inflammatory response effectuated and modulated by cytokines. The purpose of this systematic review was to present an overview of the inflammatory response and the serum markers associated with hernia repair and to compare the response between patients treated with and without mesh. METHODS: The review was conducted in line with PRISMA guidelines. The outcomes of interest were serum concentration of leukocytes, cytokines, and acute phase proteins before and after hernia repair with or without mesh reinforcement...
August 22, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28828685/modern-diagnosis-and-treatment-of-hiatal-hernias
#6
REVIEW
Steve R Siegal, James P Dolan, John G Hunter
PURPOSE: Hiatal hernias are a common finding on radiographic or endoscopic studies. Hiatal hernias may become symptomatic or, less frequently, can incarcerate or become a volvulus leading to organ ischemia. This review examines latest evidence on the diagnostic workup and management of hiatal hernias. METHODS: A literature review of contemporary and latest studies with highest quality of evidence was completed. This information was examined and compiled in review format...
August 21, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28823033/the-combination-of-mitomycin-induced-blood-cells-with-a-temporary-treatment-of-ciclosporin-a-prolongs-allograft-survival-in-vascularized-composite-allotransplantation
#7
Christian Andreas Radu, Sebastian Fischer, Yannick Diehm, Otto Hetzel, Florian Neubrech, Laura Dittmar, Christian Kleist, Martha Maria Gebhard, Peter Terness, Ulrich Kneser, Jurij Kiefer
BACKGROUND: Vascularized composite allotransplantation (VCA) is a rapidly expanding field of transplantation and provides a potential treatment for complex tissue defects. Peripheral blood mononuclear cells (PBMCs) shortly incubated with the antibiotic and chemotherapeutic agent mitomycin C (MMC) can suppress allogeneic T cell response and control allograft rejection in various organ transplantation models. MMC-incubated PBMCs (MICs) are currently being tested in a phase I clinical trial in kidney transplant patients...
August 19, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28823005/normocalcaemic-primary-hyperparathyroidism-a-diagnostic-and-therapeutic-algorithm
#8
Joaquín Gómez-Ramírez, Radu Mihai
In recent years, there has been increasing interest in understanding the implications of diagnosing normocalcaemic primary hyperparathyroidism (nPHPT). Many patients hope that nPHPT might explain some of their symptoms, but surgeons hesitate to offer treatment to patients whose calcium levels are normal but whose parathyroid hormone (PTH) levels are elevated in the absence of secondary causes of hyperparathyroidism. This potential new diagnosis is not well understood and may lead to inappropriate investigation and possible unnecessary operations...
August 19, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28812139/groin-hernia-diagnostics-dynamic-inguinal-ultrasound-dius
#9
Henning Niebuhr, Anita König, Maciej Pawlak, Marco Sailer, Ferdinand Köckerling, Wolfgang Reinpold
PURPOSE: Although clinical examination is the gold standard for the diagnosis of groin hernia, imaging procedures can improve the detection of femoral hernias, incipient hernias, and less-common types of hernias (e.g., an obturator hernia). The aim of this study is to evaluate the sensitivity and specificity of dynamic inguinal ultrasound (DIUS). MATERIALS AND METHODS: Between July 2010 and June 2015, 4951 clinical and ultrasound examinations of the groin area were conducted at the Hanse-Hernienzentrum in Hamburg, Germany...
August 15, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28803414/laparoscopic-reversal-of-mini-gastric-bypass-to-original-anatomy-for-severe-postoperative-malnutrition
#10
Laurent Genser, Antoine Soprani, Malek Tabbara, Jean-Michel Siksik, Jean Cady, Sergio Carandina
PURPOSE: Malnutrition after mini-gastric bypass (MGB) is a rare and dreaded complication with few data available regarding its surgical management. We aim to report the feasibility, safety, and results of laparoscopic reversal of MGB to normal anatomy (RMGB) in case of severe and refractory malnutrition syndrome after intensive nutritional support (SRMS). METHODS: A 10-year retrospective chart review was performed on patients who underwent RMGB (video included) for SRMS following MGB...
August 12, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28803383/synchronous-colorectal-liver-metastases-focus-on-the-elderly-an-effectiveness-study-from-routine-care
#11
Markus Albertsmeier, Andrea Engel, Markus O Guba, Sebastian Stintzing, Tobias S Schiergens, Gabriele Schubert-Fritschle, Dieter Hölzel, Jens Werner, Martin K Angele, Jutta Engel
PURPOSE: The goal of this study was to analyze the use and the effectiveness of both surgery and different chemotherapies in patients with synchronous colorectal liver metastases (CLMs) ≥70 years compared to younger patients. METHODS: Survival was analyzed in 456 patients (24.3% ≥70 years) treated for CLM in a single center using Kaplan-Meier estimation of overall survival (OS), calculation of relative survival as estimate for disease-specific survival, and a Cox regression model...
August 12, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28803334/surgical-approaches-to-adenocarcinoma-of-the-gastroesophageal-junction-the-siewert-ii-conundrum
#12
REVIEW
Andrew M Brown, Danica N Giugliano, Adam C Berger, Michael J Pucci, Francesco Palazzo
BACKGROUND: The Siewert classification system for gastroesophageal junction adenocarcinoma has provided morphological and topographical information to help guide surgical decision-making. Evidence has shown that Siewert I and III tumors are distinct entities with differing epidemiologic and histologic characteristics and distinct patterns of disease progression, requiring different treatment. Siewert II tumors share some of the characteristics of type I and III lesions, and the surgical approach is not universally agreed upon...
August 12, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28801721/surgery-is-essential-in-squamous-cell-cancer-of-the-rectum
#13
D C Steinemann, P C Müller, A T Billeter, T Bruckner, A Ulrich, B P Müller-Stich
PURPOSE: Squamous cell cancer (SCC) is a rare histological subtype of rectal cancer. It is unclear whether SCC should be treated by multimodal therapy, including surgery, or by chemoradiation alone. The objective of the study was to define an optimal treatment strategy. METHODS: Patients with rectal cancer and SCC histology were identified in the Surveillance Epidemiology and End Results Database between 1990 and 2013. According to treatment, three groups were defined: radiotherapy and surgery (RT/SX), radiotherapy (RT), and surgery (SX)...
August 11, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28780622/outcomes-after-bariatric-surgery-according-to-large-databases-a-systematic-review
#14
Andrea Balla, Gabriela Batista Rodríguez, Santiago Corradetti, Carmen Balagué, Sonia Fernández-Ananín, Eduard M Targarona
PURPOSE: The rapid development of technological tools to record data allows storage of enormous datasets, often termed "big data". In the USA, three large databases have been developed to store data regarding surgical outcomes: the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP), the Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (NIS) and the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP)...
August 5, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28770343/value-of-gastrografin-in-adhesive-small-bowel-obstruction
#15
Anna Weiss, Divya Sood, Scott E Greenway, Marco Tomassi
BACKGROUND: Small bowel obstruction (SBO) from adhesive disease presents great burden for the healthcare system. Some groups have reported water soluble contrast agents (WSCA) protocols, but published studies are underpowered. This study introduces a WSCA protocol to improve outcomes and streamline patient care. STUDY DESIGN: The study ran July 1, 2013-June 30, 2015, at Kaiser Permanente San Diego; protocol started July 1, 2014. Data was collected prospectively, on an intention to treat basis...
August 2, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28755240/bridging-to-liver-transplantation-in-hcc-patients
#16
REVIEW
Dagmar Kollmann, Nazia Selzner, Markus Selzner
BACKGROUND: Liver transplantation (LT) is the only cure for patients diagnosed with unresectable hepatocellular carcinoma (HCC), and HCC has become the leading indication for LT in the USA. The shortage of liver grafts results in a significant waiting time for LT with the risk of tumour progression. Treating HCCs during the waiting time prior to transplantation (bridging therapy) is an attractive strategy to reduce the risk of exceeding the tumour criteria for transplantation. Studies on bridging therapy are heterogenous and due to ethical issues, mostly of retrospective design...
July 28, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28752336/acute-appendicitis-in-children-can-surgery-be-postponed-short-term-results-in-a-cohort-of-225-children
#17
Clemens-Magnus Meier, Helge Latz, Jens Kraemer, Stefan Wagenpfeil, Stefan Graeber, Matthias Glanemann, Arne Simon
PURPOSE: To our knowledge, there is no German study, which has examined the relationship between a postponement of surgery (from emergency service to standard working time) and the corresponding risk of postoperative complications in children and adolescents with acute appendicitis. The aim of this study is to examine if surgery of acute appendicitis in childhood can be postponed from night shift to the next working day without negative effects for the patient. METHODS: In a retrospective analysis (September 2001 to June 2007), the files of 225 paediatric surgical patients with acute appendicitis have been analysed concerning history, histology, course of treatment and development of complications...
July 27, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28752335/risk-factors-for-morbidity-after-appendectomy
#18
Anne Andert, H P Alizai, C D Klink, N Neitzke, C Fitzner, C Heidenhain, A Kroh, U P Neumann, M Binnebösel
INTRODUCTION: The aim of the present study was to evaluate the risk factors for postoperative complications after an appendectomy with special regard to both the time period from hospital admission to operation and night time surgery. PATIENTS AND METHODS: Patients who underwent an appendectomy due to acute appendicitis and were admitted to the University Hospital Aachen between January 2003 and January 2014 were included in this retrospective analysis. Regarding the occurrence of postoperative complications, patients were divided into the following two groups: the group with complications (group 1) and the group without complications (group 2)...
July 27, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28733926/perioperative-management-of-endocrine-insufficiency-after-total-pancreatectomy-for-neoplasia
#19
REVIEW
Ajay V Maker, Raashid Sheikh, Vinita Bhagia
PURPOSE: Indications for total pancreatectomy (TP) have increased, including for diffuse main duct intrapapillary mucinous neoplasms of the pancreas and malignancy; therefore, the need persists for surgeons to develop appropriate endocrine post-operative management strategies. The brittle diabetes after TP differs from type 1/2 diabetes in that patients have absolute deficiency of insulin and functional glucagon. This makes glucose management challenging, complicates recovery, and predisposes to hospital readmissions...
July 21, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28733925/polypropelene-mesh-properties-and-type-of-anchoring-do-not-influence-strength-of-parietal-ingrowth
#20
S Harsløf, N Zinther, T Harsløf, C Danielsen, P Wara, H Friis-Andersen
PURPOSE: In laparoscopic ventral hernia repair, parietal ingrowth of the mesh is of crucial importance. Until significant ingrowth occurs integrity of the repair depends solely on mesh overlap and anchoring device. Relatively few studies have addressed the effect of mesh properties and anchoring device on long-term parietal ingrowth. METHODS: In 20 sheep, using laparoscopy, we inserted two different polypropylene-based meshes, Physiomesh™ and Ventralight™ ST, anchored with Protack™, SecureStrap™, or Glubran™...
July 21, 2017: Langenbeck's Archives of Surgery
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