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Henk-Thijs Brandsma, Birgitta M E Hansson, Theo J Aufenacker, Dick van Geldere, Felix M V Lammeren, Chander Mahabier, Peter Makai, Pascal Steenvoorde, Tammo S de Vries Reilingh, Marinus J Wiezer, Johannes H W de Wilt, Robert P Bleichrodt, Camiel Rosman
OBJECTIVE: The aim of this study was to investigate the incidence of parastomal hernias (PSHs) after end-colostomy formation using a polypropylene mesh in a randomized controlled trial versus conventional colostomy formation. BACKGROUND: A PSH is the most frequent complication after stoma formation. Symptoms may range from mild abdominal pain to life-threatening obstruction and strangulation. The treatment of a PSH is notoriously difficult and recurrences up to 20% have been reported despite the use of mesh...
April 2017: Annals of Surgery
Karen N Zaghiyan, Harry C Sax, Emily Miraflor, David Cossman, Willis Wagner, James Mirocha, Bruce Gewertz, Phillip Fleshner
OBJECTIVE: To identify the optimal timing of perioperative chemical thromboprophylaxis (CTP) and incidence of occult preoperative deep vein thrombosis (OP-DVT) in patients undergoing major colorectal surgery. BACKGROUND: There is limited Level 1 data regarding the optimal timing of CTP in major colorectal surgery and the incidence of OP-DVT remains unclear. Both issues influence the occurrence of venous thromboembolism (VTE) and may impact Medicare reimbursement because of penalties for hospital-acquired conditions...
October 2016: Annals of Surgery
Ji-Ho Park, Young-Gil Son, Tae-Han Kim, Yeon-Ju Huh, Jun-Young Yang, Yong-Joon Suh, Yun-Suhk Suh, Seong-Ho Kong, Hyuk-Joon Lee, Han-Kwang Yang
OBJECTIVE: The aim of this study was to analyze clinical and laboratory variables associated with complications after gastrectomy for gastric cancer to predict candidates for successful early discharge. METHODS: Consecutive patients undergoing gastrectomy at Seoul National University Hospital from January through December 2013 were identified from a prospective complications database. Clinicopathologic and postoperative laboratory parameters were analyzed to determine variables associated with complications...
January 2017: Annals of Surgical Oncology
J L de Bruin, R H H Groenwold, A F Baas, J R Brownrigg, M Prinssen, D E Grobbee, J D Blankensteijn
BACKGROUND: Long-term survival is similar after open or endovascular repair of abdominal aortic aneurysm. Few data exist on the effect of either procedure on long-term health-related quality of life (HRQoL) and health status. METHODS: Patients enrolled in a multicentre randomized clinical trial (DREAM trial; 2000-2003) in Europe of open repair versus endovascular repair (EVAR) of abdominal aortic aneurysm were asked to complete questionnaires on health status and HRQoL...
July 2016: British Journal of Surgery
John W Scott, Olubode A Olufajo, Gabriel A Brat, John A Rose, Cheryl K Zogg, Adil H Haider, Ali Salim, Joaquim M Havens
IMPORTANCE: Emergency general surgery (EGS) represents 11% of surgical admissions and 50% of surgical mortality in the United States. However, there is currently no established definition of the EGS procedures. OBJECTIVE: To define a set of procedures accounting for at least 80% of the national burden of operative EGS. DESIGN, SETTING, AND PARTICIPANTS: A retrospective review was conducted using data from the 2008-2011 National Inpatient Sample...
June 15, 2016: JAMA Surgery
Roger Chou, Shelley S Selph, David I Buckley, Katie S Gustafson, Jessica C Griffin, Sara E Grusing, John L Gore
There is uncertainty regarding the use of bladder-sparing alternatives to standard radical cystectomy, optimal lymph node dissection techniques, and optimal chemotherapeutic regimens. This study was conducted to systematically review the benefits and harms of bladder-sparing therapies, lymph node dissection, and systemic chemotherapy for patients with clinically localized muscle-invasive bladder cancer. Systematic literature searches of MEDLINE (from 1990 through October 2014), the Cochrane databases, reference lists, and the ClinicalTrials...
March 15, 2016: Cancer
Charles de Mestral, Jeffrey S Hoch, Andreas Laupacis, Harindra C Wijeysundera, Ori D Rotstein, Aziz S Alali, Avery B Nathens
BACKGROUND: The application of early cholecystectomy for acute cholecystitis remains inconsistent across hospitals worldwide. Given the constrained nature of health care spending, careful consideration of costs relative to the clinical consequences of alternative treatments should support decision making. We present a cost-utility analysis comparing alternative time frames of cholecystectomy for acute cholecystitis. STUDY DESIGN: A Markov model with a 5-year time horizon was developed to compare costs and quality-adjusted life-years (QALY) gained from 3 alternative management strategies for the treatment of acute cholecystitis: early cholecystectomy (within 7 days of presentation), delayed elective cholecystectomy (8 to 12 weeks from presentation), and watchful waiting, where cholecystectomy is performed urgently only if recurrent symptoms arise...
February 2016: Journal of the American College of Surgeons
Eva B Deerenberg, Joris J Harlaar, Ewout W Steyerberg, Harold E Lont, Helena C van Doorn, Joos Heisterkamp, Bas Pl Wijnhoven, Willem R Schouten, Huib A Cense, Hein Bac Stockmann, Frits J Berends, F Paul Hlj Dijkhuizen, Roy S Dwarkasing, An P Jairam, Gabrielle H van Ramshorst, Gert-Jan Kleinrensink, Johannes Jeekel, Johan F Lange
BACKGROUND: Incisional hernia is a frequent complication of midline laparotomy and is associated with high morbidity, decreased quality of life, and high costs. We aimed to compare the large bites suture technique with the small bites technique for fascial closure of midline laparotomy incisions. METHODS: We did this prospective, multicentre, double-blind, randomised controlled trial at surgical and gynaecological departments in ten hospitals in the Netherlands...
September 26, 2015: Lancet
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