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Blood transfusions are an independent risk factor for adverse outcomes after hepatectomy. In-hospital transfusions are still reported in one third of patients in major series. Data on factors affecting blood transfusions in large series of liver resection are limited. The aim of this study was to evaluate factors predictive of blood transfusion in hepatectomies performed at a tertiary referral center...
Female animals tolerate trauma and hemorrhage better than male animalsANDEstrogen has rapid nongenomic effects that protect organs from damage and attenuate insult–induced inflammationMOREOVERThe survival deficit from trauma and hemorrhage produced in ovariectomized female animals is repaired with administration of exogenous estrogenANDWomen survive injury, sepsis, and trauma-hemorrhage–induced hypoxemia/reperfusion...
The relationship among bile duct (BD), portal vein (PV), and/or hepatic artery (HA) anatomy is controversial, but no investigation has previously compared left and right liver graft transplantation in terms of variant vasculobiliary anatomy. Therefore, in this study, we explored whether variant BD anatomy can be predicted from portal PV or HA anatomy, and we compared left and right liver graft transplantation...
Paragangliomas are extra-adrenal neuroendocrine neoplasms derived from neural crest precursors. These tumors rarely arise from the female genital tract. Vaginal paragangliomas are extremely rare. We describe a case of vaginal paraganglioma managed with minimally invasive surgical techniques.
The complex environment of the operative setting provides multiple opportunities for health care workers to sustain scalpel injuries; scalpels are the second most frequent source of sharps injuries in this setting. Little evidence has been published detailing the effectiveness of proposed safety procedures and devices.A systematic search strategy was used to identify relevant studies. Studies were...
The management of incidental pancreatic cysts is not well established because of lack of information on their natural history. International Consensus Guidelines advocate observation of asymptomatic patients with small lesions, despite limited data to support this approach.To characterize clinical outcomes in a cohort of asymptomatic patients with incidental pancreatic cysts who underwent endoscopic...
Owing to their rarity, the prognostic ramifications of thyroid metastases from renal cell cancer are unclear.This retrospective analysis comprised 17 patients who underwent thyroid surgery (15 total thyroidectomies, 2 lobectomies) for renal cell cancer metastases.The mean follow-up after thyroid surgery was 65 months. Seven of the 9 deaths involved patients with extrathyroidal metastatic growth despite...
A prior study revealed a paucity of surgical research in the 5 top-rated general surgery journals for 1998. The hypothesis of the current study was that a large amount of surgical research was published in other journals.In all, 15 research journals and 9 surgery specialty journals were reviewed for basic research, funded clinical studies, randomized clinical trials, and drug trials. The funding sources...
Repairs of superior mesenteric artery (SMA) injuries are difficult and often result in high mortality. Our group has employed temporary intravascular shunts (TIVS) as a damage control procedure in a SMA transection model and hypothesized that TIVS would improve survival when compared with primary vascular anastomosis in the setting of a damage control surgery.The SMA was clamped and completely transected...
Pancreaticoduodenectomy and distal pancreatectomy for lesions of the neck or body of the pancreas sacrifice a large amount of normal pancreatic tissue. Middle pancreatectomy (MP) is a parenchyma sparing technique that reduces the risk of postoperative endocrine and exocrine insufficiency. This study aims to evaluate the perioperative and long-term results of MP and to clarify whether MP can be performed...
Our aim was to assess pressure dynamics within the esophagogastric junction (EGJ) in sliding hiatus hernia (HH) during normal peristalsis and to compare the pressure profiles of HH patients with gastroesophageal reflux disease (GERD) symptoms (HH-GERD) to HH patients with dysphagia (HH-dysphagia).High-resolution manometry studies in 230 consecutive patients and 68 controls were reviewed. HH patients...
An operating room is a noisy environment. How noise affects performance during robotic surgery remains unknown. We investigated whether noise during training with the da Vinci surgical robot (Intuitive Surgical, Inc., Sunnyvale, CA) would affect the performance of simple operative tasks by the surgeon.Twelve medical students performed 3 inanimate operative tasks (bimanual carrying, suture tying, and...
Anastomotic leaks are inevitable complications of gastrointestinal surgery. Early hospital discharge protocols have increased concern regarding outpatient presentation with anastomotic leaks.One hundred anastomotic leaks in 5,387 intestinal operations performed at a single institution from 2002 to 2007 were identified from a prospectively maintained database. Statistical analysis was conducted by...
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