International journal of surgery
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Retroperitoneal sarcomas are a rare group of malignant soft tissue tumors with a generally poor prognosis. The aim of the study was to define the demographic characteristics and prognostic factors for patients with retroperitoneal sarcomas (RPS) in a Tertiary Referral Center at Mexico. ⋯ In this study of patients with retroperitoneal, complete resection and liposarcoma histology are prognostic factors related to the disease-free and overall survival. Patients approached with curative intent should undergo aggressive attempts at complete surgical resection.
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In February 2010, the UK National Patient Safety Agency set a mandate that the World Health Organisation's Surgical Safety Checklist (SSC) should be completed for every surgical patient within the NHS in a bid to improve surgical safety. However since its introduction, there have been issues with checklist compliance, staff engagement and surgical serious incidents continue. ⋯ The intervention seems to improve rate of checklist completion, particularly signout. It also brought more consistency on the questions read out during checklist administration. It doesn't necessarily ensure all key staff are present neither does it significantly improve staff engagement in the process.
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While the analgesic benefits of systemically administered non-steroidal anti-inflammatory drugs (NSAIDs) for postoperative pain are well established, benefits of locally administered NSAIDs remain unclear outside the field of ophthalmologic surgery. Studies of local NSAID administration for postoperative analgesia vary considerably in terms of dosing and methodologic quality, making it difficult to derive clinically useful information. The primary objective of this systematic review is to summarize the currently available literature in order to assess the value of local NSAIDs as a component of the multimodal postoperative pain management regimen. ⋯ CRD42016038464.
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To investigate the efficacy of our technique and policy on left hepatectomy (LH) with hepatic artery resection but without arterial reconstruction (HAR) in selected patients with hilar cholangiocarcinoma. ⋯ Left hepatectomy combined with hepatic artery resection and no reconstruction for hilar cholangiocarcinoma is recommended when the following conditions are satisfied: 1) Bismuth-Corlette I, II, or IIIb hilar cholangiocarcinoma; 2) the tumor has infiltrated the hepatic artery with disappearance or markedly reduced arterial flow as detected by intraoperative ultrasound; 3) the color of the liver by visual observation does not change when the hepatic artery has been blocked for 5 min; and 4) removal of the tumor-infiltrated hepatic artery increases the probability of R0 resection for hilar cholangiocarcinoma. For obstructive jaundice from hilar cholangiocarcinoma, we recommend bile duct drainage before resection in patients with elevated preoperative serum TB.
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Review Meta Analysis Comparative Study
Intravenous versus topical tranexamic acid in primary total hip replacement: A systemic review and meta-analysis.
Total hip arthroplasty (THA) is associated with substantial blood loss. Tranexamic acid (TXA) could reduce perioperative blood loss. The optimal administration routine of TXA remains controversial. The objective of the present systemic review and meta-analysis was to compare the effectiveness and safety of various application methods of tranexamic acid in primary THA. ⋯ The topical administration of TXA in THA carried similar hemostasis effects compared with intravenous use without an increased risk of thrombotic complications. No other adverse effect was identified. Topical TXA application was a simple, safe, effective and cost-effective adjunct for blood management following primary THA. For patients with a high risk of thromboembolic events, there may be benefits with topical administration.