International journal of surgery
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To assess the frailty and the incidence of delirium in elderly patients undergoing elective and acute colorectal surgery in correlation with morbidity and mortality. ⋯ High incidence of delirium was found in both acute and elective colorectal surgery. Delirium was associated with adverse outcomes.
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Acute appendicitis is a common surgical diagnosis. We investigated the use of blood markers (WCC, CRP and serum bilirubin) and diagnostic imaging (USS and CT scan) to arrive at this diagnosis, as well as the surgical approach used for appendicectomy. ⋯ Serum bilirubin has utility in diagnosing acute appendicitis, irrespective of whether perforation has occurred. CT scanning should be considered the first line imaging modality for investigation of acute appendicitis if diagnosis is in doubt.
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Randomized Controlled Trial
Comparative study between duct to mucosa and invagination pancreaticojejunostomy after pancreaticoduodenectomy: a prospective randomized study.
The ideal technical pancreatic reconstruction following pancreaticoduodenectomy (PD) is still debated. The aim of the study was to assess the surgical outcomes of duct to mucosa pancreaticojejunostomy (PJ) (G1) and invagination PJ (G2) after PD. ⋯ NCT02142517.
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Review
Strategies to reduce deep sternal wound infection after bilateral internal mammary artery grafting.
Deep sternal wound infections (DSWI) continue to be an infrequent but potentially devastating complication after cardiac surgical procedures. Its prevalence is more after coronary artery bypass grafting using single internal mammary artery (IMA) graft. Bilateral internal mammary artery (BIMA) harvesting carries a higher risk of sternal infection than harvesting single IMA. ⋯ Strategies that reduce DSWI target the modifiable risk factors that include microbiological factors, appropriate antibiotic prophylaxis, tight glycemic control. Surgical strategies to reduce DSWI following BIMA harvest include techniques of IMA harvesting with lesser devascularization of sternum using skeletonized, semiskeletonized and modified pedicle harvest are associated with greater preservation of sternal blood supply and sternal closure and stability techniques. The various strategies to minimize sternal wound infections during preoperative, intra and postoperative periods are summarized in this article.