World journal of surgery
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World journal of surgery · Jun 2006
Indications and techniques of extended resection for pancreatic cancer.
The resectability rate and postoperative survival rate for pancreatic carcinoma are poor. Aggressive resection including vascular resection and extended lymphadenectomy represent one strategy for improving survival. This study was carried out to clarify the indications for extended resection, especially vascular resection, for pancreatic carcinoma. ⋯ The most important indication for vascular resection in patients with pancreatic cancer is the ability to obtain cancer-free surgical margins. Otherwise, vascular resection is contraindicated. Extended lymphadenectomy may be not of benefit.
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World journal of surgery · Jun 2006
Randomized Controlled TrialEffects of half-dose aprotinin in off-pump coronary artery bypass grafting.
The effects of half-dose aprotinin in off-pump coronary artery bypass (OPCAB) surgery have not yet been described. The present prospective study was designed to investigate its effects in OPCAB. ⋯ The results indicated that half-dose aprotinin limits fibrinolysis and myocardial injury, and reduces blood loss after OPCAB surgery.
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World journal of surgery · Jun 2006
Randomized Controlled TrialIntraoperative blood salvage in penetrating abdominal trauma: a randomised, controlled trial.
Blood is a scarce and costly resource. Transfusion is often required after major trauma but blood may not be readily available, and concerns remain over the potential adverse consequences of allogeneic blood transfusion. Intraoperative blood salvage (IBS) is used extensively after blunt abdominal trauma, but when blood is contaminated by enteric contents its use has been considered contraindicated. ⋯ In this randomised, controlled trial for patients with penetrating abdominal injuries, IBS led to a significant reduction in allogeneic blood usage with no discernable effect on rates of postoperative infection or mortality.
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World journal of surgery · Jun 2006
Evaluation of Trauma Care capabilities in four countries using the WHO-IATSIC Guidelines for Essential Trauma Care.
We sought to identify affordable and sustainable methods to strengthen trauma care capabilities globally, especially in developing countries, using the Guidelines for Essential Trauma Care. These guidelines were created by the World Health Organization (WHO) and the International Society of Surgery and provide recommendations on elements of trauma care that should be in place at the range of health facilities globally. ⋯ This study identified several low-cost ways in which to strengthen trauma care globally. It also has demonstrated the usefulness of the Guidelines for Essential Trauma Care in providing an internationally applicable, standardized template by which to assess trauma care capabilities.
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World journal of surgery · Jun 2006
Advancing Essential Trauma Care through the partner organizations: IATSIC, ISS-SIC, and WHO.
The publication Guidelines for Essential Trauma Care offers an opportunity to improve trauma care services in an affordable and sustainable fashion, primarily through improved organization and planning. The publication will be useful, however, only if it actually catalyzes improvements in trauma care in health care facilities in individual countries, especially those low- and middle-income countries with the greatest needs. ⋯ This includes such activities as organizing multi-sectoral stakeholders' meetings to adapt the Essential Trauma Care (EsTC) criteria to local needs; conducting trauma care needs assessments to identify priorities for low-cost improvements; having surgical colleges and societies throughout the world endorse the Guidelines; lobbying ministries of health to incorporate the EsTC recommendations into health policy; and seeking to integrate the EsTC recommendations into the 2-year action plans of WHO country offices. In all of these activities, surgeons and others who care for the injured can play a pivotal role, especially working collaboratively with their own ministries of health and WHO country offices.