World journal of surgery
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World journal of surgery · Aug 2009
Modified maximal thymectomy for thymic epithelial tumors: predictors of survival and neurological outcome in patients with thymomatous myasthenia gravis.
Thymic epithelial tumors are characterized by slow growth and variable malignant behavior. We present our experience on the surgical management of these tumors. ⋯ Modified maximal thymectomy is safe and efficient in the treatment of thymomas. WHO histology is the prime determinant of tumor aggressiveness and patient survival. Paraneoplastic myasthenia gravis and its outcome after thymectomy is significantly correlated with the WHO classification subtypes; however, lower CSR rates are not necessarily associated with more aggressive histological subgroups.
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World journal of surgery · Aug 2009
Value of MELD and MELD-based indices in surgical risk evaluation of cirrhotic patients: retrospective analysis of 190 cases.
Recent studies have suggested that the Model for End-Stage Liver Disease (MELD) may represent a promising alternative to the Child-Turcotte-Pugh classification as a predictive factor of operative mortality and morbidity. This study was designed to evaluate the value of MELD and four MELD-based indices (iMELD: integrated MELD; MESO: MELD to sodium ratio; MELD-Na: MELD with incorporation of sodium; MELD-XI: MELD excluding the International Normalized Ratio) in the quantification of surgical risk for patients with cirrhosis and compare its prognostic value with the Child-Turcotte-Pugh classification and two derived scores (proposed by Huo and Giannini, respectively). ⋯ In this study, iMELD was a useful predictive parameter of operative mortality for patients with cirrhosis submitted to elective procedures. Further studies are necessary to define the relevance of MELD-based indices in the individual surgical risk evaluation.
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World journal of surgery · Aug 2009
Risk factors for complications after laparoscopic surgery in colorectal cancer patients: experience of 401 cases at a single institution.
Laparoscopic surgery is widely used for the treatment of colorectal cancer, but little is known about perioperative risk factors for complications. ⋯ We identified intraoperative management such as low operative infusion rate is one of the independent significant risk factors for complications after laparoscopic surgery for colorectal cancer in addition to patient characteristics and surgical procedure.