World journal of surgery
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World journal of surgery · Feb 2012
Survival after lung metastasectomy in colorectal cancer patients with previously resected liver metastases.
Resection of hepatic metastases is indicated in selected stage IV colorectal cancer (CRC) patients. A minority will eventually develop pulmonary metastases and may undergo lung surgery with curative intent. The aims of the present study were to assess clinical outcome and identify parameters predicting survival after pulmonary metastasectomy in patients who underwent prior resection of hepatic CRC metastases. ⋯ Resection of lung metastases from CRC patients may result in prolonged survival, even after previous hepatic metastasectomy. Yet, prolonged disease-free survival remains the exception, and seems to occur only in patients with a single lung lesion.
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World journal of surgery · Feb 2012
Axillary and supraclavicular recurrences are rare after axillary lymph node dissection in breast cancer.
This study was designed to evaluate the incidence of and risk factors for axillary recurrence (AR) and supraclavicular recurrence (SR) in breast cancer patients with axillary lymph node dissection. ⋯ AR and SR are rare events that often are detected concomitantly with distant metastases. SRs are associated with aggressive disease and poor survival. Our results also suggest that regional RT reduces regional recurrences in N2-N3 patients but not in N1 patients, but the retrospective, nonrandomized study setting renders this conclusion as uncertain.
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World journal of surgery · Feb 2012
Effects of seat belt usage on injury pattern and outcome of vehicle occupants after road traffic collisions: prospective study.
Injury and death from road traffic collisions (RTCs) is a major health problem worldwide. The seat belt is the most important RTC safety innovation to reduce injury severity and death from RTCs. We aimed to study the effects of seat belt usage on injury patterns and outcomes of restrained vehicle occupants compared with unrestrained occupants after RTCs. ⋯ Seat belt usage reduces the severity of injury, hospital stay, and number of operations in injured patients. Seat belt compliance is low in our community. More legal enforcement of seat belt usage is mandatory to reduce the severity of injury caused by RTCs.
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World journal of surgery · Feb 2012
Comparative StudyEnhanced recovery program following colorectal resection in the elderly patient.
The enhanced recovery program (ERP) aims to reduce the metabolic response to surgery, hastening recovery and shortening hospital stay. Concerns exist regarding morbidity and hospital stay in elderly patients. The present study aimed to compare the outcomes and compliance of elderly patients managed by an ERP protocol with a younger group. ⋯ An enhanced recovery program is feasible for colorectal surgery patients ≥ 80 years of age, with similar compliance as the younger group to some aspects of the protocol and an acceptable readmission rate. Attention to improving compliance in the postoperative phase is necessary, particularly in such high-risk patients, as such improvement may reduce the morbidity and mortality.
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World journal of surgery · Feb 2012
Incidence and prevention of postoperative venous thromboembolism: are they meaningful quality indicators in Japanese health care settings?
Venous thromboembolism (VTE) epidemiology varies widely across surgical procedures. At present, there are few epidemiologic reports regarding VTE in Japan. Japanese VTE prophylaxis guidelines recommend a risk-based approach based on previous epidemiologic statistics. VTE includes deep vein thrombosis (DVT) and pulmonary embolism (PE). PE prevention is the main goal, although the relation between PE and DVT is still controversial. ⋯ Our results are consistent with established data regarding DVT and PE incidence. Administrative data available in Japan provides a powerful epidemiologic tool to characterize rare diseases such as DVT and PE. DVT is not a suitable quality indicator in Japan. However, PE is too rare to be considered a rate-based outcome indicator, and VTE prophylaxis is [corrected] widely applied to be used as a process indicator. VTE measurement is not a useful quality indicator in Japan to compare hospitals but provides a longitudinal self-survey.