World journal of surgery
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World journal of surgery · Aug 2014
Extracapsular lymph node involvement is associated with colorectal liver metastases and impact outcome after hepatectomy for colorectal metastases.
Hepatic resection of metastatic colorectal cancer (CRC) has become the treatment of choice for patients after resection of the primary CRC. However, some patients do not benefit from immediate resection because of rapidly progressive disease. The aim of this study was to examine the prognostic value of extracapsular invasion (ECI) of lymph node (LN) metastasis of CRC with liver metastases following liver resection. ⋯ In patients with hepatic CRC metastases, ECI in regional LNs reflects a particularly aggressive behavior, such as a greater number of liver metastases. In CRC patients with liver metastases, ECI in regional LNs might be correlated with poor prognosis following liver resection.
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World journal of surgery · Aug 2014
Comparative StudyEnhanced recovery pathway for urgent colectomy.
Enhanced recovery protocols have been proven to decrease complications and hospital stay following elective colorectal surgery. However, these principles have not yet been reported for urgent surgery procedures. We aimed to assess our initial experience with urgent colectomies performed within an established enhanced recovery pathway. ⋯ Many of the intra-operative and post-operative enhanced recovery items can also be applied to urgent colectomy, entailing outcomes that approach the results achieved in the elective setting.
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World journal of surgery · Aug 2014
Comparative StudyLimited potential for prevention of emergency surgery for femoral hernia.
Femoral hernias are frequently operated on as an emergency. Emergency procedures for femoral hernia are associated with an almost tenfold increase in postoperative mortality, while no increase is seen for elective procedures, compared with a background population. ⋯ Patients who have elective and patients who have emergency femoral hernia surgery differ in previous symptoms and healthcare contacts. Patients who need emergency surgery are often unaware of their hernia and frequently completely asymptomatic prior to incarceration. Early diagnosis and expedient surgery is warranted, but the lack of symptoms hinders earlier detection and intervention in most cases.
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World journal of surgery · Aug 2014
Biography Historical ArticleInsights into Avicenna's contributions to the science of surgery.
An influential Persian scholar of the Islamic Golden Age of Medicine (from the ninth to the twelfth centuries AD), Ibn-e Sina (AD 980-1037), also known by the Latinized name Avicenna, is best remembered for his contributions to various aspects of medicine, particularly surgery. In fact, the art of surgery was a major focus of his attention and practice, and one to which he devoted several chapters of his main medical encyclopedia, Al-Qanun fi al-Tibb (The Canon of Medicine). This article presents a brief review of Avicenna's life, introduce his textbook of medicine, and present his significant contributions to the science of surgery.
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World journal of surgery · Aug 2014
Improving trauma care in low- and middle-income countries by implementing a standardized trauma protocol.
Standardized trauma protocols (STPs) have reduced morbidity and mortality in mature trauma systems. Most hospitals in low- and middle-income countries (LMICs) have not yet implemented such protocols, often due to financial and logistic limitations. We report preliminary findings from a trauma quality improvement (QI) initiative, using and evaluating the impact of a low-cost STP in an LMIC university hospital. ⋯ The institution of an STP at a university hospital in an LMIC has increased the use of vital interventions while decreasing overall LOS for all-cause trauma patients.