Surgical endoscopy
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Comparative Study
Laparoscopic colectomy for colon adenocarcinoma: an 11-year retrospective review with 5-year survival rates.
Laparoscopic colectomy for the management of colon cancer remains a controversial therapeutic option, especially when the outcomes are compared with the historically accepted survival data and recurrence rates after open surgery. The purpose of this study was to evaluate the 5-year overall and disease-free survival rates after laparoscopic colon resection for invasive colon adenocarcinoma. ⋯ For this specific cohort of patients undergoing curative laparoscopic colectomies for invasive colon adenocarcinoma, the mean follow-up was > 5 years. Overall survival and disease-free survival for stage I, II, and III colon cancer as well as for stages I-III combined are favorable and comparable to historically acceptable open colectomy survival rates. Overall survival and disease-free survival after laparoscopic colectomy for invasive colon cancer is no worse, and perhaps better than, the previously reported rates for the same procedure done by an open technique.
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Electrical stimulation of the phrenic nerve motor point of the diaphragm through laparoscopic implantation of a pacing system is an option for high spinal cord-injured patients with chronic respiratory insufficiency. This study assesses the operative learning curve for the initial series of patients. ⋯ Analysis of every step of this investigational procedure enabled us to make rapid changes in surgical protocol, leading to decreases in operative times and expectant improvements in patient safety and efficacy. In this series, analysis was the key to developing a low-risk cost-effective outpatient diaphragm pacing system.
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Case Reports
The value of endoscopic diagnosis and the treatment of pancreas injuries following blunt abdominal trauma.
Injuries to the pancreas following blunt abdominal trauma are rare due to its protected retroperitoneal position. Many pancreatic lesions remain unnoticed at first and only become apparent when complications arise or during treatment of other injuries. The mortality rate is between 12 and 30%, and if treatment is delayed it is as high as 60%. ⋯ The major advantage of the prompt retrograde discription of the pancreatobiliary system after an accident in which pancreas involvement is suspected is the more precise assessment of the extent of the injuries. If a stent is placed in the same session, it is possible to carry out definitive and interventional treatment.
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Because of the growing interest in surgery to treat morbid obesity, this study examined changes in the utilization and in-hospital outcomes of bariatric surgery in the United States over a 10-year period. ⋯ The annual rate of bariatric surgery in the United States increased nearly six fold between 1990 and 2000, with little change in in-hospital morbidity and mortality. This appears to be driven largely by the increasing popularity of gastric bypass procedures.