American journal of surgery
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Comparative Study
Liver allograft outcomes after laparoscopic-assisted and minimal access live donor hepatectomy for transplantation.
The critical shortage of deceased organ donors has led to live-donor hepatectomy as an alternative donor option for transplantation. Although laparoscopic hepatectomy has been well described for management of liver tumors and can be performed safely, few studies have examined early recipient allograft outcomes after laparoscopic live-donor hepatectomy. We describe our initial experience with laparoscopic-assisted and minimal-access donor hepatectomy and its potential as a safe alternative with graft function comparable with open resection in live-donor liver transplantation. ⋯ Our experience shows that LALD or MA live-donor hepatectomy is a safe procedure and produces early graft function comparable with standard OLD hepatectomy. Multicenter, larger-volume experience will determine the widespread application of this technique.
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To investigate the relationship between nodule size and malignancy and the correlation between the dimensional parameter and fine-needle aspiration biopsy (FNAB) in patients with a nodular goiter. ⋯ Nodule size does not appear to be a reliable parameter to improve the clinical management of a nodular goiter because of a high variability between size of nodular area and tumor diameter.
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Published comparisons of laparoscopic (laparoscopic distal pancreatectomy [LDP]) to open distal pancreatectomy (ODP) identify improved lengths of stay (LOS) after LDP but do not include data on readmissions. ⋯ Adding readmission LOS to initial LOS eliminates the perceived effect of LDP to accelerate recovery.
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Randomized Controlled Trial Multicenter Study
Prospective randomized controlled trial of traditional laparoscopic cholecystectomy versus single-incision laparoscopic cholecystectomy: report of preliminary data.
This study presents preliminary data from a prospective randomized multicenter, single-blinded trial of single-incision laparoscopic cholecystectomy (SILC) versus standard laparoscopic cholecystectomy (4PLC). ⋯ Preliminary results from this prospective trial showed SILC to be safe compared with 4PLC although operative times were longer. Cosmetic scores were higher for SILS compared with 4PLC. Satisfaction scores were similar although both groups reported a significantly higher preference towards SILC.
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Our institution initiated the implementation of the Surviving Sepsis Campaign guidelines in 2006. We hypothesize that the addition of a surgical intensivist improved results more than the implementation of the guidelines alone. ⋯ Implementation of evidence-based guidelines decreased LOS and decreased cost in our surgical intensive care unit. By adding the expertise of a surgical intensivist, we reduced LOS, cost, and relative risk of death even further than using the guidelines alone.