Journal of the American College of Surgeons
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Review Case Reports Biography Historical Article
Surgical management of inoperable lymphedema: the re-emergence of abandoned techniques.
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Multicenter Study Clinical Trial
Prevalence of adverse intraoperative events during obesity surgery and their sequelae.
Adverse intraoperative events (AIEs) during surgery are a well-known entity. A better understanding of the incidence of AIEs and their relationship with outcomes is helpful for surgeon preparation and preoperative patient counseling. The goals of this study are to describe the incidence of AIEs during bariatric surgery and examine their impact on major adverse complications. ⋯ Incidence of an AIE is not infrequent during bariatric surgery and is associated with much higher risk of major complication. Additional study is needed to assess the association between specific AIEs and short-term complications.
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Multicenter Study
Liver resection for hepatocellular carcinoma ≤3 cm: results of an Italian multicenter study on 588 patients.
The best treatment for patients with small hepatocellular carcinoma (S-HCC) is still controversial. The aim of this study was to evaluate operative and long-term results after liver resection (LR) for S-HCC, defined as tumor ≤3 cm. ⋯ Liver resection for S-HCC has improved over the years, with decreased operative risk. Long-term survival after LR has increased. Despite small tumor size, rates of microsatellite nodules and microvascular invasion are not negligible. Presence of microsatellite lesions was the only variable identified as being associated with poor both OS and DFS.
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Comparative Study
Optimizing clinical and economic outcomes of surgical therapy for patients with colorectal cancer and synchronous liver metastases.
Traditionally, for patients with colorectal cancer with resectable synchronous liver metastases, resections were performed separately. However, the safety and efficacy of simultaneous resection have been demonstrated in selected patients. The purpose of this study was to evaluate outcomes and economic implications of simultaneous and staged resections. ⋯ The simultaneous resection strategy was oncologically equivalent and more cost efficient for patients with primary colorectal cancer presenting with resectable liver metastases. A reduction in overall length of hospital stay was an associated benefit. Future studies should explore the feasibility and clinical implications of policies to maximize the potential for simultaneous resection in this cohort of patients.