Journal of the American College of Surgeons
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Multicenter Study
Pediatric inpatient humanitarian care in combat: Iraq and Afghanistan 2002 to 2012.
The purpose of this study was to define the scope of combat- and noncombat-related inpatient pediatric humanitarian care provided from 2002 to 2012 by the United States (US) Military in Iraq and Afghanistan. ⋯ Noncombat-related medical care was the primary reason for pediatric humanitarian admissions to United States military combat hospitals in Iraq and Afghanistan from 2002 to 2012. Combat-related injuries have a higher mortality than noncombat injuries or other admissions.
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Multicenter Study
Changes in colorectal cancer care in japan before and after guideline publication: a nationwide survey about D3 lymph node dissection and adjuvant chemotherapy.
The Japanese Society for Cancer of the Colon and Rectum (JSCCR) published clinical guidelines for the treatment of colorectal cancer (CRC) in 2005. To evaluate the impact of these guidelines on clinical practice nationwide, we examined the change in the proportion of patients receiving the recommended CRC treatments. ⋯ D3 dissection for stage II to III disease and adjuvant chemotherapy for stage III disease have become more prevalent and the variation in performance among institutions has decreased in the last decade. Importantly, publication of the guidelines has accelerated the spread of surgical standards.
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Multicenter Study
The importance of extreme weight percentile in postoperative morbidity in children.
Anthropometric data are important indicators of child health. This study sought to determine whether anthropometric data of extreme weight were significant predictors of perioperative morbidity in pediatric surgery. ⋯ Both extremely high and extremely low weight percentile scores can be associated with increased postoperative complications after controlling for clinical variables.
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Multicenter Study
Management of anastomotic leakage in a nationwide cohort of colonic cancer patients.
The mortality associated with anastomotic leakage (AL) after colonic cancer surgery is high and management often results in permanent fecal diversion. Preservation of bowel continuity in combination with proximal loop diversion (salvage) may reduce the number of permanent ostomies without jeopardizing safety. ⋯ Patients with Hinchey I-II and small anastomotic defect were safely managed by anastomotic salvage, which reduced the risk of permanent fecal diversion. Anastomotic salvage is a viable option for this subset of patients.