Journal of the American College of Surgeons
-
Prolonged postoperative ileus (POI) is the predominant cause of extended hospitalization after bowel resection surgery. Alvimopan accelerates gastrointestinal recovery, potentially reducing health care costs. We examined the value of alvimopan in reducing prolonged POI and length of stay for patients undergoing abdominal surgery using different definitions of POI. ⋯ The addition of alvimopan to existing treatment pathways for patients undergoing abdominal surgery can reduce overall hospital costs.
-
Liver resection is an effective treatment in select patients with huge hepatocellular carcinoma (HCC, diameter ≥10 cm). This study aimed to develop nomograms for pre- and postoperative predictions of overall survival (OS) for these patients. ⋯ The 2 nomograms achieved accurate pre- or postoperative predictions of long-term survival for patients with huge HCC after liver resection.
-
Although hepatic resection (HR) has been recommended as the first-line treatment option for patients with a solitary tumor, the first-line treatment for patients with multifocal tumors meeting the Barcelona-Clinic Liver Cancer (BCLC) stage A still remains unclear. This study compared outcomes for patients with multifocal tumors meeting the BCLC stage A treated by HR and radiofrequency ablation (RFA). ⋯ For patients with multifocal tumors meeting the BCLC stage A, HR may offer significantly better RFS than RFA, and HR may be considered as the first-line treatment option for those patients.
-
The aim of this study was to evaluate the association between the number of nodes harvested and the rate of node positivity, and to evaluate the effect of carbon nanoparticles (CNPs) in improving lymph node detection and staging accuracy in patients who received neoadjuvant chemoradiotherapy (NCRT) followed by curative resection. ⋯ More precise oncologic prognosis assessment was provided for patients with rectal cancer after NCRT by increasing the number of lymph nodes counted using a dye-tracing method, indicating that the use of CNPs is beneficial.