Journal of the American College of Surgeons
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Clinical Trial
Robotic Pancreaticoduodenectomy Is the Future: Here and Now.
This study was undertaken to examine our outcomes after robotic pancreaticoduodenectomy and to compare our outcomes with predicted outcomes using the American College of Surgeons (ACS) NSQIP Surgical Risk Calculator and with outcomes reported through ACS NSQIP. ⋯ Our patients were not a select group, they were like those reported in ACS NSQIP. Their outcomes after robotic pancreaticoduodenectomy were like or better than predicted outcomes or national data. Our mortality was high because of preoperative ill health (eg renal failure) and cardiac risk. Although we believe our results will continue to improve, our current data document the salutary benefits of minimally invasive robotic pancreaticoduodenectomy.
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Observational Study
Surgical Site Infection after Primary Closure of High-Risk Surgical Wounds in Emergency General Surgery Laparotomies and Closed Negative-Pressure Wound Therapy.
We hypothesized that the universal adoption of closed wounds with negative pressure wound therapy (NPWT) in emergency general surgery patients would result in low superficial surgical infection (SSI) rates. ⋯ Primary closure of high risk incisions combined with NPWT is associated with acceptably low SSI rates. Due to the low morbidity and decreased cost associated with this technique, primary closure with NPWT should replace open wound management in the emergency general surgery population.