Journal of the American College of Surgeons
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Multicenter Study
Liver planning software accurately predicts postoperative liver volume and measures early regeneration.
Postoperative or remnant liver volume (RLV) after hepatic resection is a critical predictor of perioperative outcomes. This study investigates whether the accuracy of liver surgical planning software for predicting postoperative RLV and assessing early regeneration. ⋯ Preoperative virtual planning of future liver remnant accurately predicts postoperative volume after hepatic resection. Early postoperative liver regeneration is measureable on imaging beginning at 5 days after surgery. Measuring TLV directly from CT scans rather than calculating based on equations accounts for extremes in TLV.
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Multicenter Study
Mortality and management of surgical necrotizing enterocolitis in very low birth weight neonates: a prospective cohort study.
Necrotizing enterocolitis (NEC) is a leading cause of death in very low birth weight (VLBW) neonates. The overall mortality of NEC is well documented. However, those requiring surgery appear to have increased mortality compared with those managed medically. The objective of this study was to establish national birth-weight-based benchmarks for the mortality of surgical NEC and describe the use and mortality of laparotomy vs peritoneal drainage. ⋯ Fifty-two percent of VLBW neonates with NEC underwent surgery, which was accompanied by a substantial increase in mortality. Regardless of birth weight, surgical NEC showed a plateau in mortality at approximately 30%. Laparotomy was the more frequent method of treatment (69%) and of those managed by drainage, 46% also had a laparotomy. The laparotomy alone and drainage with laparotomy groups had similar mortalities, while the drainage alone treatment cohort was associated with the highest mortality.
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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
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
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.