Journal of the American College of Surgeons
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Knowledge of the independent risk factors for mortality in colon and rectal surgery can aid surgeons in surgical decision making and in providing patients with appropriate information about the risks of surgery. This study endeavors to identify the risk factors for mortality that are associated with colon and rectal surgery. ⋯ In patients undergoing colorectal surgery, emergent surgery, liver disease, total colectomy, age older than 65 years, chronic renal failure, and malignant tumor are the major risk factors for in-hospital mortality.
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Comparative Study
Outcomes of endoscopic and percutaneous drainage of pancreatic fluid collections arising after pancreatic tail resection.
Up to 15% to 30% of patients develop pancreatic fluid collections (PFCs) after pancreatic tail resection. Percutaneous and endoscopic methods have been used to drain these collections, though few data are available that compare outcomes of these modalities. ⋯ Endoscopic drainage and percutaneous drainage appear to be equally effective and complementary interventions for PFCs occurring after pancreatic tail resection. Primary endoscopic drainage may be associated with shorter hospital stay and fewer CT scans.
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Recently, rib fracture fixation for flail chest has been used increasingly at both academic and nonacademic trauma centers. Although a few small non-US studies have demonstrated a clinical benefit, it is unclear whether this benefit outweighs the added expense and potential perioperative complications related to the procedure. We therefore sought to determine if open reduction and internal fixation of ribs for flail chest (ORIF-FC) represents a cost-effective means for managing these patients. ⋯ Despite the additional cost of surgery, rib fracture fixation dominates the standard of care and should be considered in the management of appropriate flail chest patients.