Annals of surgery
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Comparative Study Clinical Trial
Value of surgery in patients with negative imaging and sporadic Zollinger-Ellison syndrome.
To address the value of surgery in patients with sporadic Zollinger-Ellison syndrome (ZES) with negative imaging studies. ⋯ Sporadic ZES patients with negative imaging studies are not rare even in the post-SRS period. An experienced surgeon can find gastrinoma in almost every patient (98%) and nearly one half (46%) are cured, a rate similar to patients with positive imaging findings. Because liver metastases were found in 7%, which may have been caused by a long delay in surgery and all the disease-related deaths occurred in this group, surgery should be routinely undertaken early in ZES patients despite negative imaging studies.
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Clinical Trial
Long-term survival, nutritional autonomy, and quality of life after intestinal and multivisceral transplantation.
To assess long-term survival, graft function, and health-related quality of life (QOL) after visceral transplantation. ⋯ With new tactics to further improve long-term survival including social support measures, visceral transplantation has achieved excellent nutritional autonomy and good QOL.
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This study aims to examine trends of utilization and rates of conversion to open procedure for patients undergoing laparoscopic colon resections (LCR). ⋯ There is a trend of increasing utilization of LCR, with acceptable conversion rates, across hospitals in the United States over the recent years. When feasible, attempted LCR had better outcomes than open colectomy in the immediate perioperative period.
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Comparative Study
Thoracoscopic lobectomy has increasing benefit in patients with poor pulmonary function: a Society of Thoracic Surgeons Database analysis.
Using a national database, we asked whether video-assisted thoracoscopic surgery (VATS) lobectomy is beneficial in high-risk pulmonary patients. ⋯ Poor pulmonary function predicts respiratory complications regardless of approach. Respiratory complications increase at a significantly greater rate in lobectomy patients with poor pulmonary function after thoracotomy compared with VATS. Planned surgical approach should be considered while determining whether a high-risk patient is an appropriate resection candidate.
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To identify all trauma patients with diabetes and compare diabetic hyperglycemia (DH) patients with those with stress-induced hyperglycemia (SIH). ⋯ DM is common in patients with hyperglycemia after trauma. As opposed to DH, SIH is associated with higher mortality after trauma. Further research is warranted to identify mechanisms causing hyperglycemia and subsequent worse outcomes after trauma.