Annals of surgery
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Multicenter Study
Multicenter analysis of risk factors for anastomotic leakage after laparoscopic rectal cancer excision: the Korean laparoscopic colorectal surgery study group.
To assess the risk factors for clinical anastomotic leakage (AL) in patients undergoing laparoscopic surgery for rectal cancer. ⋯ Male sex, low anastomosis, preoperative chemoradiation, advanced tumor stage, perioperative bleeding, and multiple firings of the linear stapler increased the risk of AL after laparoscopic surgery for rectal cancer. A diverting stoma might be mandatory in patients with 2 or more of the risk factors identified in this analysis.
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To evaluate the influence of the anatomy of the right posterior bile duct (RPBD) of the donor on biliary complications in the recipients after living-donor liver transplantation (LDLT) using right hemi-liver grafts. ⋯ The anatomy of the RPBD of the donor influenced the biliary outcome in the recipients. A short RBD and a long caudal segment of the RPBD of the donor were significant risk factors for biliary complications in LDLT.
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Controversy exists on the use of mesh in the repair of paraesophageal hernias (PEH). This debate centers around the type of mesh used, its value in preventing recurrence, its short- and long-term complications, and the consequences of those complications compared with primary repair. Decision analysis is a method to account for the important aspects of a clinical decision. The purpose of this study was to determine whether or not the addition of mesh would be superior in PEH repair. ⋯ Depending on what the decision-maker accepts as the recurrence and reoperation rates for these types of repair, either mesh or primary repair may be the treatment of choice. However, the differences between the two are small, and, perhaps, clinically inconsequential.
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To use an evidenced-based approach to better understand the management and treatment of pressure ulcers. ⋯ Although many of these modalities are used, we encourage clinicians and health care providers to consider the evidence-based data when deciding how to most appropriately manage their patients' pressure sores.