Annals of surgery
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To determine utilization and accuracy of focused assessment with sonography for trauma (FAST) and computed tomography (CT) in a mature military trauma system to inform service provision for future conflicts. ⋯ FAST and CT contribute to triage, guide surgical management, and reduce nontherapeutic laparotomy. When imaging is available, these data challenge current doctrine about inadvisability of nonoperative management of abdominal injury after combat trauma.
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Randomized Controlled Trial
Randomized Phase II Study of the Anti-inflammatory Effect of Ghrelin During the Postoperative Period of Esophagectomy.
A prospective randomized phase II trial was conducted to evaluate the efficacy of ghrelin administration in reducing systemic inflammatory response syndrome (SIRS) duration after esophagectomy. ⋯ Postoperative ghrelin administration was effective for inhibiting inflammatory mediators and improving the postoperative clinical course of patients with esophageal cancer.
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Multicenter Study Comparative Study
Clinical Health Service Research on the Surgical Therapy of Acute Appendicitis: Comparison of Outcomes Based on 3 German Multicenter Quality Assurance Studies Over 21 Years.
The treatment of acute appendicitis has seen changes in diagnosis and therapy in Germany. The objective of this analysis was to assess changes in therapy and outcome after open appendectomy (OA) and laparoscopic appendectomy (LA) over the last 21 years. ⋯ Changes in patient data reflected demographic changes. Preoperative selection leads to 2 clearly defined groups. LA is the most dominant method of current operative therapy. The negative selection in OA group has influenced the worse outcome of that group.
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We describe the technical details and evaluate the safety, feasibility, and usefulness of a combined lateral and abdominal (CLA) approach for laparoscopic resection of liver segments 7 and 8. ⋯ The CLA approach permits safe laparoscopic resection of lesions in the posterosuperior area of segments 7 and 8, allowing surgeons to overcome the difficulties of limited visualization and access to the target lesions.