Annals of surgery
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Multicenter Study
Intraoperative Use of Albumin in Major non-cardiac surgery: Incidence, Variability, and Association with Outcomes.
The impact of albumin use during major surgery is unknown, and a dearth of evidence governing its use in major noncardiac surgery has long precluded its standardization in clinical guidelines. ⋯ Intravenous albumin is commonly administered among noncardiac surgeries with significant inter-institutional variability in use in the United States. Albumin administration was associated with an increased risk of postoperative complications.
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Randomized Controlled Trial
Does the use of Probe-based Near Infrared Autofluorescence Parathyroid Detection Benefit Parathyroidectomy? A Randomized Single-center Clinical Trial.
To evaluate the benefits of probe-based near-infrared autofluorescence (NIRAF) parathyroid identification during parathyroidectomy. ⋯ Probe-based NIRAF detection can be a valuable intraoperative adjunct and educational tool for improving confidence in parathyroid gland identification, while potentially reducing the number of frozen sections required.
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Multicenter Study
Current Outcome after Surgery for Type A Aortic Dissection.
The aim of this study was to evaluate the outcomes of different surgical strategies for acute Stanford type A aortic dissection (TAAD). ⋯ Replacement of the aortic root and aortic arch did not decrease the risk of aortic reoperation in patients with TAAD and should be performed only in the presence of local aortic injury or aneurysm. The relative survival of TAAD patients is poor and suggests that the causes underlying aortic dissection may also impact late mortality despite surgical repair of the dissected aorta.
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Multicenter Study
Association between Antibiotic Redosing Prior to Incision and Risk of Incisional Site Infection in Children with Appendicitis.
To evaluate whether redosing antibiotics within an hour of incision is associated with a reduction in incisional surgical site infection (iSSI) in children with appendicitis. ⋯ Redosing of antibiotics within 1 hour of incision in children who received their initial dose within 6 hours of incision was not associated with reduction in risk of incisional site infection unless cefoxitin was used as the initial antibiotic.
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To evaluate the adoption and clinical impact of endoscopic resection (ER) in early esophageal cancer. ⋯ The use of CT/PET/EUS for the staging of early esophageal cancer is accurate in only 56.3% of patients. ER may increase staging accuracy as it is related to a decrease in upstaging. ER is poorly utilized in staging of early esophageal cancer. Barriers to the implementation of ER as a staging modality should be identified and corrected.