Annals of surgery
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Evolution of pancreas transplantation: long-term results and perspectives from a high-volume center.
To describe the evolution of pancreas transplantation from 1979 to 2011. The aim was to examine factors influencing long-term patient and graft survival, surgical methods, and risk factors influencing organ performance after transplantation. ⋯ During the last 32 years, many problems in pancreas transplantation have been overcome and it may currently represent the therapeutic gold standard for some patients with diabetes and end stage renal failure.
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Low colorectal (LCRA) and coloanal anastomoses (CAA) are associated with high leakage rate. After such complication, around 17% of patients remain with their stoma. Treatment of failed LCRA and CAA is not frequently proposed. The aim of this study was to evaluate the results of redo surgery in such patients. ⋯ After failed LCRA or CAA, redo anastomosis has a high success rate and acceptable morbidity and function.
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The aim of hyperthermic intraperitoneal chemotherapy (HIPEC) is to eradicate microscopic residual tumor after radical surgical tumor excision in patients with peritoneal carcinomatosis. The common use of antineoplastic agents such as mitomycin C, doxorubicin, or oxaliplatin with hyperthermia fails to eradicate tumors in a significant subset of patients, and alternative approaches to target chemoresistant cells are needed. The induction of reactive oxygen species (ROS) by inhibiting the critical detoxification enzyme superoxide dismutase (SOD) during hyperthermia is an appealing approach to induce death of residual cancer cells. ⋯ Addition of DDC improves the efficacy of existing HIPEC protocols in a safe way and may open the door to a more effective, multimodal HIPEC.
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To identify independent factors influencing job satisfaction of academic surgeons within their first 10 years after board certification. ⋯ Satisfaction in young faculty members mostly relates to research opportunities, clinical autonomy, burnout, and lifestyle. Understanding satisfaction factors may improve productivity and competence.