Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
-
J. Gastrointest. Surg. · Nov 2012
Comparative StudyArtificial neural network model for predicting 5-year mortality after surgery for hepatocellular carcinoma: a nationwide study.
To validate the use of artificial neural network (ANN) models for predicting 5-year mortality in HCC and to compare their predictive capability with that of logistic regression (LR) models. ⋯ In comparison with the conventional LR model, the ANN model in this study was more accurate in predicting 5-year mortality. Further studies of this model may consider the effect of a more detailed database that includes complications and clinical examination findings as well as more detailed outcome data.
-
J. Gastrointest. Surg. · Nov 2012
Hospital-level outcomes associated with laparoscopic colectomy for cancer in the minimally invasive era.
Compared to the open approach, randomized trials have shown that laparoscopic colectomy is associated with a shorter hospitalization without increases in morbidity or mortality rates. With broader adoption of laparoscopic colectomy for cancer in the USA, it is unclear if laparoscopic colectomy continues to be associated with shorter hospitalization and comparable morbidity. ⋯ Higher laparoscopy rates were associated with only slightly lower postoperative morbidity rates and modestly shorter hospitalizations.
-
J. Gastrointest. Surg. · Nov 2012
Parenchyma-sparing resections for pancreatic neuroendocrine tumors.
Parenchyma-sparing pancreatectomy (PSP), including enucleation and central pancreatectomy, has been investigated as an alternative to standard resection for pancreatic endocrine neoplasm, but the benefit/risk of these procedures remains little known. ⋯ In selected patients, with small and low-grade tumors, PSP are associated with excellent overall and recurrence-free survivals. These procedures are associated with an increased postoperative morbidity but an excellent postoperative pancreatic function. Therefore, they should be considered as a valid therapeutic option in selected well-differentiated pancreatic neuroendocrine tumors.
-
J. Gastrointest. Surg. · Oct 2012
Comparative StudyPostoperative intra-abdominal complications assessed by the Clavien-Dindo classification following open and laparoscopy-assisted distal gastrectomy for early gastric cancer.
Laparoscopy-assisted gastrectomy (LAG) has been increasingly used for the treatment of early gastric cancer, and many advantages over open gastrectomy (OG) have been reported. However, only a few reports have assessed postoperative complications following LAG using the Clavien-Dindo classification. ⋯ There was no significant difference in postoperative complication rates between the LAG and the OG groups. The more severe Clavien-Dindo grade III complications, which required surgical interventions, were observed at similar rates between the two groups. Laparoscopic gastrectomy for early gastric cancer is therefore feasible in terms of the incidence and severity of intra-abdominal complications.
-
J. Gastrointest. Surg. · Oct 2012
Review Meta Analysis Comparative StudyLaparoscopic versus open appendectomy for complicated and uncomplicated appendicitis in children.
Appendectomy is one of the most common emergency operations performed in the pediatric population. The aim of this pooled analysis is to compare the outcome from complicated appendicitis (CA) and uncomplicated appendicitis (UA) following laparoscopic appendectomy (LA) and open appendectomy (OA) in children. ⋯ Pooled analysis demonstrates that, in children with uncomplicated acute appendicitis, LA is associated with a reduced hospital stay but broad equivalence in postoperative morbidity when compared with the conventional approach. Although overall morbidity is reduced when the laparoscopic approach is utilized, in cases of CA, the risk of intra-abdominal abscess is increased.