Canadian journal of surgery. Journal canadien de chirurgie
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Few studies have examined perioperative outcomes in nonagenarians undergoing abdominal surgery, and fewer have reported on 1-year mortality. Our objectives were to determine the outcomes of abdominal surgery in nonagenarians and to assess the performance of Physiologic and Operative Severity Score for enUmeration of Mortality and morbidity (POSSUM) and Portsmouth-POSSUM (p- POSSUM) as predictors of mortality. ⋯ Nonagenarians undergoing abdominal surgery have substantial operative morbidity and mortality, particularly in emergent surgical cases. Nearly 50% of patients who undergo emergency procedures die within 1 year after surgery. The POSSUM and p-POSSUM scoring systems were not reliable predictors of in-hospital mortality.
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Comparative Study
Resident self-assessment of operative experience in primary total knee and total hip arthroplasty: Is it accurate?
A prerequisite for a valuable surgical case log is the ability to perform an accurate self-assessment. Studies have shown mixed results when examining residents' ability to self-assess on varying tasks. We sought to examine the correlation between residents' self-assessment and staff surgeons' evaluation of surgical involvement and competence in performing primary total knee (TKA) and hip arthroplasty (THA). ⋯ This study supports the ability of orthopedic residents to perform self-assessments of their degree of involvement and competency in primary TKA and THA. Staff surgeons' assessment of resident involvement correlated highly with the surgical skills assessment form. Self-assessment is a valuable addition to the surgical case log.
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Review Meta Analysis Comparative Study
Management of chest tubes after pulmonary resection: a systematic review and meta-analysis.
We performed a systematic review and meta-analysis to determine the effect of suction with water seal, compared with water seal alone, applied to intra pleural chest tubes on the duration of air leaks in patients undergoing pulmonary surgery. ⋯ No differences were identified in terms of duration of air leak, incidence of prolonged air leak, duration of chest tubes and duration of hospital stay when chest tubes were placed to suction rather than water seal. Chest tube suction appears to be superior to water seal in reducing the incidence of pneumothorax; however, the clinical significance of this finding is unclear.