Surgery
-
Clinical Trial
Prediction of posthepatectomy liver failure based on liver stiffness measurement in patients with hepatocellular carcinoma.
Posthepatectomy liver failure (PHLF) is a potentially fatal complication, and the accurate prediction of PHLF is essential. Liver stiffness measurement (LSM) has been accepted widely as a noninvasive assessment for liver fibrosis. We aimed to evaluate the usefulness of LSM in predicting PHLF. ⋯ LSM was useful for the prediction of PHLF and the estimation of the safe Rem range.
-
To improve the therapeutic strategy for esophageal squamous cell carcinoma (ESCC), combined neoadjuvant chemotherapy (NAC) followed by operative surgical resection has been applied recently to patients at clinical stages II/III. Our study aimed to elucidate the impact of the circumferential resection margin (CRM) status of surgically resected specimens on the prognosis of patients undergoing neoadjuvant therapy. ⋯ Positive CRM according to CAP criteria after multimodality treatment significantly affects the overall and relapse-free survival of ESCC patients.
-
Milk fat globule-epidermal growth factor-factor VIII (MFG-E8) is a secretory glycoprotein with a known role in inflammation. In sepsis, interleukin (IL)-17 acts as a proinflammatory cytokine to exaggerate systemic inflammation. We hypothesize that MFG-E8 downregulates IL-17 expression in sepsis. ⋯ Our findings demonstrate MFG-E8-mediated downregulation of IL-17 expression, implicating its potential as a novel therapeutic agent against sepsis.
-
Hospital readmission after major surgery is a costly problem that has been associated with patient characteristics. Because hospitals are incentivized to join accountable care organizations, interventions on a hospital or health care system level may help reduce readmissions. Our objective was to identify hospital- and systems-level characteristics associated with readmissions after major operative procedures. ⋯ Select hospital characteristics are associated with readmissions after major operative procedures. Because financial penalties may worsen performance in vulnerable or low-resource settings, policies aimed at reducing readmissions should be attentive to the potential unintended consequences.
-
Intestinal ischemia/reperfusion (I/R) injury can cause a high rate of mortality in the perioperative period. Remifentanil has been reported to provide protection for organs against I/R injury. We hypothesized that remifentanil preconditioning would attenuate the small intestinal injury induced by intestinal I/R. ⋯ Remifentanil preconditioning appears to act via δ- and μ-opioid receptors to protect the small intestine from intestinal I/R injury by attenuating apoptosis of the intestinal mucosal epithelial cells.