ANZ journal of surgery
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ANZ journal of surgery · Oct 2011
Multicenter Study Comparative StudyPerioperative risk analysis for acute respiratory distress syndrome after elective oesophagectomy.
Acute respiratory distress syndrome (ARDS) is a major contributor to respiratory morbidity and mortality after oesophagectomy. Several pre-, intra- and post-operative factors are thought to predispose to its development in the post-oesophagectomy period. The aim of this study was to determine factors predisposing to ARDS in the post-oesophagectomy period. ⋯ Preoperative physiological status as indicated by a preoperative history of chronic respiratory disease and preoperative pulmonary function influenced the post-operative outcome in our patients. The use of perioperative inotropes suggests perioperative cardiorespiratory instability, and could also predispose to the development of ARDS in the post-operative period.
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ANZ journal of surgery · Nov 2008
Multicenter Study Comparative StudyLaboratory risk indicator for necrotizing fasciitis score and the outcomes.
Laboratory risk indicator for necrotizing fasciitis (LRINEC score) is a simple laboratory tool used to distinguish between necrotizing soft-tissue infections (NSTI) and other soft-tissue infections. A LRINEC score of > or =6 is considered as denoting a high risk of necrotizing fasciitis. A certain LRINEC score might also be associated with mortality and other outcomes of patients with NSTI. ⋯ The LRINEC score is associated with the outcomes of patients with NSTI. Patients with a LRINEC score of > or =6 have a higher rate of both mortality and amputation.
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ANZ journal of surgery · Apr 2008
Multicenter Study Clinical TrialPancreatoduodenectomy: role of drain fluid analysis in the management of pancreatic fistula.
Pancreatic fistula remains an important cause of death following pancreatoduodenectomy. There is still uncertainty regarding the use of drains following pancreatoduodenectomy with recent reports suggesting that it might be harmful with increased complications. We evaluated the use of drain fluid analysis in the management of patients following pancreatoduodenectomy. ⋯ The drain fluid analysis did not provide additional information that was not already evident from the clinical picture of the patient. Drain fluid analysis had no effect on patients with a biochemical leak only. Patients who had a significant disruption of their pancreatic anastamosis did not need biochemical analysis as the character, that is, turbidity of the drain fluid was an equally reliable indicator of the underlying pathology.
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ANZ journal of surgery · Nov 2006
Multicenter StudyPerforated diverticulitis managed by laparoscopic lavage.
Traditionally the management of acute diverticulitis complicated by perforation has been the Hartmann's procedure, which may be associated with significant morbidity and mortality and the unpleasantness of a colostomy. We present our early experience in managing perforated diverticulitis acutely by laparoscopic lavage and drainage. ⋯ Laparoscopic lavage and drainage in the acute management of perforated acute diverticulitis may be a promising alternative to more radical procedures, including the Hartmann's procedure. Acute resection should still be carried out in patients found to have faecal peritonitis or who fail to improve following lavage.
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ANZ journal of surgery · Jul 2006
Multicenter Study Comparative StudyOutcomes of patients with orthopaedic trauma admitted to level 1 trauma centres.
Although orthopaedic trauma results in significant disability and substantial financial cost, there is a paucity of large cohort studies that collectively describe the functional outcomes of a variety of these injuries. The current study aimed to investigate the outcomes of patients admitted with a range of orthopaedic injuries to adult Level 1 trauma centres. ⋯ A large percentage of patients have ongoing pain and disability and a reduced capacity to return to work 6 months after orthopaedic trauma. Further research into the long-term outcomes of patients with orthopaedic injuries is required to identify patient subgroups and specific injuries and procedures that result in high morbidity.