Articles: cations.
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To clarify whether bowel preparation use or its individual components [mechanical bowel preparation (MBP)/oral antibiotics] impact specific outcomes after colorectal surgery. ⋯ These data clarify the near 50-year debate whether bowel preparation improves outcomes after colorectal resection. MBP with oral antibiotics reduces by nearly half, SSI, anastomotic leak, and ileus, the most common and troublesome complications after colorectal surgery.
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A comprehensive enhanced recovery pathway (ERP) was implemented in patients undergoing laparoscopic colectomy in an attempt to reduce postoperative opioid consumption. We hypothesized that improved local analgesia and increased use of non-opioid pain medication, combined with earlier feeding and ambulation, would allow for earlier return of bowel function and shorter postoperative length of stay (LOS). ⋯ The new ERP, including TAP block and postoperative pain medication protocol limiting I.V. narcotics, is effective in controlling pain in elective partial laparoscopic colectomy. Pain control management together with regimented early feeding and ambulation allow for significantly earlier return of bowel function and shorter postoperative LOS.
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The objective of this study was to examine the ability of Focused Assessment Using Sonography for Trauma (FAST) to discriminate between survivors and nonsurvivors undergoing resuscitative thoracotomy (RT). ⋯ With a high degree of sensitivity for the detection of potential survivors after traumatic arrest, FAST represents an effective method of separating those that do not warrant the risk and resource burden of RT from those who may survive. The likelihood of survival if pericardial fluid and cardiac motion were both absent was zero.
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Comparative Study
Factors Influencing the Decision of Surgery Residency Graduates to Pursue General Surgery Practice Versus Fellowship.
Surgery residency serves 2 purposes-prepare graduates for general surgery (GS) practice or postresidency surgical fellowship, leading to specialty surgical practice (SS). This study was undertaken to elucidate factors influencing career choice for these 2 groups. ⋯ Most graduates who pursue GS practice are confident and content. The decision to pursue GS is strongly influenced by a GS mentor. Lack of confidence may be a more significant factor for choosing SS. These findings suggest opportunities for improvements in confidence and mentorship during residency.