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13 papers 1000+ followers contains papers relared to general surgery
By Yasser Abbas Sr Consultant general surgery
H M Park, S-S Han, E C Lee, S D Lee, H M Yoon, B W Eom, S H Kim, K W Ryu, S-J Park, Y W Kim, B Park
BACKGROUND: Skin antiseptic agents are used to prevent surgical-site infection (SSI); few trials have reported the superiority of any specific agent in clean-contaminated abdominal surgery. This RCT was designed to compare the effectiveness of chlorhexidine gluconate and povidone-iodine. METHODS: Consecutive patients who underwent clean-contaminated upper gastrointestinal or hepatobiliary-pancreatic open surgery between 2011 and 2014 were assigned randomly to either chlorhexidine gluconate or povidone-iodine...
January 2017: British Journal of Surgery
Manjusha Rentala, Shari Andrews, Allison Tiberio, Kumar Alagappan, Tammy Tavdy, Patrick Sheppard, Robert Silverman
OBJECTIVES: The objective of the study is to evaluate whether patients with cellulitis can be safely discharged from a 24-hour clinical decision unit (CDU) with home infusion of intravenous (IV) antibiotics. METHODS: Clinical decision unit patients receiving IV antibiotics for cellulitis were screened for enrollment in a home infusion therapy (HIT) program. Inclusion criteria were patient ability and willingness to administer IV antibiotics at home and insurers' approval of home infusion services...
July 2016: American Journal of Emergency Medicine
Samuel Minaker, Cailan MacPherson, Allen Hayashi
BACKGROUND: Port placement injuries are a potentially devastating complication of laparoscopic surgery. Ultrasound assessment for visceral slide has the ability to preoperatively determine adhesion-free areas. The utility of this technique has not been studied when performed by surgeons. METHODS: Surgeons without expertise in ultrasound were taught the visceral slide technique. Patients with a history of abdominal surgery were then assessed for adhesion-free areas on the abdominal wall...
May 2015: American Journal of Surgery
Jeffrey S Bender, Teodora O Nicolescu, Susan B Hollingsworth, Krystal Murer, Kristina R Wallace, William J Ertl
BACKGROUND: Third-party payer reimbursements will likely continue to decrease. Therefore, it is imperative for operating rooms (ORs), often a hospital's largest revenue source, to improve efficiency. We report the outcome after 3 years of a lean, Six Sigma program to improve OR utilization. METHODS: In January 2011, our hospital system instituted a facility-wide approach to address the problem of OR efficiency. Interprofessional teams were formed to examine all aspects of OR use...
March 2015: American Journal of Surgery
David W Rittenhouse, Pei-Wen Lim, Lawrence A Shirley, Karen A Chojnacki
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors in adults. They frequently occur in the stomach. Gastric GISTs typically present as a gastrointestinal bleed but can sometimes cause obstructive symptoms such as nausea and vomiting. We present a patient with a gastric GIST and liver metastases who during treatment with iminitab therapy presented with an acute gastric outlet obstruction. A computed tomography scan revealed a gastroduodenal intussusception of the gastric GIST. The patient underwent a laparoscopic exploration and resection of the GIST...
April 2013: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Yang-Yuan Chen, Tsung-Wei Chen, Yung-Fang Chen
No abstract text is available yet for this article.
September 2013: Gastroenterology
Jia-Hua Yang, Min Zhang, Zhi-Hua Zhao, Yu Shu, Jun Hong, Yi-Jun Cao
Schwannomas are rarely observed in the gastrointestinal tract. The most common symptoms of a gastric schwannoma are abdominal pain or dyspepsia, gastrointestinal bleeding, and an abdominal mass. Many gastric schwannomas are asymptomatic and are discovered incidentally or at postmortem. The diagnosis of a schwannoma is based on immunohistochemical positivity for S-100 protein. We present a case report of a rare complication of gastric schwannoma causing gastroduodenal intussusception that was successfully managed by a Billroth II distal gastrectomy...
February 21, 2015: World Journal of Gastroenterology: WJG
L Lorente-Poch, J J Sancho, S Ruiz, A Sitges-Serra
BACKGROUND: Parathyroid failure is the most common complication after total thyroidectomy but factors involved are not completely understood. Accidental parathyroidectomy and parathyroid autotransplantation resulting in fewer than four parathyroid glands remaining in situ, and intensity of medical treatment of postoperative hypocalcaemia may have relevant roles. The aim of this study was to determine the relationship between the number of parathyroid glands remaining in situ and parathyroid failure after total thyroidectomy...
March 2015: British Journal of Surgery
Syed Nabeel Zafar, Augustine Obirieze, Babawande Adesibikan, Edward E Cornwell, Terrence M Fullum, Daniel D Tran
IMPORTANCE: There is growing evidence in support of performing early laparoscopic cholecystectomy (LC) for acute cholecystitis. However, the definition of early LC varies from 0 through 10 days depending on the research protocol. The optimum time to perform early LC is still unclear. OBJECTIVES: To determine whether outcomes after early LC for acute cholecystitis vary depending on time from presentation to surgery and to determine the optimum time to perform LC for acute cholecystitis...
February 2015: JAMA Surgery
Thomas C Tsai, E John Orav, Ashish K Jha
IMPORTANCE: Despite policies aimed at incentivizing clinical integration, few data exist on whether fragmentation of care is associated with worse outcomes for elderly patients undergoing major surgery. OBJECTIVE: To determine whether postdischarge surgical care fragmentation is associated with worse outcomes and whether distances between hospitals explain differences in patient outcomes. DESIGN, SETTING, AND PARTICIPANTS: We used the 100% Medicare inpatient file for claims from January 1, 2009, through November 30, 2011...
January 2015: JAMA Surgery
Peter J Allen, Mithat Gönen, Murray F Brennan, Adjoa A Bucknor, Lindsay M Robinson, Marisa M Pappas, Kate E Carlucci, Michael I D'Angelica, Ronald P DeMatteo, T Peter Kingham, Yuman Fong, William R Jarnagin
BACKGROUND: Postoperative pancreatic fistula is a major contributor to complications and death associated with pancreatic resection. Pasireotide, a somatostatin analogue that has a longer half-life than octreotide and a broader binding profile, decreases pancreatic exocrine secretions and may prevent postoperative pancreatic fistula. METHODS: We conducted a single-center, randomized, double-blind trial of perioperative subcutaneous pasireotide in patients undergoing either pancreaticoduodenectomy or distal pancreatectomy...
May 22, 2014: New England Journal of Medicine
Jérome Zakine, David Samarcq, Emmanuel Lorne, Mona Moubarak, Philippe Montravers, Sadek Beloucif, Hervé Dupont
BACKGROUND: Ketamine decreases postoperative morphine consumption, but its optimal dosing and duration of administration remain unclear. In this study, we compared the effects of ketamine administration on morphine consumption limited to the intraoperative period, or continued for 48 h postoperatively. METHODS: Eighty-one patients scheduled for abdominal surgery were prospectively randomized under double-blind conditions to three groups: (1) PERI group receiving intraoperative and postoperative ketamine for the first 48 h after surgery (2 microg x kg(-1) x min(-1) after a 0...
June 2008: Anesthesia and Analgesia
Namir Katkhouda, Rodney J Mason, Shirin Towfigh, Anna Gevorgyan, Rahila Essani
SUMMARY BACKGROUND DATA: The value of laparoscopy in appendicitis is not established. Studies suffer from multiple limitations. Our aim is to compare the safety and benefits of laparoscopic versus open appendectomy in a prospective randomized double blind study. METHODS: Two hundred forty-seven patients were analyzed following either laparoscopic or open appendectomy. A standardized wound dressing was applied blinding both patients and independent data collectors...
September 2005: Annals of Surgery
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