This pre-post analysis of patients who received visceral angiography for acute lower gastrointestinal hemorrhage showed that preceding visceral angiography with computed tomographic angiography improves localization of the hemorrhage site. See also the Invited Commentary by Lightner and Russell.
This randomized clinical trial validates the safety and efficacy of video-assisted ablation of pilonidal sinus.
Robotic-assisted pancreatic resection and reconstruction are safe and can reproduce perioperative results seen in open surgery.
Single-institution retrospective review.
Tertiary care center.
Patients undergoing completed robotic-assisted pancreatic resection and reconstruction at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, between October 3, 2008, and February 26, 2010.
Primary pathology, operative time, operative blood loss, perioperative blood transfusions, pancreatic fistula, 90-day morbidity and mortality, and readmission rate.
Thirty patients with a median age of 70 years (range, 32-85 years) underwent completed robotic-assisted pancreatic resection and reconstruction. Procedures were robotic-assisted non-pylorus-preserving pancreaticoduodenectomy (n = 24), robotic-assisted central pancreatectomy (n = 4), and the robotic-assisted Frey procedure (n = 2). The median operative time was 512 minutes (range, 327-848 minutes). The median blood loss was 320 mL (range, 50-1000 mL), with a median length of hospital stay of 9 days (range, 4-87 days). The final diagnoses included periampullary adenocarcinoma (n = 7), pancreatic ductal adenocarcinoma (n = 6), pancreatic neuroendocrine tumor (n = 5), intraductal papillary mucinous neoplasm (n = 4), mucinous cystic neoplasm (n = 3), serous cystic adenoma (n = 2), chronic pancreatitis (n = 2), and solid pseudopapillary neoplasm (n = 1). There was 1 postoperative death. The overall pancreatic fistula rate was 27% (n = 8). The clinically significant pancreatic fistula rate (International Study Group on Pancreatic Fistula grades B and C) was 10% (n = 3). Clavien grade III and IV complications occurred in 7 patients (23%), while Clavien grade I and II complications occurred in 8 patients (27%).
Robotic-assisted complex pancreatic surgery can be performed safely in a high-volume pancreatic tertiary care center with perioperative outcomes comparable to those of open surgery. Advances in robotic technology and increasing experience may improve long operative times.
This review discusses the difficulties associated with diagnosis and treatment of median arcuate ligament syndrome and provides an algorithm to guide workup and intervention.
This case series discusses the inpatient resources, including imaging, nursing overtime, and blood bank needs, that were used to treat 63 individuals injured in the Asiana Airlines flight 214 crash.
This population-based cohort study examines the risk for perinatal complications in women with a history of bariatric surgery by comparing them with mothers without operations and examining the association of the operation-to-birth interval with perinatal outcomes.
This Special Communication describes evidence-based guidelines to enhance the appropriate, safe, and effective practice of parathyroidectomy.
This population-based registry study suggests that stereotactic ablative radiotherapy for non–small cell lung cancer may be a good option among elderly patients with multiple comorbidities.
This narrative review summarizes recent advances in understanding the epidemiology, pathophysiology, diagnosis, and treatment of critical limb ischemia.
Resnick et al investigated the accuracy of computed tomography and magnetic resonance imaging in the clearance of cervical spine injuries. See the Invited Commentary by Schreiber.
This analysis of women with breast cancer in the National Cancer Data Base describes barriers to the use of breast-conserving therapy.