1,720,957 research outputs found
Laparoscopic reversal of Hartmann procedure: is it safe and feasible?
No full textAbstract
The Hartmann procedure (HP) consists of a sigmoidectomy followed by a terminal colostomy in the left iliac fossa and closure of the rectal stump. Although done as a temporary procedure, up to 74 % of patients will not have stoma reversal with subsequent negative impact on the quality of life. A literature search was performed using MEDLINE (PubMed), The Cochrane Library, and Google Scholar, and the articles from January 2000 until December 2015, edited in English, Italian and French, prospective or retrospective, were analyzed. Outcome variables included number of patients, mean age, sex, etiology of Hartmann's procedure, time interval between initial procedure and reversal procedure (in days), mean operative time (in minutes), number of patients converted to open surgery, causes of conversion, length of hospital stay, mortality, and complication rates. For the purpose of this review, only 21 studies were considered for the final analysis and a total of 681 patients were evaluated. The mean time interval between the initial procedure and the reversal (reported in 18 articles) was 181.6 days (range 95-330 days), while the mean operative time (reported in 20 articles) was 163.2 min (range 62-285). Overall, 80 patients (11.7 %) were converted to open technique. The length of hospitalization was between 3 and 12 days. The mortality rate was reported in 19 articles and was 0.7 % (5 patients). 113 patients (16.6 %) underwent post-operative complications. The HP reversal is a challenging procedure, but it can be safely performed laparoscopically providing various advantages when compared to the open technique and it should be proposed only to a selected group of patients, young and without a severe peritonitis at the first operation
Long term outcome of conversion in laparoscopic colorectal surgery
No full textObjective: Conversion rates in colorectal laparoscopic surgery
vary from 8 to 29% in the Literature. An increased postoperative
morbidity and prolonged hospital stay have been described as
the main adverse outcomes in converted patients.
Some studies suggest a negative influence of conversion on the
oncologic outcome, but consistent data are still lacking. This study
evaluates the impact of conversion and analyze the differences in
the oncologic outcome of patients who underwent laparoscopic
resection for colorectal cancer.
Methods: A monocentric retrospective study on 247 patients
operated for colorectal cancer between 2004 and 2007 was performed.
The operative results and long-term outcomes of 44
patients with conversion (22%) were compared both with 200 cases
of successful laparoscopic and 103 open operations. We considered
as conversion a widening or an anticipation of a Pfannenstiel
incision, an upfront midline or transverse laparotomy.
Results: Median follow up was 56 months. Our results show
that the disease-free survival and local recurrence (6.81% in the
converted group) were not significantly worse by the presence of
conversion in laparoscopic cancer resections.
Conclusions: Conversion should not be viewed as a complication
but as a solution to overcome the limitations of laparoscopic
surgery. The adoption of a standardized operative strategy from
an experienced team, together with an early and prompt decision
for conversion and careful patients selection may improve the outcome
of converted patients
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Epidemiology
No full textThis chapter analyzes the epidemiology of rectal cancer, first of all on a global
scale, then concentrating on the situation in the USA, with reference to the
great number of publications available, and finally looking at the situation in
Italy, which the authors are most familiar with
Postoperative Complications
No full textIn this chapter we classify the complications of rectal surgery into early and
late, according to the moment when they usually occur. For all the complications
we have indicated the therapy, in some cases more than one, recently
reported in literature. Late complications connected to lesions of the nerve
plexus are treated in the dedicated chapter
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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