1,721,040 research outputs found
Open adrenalectomy in the era of laparoscopic surgery: a review
No full textOpen adrenalectomy still plays an important role in adrenal surgery. A review of the current literature has been carried out to discuss the main indication to open adrenalectomy with regards to the main adrenal pathologies. The authors underlined the role of open adrenalectomy on the basis of personal experience and a literature review. Indication to open adrenalectomy for adrenal cysts, myelolipomas, pheochromocytomas, metastases, adrenocortical carcinomas and tumour recurrences were analysed and discussed. Open adrenalectomy has still an important role in several adrenal pathologies: it is mandatory in some specific situations, such as big lesions, risk of malignancy, emergency settings and in case of recurrent tumoral disease
Reduced duration of stay after elective colorectal surgery during the peak phase of COVID-19 pandemic: A positive effect of infection risk awareness?
No full textBackground: While elective surgery was shut down in most settings during the 2019 novel coronavirus
pandemic, some referral centers were designated as surgery hubs. We sought to investigate how the
pandemic scenario impacted the quality of a long-established enhanced recovery protocol colorectal
surgery program in 2 referral centers, designated as colorectal surgery hubs, located in the epicentral
Italian regions hardest hit by the pandemic.
Methods: We compared short-term outcomes of patients undergoing major colorectal surgery with a
long-established enhanced recovery protocol during the coronavirus disease 2019 outbreak occurred in
2020 (group A) with the correspondent timeframe of 2019 (group B). Primary outcomes were morbidity
and mortality, duration of stay, and readmission rate.
Results: One hundred and thirty-six patients underwent major colorectal surgery in group A and 173 in
group B. Postoperative complications and readmission rate were comparable between the 2 groups.
Oncologic case-log was predominant in group A compared with group B (73.5 vs 61%; P 1⁄4 .01). A
significantly shorter overall duration of stay was found in group A (P < .001). Uncomplicated patients of
group A had a shorter duration of stay when compared with uncomplicated patients of group B (P 1⁄4
.008).
Conclusion: Under special precautionary measures, major colorectal surgery can be undertaken on
elective basis even during coronavirus disease 2019 pandemic with reasonable results. A reduction of
duration of stay within a long-established enhanced recovery protocol colorectal surgery program was
observed during the coronavirus disease 2019 pandemic occurred in 2020 in comparison with the
correspondent timeframe of the previous year without compromising short-term outcomes. The
pandemic uncovered the positive impact of patients’ commitment to reducing duration of stay as the
empowered risk awareness likely promoted their compliance to the enhanced recovery protoco
A critical and comprehensive systematic review and meta-analysis of studies comparing intracorporeal and extracorporeal anastomosis in laparoscopic right hemicolectomy
Full text linkPurpose: Two main techniques are commonly used during laparoscopic right hemicolectomy in order to perform the ileocolic anastomosis: intracorporeal (IA) and extracorporeal (EA). The aim of this study was to evaluate the safety of the two techniques. Methods: A systematic review was carried out to identify studies comparing IA and EA. The primary endpoint was anastomotic leakage. The secondary endpoints were intra- and postoperative results. A meta-analysis was carried out using the random-effects model. Results: Fourteen studies matched the selection criteria, enrolling 1717 patients (50.3 % IA, 49.7 % EA). The anastomotic leakage was similar in the IA and the EA groups (3.4 vs. 4.6 %, respectively) with a risk difference (RD) of −0.01 (95 % CI = −0.03 to 0.01; P = 0.120). IA group had lower overall complication rate (27.6 vs. 38.4 %; RD = −0.15; 95 % CI = 0.27 to −0.04; P = 0.009) and wound infection rate (4.9 vs. 8.9 %; RD = 0.52; −0.03; 95 % CI = −0.06 to −0.01; P = 0.030). Time to first oral intake (weighted mean difference (WMD) = −1; 95 % CI = −1.59 to −0.41; P < 0.001), length of hospital stay (WMD = −1.13; 95 % CI = −1.90 to −0.35; P = 0.004) and minilaparotomy size (WMD = −26; 95 % CI = −38 to −13; P < 0.001) were shorter in IA patients. The incisional hernia rate was lower in the IA group (2.3 vs. 13.7 %) with an RD of −0.09 (95 % CI = −0.17 to −0.02; P = 0.020). There were no differences in operative time, blood loss, conversion, internal hernia, reoperation, mortality, time to first flatus and defecation, analgesic required, number of lymph nodes harvested and length of distal margin. Conclusions: Laparoscopic right hemicolectomy with IA is a safe alternative to EA. Additional well-structured, prospective randomised trials are needed to confirm all the advantages regarding postoperative results which were pointed out in our study
Laparoscopic distal pancreatectomy: many meta-analyses, few certainties
Full text linkIn recent years, an increasing of the level of evidence occurred with a significant number of meta-analyses. A question remains open: can LDP be considered the “new gold standard” for benign and malignant body–tail pancreatic disease? A systematic literature search was conducted to identify all meta-analyses published up to 2016. The primary endpoint was to evaluate the clinical safety of LDP. The secondary endpoints were to evaluate: the length of hospital stay (LOS), readmission rate, postoperative pancreatic fistula (POPF), overall postoperative morbidity and oncologic safety. Nine studies were found to be suitable for the analysis. Data regarding clinical safety were extractable in all meta-analyses but a “between study” homogeneity was available only in 7. The safety of LDP was sustained by six meta-analyses in benign/low grade of malignancy body–tail pancreatic lesions, by one in ductal adenocarcinoma (PDAC). LDP has a shorter LOS compared to open distal pancreatectomy (ODP), demonstrated by three meta-analyses. Readmission rate in LDP procedures was lower than in ODP; these data are sustained by one meta-analysis. LDP is not inferior to ODP regarding the occurrence of POPF (seven meta-analyses); overall morbidity rate was lower in LDP than ODP for benign or low-grade malignant tumor. The use of the LDP in PDAC is sustained from one study. In conclusion, LDP can be considered a safe alternative to ODP. LDP could have some advantages but the data do not permit to define this procedure as the first choice or as the new gold standard
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
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
- …
