Warfarin users prone to coagulopathy in first 30 days after hospital discharge from gastric bypass.

Background: Lehigh Valley Health Network (LVHN), a nonprofit tertiary care facility in Allentown, Pennsylvania, is an accredited American College of Surgeons Bariatric Surgery Center Network (ACSBSCN) Level 1 site performing 400+ bariatric procedures annually. Bariatric data submission began in April 2008. Complication review revealed that approximately 17 % of patients on chronic anticoagulation (warfarin) therapy preoperatively were readmitted with supratherapeutic international normalized ratios (INRs), postsurgical bleeding, anastomotic ulcer, or other intraluminal hemorrhage.

Methemoglobinemia secondary to benzocaine topical anesthetic.

An 80-year-old white woman with a history of hypertension presented to the Emergency Department with bright red bleeding from the rectum. She was treated with 5 mg of midazolam and benzocaine topical anesthetic spray prior to undergoing colonoscopy and esophageal gastroduodenoscopy. Thirty minutes after endoscopy, the patient became cyanotic and dyspneic; she was suffering from methemoglobinemia, a rare complication secondary to the use of benzocaine topical anesthetic spray.

Early results of laparoscopic surgery for colorectal cancer. Retrospective analysis of 372 patients treated by Clinical Outcomes of Surgical Therapy (COST) Study Group.

Unlabelled: This study was undertaken to determine the early experience of the embers of the COST Study Group with colorectal cancer treated by laparoscopic approaches.

Method: A retrospective review was performed of all patients with colorectal cancer treated with laparoscopy by the COST Study Group before August 1994. Tumor site, stage, differentiation, procedure completion, presence of recurrence (local, distant, trocar site), and cause of death were analyzed.

Laparoscopic versus conventional appendectomy.

Background: The results of recent series suggest remarkable advantages of laparoscopic appendectomy over the conventional open appendectomy. To determine if clear advantages could be established, the charts of all patients admitted to our institution with a presumptive diagnosis of acute appendicitis and subsequent appendectomy were retrospectively reviewed.

Study Design: From January 1990 through June 1992, there were 300 conventional open appendectomies and 66 laparoscopic appendectomies performed.

Laparoscopic colectomy: at what cost?

The purpose of this study was to compare laparoscopic to open colectomy with respect to: 1) morbidity and mortality, 2) adequacy of resection for cancer (margins and number of nodes), 3) operative time, 4) postoperative time for tolerating diet and discharge, and 5) total hospital charges. A historical control group of open colon surgery patients was used. Laparoscopic colectomy was completed in 18/24 patients and 6 were converted to open colectomy.