Mortality after emergency Hartmann's procedure in octogenarians: a propensity score-matched analysis.

Background: Complicated diverticulitis is associated with a postoperative mortality rate of 20%. We hypothesized that age ≥80 was an independent risk factor for mortality after Hartmann's procedure for diverticular disease when controlling for baseline comorbidities.

Methods: Patients who underwent an urgent or emergent Hartmann's procedure (Current Procedural Terminology codes 44143 and 44206) for diverticular disease (International Classification of Diseases-9:562.

Surgeons' Experiences With Patients' Concerns Regarding Trainees.

Objective: Little is known about surgeons' attitudes toward patients' concerns about the role of trainees in their care. The nature of the discussion between surgeons and their patients about trainees and the effect on how patients are cared for is an important part of patient-centered care. We aim to elucidate surgeons' attitude toward patients' concerns regarding trainee involvement in their care.

Ideal timing of surgery for acute uncomplicated appendicitis.

Background: Early surgery for appendicitis is thought to avoid complications associated with appendiceal rupture.

Aims: This study was to evaluate the effect of timing of surgery on complications, length of stay (LOS) and cost in patients undergoing appendectomy.

Materials And Methods: Retrospective review of 396 patients with appendectomies from January 1, 2005 to December 31, 2007 was performed.

The 912th forward surgical team in Operation New Dawn: employment of the forward surgical team during troop withdrawal under combat conditions.

The Wars in Afghanistan and Iraq witnessed the first widespread use of U.S. Army Forward Surgical Teams (FSTs).

Is spine consultation needed for all thoracolumbar fractures? Evaluation of a subspecialist-sparing protocol for screening and management of stable fractures.

Background: The shortage of neurosurgeons is a problem in many US trauma centers. Most thoracolumbar spine fractures are treated conservatively, and at our institution, we found that most patients did not require surgery. We hypothesize that most spine fractures can be treated safely and effectively by the trauma team, without neurosurgical consultation, using a protocol to guide diagnosis and treatment.

Fast track colorectal surgery.

A "fast track" colon surgery program is the global package of perioperative care encompassing preoperative, operative, and postoperative techniques, which in aggregate result in fewer complications, a reduction in cost, less postoperative pain, a reduction in the hospital length of stay, and quicker return to work and normal activities. Results of fast track programs have shown significant advantages; however, strong evidence is forthcoming. Implementation of a fast track program requires a significant commitment and a multidisciplinary approach.

Benefits of laparoscopic peritoneal lavage for complicated sigmoid diverticulitis.

Background: The traditional therapy for perforated sigmoid diverticulitis with peritonitis is emergency colectomy usually with colostomy. We report laparoscopic exploration with peritoneal lavage as an alternative in seven patients who required emergency surgery for diverticulitis.

Methods: Six patients presented with diffuse peritonitis and one with a failure of percutaneous therapy.

Tuberculous fistulae in ano: a case report and literature review.

Tuberculosis can present anywhere in the gastrointestinal tract; however, anorectal tuberculosis has been reported rarely. We present a case report of tuberculous fistulae in ano and review the extrapulmonary manifestations of tuberculosis.

Simple harmonic scalpel hemorrhoidectomy utilizing local anesthesia combined with intravenous sedation: a safe and rapid alternative to conventional hemorrhoidectomy.

Background: Harmonic Scalpel(R) hemorrhoidectomy (HSH) is an established surgical therapy for the treatment of symptomatic grade III and IV hemorrhoids. Hemorrhoid surgery is still being performed as an inpatient procedure with general or regional anesthesia in many centers today. There was a trend toward performing hemorrhoid surgery as an ambulatory procedure using local anesthesia supplemented with intravenous sedation.

Combination propofol/ketamine is a safe and efficient anesthetic approach to anorectal surgery.

Purpose: Concerns persist regarding respiratory complications from combination deep intravenous sedation and local anesthesia for prone position anorectal surgery. We examined the safety and efficacy of this approach by using a propofol-based and ketamine-based technique.

Methods: A retrospective review was conducted on all patients undergoing anorectal surgery.