Pneumomediastinum and pneumothorax: a rare complication of laparoscopic total extraperitoneal inguinal hernia repair.

Increasing utilization of a laparoscopic total extraperitoneal (TEP) approach for inguinal hernia repairs has led to rare complications. We describe a rare case of subcutaneous emphysema, pneumomediastinum and pneumothorax following a laparoscopic TEP inguinal hernia repair in a 29-year-old male. Mechanisms posited include extraperitoneal carbon dioxide migration via the retroperitoneal space and dissection along the fascia transversalis and endothoracic fascia anteriorly to enter the mediastinum.

Electronic medical orders for life-sustaining treatment in New York State: Length of stay, direct costs in an ICU setting.

Objective: In the United States, approximately 20% patients die annually during a hospitalization with an intensive care unit (ICU) stay. Each year, critical care costs exceed $82 billion, accounting for 13% of all inpatient hospital costs. Treatment of sepsis is listed as the most expensive condition in US hospitals, costing more than $20 billion annually.

Surgical specialty, surgical unit volume and mortality after oesophageal cancer surgery.

Background: Mortality after oesophagectomy is lower in high-volume than in low-volume surgical units. Case series from cardiothoracic surgeons report lower mortality rates than those from general surgeons. We therefore used a national data set to investigate the effects of surgical specialty and volume on mortality after oesophagectomy.

Impact of socio-economic deprivation on death rates after surgery for upper gastrointestinal tract cancer.

We hypothesised that socio-economic deprivation in England may be a prognostic factor for death after oesophagectomy or gastrectomy for cancer of the upper gastrointestinal tract. We analysed statistical data from hospital records linked to death records for patients who underwent operations for oesophageal and gastric cancer in England from April 1998 to March 2002. The patients were stratified into quintiles according to the index of multiple deprivation (IMD) (2000) for their place (ward) of residence.