Supplemental 80 % FiO2 provided during and for 6 h after major gastric cancer surgery to reduce postoperative anastomotic dehiscence should be considered part of ongoing quality improvement activities related to surgical care, with few risks to the patient and little associated cost.

An increase in intestinal permeability and a greater degree of systemic endotoxemia are observed during laparotomic cholecystectomy. This suggests that intestinal manipulation may impair gut mucosal barrier function and contribute to the systemic inflammatory response see in open cholecystectomy.

Importance: Recurrent laryngeal nerve dysfunction and hypoparathyroidism are well-recognized, important complications of thyroid surgery. The duration of convalescence after noncomplicated thyroid operation may depend on several factors, of which pain and fatigue are the most important. Nausea and vomiting occur mainly on the day of operation. Glucocorticoids are well known for their analgesic, anti-inflammatory, immunemodulating and antiemetic effects. However, there is little information in the literature on the use of steroids in thyroid surgery, and the information that is available is conflicting.Objective: To investigate whether preoperative dexamethasone could improve surgical outcome in patients undergoing thyroid surgery.Design: A randomized double-blind placebocontrolled trial. A 30-day follow-up for morbidity was performed in all cases.Setting: All patients were hospitalized in a public hospital.Participants: From June 2008 through August 2011, 328 patients were randomized to receive either intravenous dexamethasone, 8 mg, administered 90 minutes before skin incision, or saline solution (placebo).Interventions: Intravenous dexamethasone, 8 mg. Main Outcomes and Measures:The primary end points were temporary or permanent recurrent laryngeal nerve palsy. Transient and definitive hypoparathyroidism, pain and fatigue scores, nausea, and the number of vomiting episodes were also registered. Preoperatively and at several times during the first 24 postoperative hours, we measured C-reactive protein, interleukin 6, and interleukin 1␤ levels.Results: In the dexamethasone group, the rate of temporary recurrent laryngeal nerve palsy (4.9%) was significantly lower compared with the placebo group (8.4%) (P=.04). Also, postoperative transient biochemical hypoparathyroidism occurred more frequently in the placebo group (37.0%) than in the dexamethasone group (12.8%). Dexamethasone use significantly reduced postoperative levels of C-reactive protein (P =.01) and interleukin 6 and interleukin 1␤ (P=.02), fatigue (P=.01), and overall pain during the first 24 postoperative hours (P = .04), as well as the total analgesic (ketorolac tromethamine) requirement (P=.04). Dexamethasone use also reduced nausea and vomiting on the day of operation (P =.045). Conclusions and Relevance:Preoperative administration of dexamethasone, 8 mg, reduced postoperative temporary recurrent laryngeal nerve palsy and hypoparathyroidism rates and reduced pain, fatigue, nausea, and vomiting after thyroid surgery. However, these data require further analysis in randomized prospective studies.Trial Registration: clinicaltrials.gov Identifier: NCT01690806 Otolaryngol Head Neck Surg. 2013;139(5):471-478 T OTAL THYROIDECTOMY OR thyroid lobectomy has been accepted as the current surgical therapy for benign and malignant thyroidal disorders, 1-5 but extensive resection might increase the risk of postoperative complications. JAMA6,7 Recurrent laryngeal nerve (RLN) dysfunction and hypoparathyroidism are well-recognized, important complications of thyro...

Supplemental 80% FiO2 during and for 6 h after open surgery for PPU, which reduces post-operative SSI, should be considered part of ongoing quality improvement activities related to surgical care, with few risks to the patient and little associated cost.

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Therefore, supplemental 80% FiO2 during and for 6 h after major rectal cancer surgery, reducing postoperative anastomotic dehiscence, should be considered part of ongoing quality improvement activities related to surgical care, with few risks to the patient and little associated cost.

LFNF is an effective long-term treatment for gastroesophageal reflux disease, yielding similar results to open fundoplication.

This study demonstrated that reducing the pressure of the pneumoperitoneum to 6 to 8 mm Hg during LNF is reduced p.o. inflammatory response and avoided p.o. immunosuppression.