Publisher Correction: Feasibility and effects of enhanced recovery vs. conventional care after emergency colon surgery for patients with left colon perforation.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Feasibility and effects of enhanced recovery vs. conventional care after emergency colon surgery for patients with left colon perforation.

The impact of an enhanced recovery after surgery (ERAS) programme in emergency colorectal surgery has not yet been reported. The objective of this study was to evaluate the feasibility and the results of patients included in an ERAS protocol following emergency colon surgery for left colon perforation. For this purpose, patients with a low to moderate risk of mortality, according to a Peritonitis Severity Score (PSS), and treated with an ERAS protocol (ERAS group) after emergency surgery for left colon perforation were compared for a period of 40 months (March 2014-June 2017) with a control group of patients treated with conventional care (CC group) during the 38 months prior to implementation of the new ERAS protocol (January 2011-February 2014). The main endpoint was 90-day postoperative morbidity according to the Clavien-Dindo classification. Secondary endpoints included length of postoperative hospital stay, 90-day readmission rate, protocol compliance and mortality. Fifty patients were included in the study, 29 in the ERAS group and 21 in the CC group. There were no significant differences between the groups in the demographic data or in the operative characteristics. A reduction in the incidence of postoperative complications (20.7% vs. 38%; p > 0.05) and in the postoperative hospital stay (7.7 + /- 3.85 vs. 10.9 + /- 5.6 days; p = 0.009) were observed in the ERAS group. The 90-day readmission rate did not differ significantly between the two groups (2 vs. 1). No 90-day mortality was observed in either group. The ERAS group showed better results than the CC group in protocol compliance. We conclude that ERAS protocols are feasible and help to reduce morbidity and length of hospital stay without adversely affecting the rate of readmission or mortality.

Suppression of superfluidity upon overflow of trapped fermions: quantal and Thomas-Fermi studies.

Two issues are treated in this work. (i) The generic fact that, if a fermionic superfluid in the BCS regime overflows from a narrow container into a much wider one, pairing is much suppressed at the overflow point. Physical examples where this feature may play an important role are discussed. (ii) A Thomas-Fermi approach to inhomogeneous superfluid Fermi systems is presented and shown to work well in cases where the local density approximation breaks down.

Neutron skin of (208)Pb, nuclear symmetry energy, and the parity radius experiment.

A precise determination of the neutron skin Δr(np) of a heavy nucleus sets a basic constraint on the nuclear symmetry energy (Δr(np) is the difference of the neutron and proton rms radii of the nucleus). The parity radius experiment (PREX) may achieve it by electroweak parity-violating electron scattering (PVES) on (208)Pb. We investigate PVES in nuclear mean field approach to allow the accurate extraction of Δr(np) of (208)Pb from the parity-violating asymmetry A(PV) probed in the experiment. We demonstrate a high linear correlation between A(PV) and Δr(np) in successful mean field forces as the best means to constrain the neutron skin of (208)Pb from PREX, without assumptions on the neutron density shape. Continuation of the experiment with higher precision in A(PV) is motivated since the present method can support it to constrain the density slope of the nuclear symmetry energy to new accuracy.

Bilateral inguinal hernia repair: laparoscopic or open approach?

BACKGROUND: The aim of this study was to investigate outcomes in the treatment of bilateral inguinal hernia, comparing the laparoscopic totally extraperitoneal (TEP) and open tension-free mesh repair (LICHT) approaches. METHODS: We performed a prospective controlled non randomized clinical study in 128 patients with bilateral inguinal hernia over a period of 3 years. LICHT was used in 106 cases (53 patients) while TEP was employed in 150 cases (75 patients). The main outcome measurements were: recurrence rate, operating time, hospital stay and postoperative complications. RESULTS: There were three recurrences (2.3%): two in the LICHT group (3.8%) and one (1.3%) in the TEP group P = NS. The TEP procedure was faster than LICHT repair (48.8 ± 10.8 vs. 70.4 ± 11.2 min) P < 0.01. Postoperative complications were more frequent in LICHT group (16%) than TEP group (5.3%) P < 0.01. Hospital stay was significantly shorter in the TEP group (0.6 ± 0.8 vs. 1.3 ± 1.2 days) P < 0.001. CONCLUSIONS: The TEP approach is an effective option for the treatment of bilateral inguinal hernia when performed by experienced surgeons.

Nuclear symmetry energy probed by neutron skin thickness of nuclei.

We describe a relation between the symmetry energy coefficients c(sym)(rho) of nuclear matter and a(sym)(A) of finite nuclei that accommodates other correlations of nuclear properties with the low-density behavior of c(sym)(rho). Here, we take advantage of this relation to explore the prospects for constraining c(sym)(rho) of systematic measurements of neutron skin sizes across the mass table, using as example present data from antiprotonic atoms. The found constraints from neutron skins are in harmony with the recent determinations from reactions and giant resonances.

Preperitoneal repair for recurrent inguinal hernia: laparoscopic and open approach.

BACKGROUND: The aim of this study was to investigate the outcome of preperitoneal repair using laparoscopic (TEP) and open (OPM) approach in recurrent inguinal hernia. METHODS: We performed a prospective controlled nonrandomized clinical study in 188 patients with 207 recurrent inguinal hernias over a period of 5 years. TEP repair was employed for 86 repairs, and OPM was used in 121 procedures. The main outcome measurements were: recurrence rate, operating time, hospital stay, and postoperative complications. RESULTS: There were three recurrences (1.7%). Two in the OPM group (1.8%) and one (1.3%) in the TEP group [ P=NS (not significant)]. The TEP procedure was faster than OPM for unilateral repair (40.8 vs 46.3 min) (P<0.001). Postoperative complications were more frequent in the OPM group (23.9%) than the TEP group (13.9%) ( P=NS). Hospital stay was significantly shorter in the TEP group (1.2 vs 3.9 days) (P<0.001). CONCLUSIONS: Preperitoneal approach (open or laparoscopic) seems to be a good option in recurrent inguinal hernia when these procedures are done by experienced surgeons.