Changing role of surgery in XXXX : a single-center experience.

@entity1 @entity788 @entity656
BACKGROUND/AIMS: The incidence of @entity656 varies from 5 to 80 per 100,000 inhabitants throughout the world. Recognizing the natural course of severe @entity656 a multidisciplinary approach had become the standard. The strategy of postponing surgical intervention was implemented in the treatment algorithm several years ago. METHODOLOGY: A retrospective analysis of @entity1 data from two five-year periods. The first period was from 01/1992 to 12/1997 (group 1), the second period from 10/2001 to 12/2006 (group 2). RESULTS: In this study, we retrospectively analyzed the impact of this approach on the outcome of our @entity1 with @entity788 . The time interval between onset of disease and first necrosectomy was in the mean 19.5 days in @entity1 of group 1 and 30 days in group 2 (p = 0.015). In group 1, 45/78 @entity1 (57%) were operated on during the first 14 days compared to 8/32 @entity1 (25%; p = 0.002) in group 2. The mortality was 41% in group 1 and 18% in group 2 (p = 0.026). There was also a statistically significant decrease in mortality when first necrosectomy was postponed after day 29 (p = 0.015). CONCLUSION: Our results are in line with several other analyses suggesting that the strategy of postponing surgery in @entity1 with @entity788 is associated with a decreased mortality.
