Single-access laparoscopic sigmoidectomy seems to be feasible and safe when performed by experienced laparoscopic surgeons who are familiar with the unique principles of this procedure. Additional experience and continued investigations are warranted.

This procedure can be safely and feasibly performed using extracorporeal magnetic retraction.

No abstract

BackgroundLittle is known about the effects of antimicrobial stewardship team (AST) without infectious disease physician (IDP) on clinical outcome in patients with candidemia.MethodsWe conducted a before and after study involving patients with hospital‐acquired candidemia at a tertiary hospital without IDPs. The AST consisted of physicians, pharmacists, nurse, microbiologist, and administrative staff. A candidemia care bundle was developed based on the Infectious Disease Society of America (IDSA) guideline. The non‐IDP AST provided recommendations to the attending physicians whose patients developed candidemia during hospitalization. The primary outcome was 30‐day all‐cause mortality, while the secondary outcomes were adherence to the IDSA guidelines regarding the management of candidemia. Data of up to 3 years of preintervention and 3 years of intervention period were analyzed.ResultsBy 30 days, 11 of 46 patients (23.9%) in the intervention group and 7 of 30 patients (23.3%) in the preintervention group died (adjusted hazard ratio for the intervention group: 0.68 [95% CI 0.24‐1.91]). The non‐IDP AST was associated with appropriate empirical antifungal therapy (100% vs 60.0%; proportion ratio 1.67 [95% CI 1.24‐2.23]), appropriate duration of treatment (84.7% vs 43.3%; 1.96 [1.28‐3.00]), removal of central venous catheters (94.4% vs 70.8%; 1.33 [1.02‐1.74]), and ophthalmological examination (93.5% vs 63.3%; 1.48 [1.12‐1.96]).ConclusionsAlthough we found no significant difference in 30‐day mortality, the non‐IDP AST was associated with improved adherence to guidelines for management of candidemia.

Low anterior single-access laparoscopic resection seems safe and feasible when the rectum is suspended like a swing to ensure an adequate operative field.