International journal of surgery
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The exponential rise in published medical research on a yearly basis demands a method to summarise best evidence towards its application to patient care in clinical practice. A robust meta-analysis is a valid tool. It is often considered to be a simple process of pooling results from different studies. This is not true. It appears that surgeons lack a reference guide to help them conduct and appraise a meta-analysis. ⋯ Whereas meta-analyses of homogeneous studies are the highest form of evidence, poorly conducted meta-analyses create confusion and serve to harm the patient. Surgeons practising their art in an era of evidence-based surgery need to understand the principles of meta-analyses.
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Over the last decade, breast cancer surgery has become less invasive and potentially suitable for day surgery. The aim of this systematic review was to establish the benefits and disadvantages of day surgery for breast cancer. ⋯ Day surgery for breast cancer is safe, with equivalent complication rates, but there is lack of evidence from randomised controlled trials. Patient satisfaction and psychological well-being is high. Further trials with validated questionnaires are required to confirm this.