International journal of surgery
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Effect of local glial derived neurotrophic factor (GDNF) on nerve regeneration was assessed. Eighty male Wistar rats were divided into four experimental groups (n = 20), randomly: In transected group left sciatic nerve was transected and stumps were fixed in adjacent muscle. In treatment group defect was bridged using an artery graft filled with 10 μL GDNF. ⋯ Immunohistochemical reactions to S-100 in IOAG/GDNF were more positive than that in IOAG group. GDNF improved functional recovery and morphometric indices of sciatic nerve. It could be considered as an effective treatment for peripheral nerve repair in practice.
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Randomized Controlled Trial
Open reduction and internal fixation with conventional plate via L-shaped lateral approach versus internal fixation with percutaneous plate via a sinus tarsi approach for calcaneal fractures - a randomized controlled trial.
We aimed to compare the clinical outcomes of intra-articular calcaneus fractures treated with open reduction and internal fixation with conventional plate via L-shaped lateral approach (routine treatment) versus those with percutaneous plate via a sinus tarsi approach (minimally invasive treatment). ⋯ Compared with L-shaped lateral approach treatment of displaced intra-articular calcaneal fractures, sinus tarsi approach for the reduction and internal fixation with percutaneous plate seems to be more safe and effective, with satisfactory clinical therapeutic effects and without postoperative complications.
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This best evidence topic was investigated according to a described protocol. The question asked was: should patients on acetylsalicylic acid (ASA) for secondary prevention stop or continue the medication prior to elective, abdominal surgery. Using the reported search 826 papers were found of which five represented the best evidence to answer the clinical question. ⋯ This heterogeneity in methodology makes it difficult to draw justifiable conclusions from the data. However, it appears that continuing ASA isn't associated with excessive bleeding. Further adequately powered trials with well-defined end points are needed to answer this important clinical question.
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Partial hepatectomy with clear surgical margins is the main curative treatment for hepatic malignancies. The safety of liver resection, to a great extent, depends on the volume of future liver remnant. This manuscript reviews some important strategies that have been developed to increase resectability for patients with borderline volume of future liver remnant, particularly associating liver partition and portal vein ligation for staged hepatectomy (ALPPS). ⋯ ALPPS has emerged as a new strategy to increase resectability of hepatic malignancies. Due to high morbidity and mortality rates of ALPPS procedure, the surgical candidates should be selected carefully. Moreover, there are very limited available evidence for its technical feasibility, safety and oncological outcome which are needed for further evaluation in larger scale of studies.