Journal of the American College of Surgeons
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Randomized Controlled Trial Comparative Study
Preoperative vs Postoperative Eradication of Helicobacter pylori in 150 Patients with Gastric Cancer: A Randomized Controlled Trial.
The Maastricht, Asia-Pacific consensus guidelines strongly recommend eradication of Helicobacter pylori in patients who have a history of gastric cancer. This open-label, single-center, randomized controlled trial was conducted to investigate the appropriate timing of eradication for patients undergoing gastrectomy. ⋯ Preoperative H pylori eradication therapy for gastric cancer patients scheduled for gastrectomy is not necessary, regardless of the planned reconstruction procedure.
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Randomized Controlled Trial Comparative Study
A Double-Blinded Randomized Trial to Compare the Effectiveness of Minimally Invasive Procedures Using Patient-Reported Outcomes.
The Institute of Medicine has included the comparison of minimally invasive surgical techniques in its research agenda. This study seeks to evaluate a model for the comparison of minimally invasive procedures using patient-reported outcomes. ⋯ Early postoperative quality of life data captured differences in fatigue, indicating improved recovery after FP within a controlled trial. Physiologic measures were similar, suggesting that the differences between SP and FP are minimal.
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Randomized Controlled Trial Comparative Study
How does high-concentration supplemental perioperative oxygen influence surgical outcomes after thyroid surgery? A prospective, randomized, double-blind, controlled, monocentric trial.
Recurrent laryngeal nerve palsy (RLNP) and hypoparathyroidism are complications of thyroid surgery. The convalescence can depend on several factors (ie, pain, fatigue, nausea, and vomiting). Supplemental oxygen improves inflammatory and immune function and decreases nausea and vomiting after surgical procedures. We have investigated whether supplemental perioperative oxygen administration could improve surgical outcomes in patients undergoing thyroid surgery. ⋯ Supplemental 80% FiO2 reduced postoperative temporary RLNP and hypoparathyroidism rates and reduced pain, fatigue, nausea, and vomiting after thyroid surgery.
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Randomized Controlled Trial
A prospective, randomized, double-blind, placebo controlled trial on the efficacy of ethanol celiac plexus neurolysis in patients with operable pancreatic and periampullary adenocarcinoma.
Ethanol celiac plexus neurolysis (ECPN) has been shown to be effective in reducing cancer-related pain in patients with locally advanced pancreatic and periampullary adenocarcinoma (PPA). This study examined its efficacy in patients undergoing PPA resection. ⋯ In this study, we demonstrated a significant reduction in pain after surgical resection of PPA. However, the addition of ECPN did not synergize to result in a further reduction in pain, and in fact, its effect may have been masked by surgical resection. Given this, we cannot recommend the use of ECPN to mitigate cancer-related pain in resectable PPA patients.
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Randomized Controlled Trial Multicenter Study
A novel risk scoring system reliably predicts readmission after pancreatectomy.
Postoperative readmissions have been proposed by Medicare as a quality metric and can impact provider reimbursement. Because readmission after pancreatectomy is common, we sought to identify factors associated with readmission to establish a predictive risk scoring system. ⋯ The RAP score is a novel and clinically useful risk scoring system for readmission after pancreatectomy. Identification of patients with increased risk of readmission using the RAP score will allow efficient resource allocation aimed to attenuate readmission rates. It also has potential to serve as a new metric for comparative research and quality assessment.