Annals of surgery
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Randomized Controlled Trial Multicenter Study Comparative Study
Short-term outcomes of the Australasian randomized clinical study comparing laparoscopic and conventional open surgical treatments for colon cancer: the ALCCaS trial.
Laparoscopy has revolutionized many abdominal surgical procedures. Laparoscopic colectomy has become increasingly popular. The short- and long-term benefits and satisfactory surgical oncological treatment of colorectal cancer by laparoscopic-assisted resection remain topical. The long-term outcomes of all international randomized controlled trials are still awaited, and short-term outcomes are important in the interim. ⋯ Laparoscopic-assisted colonic resection gives significant improvements in return of gastrointestinal function and length of stay, with an increased operative time and no difference in the postoperative complication rate.
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Randomized Controlled Trial Multicenter Study
Effects of a perioperative smoking cessation intervention on postoperative complications: a randomized trial.
To determine whether an intervention with smoking cessation starting 4 weeks before general and orthopedic surgery would reduce the frequency of postoperative complications. ⋯ Perioperative smoking cessation seems to be an effective tool to reduce postoperative complications even if it is introduced as late as 4 weeks before surgery.
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Multicenter Study
Surgeon volume does not predict outcomes in the setting of technical credentialing: results from a randomized trial in colon cancer.
To test the hypothesis that surgeon volume would not predict short- and long-term outcomes when evaluated in the setting of technical credentialing. ⋯ When tested in a randomized controlled trial with case-specific surgical technical credentialing and auditing, surgeon volume did not predict differences in rates of conversion, complications, or long-term cancer outcomes. Case-specific technical credentialing should be further studied specific to the role it could play in creating consistent, high quality outcomes.
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Comment Multicenter Study
Operating room ventilation with laminar airflow shows no protective effect on the surgical site infection rate in orthopedic and abdominal surgery.
To evaluate whether operating room (OR) ventilation with (vertical) laminar airflow impacts on surgical site infection (SSI) rates. ⋯ Unexpectedly, in this analysis, which controlled for many patient and hospital-based confounders, OR ventilation with laminar airflow showed no benefit and was even associated with a significantly higher risk for severe SSI after hip prosthesis.
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Multicenter Study
Racial disparity in the relationship between hospital volume and mortality among patients undergoing coronary artery bypass grafting.
To examine whether the volume-mortality relationship in coronary artery bypass grafting (CABG) differs by race and operative risk. ⋯ Blacks have greater reduction in mortality than whites by undergoing CABG at higher-volume hospitals, regardless of operative risk. Because of limited generalizability, these findings should be confirmed using more representative database.