Annals of surgery
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Randomized Controlled Trial Multicenter Study Comparative Study
A randomized trial of hemithyroidectomy versus Dunhill for the surgical management of asymmetrical multinodular goiter.
To assess the immediate and long-term clinical results of 2 different surgical procedures for the treatment of asymmetrical multinodular goiter (AMG). ⋯ DUN appears superior to HMT for the treatment of AMG in terms of early reoperation for missed carcinomas and disease progression. Both procedures have a similarly uneventful postoperative course.
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Randomized Controlled Trial Multicenter Study Comparative Study
A multicenter randomized clinical trial of primary anastomosis or Hartmann's procedure for perforated left colonic diverticulitis with purulent or fecal peritonitis.
To evaluate the outcome after Hartmann's procedure (HP) versus primary anastomosis (PA) with diverting ileostomy for perforated left-sided diverticulitis. ⋯ This is the first randomized clinical trial favoring PA with diverting ileostomy over HP in patients with perforated diverticulitis.
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Comparative Study
Tumor progression after preoperative portal vein embolization.
To evaluate tumor growth in a series of patients undergoing liver resection after portal vein embolization (PVE). ⋯ Portal vein embolization is associated with increased TGR and new tumor in the FRL and recurrent tumor after resection. Short intervals and interval chemotherapy between PVE and resection are, therefore, advised.
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Comparative Study
A survival analysis of the liver-first reversed management of advanced simultaneous colorectal liver metastases: a LiverMetSurvey-based study.
Liver-first reversed management (RM) for the treatment of patients with simultaneous colorectal liver metastases (CRLM) includes liver-directed chemotherapy, the resection of the CRLM, and the subsequent resection of the primary cancer. Retrospective data have shown that up to 80% of patients can successfully undergo a complete RM, whereas less than 30% of those undergoing classical management (CM) do so. This registry-based study compared the 2 approaches. ⋯ Classical and reversed managements of metastatic liver disease in colorectal cancer are associated with similar survival when successfully completed.
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To evaluate at a national level the incidence of liver resection, postoperative mortality, and variables that predict this outcome. ⋯ There were significant disparities in practice. In-hospital mortality underestimated true, postoperative mortality by more than 50%. The model created may be useful for more efficient regionalization of care and patient counseling.