Annals of surgery
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Review Meta Analysis
Triclosan-impregnated sutures to decrease surgical site infections: systematic review and meta-analysis of randomized trials.
To determine the efficacy and safety of triclosan-impregnated sutures. ⋯ Triclosan-impregnated sutures do not decrease the rate of SSIs or decrease the rate of wound breakdown. Further high-quality independent studies within the right context are required before routine clinical use can be considered.
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The aim of this study was to develop and validate a scoring system for bowel dysfunction after low anterior resection (LAR) for rectal cancer, on the basis of symptoms and impact on quality of life (QoL). ⋯ We have constructed a valid and reliable LARS score correlated to QoL--a simple tool for quick clinical evaluation of the severity of LARS.
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Meta Analysis Comparative Study
A meta-analysis of surgical morbidity and recurrence after laparoscopic and open repair of primary unilateral inguinal hernia.
Laparoscopic inguinal hernia repair (LIHR), using a transabdominal preperitoneal (TAPP) or totally extraperitoneal (TEP) technique, is an alternative to conventional open inguinal hernia repair (OIHR). A consensus on outcomes of LIHR when compared with OIHR for primary, unilateral, inguinal hernia has not been reached. ⋯ For primary unilateral inguinal hernia, TEP is associated with an increased risk of recurrence relative to OIHR but TAPP is not. TAPP is associated with increased risk of perioperative complications relative to OIHR. LIHR has a reduced risk of chronic pain and numbness relative to OIHR.
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Randomized Controlled Trial Comparative Study
A comparison of 2 ex vivo training curricula for advanced laparoscopic skills: a randomized controlled trial.
To compare the effectiveness and cost of 2 ex vivo training curricula for laparoscopic suturing. ⋯ Training on either a VR simulator or on a box trainer significantly decreased the learning curve necessary to learn laparoscopic suturing. VR training, however, is the more efficient training modality, whereas box training the more cost-effective option.
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To provide an evidence-based focused review of aspirin use in the perioperative period along with an in-depth discussion of the considerations and risks associated with its preoperative withdrawal. ⋯ Clinicians should employ a patient-specific strategy for perioperative aspirin management that weighs the risks of stopping aspirin with those associated with its continuation. Most patients, especially those taking aspirin for secondary cardiovascular prevention, should have their aspirin continued throughout the perioperative period. When aspirin is held preoperatively, the aspirin withdrawal syndrome may significantly increase the risk of a major thromboembolic complication. For many operative procedures, the risk of perioperative bleeding while continuing aspirin is minimal, as compared with the concomitant thromboembolic risks associated with aspirin withdrawal. Those cases where aspirin should be stopped include patients undergoing intracranial, middle ear, posterior eye, intramedullary spine, and possibly transurethral prostatectomy surgery.