Annals of surgery
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Multicenter Study Comparative Study
Surgical adverse outcomes in patients with schizophrenia: a population-based study.
To validate the global features of postoperative adverse outcomes for surgical patients with schizophrenia. ⋯ Surgical patients with schizophrenia showed significantly higher postoperative adverse outcome rates with risk of 30-day mortality nearly threefold when compared with patients without mental disorders. Our findings suggest the urgency revising the protocol of postoperative care for this specific population.
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Comparative Study
Is competency assessment at the specialist level achievable? A study for the national training programme in laparoscopic colorectal surgery in England.
To develop, validate, and implement a competency assessment tool (CAT) for technical surgical performance in the context of a summative assessment process for the National Training Programme in Laparoscopic Colorectal Surgery (NTP). ⋯ The CAT can reliably assess technical performance in laparoscopic colorectal surgery. The use of CATs to judge specialist technical performance before embarking on independent practice of new procedures is achievable on a national scale and can be adapted by other specialties.
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This study aimed to clarify the incidence of hepatitis B virus (HBV) reactivation and its significance on long-term survival after partial hepatectomy in patients with HBV-related hepatocellular carcinoma (HCC), who had preoperative low HBV-DNA level of less than 2000 IU/mL. ⋯ HBV reactivation was common after partial hepatectomy for HBV-related HCC with a preoperative low HBV-DNA level of less than 2000 IU/mL. Routine prophylactic antiviral treatment should be given before partial hepatectomy.
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Since the development of liver surgery, several descriptions of liver anatomical division and hepatectomies have been made, causing some confusion among surgeons. ⋯ It is hoped that the proposal of this anatomical description and this terminology of hepatectomies may find a consensus among the liver surgical community from America, Asia, and Europe.
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Comparative Study
Wnt pathway activation predicts increased risk of tumor recurrence in patients with stage I nonsmall cell lung cancer.
To determine the incidence of Wnt pathway activation in patients with stage I NSCLC and its influence on lung cancer recurrence. ⋯ Wnt pathway activation occurred in a substantial fraction of Stage I NSCLCs, which was rarely due to mutations. Moreover, Wnt pathway activation was associated with a significantly higher rate of tumor recurrence. These findings suggest that Wnt pathway activation reflects a more aggressive tumor phenotype and identifies patients who may benefit from more aggressive therapy in addition to resection.