Annals of surgery
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Randomized Controlled Trial
Use of bioresorbable membranes to reduce abdominal and perihepatic adhesions in 2-stage hepatectomy of liver metastases from colorectal cancer: results of a prospective, randomized controlled phase II trial.
To assess by prospective randomized controlled trial the feasibility and efficacy of using a bioresorbable hyaluronic acid/carboxymethylcellulose membrane (HA membrane) to prevent abdominal and perihepatic adhesions in metastatic colorectal cancer patients requiring 2-stage hepatectomy. ⋯ Use of 4 HA membranes at the end of first hepatectomy reduced the extent and severity of adhesions and facilitated the second hepatectomy in patients with liver metastases who required a 2-stage hepatectomy. A larger study to confirm these findings is warranted. (NCT01262417).
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Randomized Controlled Trial Multicenter Study Comparative Study
Short-term outcomes for open and laparoscopic midline incisional hernia repair: a randomized multicenter controlled trial: the ProLOVE (prospective randomized trial on open versus laparoscopic operation of ventral eventrations) trial.
: The aim of the trial was to compare laparoscopic technique with open technique regarding short-term pain, quality of life (QoL), recovery, and complications. ⋯ : Postoperative pain or recovery at 3 weeks after repair of midline incisional hernias does not differ between LR and OR, but the LR results in better physical function and less surgical site infections than the OR does. (ClinicalTrials.gov Identifier: NCT00472537).
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Randomized Controlled Trial Comparative Study
Within-team debriefing versus instructor-led debriefing for simulation-based education: a randomized controlled trial.
To compare the effectiveness of an interprofessional within-team debriefing with that of an instructor-led debriefing on team performance during a simulated crisis. ⋯ Within-team debriefing results in measurable improvements in team performance in simulated crisis scenarios. This form of debriefing may be as effective as instructor-led team debriefing, which could improve resource utilization and feasibility of team-based simulation (NCT01067378).
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Randomized Controlled Trial
T-tube or no T-tube in cadaveric orthotopic liver transplantation: the eternal dilemma: results of a prospective and randomized clinical trial.
To compare the incidence and severity of biliary complications due to liver transplantation after choledochocholedochostomy with or without a T-tube in a single-center, prospective, randomized trial. ⋯ Complications in the T-tube group were less severe and required less aggressive treatment. The incidence of anastomotic strictures was higher in patients with no T-tube. We recommend conducting choledochocholedochostomy with a rubber T-tube during liver transplantation in risky anastomosis and when the bile duct diameter is less than 7 mm. This study is registered at http://www.clinicaltrials.gov: Clinical trial ID# NCT01546064.
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To analyze the risk and benefit of aggressive hepatectomy for the curative treatment of bilobar bile duct cysts (BDCs) of type IV-A. ⋯ Aggressive hepatectomy, a challenging procedure, provides an efficient treatment option for some selected patients with bilobar BDCs of type IV-A. The role of aggressive hepatectomy in the curative treatment of bilobar BDCs of type IV-A should be paid particular attention in the future.