Annals of surgery
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Randomized Controlled Trial Multicenter Study Comparative Study
Decreased Morbidity of Laparoscopic Distal Gastrectomy Compared With Open Distal Gastrectomy for Stage I Gastric Cancer: Short-term Outcomes From a Multicenter Randomized Controlled Trial (KLASS-01).
To determine the safety of laparoscopy-assisted distal gastrectomy (LADG) compared with open distal gastrectomy (ODG) in patients with clinical stage I gastric cancer in Korea. ⋯ LADG for patients with clinical stage I gastric cancer is safe and has a benefit of lower occurrence of wound complication compared with conventional ODG.
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Randomized Controlled Trial
Evaluating a Novel 3D Stereoscopic Visual Display for Transanal Endoscopic Surgery: A Randomized Controlled Crossover Study.
To compare surgical performance with transanal endoscopic surgery (TES) using a novel 3-dimensional (3D) stereoscopic viewer against the current modalities of a 3D stereoendoscope, 3D, and 2-dimensional (2D) high-definition monitors. ⋯ This novel 3D stereoscopic viewer allows surgical performance in TES equivalent to that achieved using the current stereoendoscope and superior to standard 2D and 3D displays, but with lower physical and mental demands for the surgeon. Participants expressed a preference for this system, ranking it more highly on a questionnaire. Clinical translation of this work has begun with the novel viewer being used in 5 TES patients.
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To determine the feasibility of genotyping pancreatic tumors via fine needle aspirates (FNAs). ⋯ FNA sequencing is feasible and subsets of patients may harbor actionable mutations that could potentially impact therapy. Moreover, preoperative FNA sequencing has the potential to influence the timing of surgery relative to systemic therapy. FNA sequencing opens the door to clinical trials in which patients undergo neoadjuvant or a surgery-first approach based on their tumor genetics with the goal of utilizing cancer genomics in the clinical management of pancreatic cancer.
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We prospectively examined the psychosocial predictors and the decision-making process regarding contralateral prophylactic mastectomy (CPM) among women with sporadic breast cancer. ⋯ Interest in CPM is common among women with sporadic breast cancer. The informational and emotional aspects of CPM may affect the decision to have CPM and should be addressed when discussing surgical options.
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To evaluate impact of WHO checklist compliance on risk-adjusted clinical outcomes, including the influence of checklist components (Sign-in, Time-out, Sign-out) on outcomes. ⋯ Checklist implementation was associated with reduced case-mix-adjusted complications after surgery and was most significant when all 3 components of the checklist were completed. Full, as opposed to partial, checklist completion provides a health policy opportunity to improve checklist impact on surgical safety and quality of care.