Annals of surgery
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Randomized Controlled Trial Multicenter Study Comparative Study
Better Function With a Colonic J-Pouch or a Side-to-end Anastomosis?: A Randomized Controlled Trial to Compare the Complications, Functional Outcome, and Quality of Life in Patients With Low Rectal Cancer After a J-Pouch or a Side-to-end Anastomosis.
We aimed to compare prospectively the complications and functional outcome of patients undergoing a J-Pouch (JP) or a side-to-end anastomosis (SE) for treatment of low rectal cancer at a 2-year time point after resection for rectal cancer. ⋯ At time points of 1 and 2 years after a JP or a SE for low rectal cancer, QOL, functional outcome, and complications are comparable between the groups. Although choosing a particular procedure may depend on surgeon/patient choice or anatomical considerations at the time of surgery, SE functions similar to JP and may be chosen due to the ease of construction.
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Multicenter Study Comparative Study Observational Study
Long-term Outcomes of Laparoscopic Versus Open Surgery for Clinical Stage II/III Gastric Cancer: A Multicenter Cohort Study in Japan (LOC-A Study).
A large-scale multicenter historical cohort study was conducted to investigate the efficacy of laparoscopic gastrectomy (LG) in comparison to open gastrectomy (OG) for locally advanced gastric cancer. ⋯ This observational study strictly adjusted for confounding factors has provided evidence to suggest that LG is oncologically comparable to OG for locally advanced gastric cancer. The validity of this result will be examined in ongoing randomized trials.
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To evaluate preoperative body composition, including skeletal muscle and visceral adipose tissue, and to clarify the impact on outcomes after hepatectomy for hepatocellular carcinoma (HCC). ⋯ Preoperative sarcopenic obesity was an independent risk factor for death and HCC recurrence after hepatectomy for HCC.
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The aim of this study was to analyze the health care costs and savings associated with quality improvement (QI) interventions initiated and implemented utilizing NSQIP. ⋯ QI interventions initiated and implemented utilizing NSQIP appear to be effective and cost-saving for AHS. These cost-savings would be even larger if NSQIP was prolonged in the pilot sites and/or expanded to other sites across the province.
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Observational Study
Relationship Between Postoperative Pain and Overall 30-Day Complications in a Broad Surgical Population: An Observational Study.
The aim of this study was to establish the relationship between postoperative pain and 30-day postoperative complications. ⋯ Higher actual postoperative pain scores and unacceptable pain, even on the first postoperative day, are associated with more postoperative complications. Our findings provide important support for the centrality of personalized analgesia in modern perioperative care.