Annals of surgery
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Randomized Controlled Trial Multicenter Study
Methods of Colostomy Construction: No Effect on Parastomal Hernia Rate: Results From Stoma-const-A Randomized Controlled Trial.
The primary objective of this trial was to compare the parastomal hernia rates 1 year after the construction of an end colostomy by 3 surgical techniques: cruciate incision, circular incision in the fascia and using prophylactic mesh. Secondary objectives were evaluation of postoperative complications, readmissions/reoperations, and risk factors for parastomal hernia. ⋯ We found no significant differences in the rates of parastomal hernia within 12 months of index surgery between the 3 surgical techniques of colostomy construction.
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Multicenter Study Observational Study
Outcomes of Vascular and Endovascular Interventions Performed During the Coronavirus Disease 2019 (COVID-19) Pandemic: The Vascular and Endovascular Research Network (VERN) Covid-19 Vascular Service (COVER) Tier 2 Study.
The aim of the COVER Study is to identify global outcomes and decision making for vascular procedures during the pandemic. ⋯ Mortality after vascular interventions during this period was unexpectedly high. Suspected or confirmed COVID-19 cases were uncommon. Therefore an alternative cause, for example, recommendations for delayed surgery, should be considered. The vascular community must anticipate longer term implications for survival.
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Multicenter Study Observational Study
Frailty in Older Patients Undergoing Emergency Laparotomy: Results From the UK Observational Emergency Laparotomy and Frailty (ELF) Study.
This study aimed to document the prevalence of frailty in older adults undergoing emergency laparotomy and to explore relationships between frailty and postoperative morbidity and mortality. ⋯ A fifth of older adults undergoing emergency laparotomy are frail. The presence of frailty is associated with greater risks of postoperative mortality and morbidity and is independent of age. Frailty scoring should be integrated into acute surgical assessment practice to aid decision-making and development of novel postoperative strategies.
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To compare the oncologic outcomes of liver resection (LR) and local ablation therapies for HCC. ⋯ Our meta-analysis showed that LR was superior to RFA in terms of RFS and incidence of local recurrence. Moreover, LR showed better oncologic outcomes than MWA or RFA plus TACE.
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The aim of this study was to propose an evidence-based blueprint for training, assessment, and certification of operative performance for surgical trainees. ⋯ A competency-based operative skill assessment can be incorporated into surgical training, assessment, and certification. The time has come to develop a systematic approach to this issue as a means of demonstrating professional standards worthy of the public trust.