Annals of surgery
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Randomized Controlled Trial Multicenter Study
Antiseptic Skin Agents to Prevent Surgical Site Infection after Incisional Surgery: A Randomized, Three-Armed Combined Non-Inferiority and Superiority Clinical Trial (NEWSkin Prep Study).
To compare SSI rates between the skin preparation agents: PI-Aq, povidone-iodine with alcohol (PI-Alc), and chlorhexidine with alcohol (C-Alc). ⋯ PI-Alc is non-inferior to C-Alc and not superior to PI-Aq. This is at odds with current guidelines that suggest alcohol-based chlorhexidine solutions should routinely be used for surgical skin preparation.
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Randomized Controlled Trial
Direct Oral Feeding After a Minimally Invasive Esophagectomy: A Single-Center Prospective Cohort Study.
The aim of this single-center cohort study was to compare direct oral feeding (DOF) to standard of care after a minimally invasive esophagectomy (MIE) performed in a center with a stable and acceptable postoperative complication rate. ⋯ Direct oral feeding following a MIE results in a faster time to functional recovery and lower 30-day postoperative complication rate compared to patients that were orally fasted.
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To explore the impact of PMRT on PROs of IBBR performed with and without mesh. ⋯ PMRT may adversely affect PROs after IBBR irrespective of whether mesh is used. These findings should be discussed with all patients considering IBBR and when indications for PMRT are borderline to enable informed decision-making regarding oncological and reconstructive treatment options.
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To determine the incidence, risk factors, and consequences of AKI in patients undergoing surgery for esophageal cancer. ⋯ AKI is common but mostly self-limiting after esophageal cancer surgery. It is associated with age, male sex, increased BMI, dyslipidemia, and postoperative morbidity.
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To examine the relationship between aspects of surgical intensity and postoperative opioid prescribing. ⋯ Surgical intensity is correlated with initial opioid prescribing and rates of refill. Aspects of surgical intensity could serve as a guide for procedures in which guidelines based on patient-reported outcomes are not available.