Annals of surgery
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This trial evaluated the superiority of intraoperative wound irrigation (IOWI) with aqueous povidone-iodine (PVP-I) compared with that with saline for reducing the incidence of surgical site infection (SSI). ⋯ The current recommendation of IOWI with aqueous PVP-I should be reconsidered.
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Randomized Controlled Trial
STOP signs: A Population-Based Interrupted Time Series Analysis of Antibiotic Duration for Complicated Intra-Abdominal Infection Before and After the Publication of a Landmark RCT.
To determine if the STOP-IT randomized controlled trial changed antibiotic prescribing in patients with Complicated Intraabdominal Infection (CIAI). ⋯ For appendiceal or biliary sources of CIAI, antibiotic duration was commensurate with the experimental arm of STOP-IT. For other sources, antibiotic duration was long and did not change in response to trial publication. Additional implementation science is needed to improve antibiotic stewardship.
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Randomized Controlled Trial
Professional Coaching and Surgeon Well-Being. A Randomized Controlled Trial.
To determine if individualized professional coaching reduces burnout, improves quality of life, and increases resilience among surgeons. ⋯ Professional coaching over 6 months improved burnout and resilience among surgeons, with reductions in improvement over the ensuing 6 months.
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Randomized Controlled Trial Multicenter Study
Cost-Effectiveness of Early Surgery Versus Endoscopy-First Approach for Painful Chronic Pancreatitis in the ESCAPE Trial.
Economic evaluation of early surgery compared to the endoscopy-first approach in CP. ⋯ In patients with painful CP and a dilated main pancreatic duct, early surgery was more cost-effective than the endoscopy-first approach.
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Randomized Controlled Trial
Neoadjuvant Chemotherapy with CAPOX versus Chemoradiation for Locally Advanced Rectal Cancer with Uninvolved Mesorectal Fascia (CONVERT): Initial Results of a Phase III Trial.
To compare neoadjuvant chemotherapy (nCT) with CAPOX alone versus neoadjuvant chemoradiotherapy (nCRT) with capecitabine in locally advanced rectal cancer (LARC) with uninvolved mesorectal fascia (MRF). ⋯ nCT achieved similar pCR and downstaging rates with lower incidence of perioperative distant metastasis and preventive ileostomy compared with nCRT. CAPOX could be an effective alternative to neoadjuvant therapy in LARC with uninvolved MRF. Long-term follow-up is needed to confirm these results.