Annals of surgery
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Randomized Controlled Trial Clinical Trial
Enhancing the clinical skills of surgical residents through structured cancer education.
To assess the short and long-term educational value of a highly structured, interactive Breast Cancer Structured Clinical Instruction Module (BCSCIM). ⋯ This interactive patient-based workshop was associated with objective evidence of educational benefit as determined by a unique method of outcome assessment.
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Randomized Controlled Trial Comparative Study Clinical Trial
Randomized controlled trial of botulinum toxin versus laparoscopic heller myotomy for esophageal achalasia.
To compare laparoscopic cardia myotomy and fundoplication with botulinum toxin (BoTx) injection in patients with esophageal achalasia. ⋯ Laparoscopic myotomy is as safe as BoTx treatment and is a 1-shot treatment that cures achalasia in most patients. BoTx should be reserved for patients who are unfit for surgery or as a bridge to more effective therapies, such as surgery or endoscopic dilation.
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Randomized Controlled Trial Clinical Trial
Abdominal drainage after hepatic resection is contraindicated in patients with chronic liver diseases.
The aim of this study was to determine whether abdominal drainage is beneficial after elective hepatic resection in patients with underlying chronic liver diseases. ⋯ Routine abdominal drainage after hepatic resection is contraindicated in patients with chronic liver diseases.
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Randomized Controlled Trial Comparative Study Clinical Trial
Cervical or thoracic anastomosis after esophageal resection and gastric tube reconstruction: a prospective randomized trial comparing sutured neck anastomosis with stapled intrathoracic anastomosis.
The purpose of the study was to compare in prospective randomized fashion a manually sutured esophagogastric anastomosis in the neck and a stapled in the chest after esophageal resection and gastric tube reconstruction. ⋯ When performed in a standardized way, neck and chest anastomoses after esophageal resection are equally safe. The additional esophageal resection of 5 cm in the neck group did not increase tumor removal and survival; on the other hand, it did not adversely influence morbidity, anastomotic diameter, or eating as reflected by body weight development.
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Randomized Controlled Trial Comparative Study Clinical Trial
A prospective randomized study in 100 consecutive patients undergoing major liver resection with versus without ischemic preconditioning.
To evaluate the protective effects of ischemic preconditioning in a prospective randomized study involving a large population of unselected patients and to identify factors affecting the protective effects. ⋯ This study establishes ischemic preconditioning as a protective strategy against hepatic ischemia in humans. The strategy is particularly effective in young patients requiring a prolonged period of inflow occlusion, and in the presence of steatosis, and is possibly related to preservation of ATP content in liver tissue. Other strategies are needed in older patients.