Annals of surgery
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Randomized Controlled Trial Clinical Trial
Prospective, randomized trial on the effect of cyclic versus continuous enteral nutrition on postoperative gastric function after pylorus-preserving pancreatoduodenectomy.
The effect of a cyclic versus a continuous enteral feeding protocol on postoperative delayed gastric emptying, start of normal diet, and hospital stay was assessed in patients undergoing pylorus-preserving pancreatoduodenectomy (PPPD). ⋯ Cyclic enteral feeding after PPPD is associated with a shorter period of enteral nutrition, a faster return to a normal diet, and a shorter hospital stay. Continuously high CCK levels could be a cause of prolonged time until normal diet is tolerated in patients on continuous enteral nutrition. Cyclic enteral nutrition is therefore the feeding regimen of choice in patients after PPPD.
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Randomized Controlled Trial Clinical Trial
Prospective double-blind randomized trial of laparoscopic Nissen fundoplication with division and without division of short gastric vessels.
To determine whether division of the short gastric vessels (SGVs) and full mobilization of the gastric fundus is necessary to reduce the incidence of postoperative dysphagia and other adverse sequelae of laparoscopic Nissen fundoplication. ⋯ Division of the SGVs during laparoscopic Nissen fundoplication did not improve any clinical or objective postoperative outcome.
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Randomized Controlled Trial Clinical Trial
Is hypothermia in the victim of major trauma protective or harmful? A randomized, prospective study.
The purpose of this randomized, prospective clinical trial was to determine whether hypothermia during resuscitation is protective or harmful to critically injured trauma patients. ⋯ Hypothermia increases fluid requirements and independently increases acute mortality after major trauma.
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Randomized Controlled Trial Clinical Trial
A prospective, randomized trial of early enteral feeding after resection of upper gastrointestinal malignancy.
The purpose of the study was to determine whether early postoperative enteral feeding with an immune-enhancing formula (IEF) decreases morbidity, mortality, and length of hospital stay in patients with upper gastrointestinal (GI) cancer. ⋯ Early enteral feeding with an IEF was not beneficial and should not be used in a routine fashion after surgery for upper GI malignancies.
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Randomized Controlled Trial Clinical Trial
Routine pulmonary artery catheterization does not reduce morbidity and mortality of elective vascular surgery: results of a prospective, randomized trial.
The authors determined whether the preoperative placement of a pulmonary artery catheter (PAC) with optimization of hemodynamics results in outcome improvement after elective vascular surgery. ⋯ Routine PAC use in elective vascular surgery increases the volume of fluid given to patients without demonstrable improvement in morbidity or mortality.