Annals of surgery
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Randomized Controlled Trial Multicenter Study
Improving informed consent of surgical patients using a multimedia-based program? Results of a prospective randomized multicenter study of patients before cholecystectomy.
The term "informed consent" explains the process by which a patient, before treatment, is provided comprehensive and impartial information regarding a planned operative procedure so that he/she understands the implications of the procedure before consenting. The goal of the current study was to investigate whether standard methods of consenting can be improved using a multimedia-based information program (MM-IP). ⋯ Use of the multimedia-based program was positively evaluated by patients, and significantly improved patients' perceived understanding of their disease and its treatment. It is, therefore, valuable in the informed consent process.
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Multicenter Study Comparative Study
Trauma care systems: a comparison of trauma care in Victoria, Australia, and Hong Kong, China.
Despite the high incidence of major trauma, few studies have directly compared the performance of trauma systems. This study compared the trauma system performance in Victoria, Australia, (VIC) and Hong Kong, China (HK). ⋯ The performance of the HK trauma system was comparable to international standards, but there was a significant difference in the probability of survival of major trauma between the 2 systems. Possible modifiable factors may include criteria for activation of trauma calls and improved ICU utilization.
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Multicenter Study
Mortality after bariatric surgery: analysis of 13,871 morbidly obese patients from a national registry.
To define mortality rates and risk factors of different bariatric procedures and to identify strategies to reduce the surgical risk in patients undergoing bariatric surgery. ⋯ Mortality after bariatric surgery is a rare event. It is influenced by different risk factors including type of surgery, open surgery, prolonged operative time, comorbidities, and volume of activity. In defining the best bariatric procedure for each patient the different mortality risks should be taken into account. Choice of the procedure, prevention, early diagnosis, and therapy for cardiovascular complications may reduce postoperative mortality.
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Randomized Controlled Trial Multicenter Study Comparative Study
Extended transthoracic resection compared with limited transhiatal resection for adenocarcinoma of the mid/distal esophagus: five-year survival of a randomized clinical trial.
To determine whether extended transthoracic esophagectomy for adenocarcinoma of the mid/distal esophagus improves long-term survival. ⋯ There is no significant overall survival benefit for either approach. However, compared with limited transhiatal resection extended transthoracic esophagectomy for type I esophageal adenocarcinoma shows an ongoing trend towards better 5-year survival. Moreover, patients with a limited number of positive lymph nodes in the resection specimen seem to benefit from an extended transthoracic esophagectomy.
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Multicenter Study Comparative Study
Pancreatic head resection with segmental duodenectomy: safety and long-term results.
To evaluate the usefulness and long-term results with pancreatic head resection with segmental duodenectomy (PHRSD; Nakao's technique) in patients with branch-duct type intraductal papillary mucinous neoplasms (IPMNs). A prospective study from Nagoya (Japan) and Barcelona (Spain). ⋯ PHRSD is a safe and reasonable technique appropriate for selected patients with branch-duct IPMN. The major advantages of PHRSD are promising long-term results in terms of pancreatic function (exocrine and endocrine) with important consequences in elderly patients. Long-term outcome was satisfactory without tumor recurrence in noninvasive carcinoma. PHRSD should therefore be considered as an adequate operation as an organ-preserving pancreatic resection for branch-duct type of IPMN located at the head of the pancreas.