Annals of surgery
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We performed a meta-analysis to investigate benefits and harms of chemoprophylaxis among surgical patients individually risk stratified for venous thromboembolism (VTE) using Caprini scores. ⋯ The benefit of peri-operative VTE chemoprophylaxis was only found among surgical patients with Caprini scores ≥7. Precision medicine using individualized VTE risk stratification helps ensure that chemoprophylaxis is used only in appropriate surgical patients and may minimize bleeding complications.
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Review Meta Analysis Comparative Study
Antibiotics Versus Surgical Therapy for Uncomplicated Appendicitis: Systematic Review and Meta-analysis of Controlled Trials (PROSPERO 2015: CRD42015016882).
The aim was to investigate available evidence regarding effectiveness and safety of surgical versus conservative treatment of acute appendicitis. ⋯ Although antibiotics may prevent some patients from appendectomies, surgery represents the definitive, one-time only treatment with a well-known risk profile, whereas the long-term impact of antibiotic treatment on patient quality of life and health care costs is unknown. This systematic review and meta-analysis helps physicians and patients in choosing between treatment options depending on whether they are risk averse or risk takers.
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Review Meta Analysis
Laparoscopic Lavage in the Management of Hinchey Grade III Diverticulitis: A Systematic Review.
To compare the outcomes of laparoscopic lavage and sigmoid resection in perforated diverticulitis with purulent peritonitis. ⋯ Laparoscopic lavage used in the management of Hinchey grade III diverticulitis leads to more reinterventions within 30 days postoperatively, but does not increase the 30 or 90-day mortality rates compared with sigmoid resection.
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Review Meta Analysis
The Effect of Technical Performance on Patient Outcomes in Surgery: A Systematic Review.
Systematic review of the effect of intraoperative technical performance on patient outcomes. ⋯ The results of this systematic review demonstrated that superior technical performance positively affects patient outcomes. Despite this initial evidence, more robust research is needed to directly assess intraoperative technical performance and its effect on postoperative patient outcomes using meaningful assessment instruments and reliable processes.
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Review Meta Analysis
A Systematic Review to Assess Resection Margin Status After Abdominoperineal Excision and Pelvic Exenteration for Rectal Cancer.
The aim of this study was to assess resection margin status and its impact on survival after abdominoperineal excision and pelvic exenteration for primary or recurrent rectal cancer. ⋯ Resection margin status influences survival and a multidisciplinary approach in experienced centers may result in reduced positive resection margins. For advanced anterior rectal cancer, posterior pelvic exenteration instead of abdominoperineal excision may improve resection margins.