The British journal of surgery
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Randomized Controlled Trial Clinical Trial
Randomized controlled trial of prophylactic chest physiotherapy in major abdominal surgery.
This randomized controlled study evaluated the clinical benefit and physiological effects of prophylactic chest physiotherapy in open major abdominal surgery. ⋯ Preoperative chest physiotherapy reduced the incidence of postoperative pulmonary complications and improved mobilization and oxygen saturation after major abdominal surgery.
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Randomized Controlled Trial Clinical Trial
Long-term oral administration of branched chain amino acids after curative resection of hepatocellular carcinoma: a prospective randomized trial. The San-in Group of Liver Surgery.
Live cirrhosis is a state of protein calorie malnutrition which may induce various complications. This study aimed to elucidate if long-term nutritional support with branched chain amino acids (BCAAs) is effective after hepatic resection for hepatocellular carcinoma (HCC). ⋯ Long-term oral nutritional support with BCAAs after resection of HCC is beneficial in improving clinical features and laboratory data without increasing the rate of tumour recurrence, particularly in patients with advanced cirrhosis or after major hepatic resection.
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Early classification of patients presenting with peritonitis and intra-abdominal sepsis by means of objective scoring systems is desirable to select patients for 'aggressive' surgery and to compare results of different treatment regimens. However, none of the existing scoring systems has fulfilled all expectations. ⋯ Combination of the APACHE II and the MPI provides the best scoring system fitting clinical goals.
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Randomized Controlled Trial Clinical Trial
Risk factors for surgical treatment in the Dutch Gastric Cancer Trial.
A multicentre randomized study of surgical treatment of gastric cancer has shown increased mortality and morbidity rates in patients having D2 resection. The aim of this report is to analyse risk factors in these patients. ⋯ The cumulative mortality risks of these factors should be considered carefully when planning surgery for individual patients.
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Hand-held Doppler is in common use for evaluating varicose veins, but its accuracy in identifying the exact sites of venous reflux is inferior to that of duplex scanning. It has been suggested that duplex should be used to investigate all varicose veins, but this is currently impractical, and should be unnecessary if hand-held Doppler examination were shown to be an adequate screening test. ⋯ Hand-held Doppler examination missed LSV or SSV incompetence in 11 per cent of legs, but these included cases with short-duration and low-velocity reflux of dubious clinical importance.