The British journal of surgery
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Rectal prolapse is a condition that has fascinated surgeons for a long time. To date, no single ideal surgical treatment has been identified. The aetiology of rectal prolapse remains highly controversial, but it is recognized that associated functional problems, such as incontinence and constipation, are common. The pathophysiology, and controversies surrounding continence and constipation, remain topics of debate. ⋯ The surgical management of rectal prolapse has evolved from historical encirclement procedures to current minimally invasive ones. Successful management must include adequate attention to the associated functional problems in order to eradicate the basic abnormality.
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Multicenter Study
Initial experience with an absorbable laparoscopic ligation clip.
Laparoscopic surgery requires secure and safe methods of ligation and haemostasis. This study evaluated the efficacy of an absorbable ligation clip with a novel compression closure mechanism. ⋯ This new clip is as safe and effective as presently available metal and absorbable clips in providing haemostasis and securing tubular structures.
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The development of duplex ultrasonography and colour flow imaging has greatly extended the scope of non-invasive assessment of lower limb arterial disease. This review questions whether recent advances might allow colour duplex imaging to displace arteriography as the primary imaging modality for native vessel occlusive disease. ⋯ Arteriography should no longer be considered the gold standard of imaging of peripheral arterial occlusive disease. Future studies should concentrate on the efficacy of colour duplex sonography in guiding clinical decision making.
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Multicenter Study
Long-term survival following resection of colorectal hepatic metastases. Association Française de Chirurgie.
The aim of this study was to analyse characteristics of patients who survived more than 5 years after liver resection of colorectal metastases. ⋯ Resection of colorectal hepatic metastases can provide long-term survival even in patients with poor prognostic factors. It seems justified to undertake resection of colorectal liver metastases whenever it may be performed safely as a curative treatment.
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Primary retroperitoneal germ cell tumours: excision via a thoracoabdominal extraperitoneal approach.
Primary retroperitoneal germ cell tumours usually present as a large abdominal mass in young men. The testes are normal on examination and ultrasonography but there are usually raised serum levels of human chorionic gonadotrophin and/or alpha-fetoprotein. ⋯ The thoracoabdominal extraperitoneal approach for the removal of retroperitoneal germ cell tumours and their metastases after chemotherapy improves tumour clearance, morbidity and recovery time compared with the transperitoneal anterior approach.