The British journal of surgery
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Inadvertent enterotomy is a feared complication of adhesiotomy during abdominal reoperation. The nature and extent of this adhesion-associated problem are unknown. ⋯ The incidence of inadvertent enterotomy during reoperation is high. This adhesion-related complication has an impact on postoperative morbidity
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Untreated chronic critical leg ischaemia (CLI) usually leads to an amputation or death of a patient. Surgical and endovascular interventions may improve arterial flow. Long infrainguinal reconstruction may be the most useful method for preventing amputations. The value of different reconstruction methods was assessed by their impact on amputation incidence. ⋯ These results suggest that long surgical reconstructions improving perfusion directly to the ischaemic tissue can improve leg salvage.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Pancreaticojejunostomy versus pancreaticogastrostomy in reconstruction following pancreaticoduodenectomy.
Pancreaticogastrostomy (PG) after pancreaticoduodenectomy has been reported to have a lower incidence of pancreatic fistula than pancreaticojejunostomy (PJ) but this was not confirmed in a recent prospective randomized study. ⋯ This controlled clinical study supports the hypothesis that PG is safer than PJ, particularly with regard to the incidence of pancreatic fistula.
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Randomized Controlled Trial Comparative Study Clinical Trial
Randomized clinical trial of haemorrhoidectomy under a mixture of local anaesthesia versus general anaesthesia.
Application of a topical anaesthetic agent may facilitate infiltration of local anaesthetic at haemorrhoidectomy. ⋯ Topical anaesthetic and local anaesthesia can be used effectively for haemorrhoidectomy and provide an alternative to general anaesthesia.
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An analysis of the process of care may improve quality of care within a trauma system. Early operative control of haemorrhage is vital and any delay before surgery may adversely affect outcome. ⋯ The time to emergency trauma laparotomy may be used effectively as an audit of process for the clinical governance of a trauma system. Presented to the British Trauma Society, Bath, October 1997 and the Faculty of Accident and Emergency Medicine, Glasgow, December 1997, and published in abstract form as J Accid Emerg Med 1998; 15: 134