The British journal of surgery
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Randomized Controlled Trial Multicenter Study Clinical Trial
Randomized clinical trial of the effects of preoperative and postoperative oral nutritional supplements on clinical course and cost of care.
Postoperative oral nutritional supplementation has been shown to be of clinical benefit. This study examined the clinical effects and cost of administration of oral supplements both before and after surgery. ⋯ Perioperative oral nutritional supplementation started before hospital admission for lower gastrointestinal tract surgery significantly diminished the degree of weight loss and incidence of minor complications, and was cost-effective.
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Review Meta Analysis
Systematic review and meta-analysis of controlled trials assessing spinal cord stimulation for inoperable critical leg ischaemia.
Spinal cord stimulation (SCS) may have a place in the treatment of patients with inoperable chronic critical leg ischaemia. ⋯ The addition of SCS to standard conservative treatment improves limb salvage, ischaemic pain and the general clinical situation in patients with inoperable chronic critical leg ischaemia. These benefits should be weighed against the cost and the (minor) complications associated with the technique.
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Randomized Controlled Trial Comparative Study Clinical Trial
Randomized clinical trial of laparoscopic versus open fundoplication for gastro-oesophageal reflux disease.
The aim of this study was to compare laparoscopic and open Nissen fundoplication for gastro-oesophageal reflux disease in a randomized clinical trial. ⋯ The laparoscopic approach to Nissen fundoplication improved early postoperative recovery, with an equally good outcome up to 12 months.
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There have been three previous reviews of the world literature describing postoperative mortality rate following oesophagectomy. The first documented rates in the first half of the last century, the second the period 1960-1979 and the third the interval 1980-1988. The aim of this review was to document the rate for the period 1990-2000. ⋯ Operative mortality rates following oesophagectomy have continued to fall. However, the true rate is almost certainly higher than that reported here, for a variety of reasons. The 1-year survival of patients was only reported in about a quarter of the papers. It may be a more meaningful figure than postoperative mortality rate.