The British journal of surgery
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Review Meta Analysis
Feasibility of randomized controlled trials in liver surgery using surgery-related mortality or morbidity as endpoint.
There is a shortage of randomized controlled trials (RCTs) on which to base guidelines in liver surgery. The feasibility of conducting an adequately powered RCT in liver surgery using the dichotomous endpoints surgery-related mortality or morbidity was examined. ⋯ The feasibility of conducting an adequately powered RCT in liver surgery using outcomes such as mortality or specific complications seems low. Conclusions of underpowered RCTs should be interpreted with caution. A liver surgery-specific composite endpoint may be a useful and clinically relevant solution to pursue.
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Randomized Controlled Trial Comparative Study
Randomized clinical trial of folate supplementation in patients with peripheral arterial disease.
The aim was to determine whether folate supplementation improved arterial function in patients with peripheral arterial disease (PAD). ⋯ Folate administration reduced plasma homocysteine, and slightly improved ABPI and bk-PWV.
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This is the third leading article in the Journal's series on major trauma. In it Karim Brohi, Professor of Trauma Sciences at Queen Mary University of London, deals with the important topic of the defects in blood coagulation that are often encountered after serious injury.
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Multicenter Study Meta Analysis
Multicentre analysis of oncological and survival outcomes following anastomotic leakage after rectal cancer surgery.
The association between diverting stomas and symptomatic anastomotic leakage after rectal cancer surgery was studied, as well as the impact of leakage on local recurrence, distant metastasis, and disease-free, overall and cancer-specific survival. ⋯ Diverting stomas were associated with less symptomatic anastomotic leakage. Oncological outcome was not significantly influenced by leakage, but overall survival was reduced.
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Randomized Controlled Trial Comparative Study
Prospective randomized trial using cost-utility analysis of early versus delayed laparoscopic cholecystectomy for acute gallbladder disease.
This randomized controlled trial compared the cost-utility of early laparoscopic cholecystectomy with that for conventional management of newly diagnosed acute gallbladder disease. ⋯ In this pragmatic trial, the cost-utilities of both the early and conventional approaches were similar, but the incremental cost per additional QALY gained favoured conventional management.