The British journal of surgery
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Randomized Controlled Trial Multicenter Study Comparative Study
Cost-effectiveness analysis of general anaesthesia versus local anaesthesia for carotid surgery (GALA Trial).
Health outcomes and costs are both important when deciding whether general (GA) or local (LA) anaesthesia should be used during carotid endarterectomy. The aim of this study was to assess the cost-effectiveness of carotid endarterectomy under LA or GA in patients with symptomatic or asymptomatic carotid stenosis for whom surgery was advised. ⋯ If cost-effectiveness was considered in the decision to adopt GA or LA for carotid endarterectomy, given the evidence provided by this study, LA is likely to be the favoured treatment for patients for whom either anaesthetic approach is clinically appropriate.
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Randomized Controlled Trial
Use of baseline factors to predict complications and reinterventions after endovascular repair of abdominal aortic aneurysm.
It is uncertain which baseline factors are associated with graft-related complications and reinterventions after endovascular aneurysm repair (EVAR) in patients with a large abdominal aortic aneurysm. ⋯ Graft-related complication and reintervention rates were common after EVAR in patients with a large aneurysm. Younger patients and those with aneurysms closer to the 5.5-cm threshold for intervention experienced lower rates.
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Comparative Study
Comparison of simultaneous or delayed liver surgery for limited synchronous colorectal metastases.
The optimal surgical strategy for patients with synchronous colorectal liver metastases (CLMs) is still unclear. The aim of this study was to compare simultaneous colorectal and hepatic resection with a delayed strategy in patients who had a limited hepatectomy (fewer than three segments). ⋯ Combining colorectal resection with a limited hepatectomy is safe in patients with synchronous CLMs and associated with less cumulative morbidity than a delayed procedure. However, the combined strategy has a negative impact on progression-free survival.
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Review Meta Analysis
Systematic review and meta-analysis of sex differences in outcome after intervention for abdominal aortic aneurysm.
The aim of this study was to assess possible differences in mortality between men and women with an abdominal aortic aneurysm (AAA) treated either by elective repair or following aneurysm rupture. ⋯ Women with an AAA had a higher mortality rate following elective open and endovascular repair.