The British journal of surgery
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Randomized Controlled Trial
Randomized clinical trial on enhanced recovery versus standard care following open liver resection.
Enhanced recovery programmes (ERPs) have been shown to reduce length of hospital stay (LOS) and complications in colorectal surgery. Whether ERPs have the same benefits in open liver resection surgery is unclear, and randomized clinical trials are lacking. ⋯ ISRCTN03274575 (http://www.controlled-trials.com).
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Comparative Study
Clinical trial of combined radio- and fluorescence-guided sentinel lymph node biopsy in breast cancer.
Combining radioactive colloids and a near-infrared (NIR) fluorophore permits preoperative planning and intraoperative localization of deeply located sentinel lymph nodes (SLNs) with direct optical guidance by a single lymphatic tracer. The aim of this clinical trial was to evaluate and optimize a hybrid NIR fluorescence and radioactive tracer for SLN detection in patients with breast cancer. ⋯ NTR3685 (Netherlands Trial Register; http://www.trialregister.nl).
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Improvements in surgical technique and perioperative care have made partial hepatectomy a safe and effective treatment for hepatocellular carcinoma (HCC), even in the event of spontaneous HCC rupture. ⋯ Spontaneous rupture predicted poor long-term survival after hepatectomy for HCC, but surgical treatment seems possible, safe and appropriate in selected patients.
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Comparative Study
Association between operative approach and complications in patients undergoing Hartmann's reversal.
Complications following reversal of Hartmann's procedure are common, with morbidity rates of up to 50 per cent, and a mortality rate as high as 10 per cent. This is based on case series with heterogeneous data collection and analysis. This study determined risk factors for complications following Hartmann's reversal. ⋯ A laparoscopic approach to Hartmann's reversal was associated with fewer complications than open surgery in this highly selected group of patients.
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Comparative Study
Cost-effectiveness of the implementation of an enhanced recovery protocol for colorectal surgery.
Enhanced recovery protocols may reduce postoperative complications and length of hospital stay. However, the implementation of these protocols requires time and financial investment. This study evaluated the cost-effectiveness of enhanced recovery implementation. ⋯ Enhanced recovery is cost-effective, with savings evident even in the initial implementation period.