The British journal of surgery
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Randomized Controlled Trial Multicenter Study Comparative Study
Ten-year follow-up results of a randomized clinical trial comparing left thoracoabdominal and abdominal transhiatal approaches to total gastrectomy for adenocarcinoma of the oesophagogastric junction or gastric cardia.
The optimal surgical approach for treatment of oesophagogastric junction (OGJ) cancer is controversial. A randomized clinical trial (JCOG9502) comparing transhiatal (TH) and left thoracoabdominal (LTA) approaches was stopped after the first interim analysis owing to limited efficacy for LTA resections. Complete 10-year follow-up data are now available. ⋯ NCT00149266 (https://www.clinicaltrials.gov).
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Multicenter Study Comparative Study Observational Study
Surgical complications after open and laparoscopic surgery for perforated peptic ulcer in a nationwide cohort.
Surgery for perforated peptic ulcer (PPU) is associated with a risk of complications. The frequency and severity of reoperative surgery is poorly described. The aims of the present study were to characterize the frequency, procedure-associated risk and mortality associated with reoperation after surgery for PPU. ⋯ Reoperation was necessary in almost one in every five patients operated on for PPU. Laparoscopy was associated with lower risk of reoperation than laparotomy or a converted procedure. However, there was a risk of bias, including confounding by indication.
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Multicenter Study Comparative Study Observational Study
Oncological outcome following anastomotic leak in rectal surgery.
The influence of anastomotic leak on local recurrence and survival remains debated in rectal cancer. ⋯ Anastomotic leak after low anterior resection did not affect oncological outcomes in these patients.
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Multicenter Study Comparative Study Observational Study
Cost-utility analysis of operative versus non-operative treatment for colorectal liver metastases.
Surgical resection of colorectal liver metastases (CRLMs) is the standard of care when possible, although this strategy has not been compared with non-operative interventions in controlled trials. Although survival outcomes are clear, the cost-effectiveness of surgery is not. This study aimed to estimate the cost-effectiveness of resection for CRLMs compared with non-operative treatment (palliative care including chemotherapy). ⋯ Operative treatment of CRLMs yields greater survival than non-operative treatment, and is both more effective and less costly.
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Multicenter Study
Long-term outcomes of sacral nerve stimulation for faecal incontinence.
Sacral nerve stimulation (SNS) has proven short- to medium-term effectiveness for the treatment of faecal incontinence (FI); fewer long-term outcomes have been presented and usually in small series. Here, the long-term effectiveness of SNS was evaluated in a large European cohort of patients with a minimum of 5 years' follow-up. ⋯ SNS remains an effective treatment for FI in the long term for approximately half of the patients starting therapy.