The British journal of surgery
-
Randomized Controlled Trial Multicenter Study Comparative Study
Randomized clinical trial of mesh fixation with glue or sutures for Lichtenstein hernia repair.
Pain is the most likely reason for delay in resuming normal activities after groin hernia repair. The primary aim of this study was to determine whether the use of glue to fix the mesh instead of sutures reduced acute postoperative pain after inguinal hernia repair. Secondary objectives were to compare postoperative complications, chronic pain and early recurrence rates during 1-year follow-up. ⋯ Atraumatic mesh fixation with glue was quicker and resulted in less acute postoperative pain than sutures for Lichtenstein hernia repair. Registration number: NCT02632097 (http://www.clinicaltrials.gov).
-
Multicenter Study Comparative Study
Outcome after laparoscopic and open resections of posterosuperior segments of the liver.
Laparoscopic resection of posterosuperior (PS) segments of the liver is hindered by limited visualization and curvilinear resection planes. The aim of this study was to compare outcomes after open and laparoscopic liver resections of PS segments. ⋯ LLR of tumours in PS segments is feasible in selected patients. LLR is associated with fewer complications and does not compromise survival compared with OLR.
-
Randomized Controlled Trial Multicenter Study
Non-technical skills of surgical trainees and experienced surgeons.
In addition to technical expertise, surgical competence requires effective non-technical skills to ensure patient safety and maintenance of standards. Recently the Royal Australasian College of Surgeons implemented a new Surgical Education and Training (SET) curriculum that incorporated non-technical skills considered essential for a competent surgeon. This study sought to compare the non-technical skills of experienced surgeons who completed their training before the introduction of SET with the non-technical skills of more recent trainees. ⋯ The drop in NOTSS score was unexpected and highlights that even experienced surgeons are not immune to deficiencies in non-technical skills. Consideration should be given to continuing professional development programmes focusing on non-technical skills, regardless of the level of professional experience.
-
Multicenter Study
Timing of completion lymphadenectomy after positive sentinel node biopsy in patients with melanoma.
Nodal staging with sentinel node biopsy (SNB) and completion lymph node dissection (CLND) provides prognostic information to patients with melanoma and their physicians. It is not known whether the timing of CLND is associated with survival outcome and/or CLND tumour load. This study investigated whether CLND timing is associated with CLND tumour load, disease-free survival (DFS) and/or melanoma-specific survival (MSS). ⋯ The time interval between diagnosis of melanoma and CLND did not influence CLND tumour load, DFS or MSS.
-
Quality assurance is acknowledged as a crucial factor in the assessment of oncological surgical care. The aim of this study was to develop a composite measure of multiple outcome parameters defined as 'textbook outcome', to assess quality of care for patients undergoing oesophagogastric cancer surgery. ⋯ Most patients did not achieve a textbook outcome and there was wide variation between hospitals.