The British journal of surgery
-
Randomized Controlled Trial Multicenter Study
Randomized clinical trial of stapler hepatectomy versus LigaSure™ transection in elective hepatic resection.
Previous studies have demonstrated stapler hepatectomy and use of various energy devices to be safe alternatives to the clamp-crushing technique in elective hepatic resection. In this randomized trial, the effectiveness and safety of stapler hepatectomy were compared with those of parenchymal transection with the LigaSure™ vessel sealing system. ⋯ Stapler hepatectomy was associated with reduced blood loss and a shorter duration of operation than the LigaSure™ device for parenchymal transection in elective partial hepatectomy. Registration number: NCT01858987 (http://www.clinicaltrials.gov).
-
Randomized Controlled Trial Multicenter Study
Value of risk scores in the decision to palliate patients with ruptured abdominal aortic aneurysm.
The aim of this study was to develop a 48-h mortality risk score, which included morphology data, for patients with ruptured abdominal aortic aneurysm presenting to an emergency department, and to assess its predictive accuracy and clinical effectiveness in triaging patients to immediate aneurysm repair, transfer or palliative care. ⋯ The assessed risk scores did not have sufficient accuracy to enable potentially life-saving decisions to be made regarding intervention. Focus should therefore shift to offering repair to more patients and reducing non-intervention rates, while respecting the wishes of the patient and family.
-
Randomized Controlled Trial Multicenter Study
Development and validation of a difficulty score to predict intraoperative complications during laparoscopic liver resection.
Previous studies have demonstrated that patient, surgical, tumour and operative variables affect the complexity of laparoscopic liver resections. However, current difficulty scoring systems address only tumour factors. The aim of this study was to develop and validate a predictive model for the risk of intraoperative complications during laparoscopic liver resections. ⋯ This comprehensive scoring system, based on patient, surgical and tumour factors, and developed and validated using a large multicentre European database, helped estimate the risk of intraoperative complications.
-
Multicenter Study
Morbidity and mortality according to age following gastrectomy for gastric cancer.
This study investigated age-related differences in surgically treated patients with gastric cancer, and aimed to identify factors associated with outcome. ⋯ ASA grade, neoadjuvant chemotherapy and type of resection are independent predictors of morbidity and death in patients with gastric cancer, irrespective of age.
-
Multicenter Study
Population-based study of mortality and major amputation following lower limb revascularization.
The aim of this study was to estimate separate risks of major lower limb amputation and death following revascularization for peripheral artery disease (PAD) using competing risks analysis. ⋯ The 5-year risk of major amputation following lower limb revascularization for PAD appears lower than estimated previously. Patients undergoing revascularization for tissue loss and those who require an open procedure are at highest risk of limb loss.