The British journal of surgery
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Review Meta Analysis
Role of bariatric surgery in reducing the risk of colorectal cancer: a meta-analysis.
Obesity increases the risk of multiple co-morbidities such as type 2 diabetes, cardiovascular disease and most cancers, including colorectal cancer. Currently, the literature presents conflicting results regarding the protective effects of bariatric surgery on the incidence of colorectal cancer. This meta-analysis was conducted to investigate the effect of bariatric surgery on the risk of developing colorectal cancer in obese individuals. ⋯ Patients who underwent bariatric surgery had a greater than 35 per cent reduction in the risk of developing colorectal cancer compared with obese individuals who had no surgery.
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Randomized Controlled Trial
Effect of footplate neuromuscular electrical stimulation on functional and quality-of-life parameters in patients with peripheral artery disease: pilot, and subsequent randomized clinical trial.
Supervised exercise programmes for intermittent claudication have poor access and limited compliance. Neuromuscular electrical stimulation (NMES) may be an effective alternative. A proof-of-concept study and RCT were conducted. ⋯ Footplate NMES significantly improved walking distance in patients with intermittent claudication when used independently and also as an adjunct to supervised exercise. Registration number: trial 1, NCT02436200; trial 2, NCT02429310 (http://www.clinicaltrials.gov).
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Randomized Controlled Trial Comparative Study
Randomized clinical trial of intracorporeal versus extracorporeal anastomosis in laparoscopic right colectomy (IEA trial).
Several non-randomized and retrospective studies have suggested that intracorporeal anastomosis (IA) has advantages over extracorporeal anastomosis (EA) in laparoscopic right colectomy, but scientific evidence is lacking. The aim was to compare short-term outcomes and to define the possible benefits of IA compared with EA in elective laparoscopic right colectomy. ⋯ Duration of hospital stay was similar, but IA was associated with less pain and fewer complications. Registration number: NCT02667860 ( http://www.clinicaltrials.gov).
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Circulating cell-free DNA (cfDNA) is not found in healthy subjects, but is readily detected after thermal injury and may contribute to the risk of multiple organ failure. The hypothesis was that a postburn reduction in DNase protein/enzyme activity could contribute to the increase in cfDNA following thermal injury. ⋯ The results of this study suggest a novel biological mechanism for the accumulation of cfDNA following thermal injury by which high levels of actin released by damaged tissue cause a reduction in DNase activity. Restoration of the actin scavenging system could therefore restore DNase activity, and reduce the risk of cfDNA-induced host tissue damage and thrombosis.
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Multicenter Study
Multicentre evaluation of case volume in minimally invasive hepatectomy.
Surgical outcomes may be associated with hospital volume and the influence of volume on minimally invasive liver surgery (MILS) is not known. ⋯ A volume-outcome association existed for minimally invasive hepatectomy. Complex and major resections may be best managed in high-volume centres.