The British journal of surgery
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Outcomes after surgery for sporadic pancreatic neuroendocrine neoplasms (Pan-NENs) were evaluated. ⋯ A surgical approach seems without benefit for Pan-NECs, and unnecessary for small G1 sporadic Pan-NENs. Surgery alone may be insufficient for stage III-IV and G3 Pan-NENs.
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Randomized Controlled Trial Multicenter Study
Preoperative portal vein or portal and hepatic vein embolization: DRAGON collaborative group analysis.
The extent of liver resection for tumours is limited by the expected functional reserve of the future liver remnant (FRL), so hypertrophy may be induced by portal vein embolization (PVE), taking 6 weeks or longer for growth. This study assessed the hypothesis that simultaneous embolization of portal and hepatic veins (PVE/HVE) accelerates hypertrophy and improves resectability. ⋯ PVE/HVE achieved better FLR hypertrophy and resectability than PVE in this collaborative experience.
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Multicenter Study Observational Study
Post-thyroidectomy bleeding: analysis of risk factors from a national registry.
Post-thyroidectomy haemorrhage occurs in 1-2 per cent of patients, one-quarter requiring bedside clot evacuation. Owing to the risk of life-threatening haemorrhage, previous British Association of Endocrine and Thyroid Surgeons (BAETS) guidance has been that day-case thyroidectomy could not be endorsed. This study aimed to review the best currently available UK data to evaluate a recent change in this recommendation. ⋯ The highest risk for bleeding occurred following total thyroidectomy in men, but overall bleeding was unpredictable. In hemithyroidectomy increasing surgeon thyroidectomy volume reduces bleeding risk. This analysis supports the revised BAETS recommendation to restrict day-case thyroid surgery to hemithyroidectomy performed by high-volume surgeons, with caution in the elderly, men, patients with retrosternal goitres, and those undergoing redo surgery.
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Randomized Controlled Trial Multicenter Study
Faecal immunochemical testing in symptomatic patients to prioritize investigation: diagnostic accuracy from NICE FIT Study.
This study investigated whether a quantitative faecal immunochemical test (FIT) could be used to select patients with either high- or low-risk symptoms of colorectal cancer for urgent investigation. ⋯ FIT safely selects patients with high or low risk symptoms of colorectal cancer for investigation.
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Randomized Controlled Trial Multicenter Study
Supervised exercise after oesophageal cancer surgery: the PERFECT multicentre randomized clinical trial.
This study investigated whether a supervised exercise programme improves quality of life (QoL), fatigue and cardiorespiratory fitness in patients in the first year after oesophagectomy. ⋯ A supervised exercise programme improved cardiorespiratory fitness and aspects of QoL.