The British journal of surgery
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Randomized Controlled Trial Multicenter Study
Tranexamic acid and blood loss in pancreaticoduodenectomy: TAC-PD randomized clinical trial.
Tranexamic acid (TXA) may reduce intraoperative blood loss, but it has not been investigated in pancreaticoduodenectomy (PD). ⋯ jRCTs041190062 (https://jrct.niph.go.jp).
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The number of units with experience in extended radical resections for advanced pelvic tumours has grown substantially in recent years. The use of complex vascular resections and reconstructive techniques in these units is expected to increase with experience. This review aimed to provide a cutting-edge overview of this evolving surgical approach to complex pelvic tumours with vascular involvement. ⋯ En bloc resection of the common or external iliac vessels during exenterative pelvic surgery is a feasible strategy for patients with advanced tumours which infiltrate major pelvic vascular structures. Oncological, morbidity, and survival outcomes appear comparable to more central pelvic tumours. These encouraging outcomes, combined with an increasing interest in extended pelvic resections globally, will likely lead to more exenteration units developing oncovascular experience.
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A major restriction to transplantation is the requirement for ABO blood group compatibility between donor and recipient. In this study, an α-galactosidase enzyme from Bacteroides fragilis was used successfully to remove type B blood group antigens enzymatically from human kidneys using ex vivo normothermic machine perfusion. This provides the first step for a strategy to overcome the ABO barrier in kidney transplantation.
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Comment Letter Randomized Controlled Trial
Author response to: Comment on: DIAgnostic iMaging or Observation in early equivocal appeNDicitis (DIAMOND): open-label, randomized clinical trial.