The British journal of surgery
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Multicenter Study
Results of aortic screening in the brothers of patients who had elective aortic aneurysm repair.
Brothers of patients with an abdominal aortic aneurysm (AAA) are at high risk. In the present study brothers of patients who underwent elective AAA surgery were invited for aneurysm screening and the psychological consequences studied. ⋯ The prevalence of AAA in brothers of patients with AAA is far higher than in the overall male population of the same age. Screening does not seem to have a negative influence on psychological well-being.
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Randomized Controlled Trial Clinical Trial
Randomized placebo-controlled trial of local anaesthetic infusion in day-case inguinal hernia repair.
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Application of laparoscopy to the resection of malignancy has been followed by a literature describing cases of metastatic involvement at laparoscopic port sites. These include patients who underwent surgery for early stage carcinoma and instances following laparoscopic procedures during which tumours were not dissected. ⋯ Further research in this area is urgent. Until the issue is better understood, patients undergoing laparoscopic surgery for malignancy should be entered into clinical trials.
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Percutaneous computed tomography (CT)-guided aspiration of abdominal collections is performed in necrotizing pancreatitis to detect infection of necrosis, which is an adverse prognostic factor and requires surgical drainage. However, in the case of sterile aspirates, the outcome and the optimum management are subject to debate. This study examined the clinical and bacteriological outcome of patients with severe acute pancreatitis with initially sterile necrosis and assessed the efficiency of percutaneous drainage in this setting. ⋯ Percutaneous drainage of sterile collections predisposed to secondary infection of the necrosis and did not cure the patients. A first sterile percutaneous aspiration did not predict a favourable course and surgery frequently remains necessary.
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The incidence of abdominal aortic aneurysm (AAA) has increased steadily during the past 30 years. ⋯ The decline in mortality rate and emergency procedures may result from a fall in the incidence of ruptured AAA, due to an increasing rate of elective surgery before 1992. The decline in elective procedures from 1992 may be due to a fall in the prevalence of AAA owing to high rates of elective surgery, or to a fall in the incidence of the disease itself.