The British journal of surgery
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Randomized Controlled Trial Multicenter Study Clinical Trial
Randomized clinical trial of the effects of preoperative and postoperative oral nutritional supplements on clinical course and cost of care.
Postoperative oral nutritional supplementation has been shown to be of clinical benefit. This study examined the clinical effects and cost of administration of oral supplements both before and after surgery. ⋯ Perioperative oral nutritional supplementation started before hospital admission for lower gastrointestinal tract surgery significantly diminished the degree of weight loss and incidence of minor complications, and was cost-effective.
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Multicenter Study Clinical Trial Controlled Clinical Trial
Recurrence and survival after mesorectal excision for rectal cancer.
Mesorectal excision for rectal cancer has resulted in local recurrence rates of 3-11 per cent compared with up to 38 per cent after conventional methods. The results of a prospective Danish study with a historical control group are presented. ⋯ Mesorectal excision is associated with a considerably lower risk of local recurrence and a better survival rate than conventional surgery, and is the optimum method for rectal cancer resection.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Impact of the introduction and training of total mesorectal excision on recurrence and survival in rectal cancer in The Netherlands.
Local control and survival following surgical treatment of rectal cancer have been improved by the introduction of total mesorectal excision (TME). The aim of this study was to determine the nationwide impact of the introduction and training of TME on recurrence and survival in rectal cancer. ⋯ The introduction and training of TME has led to improved long-term outcome of patients with rectal cancer in the Netherlands.
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Multicenter Study
Cohort study in South and West England of the influence of specialization on the management and outcome of patients with oesophageal and gastric cancers.
To evaluate specialization in National Health Service (NHS) cancer care, volume-outcome relationships were examined. ⋯ The study supports concentration of services for oesophageal and gastric cancers. Specialization of doctors and their teams is at least as important as specialization of hospitals.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Randomized clinical trial of suture repair, polypropylene mesh or autodermal hernioplasty for incisional hernia.
Since conventional suture repair for incisional hernia is associated with high recurrence rates, alloplastic and autoplastic prosthetic techniques have been suggested. ⋯ Suture repair was safe for small incisional hernias. Both autoplastic and alloplastic hernia repair yielded comparably low recurrence rates, but led to a high rate of wound infection.