The British journal of surgery
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Pancreaticojejunostomy versus pancreaticogastrostomy in reconstruction following pancreaticoduodenectomy.
Pancreaticogastrostomy (PG) after pancreaticoduodenectomy has been reported to have a lower incidence of pancreatic fistula than pancreaticojejunostomy (PJ) but this was not confirmed in a recent prospective randomized study. ⋯ This controlled clinical study supports the hypothesis that PG is safer than PJ, particularly with regard to the incidence of pancreatic fistula.
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Multicenter Study
Epidemiology of lower extremity amputation in centres in Europe, North America and East Asia.
This study was established to enable a comparison of lower extremity amputation incidence rates between different centres around the world. ⋯ Apart from the Navajo centre, differences in the known prevalence of diabetes could not account for the differences in overall incidence of amputation. Differences in the prevalence of peripheral vascular disease are likely to be important, but this and the role of other factors, including availability of health care, are worthy of further investigation.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Prospective randomized multicentre study of laparoscopic versus open appendicectomy.
A prospective randomized multicentre study was performed to compare the outcome of laparoscopic and open appendicectomy in patients with suspected acute appendicitis. ⋯ Laparoscopic appendicectomy is as safe as open appendicectomy and has the advantage of allowing a quicker recovery.
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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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To obtain information on the contemporary management of colorectal cancer in the UK to assist in the development of management guidelines, an independent, 1-year population audit was carried out in Trent Region and Wales. ⋯ This initial report from a comprehensive, independent audit of colorectal cancer management shows improvement in some aspects of treatment as evidenced by improved anastomotic dehiscence and stoma rates when compared with previous studies. However, there has been little improvement in the proportion of patients presenting with advanced disease, and curative resection rates remain low.