The British journal of surgery
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Review Meta Analysis
Meta-analysis of epidural analgesia versus parenteral opioid analgesia after colorectal surgery.
Epidural analgesia (EA) with local anaesthetic is considered to play a key role after colorectal surgery. However, its effect on postoperative recovery is still a matter of debate. ⋯ Despite improved analgesia and a decrease in ileus, EA has some adverse effects and does not shorten the duration of hospital stay after colorectal surgery.
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Review
A systematic review of the impact of volume of surgery and specialization on patient outcome.
Volume of surgery and specialization may affect patient outcome. Articles examining the effects of one or more of three variables (hospital volume of surgery, surgeon volume and specialization) on outcome (measured by length of hospital stay, mortality and complication rate) were analysed. Reviews, opinion articles and observational studies were excluded. The methodological quality of each study was assessed, a correlation between the variables analysed and the outcome accepted if it was significant. ⋯ High surgeon volume and specialization are associated with improved patient outcome, while high hospital volume is of limited benefit.
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Review
A systematic review of the impact of volume of surgery and specialization on patient outcome.
Volume of surgery and specialization may affect patient outcome. Articles examining the effects of one or more of three variables (hospital volume of surgery, surgeon volume and specialization) on outcome (measured by length of hospital stay, mortality and complication rate) were analysed. Reviews, opinion articles and observational studies were excluded. The methodological quality of each study was assessed, a correlation between the variables analysed and the outcome accepted if it was significant. ⋯ High surgeon volume and specialization are associated with improved patient outcome, while high hospital volume is of limited benefit.
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Peroperative identification and subsequent division or preservation of the inguinal nerves during open hernia repair may influence the incidence of chronic postoperative pain. ⋯ The nerves should probably be identified during open hernia repair. Division of and preservation of the ilioinguinal nerve show similar results.
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Review Meta Analysis Comparative Study
A meta-analysis comparing suprapubic and transurethral catheterization for bladder drainage after abdominal surgery.
Although bladder drainage is widely used for general surgical patients undergoing laparotomy, there is little consensus on whether suprapubic or transurethral catheterization is better. ⋯ The suprapubic route for bladder drainage in general surgery is more acceptable to patients and reduces microbiological morbidity.