The British journal of surgery
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Review Meta Analysis
Meta-analysis comparing upfront surgery with neoadjuvant treatment in patients with resectable or borderline resectable pancreatic cancer.
Studies comparing upfront surgery with neoadjuvant treatment in pancreatic cancer may report only patients who underwent resection and so survival will be skewed. The aim of this study was to report survival by intention to treat in a comparison of upfront surgery versus neoadjuvant treatment in resectable or borderline resectable pancreatic cancer. ⋯ Neoadjuvant treatment appears to improve overall survival by intention to treat, despite lower overall resection rates for resectable or borderline resectable pancreatic cancer. PROSPERO registration number: CRD42016049374.
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Review Meta Analysis
Meta-analysis of in-hospital delay before surgery as a risk factor for complications in patients with acute appendicitis.
The traditional fear that every case of acute appendicitis will eventually perforate has led to the generally accepted emergency appendicectomy with minimized delay. However, emergency and thereby sometimes night-time surgery is associated with several drawbacks, whereas the consequences of surgery after limited delay are unclear. This systematic review aimed to assess in-hospital delay before surgery as risk factor for complicated appendicitis and postoperative morbidity in patients with acute appendicitis. ⋯ This meta-analysis demonstrates that delaying appendicectomy for presumed uncomplicated appendicitis for up to 24 h after admission does not appear to be a risk factor for complicated appendicitis, postoperative surgical-site infection or morbidity. Delaying appendicectomy for up to 24 h may be an acceptable alternative for patients with no preoperative signs of complicated appendicitis.
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Review Meta Analysis
Meta-analysis of outcomes following resection of the primary tumour in patients presenting with metastatic colorectal cancer.
It is not clear whether resection of the primary tumour (when there are metastases) alters survival and/or whether resection is associated with increased morbidity. This systematic review and meta-analysis assessed the prognostic value of primary tumour resection in patients presenting with metastatic colorectal cancer. ⋯ Primary tumour resection may provide a modest survival advantage in patients presenting with metastatic colorectal cancer.
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Review Meta Analysis
Meta-analysis evaluating music interventions for anxiety and pain in surgery.
This study aimed to evaluate anxiety and pain following perioperative music interventions compared with control conditions in adult patients. ⋯ Music interventions significantly reduce anxiety and pain in adult surgical patients.
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Review Meta Analysis Comparative Study
Meta-analysis of an artery-first approach versus standard pancreatoduodenectomy on perioperative outcomes and survival.
The aim of this systematic review and meta-analysis was to evaluate perioperative outcomes and survival in patients undergoing an artery-first approach to pancreatoduodenectomy in comparison with those having standard pancreatoduodenectomy. ⋯ The artery-first approach to pancreatoduodenectomy may be associated with improved perioperative outcomes and survival.