The British journal of surgery
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Review Meta Analysis
Meta-analysis of negative pressure wound therapy of closed groin incisions in arterial surgery.
Surgical-site infection (SSI) after groin incisions for arterial surgery is common and may lead to amputation or death. Incisional negative pressure wound therapy (NPWT) dressings have been suggested to reduce SSIs. The aim of this systematic review with meta-analysis was to assess the effects of incisional NPWT on the incidence of SSI in closed groin incisions after arterial surgery. ⋯ Incisional NPWT after groin incisions for arterial surgery reduced the incidence of SSI compared with standard wound dressings. The risk of bias highlighted the need for a high-quality RCT with cost-effectiveness analysis.
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Randomized Controlled Trial Comparative Study
Sex differences in faecal occult blood test screening for colorectal cancer.
This analysis of patients in a randomized population-based health services study was done to determine the effects of faecal occult blood test (FOBT) screening of colorectal cancer (CRC) in outcomes beyond mortality, and to obtain explanations for potential sex differences in screening effectiveness. ⋯ Biennial FOBT screening seems to be effective in terms of improving several different outcomes in men, but not in women. Differences in incidence, symptoms and tumour location may explain the differences in screening efficacy between sexes.
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According to guidelines, adjuvant treatment or re-excision should be considered after R1 resection of gastrointestinal stromal tumours (GISTs). However, the prognostic significance of R1 resection is uncertain and tumour rupture confounds its assessment. Here, the impact of positive margins was examined and related to rupture in a population-based cohort. ⋯ Positive resection margins are strongly associated with tumour rupture. R1 resection does not independently influence prognosis. Adjuvant imatinib may not be justified after R1 resection in the absence of tumour rupture or other high-risk features.
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Multicenter Study
Patient-reported functional and quality-of-life outcomes after transanal total mesorectal excision.
Follow-up of more than 1 year after transanal total mesorectal excision for rectal cancer demonstrated improved quality of life and stable or improved functional outcomes. Continued experience and operative efficiency hold promise for improved overall outcomes with this emerging technology. Key patient-reported outcomes.
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Review Meta Analysis Comparative Study
Meta-analysis of clinical outcome after treatment for achalasia based on manometric subtypes.
The introduction of high-resolution manometry and the Chicago classification has made it possible to diagnose achalasia and predict treatment response accurately. The aim of this study was to compare the effect of the different treatments available on symptomatic outcomes across all achalasia subtypes. ⋯ Pneumatic dilatation had a lower but still acceptable success rate compared with POEM or LHM in patients with type II achalasia. POEM is an excellent treatment modality for type I and type III achalasia, although it did not show any superiority over LHM for type II achalasia.