The British journal of surgery
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Review Meta Analysis
Meta-analysis of the effect of warm humidified insufflation on pain after laparoscopy.
Studies on the use of warmed and humidified insufflation (WHI) in laparoscopic abdominal procedures to reduce pain have been inconclusive owing to small sample sizes. ⋯ WHI reduces pain after laparoscopy.
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Review Meta Analysis
A meta-analysis of 21,178 patients undergoing open or endovascular repair of abdominal aortic aneurysm.
Several studies have compared outcomes after elective open and endovascular approaches to abdominal aortic aneurysm (AAA) surgery, with varying results. ⋯ The endovascular repair of AAA offers a clear benefit in terms of reduction in postoperative adverse events and 30-day mortality. In the longer term, it is also associated with a reduction in aneurysm-related mortality, but not in all-cause mortality.
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Review Meta Analysis Comparative Study
Systematic review and meta-analysis of the effect of portal triad clamping on outcome after hepatic resection.
The effect of portal triad clamping (PTC) on outcome after hepatic resection is uncertain. ⋯ On currently available evidence, the routine use of PTC does not offer any benefit in perioperative outcome after liver resection. It cannot be recommended as a standard procedure.
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Neoadjuvant chemotherapy for breast cancer reduces tumour cellularity, the percentage of the primary tumour area that is composed of invasive tumour cells. Minimal residual tumour cellularity (5 per cent or less of tumour area composed of invasive tumour cells) may be associated with an increased risk of false-negative intraoperative margins. The aim of this study was to evaluate the incidence of minimal residual tumour cellularity after neoadjuvant chemotherapy and its impact on the frequency of false-negative margins and conversion from breast-conserving surgery to mastectomy. ⋯ Minimal residual cellularity after neoadjuvant chemotherapy occurred in about 25 per cent of specimens, but did not alter the rate of false-negative intraoperative margins.
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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.