The British journal of surgery
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Multicenter Study
Feasibility work to inform the design of a randomized clinical trial of wound dressings in elective and unplanned abdominal surgery.
Designing RCTs in surgery requires consideration of existing evidence, stakeholders' views and emerging interventions, to ensure that research questions are relevant to patients, surgeons and the health service. When there is uncertainty about RCT design, feasibility work is recommended. This study aimed to assess how feasibility work could inform the design of a future pilot study and RCT (Bluebelle, HTA - 12/200/04). ⋯ Based on the findings from this large study of current practice, the pilot study design has evolved. The inclusion criteria have expanded to encompass patients undergoing unscheduled surgery, and tissue adhesive as a dressing will be evaluated as an additional intervention group. Collaborative methods are recommended to inform the design of RCTs in surgery, helping to ensure they are relevant to current practice.
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Faecal incontinence (FI) is widely recognized as a significant problem in the community. Conjecture exists around the proportion of the population affected. This systematic review evaluated studies reporting the community prevalence of FI in terms of methodology, design and definitions. ⋯ When comparable methodologies and definitions are used, studies produce remarkably similar prevalence rates in different community populations. FI remains an unspoken symptom, with lower rates reported in personal interviews compared with anonymous postal questionnaires.
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Multicenter Study Observational Study
Population-based cohort study of outcomes following cholecystectomy for benign gallbladder diseases.
The aim was to describe the management of benign gallbladder disease and identify characteristics associated with all-cause 30-day readmissions and complications in a prospective population-based cohort. ⋯ Readmissions and complications following cholecystectomy are common and associated with patient and disease characteristics.
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Mesenteric panniculitis (MP) is a rare condition that historically has been associated with the presence of malignancy. Paraneoplastic phenomena in general regress with cure and in most cases with treatment of the cancer. This study was undertaken to determine whether MP regressed with cancer treatment and cure. ⋯ MP does not behave like a paraneoplastic phenomenon. The association with malignancy is most likely an epiphenomenon of the many CT images acquired for staging of cancer.
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Multicenter Study
Prognostic impact of extracapsular lymph node involvement after neoadjuvant therapy and oesophagectomy.
The significance of extracapsular lymph node involvement (LNI) is unclear in patients with oesophageal cancer who have undergone neoadjuvant treatment followed by oesophagectomy. The aim of this study was to assess the incidence and prognostic significance of extracapsular LNI in a large multicentre series of consecutive patients with oesophageal cancer treated by neoadjuvant chemotherapy or chemoradiotherapy and surgery. ⋯ The presence of extracapsular LNI after neoadjuvant therapy carries a poor prognosis.