The British journal of surgery
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Axillary reverse mapping (ARM) assesses the lymphatic drainage of the arm simultaneously with that of the breast, enabling preservation of arm lymphatics during axillary surgery for breast cancer. This article systematically reviews the evidence on the lymphoedema rate and oncological safety of the ARM technique. ⋯ ARM can achieve low rates of lymphoedema, but the risk of metastasis in crossover and clinically suspicious ARM nodes, or those in close proximity to an involved sentinel node, warrants their excision.
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Randomized Controlled Trial
Randomized clinical trial of 940- versus 1470-nm endovenous laser ablation for great saphenous vein incompetence.
The independent effect of wavelength used for endovenous laser ablation (EVLA) on patient-reported outcomes, health-related quality of life (HRQoL), treatment success and complications has not yet been established in a randomized clinical trial. The aim was to compare two different wavelengths, with identical energy level and laser fibres, in patients undergoing EVLA. ⋯ NCT01637181 (http://www.clinicaltrials.gov).
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Simulation enables safe practice and facilitates objective assessment of technical skills. However, simulation training in breast surgery is rare and assessment remains subjective. The primary aim was to evaluate the construct validity of technical skills assessments in wide local excision (WLE). ⋯ Video ratings of performance and a proposed ODS differentiate surgeons based on technical skills in WLE and may be useful for objective assessment of breast surgery trainees.
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The lack of uniform criteria for coding of gastroenteropancreatic neuroendocrine neoplasia (GEP-NEN) has hampered previous epidemiological studies. The epidemiology of GEP-NEN was investigated in this study using currently available criteria. ⋯ A high crude incidence of GEP-NEN, at 5.83 per 100,000 inhabitants, was noted together with a significant increasing trend over time.
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One of the major challenges of competency-based training is defining a score representing a competent performance. The objective of this study was to set pass scores for the Objective Structured Assessment of Technical Skill. ⋯ Consistency in pass-fail status between the various methods builds evidence of validity for the set scores. These methods can be applied and studied across a variety of assessment platforms, helping to increase the use of standard setting for competency-based training.