The British journal of surgery
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Comparative Study
Association between operative approach and complications in patients undergoing Hartmann's reversal.
Complications following reversal of Hartmann's procedure are common, with morbidity rates of up to 50 per cent, and a mortality rate as high as 10 per cent. This is based on case series with heterogeneous data collection and analysis. This study determined risk factors for complications following Hartmann's reversal. ⋯ A laparoscopic approach to Hartmann's reversal was associated with fewer complications than open surgery in this highly selected group of patients.
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Comparative Study
Cost-effectiveness of the implementation of an enhanced recovery protocol for colorectal surgery.
Enhanced recovery protocols may reduce postoperative complications and length of hospital stay. However, the implementation of these protocols requires time and financial investment. This study evaluated the cost-effectiveness of enhanced recovery implementation. ⋯ Enhanced recovery is cost-effective, with savings evident even in the initial implementation period.
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There are concerns about the extent of impaired endocrine and exocrine pancreatic function and poor quality of life (QoL) after pancreatectomy, but there is little information from large prospective follow-up studies. ⋯ About half of all patients can expect recovery from pancreatectomy after 6 months, but those with risk factors need more careful follow-up and supportive management.
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A gross proximal oesophageal margin greater than 5 cm is considered to be necessary for curative surgery of adenocarcinoma of the oesophagogastric junction. This study investigated whether a shorter proximal margin might suffice in the context of total gastrectomy for Siewert type II and III tumours. ⋯ Gross proximal margin lengths of more than 20 mm in resected specimens seem satisfactory for patients with type II and III adenocarcinoma of the oesophagogastric junction treated by transhiatal gastrectomy.
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Surgical error analysis is essential for investigating mechanisms of errors, events and adverse outcomes. Furthermore, it provides valuable information for formative feedback and quality control. The aim of the present study was to design and validate a technical error rating tool in laparoscopic surgery. ⋯ The proposed error rating tool allows an objective and reliable assessment of operative performance in laparoscopic gastric bypass procedures.