The British journal of surgery
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Review Meta Analysis
Meta-analysis of observational studies on the safety and effectiveness of robotic gynaecological surgery.
The safety and effectiveness of robotic, open and conventional laparoscopic surgery in gynaecological surgery was assessed in a systematic review of the literature. This will enable the general surgical community to understand where robotic surgery stands in gynaecology. ⋯ The available evidence shows that robotic surgery offers limited advantages with respect to short-term outcomes. However, the clinical outcomes should be interpreted with caution owing to the methodological quality of the studies.
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Identification of a patient cohort at high risk of developing oesophageal cancer might enable a greater proportion of patients with curable disease stages to be identified and permit better use of investigative resources. The aim of this study was to develop a scoring system that identifies patients with dysphagia at greatest risk of having oesophageal cancer. ⋯ From 574 referrals, the EDS correctly classified as higher risk all but one patient with cancer. Some 34·0 per cent of patients identified as lower risk could have been investigated less urgently. This simple scoring system permits sensitive prioritization of patients referred with dysphagia, and enables more efficient use of investigative resources.
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The aim of this study was to review an experience with retroperitoneal endoscopic adrenalectomy (REA). This is the procedure of choice for adrenal tumours at this institution. ⋯ REA appears to be a safe and effective surgical technique for adrenal gland tumours up to 6 cm in diameter, with a minimal complication rate.
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Review Meta Analysis Comparative Study
Systematic review and meta-analysis of preoperative antisepsis with chlorhexidine versus povidone-iodine in clean-contaminated surgery.
Surgical-site infection increases morbidity, mortality and financial burden. The preferred topical antiseptic agent (chlorhexidine or povidone-iodine) for preoperative skin cleansing is unclear. ⋯ Chlorhexidine should be used preferentially for preoperative antisepsis in clean-contaminated surgery.