The British journal of surgery
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Despite widespread use of imaging technologies including ultrasonography and computed tomography, rates of negative appendicectomy and perforated appendicitis remain high. This trend analysis examined whether rates of negative appendicectomy and perforated appendicitis have decreased over time, and sought to evaluate clinical predictors associated with negative appendicectomy and perforated appendicitis. ⋯ The rate of negative appendicectomy decreased over time, without an accompanying increase in perforated appendicitis. The risk of having a negative appendicectomy was highest in girls aged 12-18 years without local or generalized peritonitis during the early study period, whereas perforation was associated with age over 36 years, presence of localized or generalized peritonitis, and greater co-morbidity. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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Infrainguinal revascularization for critical leg ischaemia (CLI) in patients aged 80 years and over is associated with increased operative risk. The aim was to compare the results of percutaneous transluminal angioplasty (PTA) and bypass surgery in these patients. ⋯ When feasible, a strategy of PTA first appears to achieve better results than infrainguinal bypass surgery in patients aged 80 years and older.
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Sentinel node biopsy (SNB) is employed as standard treatment in some solid organ cancers to assess lymph node spread and enable targeted treatment. Several studies have investigated the role of SNB in thyroid cancer. This is a systematic review and meta-analysis of the role of SNB in the management of thyroid cancer. ⋯ SNB in thyroid cancer is a promising technique that has the potential to avoid prophylactic lymph node surgery in up to 57 per cent of patients with clinically node-negative thyroid cancer.