The British journal of surgery
-
Recent literature suggests that early laparoscopic cholecystectomy for acute gallbladder disease is safe and efficacious, but few data are available on the management of acute gallbladder disease in England. ⋯ Early cholecystectomy for acute gallbladder disease is not widely practised by surgeons in England. Open cholecystectomy is more commonly used in the emergency than in the elective setting. Early laparoscopic cholecystectomy following an emergency admission carries a higher conversion rate than elective cholecystectomy.
-
Review Meta Analysis Comparative Study
Systematic review and meta-analysis of the effect of portal triad clamping on outcome after hepatic resection.
The effect of portal triad clamping (PTC) on outcome after hepatic resection is uncertain. ⋯ On currently available evidence, the routine use of PTC does not offer any benefit in perioperative outcome after liver resection. It cannot be recommended as a standard procedure.
-
Neoadjuvant chemotherapy for breast cancer reduces tumour cellularity, the percentage of the primary tumour area that is composed of invasive tumour cells. Minimal residual tumour cellularity (5 per cent or less of tumour area composed of invasive tumour cells) may be associated with an increased risk of false-negative intraoperative margins. The aim of this study was to evaluate the incidence of minimal residual tumour cellularity after neoadjuvant chemotherapy and its impact on the frequency of false-negative margins and conversion from breast-conserving surgery to mastectomy. ⋯ Minimal residual cellularity after neoadjuvant chemotherapy occurred in about 25 per cent of specimens, but did not alter the rate of false-negative intraoperative margins.
-
Multicenter Study
Validation of an Inguinal Pain Questionnaire for assessment of chronic pain after groin hernia repair.
Long-term pain is an important outcome after inguinal hernia repair. The aim of this study was to test the validity and reliability of a specific Inguinal Pain Questionnaire (IPQ). ⋯ This study found good validity and reliability for the IPQ, making it a useful instrument for assessing pain following groin hernia repair.
-
Randomized Controlled Trial Comparative Study
Randomized clinical trial comparing endovenous laser ablation with surgery for the treatment of primary great saphenous varicose veins.
Endovenous laser ablation (EVLA) is a minimally invasive technique for treating varicose veins due to truncal vein incompetence. This randomized trial compared EVLA with conventional surgery in patients with primary saphenofemoral and great saphenous vein (GSV) reflux. ⋯ ISRCTN99270116 (http://www.controlled-trials.com).