The British journal of surgery
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Sentinel lymph node biopsy (SLNB) is the standard procedure for axillary staging in patients with primary operable breast cancer and uninvolved axillary nodes. These patients increasingly have breast-conserving surgery (BCS), and 5 to 10 per cent develop ipsilateral breast tumour recurrence during follow-up. If axillary nodes remain clinically uninvolved after a previous negative SLNB the question remains whether second SLNB is a suitable option. ⋯ Second SLNB after previous BCS and negative SLNB plus adjuvant radiotherapy may be offered to selected women with ipsilateral breast tumour recurrence.
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The aim of the study was to validate the use of the Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM), Portsmouth (P) POSSUM and upper gastrointestinal (O) POSSUM models in patients undergoing elective thoracic oesophagectomy for carcinoma. ⋯ P-POSSUM provided the most accurate prediction of in-hospital mortality in this group of patients who had elective oesophagectomy.
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Differences between women and men in treatment and outcome after admission with a ruptured abdominal aortic aneurysm (AAA) in England were studied. ⋯ Women with a ruptured AAA were less likely to be treated surgically than men, and their overall mortality rate was higher. Lower rates of surgery in women than in men may contribute to the higher mortality in women, but other explanations are possible.
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Mild steatosis has been thought not to affect outcome after liver resection. However, recent studies have reported impaired postoperative recovery of patients with mild steatosis. This study evaluated the recovery of hepatic functional reserve during regeneration in a rat model of mild steatosis and liver resection. ⋯ Mild steatosis impaired functional recovery and increased hepatocellular damage after liver resection.
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Foam sclerotherapy is a potential treatment for varicose veins. A systematic review was undertaken to assess its safety and efficacy. ⋯ Serious adverse events associated with foam sclerotherapy are rare. There is insufficient evidence to allow a meaningful comparison of the effectiveness of this treatment with that of other minimally invasive therapies or surgery.