The British journal of surgery
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Randomized Controlled Trial Multicenter Study
Randomized controlled trial of preoperative oral carbohydrate treatment in major abdominal surgery.
Major surgery is associated with postoperative insulin resistance which is attenuated by preoperative carbohydrate (CHO) treatment. The effect of this treatment on clinical outcome after major abdominal surgery has not been assessed in a double-blind randomized trial. ⋯ ACTRN012605000456651 (http://www.anzctr.org.au).
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Randomized Controlled Trial Multicenter Study
Interim analysis of the Stockholm III trial of preoperative radiotherapy regimens for rectal cancer.
To address issues regarding the fractionation of radiotherapy (RT) and timing of surgery for rectal cancer, a multicentre trial has randomized patients to preoperative short-course RT with two different intervals to surgery, or long-course RT with delayed surgery. The present interim analysis assessed feasibility, compliance and complications after RT and surgery. ⋯ NCT00904813 (http://www.clinicaltrials.gov).
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Multicenter Study
Multicentre experience with extralevator abdominoperineal excision for low rectal cancer.
Abdominoperineal excision (APE) for low rectal cancer is associated with higher rates of circumferential resection margin (CRM) involvement and intraoperative perforation (IOPs) than anterior resection for higher tumours. This multicentre observational study was designed to confirm that extralevator APE can improve outcomes and investigated the morbidity associated with such extensive surgery. ⋯ Extralevator APE is associated with less CRM involvement and IOP than standard surgery.
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This study examined the population outcome of ruptured abdominal aortic aneurysm (rAAA) in England, the role of endovascular repair (EVAR), and the relationship between outcome and hospital workload. ⋯ EVAR offered a survival advantage over open repair for non-elective aneurysm procedures. Services for the treatment of rAAA should incorporate access to EVAR and would benefit from being based in units with a high elective caseload.