The British journal of surgery
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Randomized Controlled Trial Comparative Study Clinical Trial
Randomized clinical trial comparing suture and mesh repair of umbilical hernia in adults.
Prosthetic repair has become the standard method for inguinal hernia and has excellent results. The question remains of whether the mesh technique could also improve results for umbilical defects. ⋯ Prosthetic repair could become the standard treatment for primary umbilical hernia in adults.
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Multicenter Study Clinical Trial
Reintervention as a clinical trial endpoint after peripheral arterial bypass surgery.
Graft patency is usually the primary endpoint in studies of peripheral arterial bypass surgery, but gives only a limited indication of clinical outcome. The aim of this study was to evaluate reintervention as a study endpoint after femorodistal bypass surgery. ⋯ Recording the number of patients who did not need reintervention for 12 months after femorodistal bypass gave a more accurate assessment of the number with clinical improvement than was obtained by recording bypass graft patency. Inclusion of patient survival in a composite endpoint increased the clinical relevance of this endpoint in patients with severe ischaemia who had femorodistal bypass surgery.
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Several surgical procedures have been used to treat idiopathic megabowel. A structured approach to the surgical management of megarectum/colon is reported. ⋯ Approximately 40 per cent of patients with megabowel referred for surgery responded to conservative treatment. The remaining patients may be treated successfully by surgery. The use of either a 'diagnostic' defunctioning stoma or colonic motility studies may aid in the choice of surgical procedure.
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This study analysed the risk of surgically treated small bowel obstruction after open appendicectomy. ⋯ The risk of postoperative small bowel obstruction needing surgical treatment after open appendicectomy is lower than previously thought. Perforated appendicitis, negative appendicectomy and high age are the risk factors.
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The aim of this study was to determine the current use of thromboprophylaxis for laparoscopic surgery in Denmark. ⋯ Despite the widespread use of thromboprophylaxis, symptomatic thromboembolic complications were reported from several departments. Further studies are needed to determine whether laparoscopic surgery should be considered a high-risk procedure.