International journal of surgery
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Multi-detector computed tomography (MDCT) represents the gold standard in patients with acute abdomen syndrome and suspected bowel ischemia. It provides a correct diagnosis and contributes to appropriate treatment planning. This study aims to evaluate the role of 3D Tissue Transition Projection (TTP) transparent wall CT reconstruction for detecting the degree of bowel dilatation and to correlate this finding with the aetiology and prognosis in patients affected by mesenteric infarction. ⋯ MDCT offers different reconstruction software for diagnosing bowel ischemia. 3D TTP transparent wall reconstructions represent a rapid and automatic tool for identifying loop dilatation, which significantly correlates with an arterial aetiology and poor prognosis.
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Review Meta Analysis
Cannulated screw fixation and plate fixation for displaced intra-articular calcaneus fracture: A meta-analysis of randomized controlled trials.
Displaced intra-articular calcaneus fractures (DIACFs) are the most common type of calcaneus fracture. The differences in therapeutic effectiveness between cannulated screw fixation (CSF) and plate fixation are still unclear. Thus, in this meta-analysis, we evaluated the therapeutic effectiveness of these two fixation methods. ⋯ Cannulated screw fixation and plate fixation have similar fixation effectiveness and functional outcomes in the treatment of displaced intra-articular calcaneus fractures. Due to the shorter duration of surgery and low rate of complications, cannulated screw fixation is superior to plate fixation. However, further studies are needed to evaluate cannulated screw fixation for various Sanders types of calcaneus fractures.
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In 2014, the American Society of Clinical Oncology published an updated clinical practice guideline on axillary lymph node dissection (ALND) for early-stage breast cancer patients. However, these recommendations have been challenged because they were based on data from only one randomized controlled trial (RCT). We evaluated the rationale of these recommendations by systematically reviewing RCTs using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) system. ⋯ We recommend non-ALND management for early breast cancer patients with 1 or 2 SLN micrometastasis or macrometastasis on the basis of a systematic review of the current evidence conducted using the GRADE system. However, the optimal practice of evidence-based medicine should incorporate patient preferences, particularly when evidence is limited.
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Comparative Study Observational Study
Volar locking plate (VLP) versus non-locking plate (NLP) in the treatment of die-punch fractures of the distal radius, an observational study.
This study aims to evaluate whether volar locking plate was superior over non-locking plate in the treatment of die-punch fractures of the distal radius. ⋯ VLP leaded to significantly better results of reduction maintainance and the final joint congruity than NLP, while reducing overall and major complications. However, the results should be treated in the context of limitations and the clinical significance of the difference required further studies to investigate.
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Comparative Study
Comparisons of clinicopathologic factors and survival rates between laparoscopic and open gastrectomy in gastric cancer.
This study examined the safety and facilitative aspects of laparoscopic gastrectomy, with respect to clinicopathologic factors and complications in patients with gastric cancer, in comparison with open gastrectomy. The study also compared the safety of laparoscopic gastrectomy, with respect to the 5-year survival rate and recurrence in terms of the oncologic results, with that of open gastrectomy. ⋯ This study showed that laparoscopic gastrectomy is a safe and beneficial modality compared with open gastrectomy in patients with gastric cancer. In terms of the oncologic results, laparoscopic gastrectomy is also considered safe and provides the same results as open gastrectomy.