International journal of surgery
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The Enhanced Recovery after Surgery (ERAS) model integrates several elements of perioperative care into a standardised clinical pathway for surgical patients. ERAS programmes aim to reduce the rate of complications, improve surgical recovery, and limit postoperative length of hospital stay (LOHS). One area of growing interest that is not currently included within ERAS protocols is the use of exercise prehabilitation (PREHAB) interventions. ⋯ We discuss the findings of systematic reviews and meta-analyses and supplement these with recently published clinical trials. This article summarises the research findings and identifies pertinent gaps in the research area that warrant further investigation. Finally, studies are conceptually synthesised to discuss the feasibility of PREHAB in clinical practice and its potential role within the ERAS pathway.
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Multicenter Study Comparative Study
Laparoscopic hepatectomy versus open hepatectomy for hepatocellular carcinoma in 157 patients: A case controlled study with propensity score matching at two Chinese centres.
The aim of this study was to investigate the long-term outcomes and perioperative outcomes of laparoscopic hepatectomy (LH) versus open hepatectomy (OH) for hepatocellular carcinoma (HCC) between well-matched patient groups. ⋯ Laparoscopic hepatectomy is technically feasible and safe in selected patients. LH showed similar long-term outcomes, associated with less blood loss, shorter hospital stay, and fewer postoperative complications in selected patients with HCC compared with OH.
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Comparative Study
Reoperative central lymph node dissection for incidental papillary thyroid cancer can be performed safely: A retrospective review.
This study compares the pathological outcomes and operative morbidity for papillary thyroid cancer (PTC) patients undergoing a primary total thyroidectomy (TT) with central lymph node dissection (CLND), to those undergoing an interval CLND following a previous thyroid operation, or for the unsuspected diagnosis of PTC. ⋯ Reoperative CLND for incidental PTC frequently identifies cervical lymph node metastases, potentially reduces recurrence, and can be performed with similar morbidity to a primary lymphadenectomy.
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Lateral malleolus fracture can occur alone or is associated with the fracture of the medial malleolus leading to ankle instability. Treatment is aimed to achieve anatomical reduction and ensure stability. Compared to non-locking plate locking plate provide stable construct and compromise bone vascularity less. However, there is increase wound complication with locking plates than non-locking plates. PHILOS plate combines the principles of fixation with a conventional plate with those of locking screws. The benefits of this implant are that it gives enhanced purchase in osteopenic bone. It is the first case series of studying the outcomes of modified use of PHILOS plate in lateral malleolus fracture. ⋯ Modified use of PHILOS is neither the only nor the best means of achieving union, but rather it can offer significant advantages over previously described techniques and is a reasonable option in case of lateral malleolus fracture.
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Anterior chest wall numbness after plate fixation of clavicular shaft fractures is a common complication. This is usually related to damage of the branches of the supraclavicular nerve in conventional open plating. We investigated whether the use of minimally invasive plate osteosynthesis could reduce the incidence of post-operative numbness and improve patients' satisfaction compared to open plating. ⋯ The MIPO technique for clavicle shaft fractures is an effective way to reduce post-operative numbness and improve patients' satisfaction compare to conventional open plating. Surgeons could consider using this technique as an alternative procedure to prevent iatrogenic supraclavicular nerve damage and subsequent anterior chest wall numbness.