Surgery today
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Randomized Controlled Trial Comparative Study
Synthetic polyglycomer short-term absorbable sutures vs. polydioxanone long-term absorbable sutures for preventing incisional hernia and wound dehiscence after abdominal wall closure: a comparative randomized study of patients treated for gastric or colon cancer.
To compare the results of abdominal wall closure using interrupted synthetic short-term vs. long-term tensile strength-retaining absorbable sutures. ⋯ Outcomes were favorable in both groups and not inferior to reported outcomes of larger-scale studies. Verification of the equivalence between the two types of suture material necessitates larger-scale studies that adopt the same suture methods.
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Rib fractures are a marker of severe injury, predicting a higher incidence of associated injuries. The purpose of this study was to assess whether an increasing number of rib fractures predicts the severity of liver injury in blunt trauma patients. ⋯ Although the presence of rib fractures was associated with an increased probability of liver injury in patients with blunt torso trauma, there is no relationship between the number of fractured ribs and the severity of liver injury.
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We conducted this meta-analysis to establish whether pancreaticogastrostomy (PG) or pancreaticojejunostomy (PJ) is the better method of reconstruction for reducing the risk of postoperative pancreatic fistula (POPF). ⋯ This meta-analysis shows that PG is superior to PJ for reducing the incidence of POPF, but there were no differences in other complications or mortality. Therefore, it may be considered as an alternative to PJ and further RCTs are needed to prove our findings.
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Randomized Controlled Trial Comparative Study
Prospective randomized evaluation of open preperitoneal versus preaponeurotic primary elective mesh repair for paraumbilical hernias.
The aim of this study was to compare the preperitoneal versus the preaponeurotic mesh positioning in open paraumbilical hernia repair. ⋯ The preperitoneal mesh placement during the repair of paraumbilical hernias is superior to the preaponeurotic placement, because it is associated with fewer complications, less pain and a shorter time of return to normal daily activities.
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Liver resection is recognized as the preferred treatment for patients with colorectal liver metastases (CLM) because it offers long-term survival; it is the only hope for a cure. However, in the majority of cases, liver surgery is contraindicated due to the small volume of the future remnant liver. ⋯ We recently performed Hobson's choice two-stage hepatectomy in two cases for reasons different from those of the original planned two-stage hepatectomy. In the present report, we describe our Hobson's choice two-stage hepatectomy strategy, which provided favorable short-term outcomes.