American journal of surgery
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Randomized Controlled Trial Comparative Study
A prospective randomized clinical trial comparing the Prolene Hernia System® and the Lichtenstein patch technique for inguinal hernia repair in long term: 2- and 5-Year results.
Long-term sequelae in open inguinal hernia repair with either a bilayer mesh (Prolene Hernia System [PHS]) or an onlay mesh (Lichtenstein patch) were compared. ⋯ The 2 approaches resulted in comparable rates of recurrence and long-term chronic postoperative pain. The Lichtenstein patch caused significantly more often long-term sensory dysfunction of the skin in the operated groin.
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Randomized Controlled Trial
The effects of urinary trypsin inhibitor on liver function and inflammatory factors in patients undergoing hepatectomy: a prospective, randomized, controlled clinical study.
The inhibition of inflammation exerts benefits following massive hepatectomy in animals but not in the clinic. The aim of this study was to investigate the effectiveness and mechanism of ulinastatin on liver function and outcomes following hepatectomy. ⋯ Ulinastatin protects liver function and improves clinical outcomes, possibly via the inhibition of inflammation and oxidation at an earlier stage following major hepatectomy.
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Comparative Study
Repair of esophageal atresia with tracheoesophageal fistula via thoracotomy: a contemporary series.
A recent series detailing thoracoscopic repair of esophageal atresia with tracheoesophageal fistula (EA/TEF) reported lower complication rates compared with historic controls. This study provides a contemporary cohort of patients repaired via thoracotomy for comparison with the recent large multi-institutional thoracoscopic series. ⋯ Thoracoscopic repair of EA/TEF yielded complication rates similar to this contemporary series; however, trends toward increased anastomotic leaks and greater need for fundoplication were noted. No musculoskeletal sequelae were directly attributable to thoracotomy.
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The objective of our study was to determine the important factors that have influence on the time of sentinel node visualization using intradermal injection of (99m)Tc-antimony sulfide colloid. ⋯ Older age and higher BMI can result in slow sentinel node visualization. Longer interval between biopsy and sentinel node mapping can be associated with rapid sentinel node detection.
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Colon preparation for elective colon resection to reduce surgical site infection (SSI) remains controversial. ⋯ Mechanical bowel preparation alone does not reduce rates of SSI, but oral antibiotic preparation and systemic preoperative antibiotics are superior when compared with systemic antibiotics alone. Additional clinical trials are necessary to define the best combined overall mechanical and oral antibiotic regimen for elective colon surgery.