Journal of the American College of Surgeons
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Randomized Controlled Trial Clinical Trial
A randomized, double-blind, placebo-controlled trial to determine effectiveness of antibiotic prophylaxis for tension-free mesh herniorrhaphy.
In recent years, use of prosthetic material for inguinal hernia repair has increased dramatically. Tension-free repairs have gained popularity not only for recurrent or complicated hernias, but for primary hernia repairs as well. Although routine use of prophylactic antibiotics is not recommended in the Philippines for open nonimplant herniorrhaphy, there is little direct clinical evidence on which to base recommendations when implantable mesh is used. ⋯ Preoperative administration of single-dose antibiotic for tension-free inguinal mesh herniorrhaphy did not markedly decrease risk of wound infection in this patient population. Our results do not support use of antibiotic prophylaxis for tension-free mesh herniorrhaphy.
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Review Comparative Study Historical Article
"Modern" military surgery: 19th century compared with 20th century.
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Comparative Study
Caudate hepatectomy for cancer: a single institution experience with 150 patients.
Resection of the caudate lobe of the liver is technically demanding, with the disparate goals of preserving major vascular and biliary structures without compromising tumor clearance. Our objective was to assess our results with resection of the caudate lobe of the liver for malignant disease. ⋯ Performing caudate hepatectomy with negative microscopic margins remains a technical challenge because of the proximity of major biliary and vascular structures. Although caudate resection of the liver can be performed safely, concomitant major vascular reconstruction substantially increases the mortality of the procedure.
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Comparative Study
Increased expression of Cyr61 (CCN1) identified in peritoneal metastases from human pancreatic cancer.
Identification of extracellular matrix proteins (ECM) associated with tumor cell metastasis may generate targets for future therapy against pancreatic cancer metastases. We hypothesized that comparison of ECM-associated gene expression in primary and metastatic pancreatic tumors would identify ECM proteins associated with pancreatic metastasis. ⋯ The ECM protein Cyr61 shows increased expression in metastatic lesions in a clinically relevant model of pancreatic adenocarcinoma. Protein analysis confirms the microarray results and collocalization of Cyr61, and alpha(v) suggests that interaction between Cyr61 and alpha(v)beta(3) promotes formation of peritoneal metastases.