Annals of surgery
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Comparative Study
Recurrence and outcomes following hepatic resection, radiofrequency ablation, and combined resection/ablation for colorectal liver metastases.
To examine recurrence and survival rates for patients treated with hepatic resection only, radiofrequency ablation (RFA) plus resection or RFA only for colorectal liver metastases. ⋯ Hepatic resection is the treatment of choice for colorectal liver metastases. RFA alone or in combination with resection for unresectable patients does not provide survival comparable to resection, and provides survival only slightly superior to nonsurgical treatment.
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Comparative Study
Inflammatory mechanisms contributing to pancreatic cancer development.
Pancreatic cancer is the most deadly of all gastrointestinal (GI) malignancies, yet relatively little is known regarding mechanisms of tumor development including the role of inflammation. ⋯ Our results demonstrate that similar inflammatory components and downstream effectors are present in CP and pancreatic cancers. Importantly, these findings suggest that a common pathway for pancreatic cancer development may be through a chronic inflammatory process including stroma formation. These findings may lead to novel strategies for pancreatic cancer prophylaxis based on inhibition of inflammatory mediators.
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Comparative Study
Practicing surgeons lead in quality care, safety, and cost control.
To report the experiences of 66 surgical specialists from 15 different hospitals who performed 43 CPT-based procedures more than 16,000 times. ⋯ Since 1998, Quality Surgical Solutions, PLLC, has developed simple physician-authored protocols for delivering high-quality and cost-effective surgery that measure up to benchmark institutions. We have discovered wide areas for improvements in surgery by adherence to simple protocols, minimizing death and complications and clarifying cost issues.
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Comparative Study
The natural history of pancreatitis-induced splenic vein thrombosis.
To determine the natural history of pancreatitis-induced splenic vein thrombosis with particular attention to the risk of gastric variceal hemorrhage. ⋯ Gastric variceal bleeding from pancreatitis-induced splenic vein thrombosis occurs in only 4% of patients; therefore, routine splenectomy is not recommended.
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To determine if micrometastatic disease in the sentinel lymph node is a predictor of non-sentinel lymph node (non-SLN) involvement in breast cancer. ⋯ This study demonstrates that the incidence of non-SLN involvement is low in SLN that contains only micrometastatic foci and is within the accepted range of the false-negative rate of SLN. This suggests that a CAD may be omitted in patients with micrometastatic disease.