Annals of surgery
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Randomized Controlled Trial Comparative Study
Observation or operation for patients with an asymptomatic inguinal hernia: a randomized clinical trial.
Many patients with an inguinal hernia are asymptomatic or have little in the way of symptoms from their hernia. Repair is often associated with long-term chronic pain and has a recurrence rate of 5% to 10%. Our aim was to compare operation with a wait-and-see policy in patients with an asymptomatic hernia. ⋯ Repair of an asymptomatic inguinal hernia does not affect the rate of long-term chronic pain and may be beneficial to patients in improving overall health and reducing potentially serious morbidity.
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Review
New trends in breast cancer management: is the era of immediate breast reconstruction changing?
Review of available literature on the topic of breast reconstruction and radiation is presented. Factors influencing the decision-making process in breast reconstruction are analyzed. New trends of immediate breast reconstruction are presented. ⋯ When the indications for postoperative radiotherapy are unknown, premastectomy sentinel node biopsy, delayed-immediate reconstruction, or delayed reconstruction is preferable.
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To estimate the prevalence of residual pain 2 to 3 years after hernia surgery, to identify factors associated with its occurrence, and to assess the consequences for the patient. ⋯ Pain that is at least partly disabling appears to occur more often than recurrences. The prevalence of long-term pain can be reduced by preventing postoperative complications. The impact of repair technique on the risk of long-term pain shown in our study should be further assessed in randomized controlled trials.
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To develop an evidence-based virtual reality laparoscopic training curriculum for novice laparoscopic surgeons to achieve a proficient level of skill prior to participating in live cases. ⋯ A competency-based training curriculum for novice laparoscopic surgeons has been defined. This can serve to ensure that junior trainees have acquired prerequisite levels of skill prior to entering the operating room, and put them directly into practice.
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Biography Historical Article
Ernst Ferdinand Sauerbruch and his ambiguous role in the period of National Socialism.
The role of German physicians under National Socialism is highly controversial. We show that Ferdinand Sauerbruch, one of twentieth century's most outstanding surgeons and chair of surgery at Berlin's Charité from 1927 to 1949, openly supported National Socialism in his public statements and in his position as head of the medical section of the Reich Research Council. ⋯ But Sauerbruch also supported victims of Nazi persecution, attempted to use his influence to put a stop to the "Euthanasia Program T4," and in private expressed his criticism of National Socialists. The ambiguous stance of Ferdinand Sauerbruch is probably more typical of the role physicians played during National Socialism than the well-known black-and-white cases.