Annals of surgery
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Randomized Controlled Trial Multicenter Study Comparative Study
A double-blinded randomized controlled trial of laparoendoscopic single-site access versus conventional 3-port appendectomy.
The aim of the current study was to perform a multicentered prospective double-blinded randomized controlled trial comparing laparoendoscopic single-site access (LESS) versus conventional three-port laparoscopic appendectomy (TPLA). ⋯ LESS and conventional appendectomy resulted in similar perioperative outcomes. However, LESS appendectomy resulted in worst pain scores upon exertion and required a higher dosage of intravenous analgesics when compared with TPLA. On the contrary, wound cosmesis and satisfaction scores were better in the LESS group. Hence, adoption of the technique for appendectomy will depend on patient preferences and the presence of local expertise.
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We sought to investigate whether a volume-outcome relationship exists for lower extremity arterial bypass (LEAB) surgery. ⋯ A positive volume-outcome relationship exists for LEAB procedures even after employing multilevel risk adjustment models. There are benefits in terms of mortality and limb salvage both in the short-term and at 1 year postsurgery.
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We conducted a systematic review of published literature to gain a better understanding of the impact of advanced fellowships on surgical resident training and education. ⋯ The overall impact of advanced surgical fellowships on surgical resident education and training remains unclear, as most studies rely on limited data of questionable generalizability. A careful study of the national database of surgery resident case logs is essential to better understand how early surgical specialization and fellowships will impact the future of general surgery education.
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Comparative Study Clinical Trial
Significantly increased pregnancy rates after laparoscopic restorative proctocolectomy: a cross-sectional study.
To assess the impact of a laparoscopic approach on female fecundity in ileoanal pouch surgery. ⋯ Pregnancy rates are significantly higher after laparoscopic IPAA. This makes the laparoscopic approach the method of choice in young women.