Annals of surgery
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The aim of this study was to perform a structured systematic review and meta-analysis to evaluate the effectiveness and complication rate of cholecystectomy deferral versus prophylactic cholecystectomy among patients post-endoscopic biliary sphincterotomy for common bile duct stones. ⋯ Prophylactic cholecystectomy remains the preferred strategy compared to a deferral approach with gallbladder in situ post-sphincterotomy for patients with bile duct stones. Future studies may highlight a subset of patients (ie, those with large balloon biliary dilation) that may not require cholecystectomy.
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Randomized Controlled Trial Multicenter Study
Methods of Colostomy Construction: No Effect on Parastomal Hernia Rate: Results From Stoma-const-A Randomized Controlled Trial.
The primary objective of this trial was to compare the parastomal hernia rates 1 year after the construction of an end colostomy by 3 surgical techniques: cruciate incision, circular incision in the fascia and using prophylactic mesh. Secondary objectives were evaluation of postoperative complications, readmissions/reoperations, and risk factors for parastomal hernia. ⋯ We found no significant differences in the rates of parastomal hernia within 12 months of index surgery between the 3 surgical techniques of colostomy construction.
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Randomized Controlled Trial Multicenter Study
Clinical Evaluation of Intraoperative Near Misses in Laparoscopic Rectal Cancer Surgery.
To investigate the frequency, nature, and severity of intraoperative adverse near miss events within advanced laparoscopic surgery and report any associated clinical impact. ⋯ Intraoperative adverse events and near misses can be reliably and objectively captured in advanced laparoscopic surgery. Near misses are commonplace and closely associated with morbidity outcomes.
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Randomized Controlled Trial Pragmatic Clinical Trial
Preventing Recurrence in Clean and Contaminated Hernias Using Biologic Versus Synthetic Mesh in Ventral Hernia Repair: The PRICE Randomized Clinical Trial.
The aim of this study was to evaluate which mesh type yields lower recurrence and complication rates after ventral hernia repair. ⋯ The risk of hernia recurrence was significantly higher for patients undergoing ventral hernia repair with biologic mesh compared to synthetic mesh, with similar rates of postoperative complications. These data indicate that the use of synthetic mesh over biologic mesh to repair ventral hernias is effective and can be endorsed, including under contaminated wound conditions.
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An Assessment of Patient, Caregiver, and Clinician Perspectives on the Post-Discharge Phase of Care.
We sought to elicit patients', caregivers', and health care providers' perceptions of home recovery to inform care personalization in the learning health system. ⋯ Patients live the day-to-day of recovery, whereas caregivers and clinicians also contemplate more expansive concerns. Incorporating relevant perceptions into traditional clinical outcomes and concepts could enhance the surgical experience for all stakeholders.