Annals of surgery
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To evaluate the efficacy of non-fixation versus fixation of meshes in laparoendoscopic repair of M3 inguinal hernias in terms of recurrence, postoperative pain, and surgical complications. ⋯ Non-fixation of three-dimensional meshes is non-inferior to fixation of flat lightweight meshes for M3 inguinal hernia repair. These findings support the potential revision of international hernia management guidelines to incorporate non-fixation approaches with appropriate mesh types.
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To investigate whether the cumulative operative time spent by a surgeon operating on patients on the same day prior to starting a new procedure was associated with surgical outcomes. ⋯ First patient of the day may experience worse outcomes, prompting surgeons to warm up before starting surgery. Further research is needed to replicate these findings, as many surgeons may prioritize starting with the most complex and challenging cases, which inherently carry greater risks.
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To investigate the association between glycemic control, measured by glycated hemoglobin (HbA1c) levels, and post-operative complications across various procedures, identify the prevalence of patients with undiagnosed prediabetes or diabetes undergoing surgery, and explore whether better glycemic management is associated with reduced short-term postoperative complications. ⋯ Glycemic control significantly impacts morbidity and mortality in surgical patients. A total of 23% of patients were patients with undiagnosed prediabetes or diabetes, underscoring the importance of preoperative HbA1c screening for all patients. Both very low and very high HbA1c levels should be preoperatively addressed, with moderate control (HbA1c 7-8%, 53-64 mmol/mol) identified as optimal. Overall, these findings emphasize the need for personalized diabetes management plans tailored to each patient's needs and should inform clinical guidelines.
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Over the past two decades, the epidemiology of trauma has shifted significantly, driven primarily by demographic changes. Aim of our study was to illustrate the changing landscape of trauma mortality rates and compare them with other leading causes of death. ⋯ Level III retrospective study.