Annals of surgery
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To review quality of life (QOL) instruments for chronic limb-threatening ischemia (CLTI) patients and informal carers, and their use in QOL and cost-utility analysis (CUA) studies. ⋯ This review provides a comprehensive reference for QOL measurement in CLTI that helps end-users with instrument selection, use, and interpretation. However, a CLTI-specific instrument is needed. There is an opportunity to benefit society through future CUA studies and evaluation of QOL in informal carers.
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Randomized Controlled Trial Multicenter Study
Effect of the Use of Reinforced Stapling on the Occurrence of Pancreatic Fistula after Distal Pancreatectomy: Results of the REPLAY Multicenter Randomized clinical trial REPLAY: REinforcement of the Pancreas in distaL pAncreatectomY.
The aim of the study was to evaluate the impact of the use of a reinforced stapler (RS) during distal pancreatectomy (DP) on postoperative outcomes. ⋯ The results of this randomized clinical trial did not favor the use of RS during DP to reduce the rate of PF.
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To examine outcomes of living-donor intestinal transplant (LDITx) recipients. ⋯ LDITx is a valuable treatment option for patients with end-stage intestinal failure. Improved immunosuppression, better HLA matching, and shorter cold ischemia times were associated with reduced rates of rejection, viral-mediated infection and improved graft survival.
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To describe the incidence of new persistent opioid use after inguinal hernia repair as well as its associated risk factors. ⋯ After undergoing inguinal hernia repair, 1.5% of patients developed new persistent opioid use. Filling an opioid prescription in the 30 days before surgery had the strongest association with this complication.
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Living donor liver transplantation (LDLT) using small grafts, especially left lobe grafts (H1234-MHV) (LLG), continues to be a challenge due to small-for-size syndrome (SFSS). We herein demonstrate that with surgical modifications, outcomes with small grafts can be improved. ⋯ LLG (H1234-MHV) are feasible in adult LDLT with excellent outcomes comparable to RLG (H5678). Venous outflow augmentation and splenectomy help lower the threshold of using small-for-size grafts without compromising graft survival.