The British journal of surgery
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Over the past 18 years neuromodulation therapies have gained support as treatments for faecal incontinence (FI); sacral nerve stimulation (SNS) is the most established of these. A systematic review was performed of current evidence regarding the clinical effectiveness of neuromodulation treatments for FI. ⋯ Emerging data for SNS suggest maintenance of its initial therapeutic effect into the long term. The clinical effectiveness of PTNS is comparable to that of SNS at 12 months, although there is no evidence to support its continued effectiveness after this period. PTNS may be a useful treatment before SNS. The clinical effectiveness of TTNS is still uncertain owing to the paucity of available evidence. A consensus to standardize the use of outcome measures is recommended in order that further reports can be compared meaningfully.
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Randomized Controlled Trial Comparative Study
Randomized trial of the effect of video feedback on the acquisition of surgical skills.
Constructive feedback provides a mechanism for reinforcing learning during the acquisition of surgical skills. Feedback is usually given verbally, and sometimes documented, after direct observation by a trained assessor. The aim was to evaluate video recording as an effective modality for enhancing feedback, in comparison with standard verbal feedback alone. ⋯ The addition of video feedback can improve the acquisition of surgical skills, and could be incorporated into formal surgical curricula.
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Comparative Study
Outcome after resection and radiofrequency ablation of liver metastases from small intestinal neuroendocrine tumours.
In patients with small intestinal neuroendocrine tumour (SI-NET), liver resection or radiofrequency ablation (RFA) of liver metastases is performed for palliation of carcinoid syndrome, and in an effort to improve survival. Data are generally reported from case series, and no randomized trials have studied these treatments. The aim was to compare outcome after liver resection and/or RFA with that of non-surgical treatment in patients with liver metastases from SI-NET. ⋯ These data do not support the use of liver resection and/or RFA in an effort to prolong survival in patients with liver metastases from SI-NET.
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The aim of this study was to evaluate long-term results, quality of life, satisfaction and compensatory sweating after endothoracic sympathetic block at T4 (ESB4). ⋯ T4 endothoracic sympathetic clip application is safe and effective in patients with upper limb hyperhidrosis, with stable long-term improvements in quality of life.
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There are variations in quality of life (QoL) and reported risk of chronic pain after inguinal hernia repair. The aim of this study was to investigate the improvement in pain and QoL after open inguinal hernia repair, and the economic impact. ⋯ QoL improves after open inguinal hernia repair, with a good return on investment independent of symptom severity.