The British journal of surgery
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The aim of the study was to assess the causes and effects of delay in diagnosis in surgical patients who died in 20 public hospitals participating in the Queensland Audit of Surgical Mortality (QASM) in Australia. ⋯ General (gastrointestinal) surgery patients who experienced delayed diagnosis were at increased risk of postoperative complications.
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Comparative Study
Comparison of operative notes with real-time observation of adhesiolysis-related complications during surgery.
The operative report contains critical information for patient care, serves an educational purpose and is an important source for surgical research. Recent studies demonstrate that operative reports are unstructured and lack vital components. The accuracy of the operative notes has never been assessed. The aim of this study was to analyse the accuracy of operative reports by comparing notes with intraoperative observer-derived findings regarding adhesions and adhesiolysis-related complications. ⋯ The sensitivity and specificity of operative reports noting adhesions and adhesiolysis were low. One in seven enterotomies was not reported. Effort should be put into teaching timely, meaningful, structured and accurate reporting of surgical procedures.
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Trauma systems reduce mortality and improve functional outcomes from injury. Regional trauma networks have been established in several European regions to address longstanding deficiencies in trauma care. A perception of the geography and population distribution as challenging has delayed the introduction of a trauma system in Scotland. The characteristics of trauma incidents attended by the Scottish Ambulance Service were analysed, to gain a better understanding of the geospatial characteristics of trauma in Scotland. ⋯ The majority of trauma incidents in Scotland occur in urban and deprived areas. A regionalized system of trauma care appears plausible, although the precise configuration of such a system requires further study.
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Portal vein embolization (PVE) has become a standard procedure to increase the future liver remnant (FLR) and enable curative resection of initially unresectable liver tumours. This study investigated the safety and feasibility of a new two-stage liver resection technique that uses in situ liver transection (ISLT) and portal vein ligation before completion hepatectomy. ⋯ ISLT is an effective and reliable technique to induce rapid growth of the FLR, even in patients with insufficient volume increase after PVE.
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Prophylactic central neck dissection (CND) for papillary thyroid cancer (PTC) remains controversial. The aim of this study was to examine whether prophylactic CND for PTC affected long-term survival and locoregional control. ⋯ NCT01510002 (http://www.clinicaltrials.gov).