The British journal of surgery
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Review Meta Analysis
Systematic review and meta-analysis of the effect of perioperative steroids on ischaemia-reperfusion injury and surgical stress response in patients undergoing liver resection.
Several therapeutic strategies, such as ischaemic preconditioning, intermittent or selective pedicle clamping and pharmacological interventions, have been explored to reduce morbidity caused by hepatic ischaemia-reperfusion injury and the surgical stress response. The role of steroids in this setting remains controversial. ⋯ Perioperative steroids have a favourable impact on postoperative outcomes after liver resection.
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Randomized Controlled Trial Multicenter Study Comparative Study
Randomized clinical trial of donor-site wound dressings after split-skin grafting.
The aim was to study which dressing material was best for healing donor-site wounds (DSWs) after split-skin grafting as there is wide variation in existing methods, ranging from classical gauze dressings to modern silicone dressings. ⋯ NTR1849 (http://www.trialregister.nl).
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Radioactive seed localization (RSL) is an alternative to wire localization for guiding surgical excision of non-palpable breast cancer. This review provides an overview of the available evidence on the accuracy of RSL in patients undergoing breast-conserving surgery. ⋯ Available scientific evidence suggests that RSL is a safe and accurate technique for localization of non-palpable breast lesions.
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Randomized Controlled Trial Multicenter Study
Randomized clinical trial of the impact of insulin therapy on liver function in patients undergoing major liver resection.
Postoperative liver dysfunction is the major source of morbidity and mortality in patients undergoing partial hepatectomy. This study tested the benefits of a metabolic support protocol based on insulin infusion, for reducing liver dysfunction following hepatic resection. ⋯ NCT00774098 (http://www.clinicaltrials.gov).
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Multicenter Study
Prospective study on loss of signal on the first side during neuromonitoring of the recurrent laryngeal nerve in total thyroidectomy.
Staged thyroidectomy has been recommended when loss of the signal from intraoperative nerve monitoring is observed after first-side dissection of the recurrent laryngeal nerve. There is no high-quality evidence supporting this recommendation. In addition, it is not clear whether signal loss predicts postoperative vocal cord paralysis. ⋯ After loss of signal of the recurrent laryngeal nerve dissected initially, there was a 90 per cent chance of intraoperative signal recovery. In this setting, judicious bilateral thyroidectomy can be performed without risk of bilateral recurrent nerve paresis.