The British journal of surgery
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Review Meta Analysis
Systematic review, meta-analysis and meta-regression of the effect of tranexamic acid on surgical blood loss.
Tranexamic acid (TXA) reduces blood transfusion in surgery but the extent of the reduction in blood loss and how it relates to the dose of TXA is unclear. ⋯ TXA reduces blood loss in surgical patients by about one-third. A total dose of 1 g appears to be sufficient for most adults. There is no evidence to support the use of high doses.
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Multicenter Study Comparative Study
Predicting aortic complications after endovascular aneurysm repair.
Lifelong surveillance is standard after endovascular repair of abdominal aortic aneurysm (EVAR), but remains costly, heterogeneous and poorly calibrated. This study aimed to develop and validate a scoring system for aortic complications after EVAR, informing rationalized surveillance. ⋯ The risk score uses commonly available morphological data to stratify the rate of complications after EVAR. The proposals for rationalized surveillance could provide clinical and economic benefits.
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Multicenter Study Comparative Study
Outcome following laparoscopic and open total mesorectal excision for rectal cancer.
There are few reports on the oncological quality of resection and outcome after laparoscopic versus open total mesorectal excision (TME) for rectal cancer in everyday surgical practice. ⋯ Oncological outcome is comparable after laparoscopic and open TME in everyday surgical practice.
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Randomized Controlled Trial
Randomized clinical trial of a simple pulmonary recruitment manoeuvre to reduce pain after laparoscopy.
Shoulder tip and abdominal pain following laparoscopic procedures are well recognized causes of postoperative morbidity. In this double-blind randomized clinical trial attempts were made to reduce postoperative pain in patients undergoing laparoscopic surgery by implementing a simple intraoperative technique. ⋯ NCT01720433 (http://www.clinical trials.gov).
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Data are lacking to support the cost-effectiveness of enhanced recovery pathways (ERP) for oesophagectomy. The aim of this study was to investigate the impact of an ERP on medical costs for oesophagectomy. ⋯ A multidisciplinary ERP for oesophagectomy was associated with cost savings, with no increase in morbidity or mortality.