The British journal of surgery
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Multicenter Study
Early sac shrinkage predicts a low risk of late complications after endovascular aortic aneurysm repair.
Aneurysm shrinkage has been proposed as a marker of successful endovascular aneurysm repair (EVAR). Patients with early postoperative shrinkage may experience fewer subsequent complications, and consequently require less intensive surveillance. ⋯ Early change in aneurysm sac diameter is a strong predictor of late complications after EVAR. Patients with major sac shrinkage have a very low risk of complications for up to 5 years. This parameter may be used to tailor postoperative surveillance.
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Review Meta Analysis Comparative Study
Systematic review and meta-analysis of trainee- versus expert surgeon-performed colorectal resection.
The aim of this meta-analysis was to compare short-term and oncological outcomes following colorectal resection performed by surgical trainees and expert surgeons. ⋯ In selected patients, it is appropriate for supervised trainees to perform colorectal resection.
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Multicenter Study Comparative Study
Multicentre propensity score-matched analysis of conventional versus extended abdominoperineal excision for low rectal cancer.
Abdominal perineal excision (APE) was originally described with levator ani removal for rectal cancer. An even wider, more aggressive extralevator resection for APE has been proposed. Although some surgeons are performing a very wide 'extralevator APE (ELAPE)', there are few data to recommend it routinely. This multicentre study aimed to compare outcomes of APE and ELAPE. ⋯ ELAPE does not improve rates of CRM involvement, intraoperative tumour perforation, local recurrence or mortality.
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New oral anticoagulants (NOACs) offer an alternative to warfarin for preventing stroke in patients with atrial fibrillation. NOACs are expected to replace warfarin and other vitamin K antagonists for most of their indications in the future. Knowledge of the use of NOACs in the perioperative period is important for optimal care. ⋯ Management of NOACs in elective and emergency conditions requires knowledge of time of last intake of drug, current renal function and the planned procedure in order to assess the overall risk of bleeding. Currently no antidote exists to reverse the effects of these drugs.