The British journal of surgery
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Review Meta Analysis
Meta-analysis of the association between preoperative anaemia and mortality after surgery.
Numerous published studies have explored associations between anaemia and adverse outcomes after surgery. However, there are no evidence syntheses describing the impact of preoperative anaemia on postoperative outcomes. ⋯ Preoperative anaemia is associated with poor outcomes after surgery, although heterogeneity between studies was significant. It remains unclear whether anaemia is an independent risk factor for poor outcome or simply a marker of underlying chronic disease. However, red cell transfusion is much more frequent amongst anaemic patients.
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Meta Analysis Comparative Study
Meta-analysis comparing early versus delayed laparoscopic cholecystectomy for acute cholecystitis.
Previous studies comparing early laparoscopic cholecystectomy (ELC) with delayed laparoscopic cholecystectomy (DLC) for acute cholecystitis were incomplete. A meta-analysis was undertaken to compare the cost-effectiveness, quality of life, safety and effectiveness of ELC versus DLC. ⋯ For patients with acute cholecystitis, ELC appears as safe and effective as DLC. ELC might be associated with lower hospital costs, fewer work days lost, and greater patient satisfaction.
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Multicenter Study Clinical Trial
Prospective multicentre cohort study of patient-reported outcomes after cholecystectomy for uncomplicated symptomatic cholecystolithiasis.
Up to 33 per cent of patients with uncomplicated symptomatic cholecystolithiasis report persistent pain after cholecystectomy. The aim of this study was to determine characteristics associated with patient-reported absence of abdominal pain after cholecystectomy, improved abdominal symptoms, and patient-reported positive cholecystectomy results in a prospective cohort multicentre study. ⋯ Preoperative characteristics determine the odds for relief of abdominal pain after cholecystectomy. However, these factors were not associated with patient-reported improvement of abdominal symptoms or patient-reported positive cholecystectomy results, highlighting the variation of internal standards and expectations of patients before cholecystectomy.
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Comparative Study Observational Study
Postoperative vocal fold palsy in patients undergoing thyroid surgery with continuous and intermittent nerve monitoring.
Continuous monitoring of electromyographic (EMG) amplitudes of the vocal muscles detects impending injury of the recurrent laryngeal nerve (RLN) during thyroid operations earlier than intermittent EMG monitoring. This may alert the surgeon to stop a manoeuvre causing stretching or pressure on the RLN, with better recovery of nerve function. ⋯ Operation with CIONM resulted in fewer permanent vocal fold palsies compared with IIONM after thyroid surgery in patients with benign disease.
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Whether rescue surgery confers a survival benefit in patients undergoing non-curative endoscopic resection of early gastric cancer remains controversial. ⋯ Rescue surgery confers a survival benefit after non-curative endoscopic resection of early gastric cancer.