The British journal of surgery
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Review Meta Analysis Comparative Study
Systematic review and meta-analysis comparing three techniques for pancreatic remnant closure following distal pancreatectomy.
Established closure techniques for the pancreatic remnant after distal pancreatectomy include stapler, suture and anastomotic closure. However, controversy remains regarding the ideal technique; therefore, the aim of this study was to compare closure techniques and risk of postoperative pancreatic fistula (POPF). ⋯ The use of stapler closure or anastomotic closure for the pancreatic remnant after distal pancreatectomy significantly reduces POPF rates compared with suture closure. The combination of stapler and suture closure shows superiority over suture closure alone.
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Multicenter Study
Multicentre analysis of long-term outcome after surgical resection for gastric cancer liver metastases.
The efficacy of surgical resection for gastric cancer liver metastases (GCLMs) is currently debated. Hitherto, no large-scale clinical studies have been conducted. ⋯ Clinically resectable GCLM is rare, but strict and careful patient selection can lead to long-term survival following R0 surgical resection.
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Throughout history, surgeons have been prolific innovators, which is hardly surprising as most surgeons innovate daily, tailoring their intervention to the intrinsic uniqueness of each operation, each patient and each disease. Innovation can be defined as the application of better solutions that meet new requirements, unarticulated needs or existing market needs. In the past two decades, surgical innovation has significantly improved patient outcomes, complication rates and length of hospital stay. There is one key area that has great potential to change the face of surgical practice and which is still in its infancy: the realm of regenerative medicine and tissue engineering. ⋯ Surgical innovation in the emerging field of regenerative medicine has the ability to make a major impact on surgery on a daily basis.
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Multicenter Study Comparative Study
Use of a pathway quality improvement care bundle to reduce mortality after emergency laparotomy.
Emergency laparotomies in the U.K., U.S.A. and Denmark are known to have a high risk of death, with accompanying evidence of suboptimal care. The emergency laparotomy pathway quality improvement care (ELPQuiC) bundle is an evidence-based care bundle for patients undergoing emergency laparotomy, consisting of: initial assessment with early warning scores, early antibiotics, interval between decision and operation less than 6 h, goal-directed fluid therapy and postoperative intensive care. ⋯ Use of the ELPQuiC bundle was associated with a significant reduction in the risk of death following emergency laparotomy.