The British journal of surgery
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Review Meta Analysis
Meta-analysis of prognostic factors for amputation following surgical repair of lower extremity vascular trauma.
Lower extremity vascular trauma (LEVT) is a major cause of amputation. A clear understanding of prognostic factors for amputation is important to inform surgical decision-making, patient counselling and risk stratification. The aim was to develop an understanding of prognostic factors for amputation following surgical repair of LEVT. ⋯ A significant proportion of patients who undergo lower extremity vascular trauma repair will require secondary amputation. This meta-analysis describes significant prognostic factors needed to inform surgical judgement, risk assessment and patient counselling.
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Randomized Controlled Trial Multicenter Study Comparative Study
Randomized clinical trial of skin closure by subcuticular suture or skin stapling after elective colorectal cancer surgery.
The best suture method to prevent incisional surgical-site infection (SSI) after clean-contaminated surgery has not been clarified. ⋯ UMIN000004001 (http://www.umin.ac.jp/ctr).
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Multicenter Study
International validation of a risk score for complications and reinterventions after endovascular aneurysm repair.
Lifelong surveillance is considered mandatory after endovascular repair (EVAR) of abdominal aortic aneurysms to detect endograft complications and prevent aneurysm rupture. Current protocols are not cost-effective or clinically effective. The international validity of the St George's Vascular Institute (SGVI) score for EVAR complications was examined. ⋯ This study has provided international validation of a morphological risk score that predicts mid-term reinterventions and endograft complications. The results may enable risk-stratified surveillance after EVAR.
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Multicenter Study
Hospital teaching status and volume related to mortality after pancreatic cancer surgery in a national cohort.
The association between hospital teaching status and mortality after pancreatic resection is not well explored. Although hospital volume is related to short-term mortality, the effect on long-term survival needs investigation, taking into account hospital teaching status and selective referral patterns. ⋯ Hospital teaching status was strongly related to decreased mortality in both the short and long term. This may relate to processes of care rather than volume per se. Very low-volume hospitals had the highest short-term mortality risk.
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Controlled Clinical Trial
Global abnormalities in lymphatic function following systemic therapy in patients with breast cancer.
Breast cancer-related lymphoedema (BCRL) is a result of interaction between several pathophysiological processes, and is not simply a 'stopcock' effect resulting from removal of axillary lymph nodes. The aim of this study was to test the hypothesis that there is a constitutional 'global' lymphatic dysfunction in patients who develop BCRL. ⋯ ISRCTN84866416 ( http://www.isrctn.com).