The British journal of surgery
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Randomized Controlled Trial
Randomized clinical trial of antibiotic therapy for uncomplicated appendicitis.
Uncomplicated appendicitis may resolve spontaneously or require treatment with antibiotics or appendicectomy. The aim of this randomized trial was to compare the outcome of a non-antibiotic management strategy with that of antibiotic therapy in uncomplicated appendicitis. ⋯ Treatment failure rates in patients presenting with CT-confirmed uncomplicated appendicitis appeared similar among those receiving supportive care with either a no-antibiotic regimen or a 4-day course of antibiotics. Registration number: KCT0000124 ( http://cris.nih.go.kr).
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Randomized Controlled Trial
Randomized clinical trial of hepatic resection versus radiofrequency ablation for early-stage hepatocellular carcinoma.
Hepatic resection and radiofrequency ablation (RFA) are treatment options for early-stage hepatocellular carcinoma (HCC). Whether tumour recurrence and long-term survival favour either treatment has not been established. This randomized trial aimed to test the hypothesis that RFA is superior to hepatic resection in terms of lower tumour recurrence rate and better long-term survival. ⋯ RFA for early-stage HCC is not superior to hepatic resection, in terms of tumour recurrence, overall survival and disease-free survival. Registration number: HKUCTR-10 (http://www.hkuctr.com).
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Kelch-like 6 (KLHL6) is a cancer oncogene previously associated with specific human cancers, such as chronic lymphocytic leukaemia. Here, the mechanisms of KLHL6 function were explored in gastric cancer (GC) cells, in an in vivo experimental tumour model, and the prognostic value of KLHL6 analysis in GC tissue evaluated in a cohort of patients with GC. ⋯ Abnormal expression of the KLHL6 oncogene promoted GC progression in vitro and in vivo, and its expression level in tumour tissue was found to be of prognostic value.
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The use of synthetic mesh to repair a potentially contaminated incisional hernia may lead to higher failure rates. A biological mesh might be considered, but little is known about long-term results. Both biological and synthetic meshes were investigated in an experimental model of peritonitis to assess their characteristics in vivo. ⋯ This experimental study suggested that XCM Biologic® was superior in terms of incorporation, macroscopic mesh infection, and histological parameters such as collagen deposition and neovascularization. There must be sufficient overlap of mesh during placement, as XCM Biologic® showed a high rate of shrinkage. Surgical relevance The use of synthetic mesh to repair a potentially contaminated incisional hernia is not supported unequivocally, and may lead to a higher failure rate. A biological mesh might be considered as an alternative. There are few long-term studies, as these meshes are expensive and rarely used. This study evaluated the use of biological mesh in a contaminated environment, and investigated whether there is an ideal mesh. A new non-cross-linked biological mesh (XCM Biologic® ) was evaluated in this experiment. The new non-cross-linked biological mesh XCM Biologic® performed best and may be useful in patients with a potentially contaminated incisional hernia.
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Review Meta Analysis
Meta-analysis of the association between peripheral artery disease and growth of abdominal aortic aneurysms.
The role of atherosclerosis in the pathogenesis of abdominal aortic aneurysm (AAA) is controversial. Atherosclerosis-associated peripheral artery disease (PAD) has been reported to be a risk factor for AAA in population screening studies; its relationship with AAA growth is controversial. ⋯ This systematic review suggests that currently reported studies demonstrate no robust and consistent association between PAD and reduced AAA growth.