The British journal of surgery
-
Meta Analysis Comparative Study
Laparoscopic versus open resection of hepatocellular carcinoma in patients with cirrhosis: a meta-analysis.
The exact role of laparoscopic liver resection (LLR) in patients with hepatocellular carcinoma (HCC) and underlying liver cirrhosis (LC) is not well defined. In this meta-analysis, both long- and short-term outcomes following LLR versus open liver resection (OLR) were analysed. ⋯ Laparoscopic resection of HCC in patients with cirrhosis is associated with improved survival and perioperative outcomes.
-
The impact of acute pancreatitis in pregnancy on maternal and fetal outcomes is unclear. Historical case series document very poor outcomes, with maternal mortality rates of 20 per cent and fetal loss of 50 per cent. ⋯ This meta-analysis quantified both maternal and fetal outcomes following acute pancreatitis in pregnancy based on the concurrent literature. Maternal and fetal outcomes after acute pancreatitis in pregnancy have improved with advances in the management of pancreatitis.
-
Multicenter Study
Watch and wait after a clinical complete response in rectal cancer patients younger than 50 years.
Young-onset rectal cancer, in patients less than 50 years, is expected to increase in the coming years. A watch-and-wait strategy is nowadays increasingly practised in patients with a clinical complete response (cCR) after neoadjuvant treatment. Nevertheless, there may be reluctance to offer organ preservation treatment to young patients owing to a potentially higher oncological risk. This study compared patients aged less than 50 years with those aged 50 years or more to identify possible differences in oncological outcomes of watch and wait. ⋯ There is no additional oncological risk in young patients compared with their older counterparts when following a watch-and-wait strategy after a cCR. In light of a shared decision-making process, watch and wait should be also be discussed with young patients who have a cCR after neoadjuvant treatment.
-
Stroke and neurological injury are a complication of thoracic endovascular aortic repair (TEVAR). Cerebral microbleeds (CMBs) are common in patients with white matter damage to the brain secondary to chronic vasculopathy. The aim of this study was to examine the occurrence of CMBs after TEVAR, and to evaluate their association with patient and procedural factors. ⋯ CMBs on postoperative MRI are common after endovascular repair in the aortic arch. Their occurrence appears to be associated with key aspects of the procedure and pre-existing vascular leucoencephalopathy.