The British journal of surgery
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Randomized Controlled Trial Comparative Study
Ten-year outcomes of a randomized clinical trial of endothermal ablation versus conventional surgery for great saphenous varicose veins.
Surgical ligation and stripping (surgery) and endothermal ablation are both effective treatments for varicose veins, improving quality of life (QoL) up to 5 years. Few data are available on long-term outcomes. The aim of this study was to evaluate the outcomes 10 years after interventions in an RCT. Previously this RCT demonstrated that endothermal ablation is associated with superior postprocedural QoL, more rapid recovery, and lower rates of early clinical recurrence. This analysis reports outcomes at 10 years. ⋯ Both surgery and endothermal ablation are effective treatments for varicose veins at 10 years, with durable improvement in QoL and a very low rate of disease progression. However, endothermal ablation was associated with superior clinical and QoL outcomes. Registration number: NCT00759434 (http://www.clinicaltrials.gov).
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Randomized Controlled Trial
Impact of small-bite (5 mm) fascial closure on the incidence of incisional hernia following open colorectal cancer surgery: randomized clinical trial.
Incisional hernia is frequently observed after open colorectal cancer surgery, and should be considered a serious short- and long-term health issue. The present study evaluated the efficacy of small-bite abdominal closure in reducing the incidence of incisional hernia in this patient group. ⋯ Small-bite closure with 5-mm tissue bites placed 5 mm apart reduced the incidence of incisional hernia and surgical-site infection after open colorectal cancer surgery.
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Women with thoracic aortic aneurysms within the arch or descending thoracic aorta have poorer survival than men. Sex differences in relative thoracic aortic aneurysm size may account for some of the discrepancy. The aim of this study was to explore whether basing clinical management on aneurysm size index (maximum aneurysm diameter/body surface area) rather than aneurysm size can restore equality of survival by sex. ⋯ Guidelines for referral to specialist services should consider including aneurysm size index rather than diameter to reduce inequity due to patient sex.