The British journal of surgery
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Randomized Controlled Trial Multicenter Study
Preoperative portal vein or portal and hepatic vein embolization: DRAGON collaborative group analysis.
The extent of liver resection for tumours is limited by the expected functional reserve of the future liver remnant (FRL), so hypertrophy may be induced by portal vein embolization (PVE), taking 6 weeks or longer for growth. This study assessed the hypothesis that simultaneous embolization of portal and hepatic veins (PVE/HVE) accelerates hypertrophy and improves resectability. ⋯ PVE/HVE achieved better FLR hypertrophy and resectability than PVE in this collaborative experience.
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Multicenter Study
Mortality after surgery for primary hyperparathyroidism: results from a nationwide cohort.
Contemporary patients with primary hyperparathyroidism are often diagnosed with mildly raised serum calcium levels. Previous studies have reported increased mortality in patients with primary hyperparathyroidism. This retrospective cohort study aimed to examine whether contemporary patients operated for primary hyperparathyroidism have higher mortality than the general population, and whether mortality in these patients is associated with serum calcium concentration, adenoma weight or multiglandular disease. ⋯ Mortality was not increased in patients operated for primary hyperparathyroidism compared with controls in a contemporary setting. Preoperative serum calcium concentration might, however, influence survival.
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Multicenter Study
Centralized repeated resectability assessment of patients with colorectal liver metastases during first-line treatment: prospective study.
Metastasectomy is probably underused in metastatic colorectal cancer. The aim of this study was to investigate the effect of centralized repeated assessment on resectability rate of liver metastases. ⋯ Repeated centralized resectability assessment in patients with colorectal liver metastases improved resection and survival rates.
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Meta Analysis
Histopathological risk factors for lymph node metastases in T1 colorectal cancer: meta-analysis.
National screening programmes increase the proportion of T1 colorectal cancers. Local excision may be possible, but the risk of lymph node metastases (LNMs) could jeopardize long-term outcomes. The aim of the present study was to review the association between histopathological findings and LNMs in T1 colorectal cancer. ⋯ Distinct histopathological factors associated with nodal metastases in T1 colorectal cancer can aid selection of patients for local excision or major excisional surgery.
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Multicenter Study Observational Study
Effect of centralization and regionalization of pancreatic surgery on resection rates and survival.
Centralization of pancreatic surgery in the Netherlands has been ongoing since 2011. The aim of this study was to assess how centralization has affected the likelihood of resection and survival of patients with non-metastatic pancreatic head and periampullary cancer, diagnosed in hospitals with and without pancreatic surgery services. ⋯ After centralization of pancreatic surgery, the resection rate for patients with pancreatic head and periampullary cancer diagnosed in non-pancreatic surgery centres increased and became similar to that in pancreatic surgery centres. Overall survival remained higher in patients diagnosed in pancreatic surgery centres.