The British journal of surgery
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A video and medical data recorder in the operating theatre is possible, but concerns over privacy, data use and litigation have limited widespread implementation. The literature on legal considerations and challenges to overcome, and guidelines related to use of data recording in the surgical environment, are presented in this narrative review. ⋯ Transparency on the use and purpose of recorded data should be ensured to both staff and patients. The recorded video data do not need to be used as evidence in court if patient medical records are well maintained. Clear legislation on data responsibility is needed to use the medical recorder optimally for quality improvement initiatives.
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Multicenter Study
Multicentre analysis of the learning curve for laparoscopic liver resection of the posterosuperior segments.
Laparoscopic liver resection demands expertise and a long learning curve. Resection of the posterosuperior segments is challenging, and there are no data on the learning curve. The aim of this study was to evaluate the learning curve for laparoscopic resection of the posterosuperior segments. ⋯ The learning curve for laparoscopic liver resection of the posterosuperior segments consists of a stepwise process, during which accurate patient selection is key.
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Multicenter Study
Sex differences in repair rates and outcomes of patients with ruptured abdominal aortic aneurysm.
Data are conflicting on sex differences in ruptured abdominal aortic aneurysm (rAAA) repair rates and outcomes have rarely been addressed. The aim of this study was to investigate differences in the management and outcome of rAAA in men and women, and to describe time trends over a 15-year interval. ⋯ In this study, fewer women with rAAA received surgery and 30-day mortality was higher than in men. There was an overall decrease in rAAA incidence, principally in men.
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Burn injuries are a major cause of morbidity and mortality worldwide. Cooling is widely practised as a first aid measure, but the efficacy of cooling burns in human skin has not been demonstrated. A safe, consistent, ethically acceptable model of burning and cooling in live human skin in vivo was developed, and used to quantify the effects of cooling. ⋯ This study demonstrated the favourable effects of cooling on human burns. Public heath messaging should emphasize cooling as first aid for burns. This model will allow analysis of the molecular effects of cooling burns, and provide a platform for testing novel therapies aimed at reducing the impact of burn injury.
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Multicenter Study
Population-based study of the effect of preoperative breast MRI on the surgical management of ductal carcinoma in situ.
Determinants of the use of breast MRI in patients with ductal carcinoma in situ (DCIS) in the Netherlands were studied, and whether using MRI influenced the rates of positive resection margins and mastectomies. ⋯ Adding MRI to conventional breast imaging did not improve surgical outcome in patients diagnosed with primary DCIS. The likelihood of undergoing a mastectomy was twice as high in the MRI group, and no reduction in the risk of margin involvement was observed after BCS.