The British journal of surgery
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Randomized Controlled Trial Comparative Study
Cost-effectiveness of revascularization in patients with intermittent claudication.
Revascularization is a treatment option for patients with intermittent claudication. However, there is a lack of evidence to support its long-term benefits and cost-effectiveness. The aim of this study was to compare the cost-effectiveness of revascularization and best medical therapy (BMT) with that of BMT alone. ⋯ The costs associated with revascularization together with BMT in patients with intermittent claudication were about four times higher than those of BMT alone. The incremental cost-effectiveness ratio of revascularization was within the accepted threshold for public willingness to pay according to the Swedish National Guidelines, but exceeded that of the UK National Institute for Health and Care Excellence guidelines.
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Popliteal artery aneurysms (PAAs) are generally complicated by thrombosis and distal embolization, whereas rupture is rare. The aim of this study was to describe the clinical characteristics and outcome in a cohort of patients who had surgery for ruptured PAA (rPAA). ⋯ The diagnosis of rPAA is difficult, and often delayed. The condition affects old patients, who often are on anticoagulation treatment and have large aneurysms. The immediate surgical results are acceptable, but the condition is associated with a high risk of death within the first year after surgery.
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Multicenter Study
CCR-CARESS score for predicting operative mortality in patients with colorectal cancer.
The aim of this study was to assess factors associated with outcomes after surgery for colorectal cancer and to design and internally validate a simple score for predicting perioperative mortality. ⋯ Elderly patients with co-morbidity and palliative intention of surgery have an unacceptably high risk of death.
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The association between risk of pancreatic cancer and a dilated main pancreatic duct (MPD) in intraductal papillary mucinous neoplasm (IPMN) is debated. The aim of this study was to assess the role of MPD size in predicting pancreatic cancer in resected IPMNs and those kept under surveillance. ⋯ In patients under surveillance, a dilated MPD alone was not associated with an increased incidence of malignancy in IPMN.
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Gastric adenocarcinoma is a common cause of cancer death globally. It remains unclear whether coexisting diabetes mellitus influences survival in patients with this tumour. A cohort study was conducted to determine whether coexisting diabetes increases mortality in gastric adenocarcinoma. ⋯ These findings indicate a worse prognosis in patients with gastric adenocarcinoma and coexisting diabetes compared with those without diabetes.