The British journal of surgery
-
Review Meta Analysis
Meta-analysis of outcomes following resection of the primary tumour in patients presenting with metastatic colorectal cancer.
It is not clear whether resection of the primary tumour (when there are metastases) alters survival and/or whether resection is associated with increased morbidity. This systematic review and meta-analysis assessed the prognostic value of primary tumour resection in patients presenting with metastatic colorectal cancer. ⋯ Primary tumour resection may provide a modest survival advantage in patients presenting with metastatic colorectal cancer.
-
Review Meta Analysis
Meta-analysis evaluating music interventions for anxiety and pain in surgery.
This study aimed to evaluate anxiety and pain following perioperative music interventions compared with control conditions in adult patients. ⋯ Music interventions significantly reduce anxiety and pain in adult surgical patients.
-
Randomized Controlled Trial Multicenter Study
Multicentre randomized clinical trial of the effect of chewing gum after abdominal surgery.
Postoperative ileus is a common complication of abdominal surgery, leading to patient discomfort, morbidity and prolonged postoperative length of hospital stay (LOS). Previous studies suggested that chewing gum stimulates bowel function after abdominal surgery, but were underpowered to evaluate its effect on LOS and did not include enhanced recovery after surgery (ERAS)-based perioperative care. This study evaluated whether chewing gum after elective abdominal surgery reduces LOS and time to bowel recovery in the setting of ERAS-based perioperative care. ⋯ The addition of chewing gum to an ERAS postoperative care pathway after elective abdominal surgery does not reduce the LOS, time to bowel recovery or the rate of postoperative complications. Registration number: NTR2594 (Netherlands Trial Register).
-
Postoperative ileus (POI) is characterized by delayed gastrointestinal recovery following surgery. Current knowledge of pathophysiology, clinical interventions and methodological challenges was reviewed to inform modern practice and future research. ⋯ POI is a common condition with no established definition, aetiology or treatment. According to current literature, minimally invasive surgery, protocol-driven recovery (including early feeding and opioid avoidance strategies) and measures to avoid major inflammatory events (such as anastomotic leak) offer the best chances of reducing POI.