The British journal of surgery
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Review Meta Analysis
Meta-analysis of the prevalence of renal cancer detected by abdominal ultrasonography.
The potential for an ultrasound-based screening programme for renal cell carcinoma (RCC) to improve survival through early detection has been the subject of much debate. The prevalence of ultrasound-detected asymptomatic RCC is an important first step to establishing whether a screening programme may be feasible. ⋯ At least one RCC would be detected per 1000 individuals screened. The majority of tumours identified are early stage (T1-T2).
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Multicenter Study Comparative Study
Outcome after laparoscopic and open resections of posterosuperior segments of the liver.
Laparoscopic resection of posterosuperior (PS) segments of the liver is hindered by limited visualization and curvilinear resection planes. The aim of this study was to compare outcomes after open and laparoscopic liver resections of PS segments. ⋯ LLR of tumours in PS segments is feasible in selected patients. LLR is associated with fewer complications and does not compromise survival compared with OLR.
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Multicenter Study
Timing of completion lymphadenectomy after positive sentinel node biopsy in patients with melanoma.
Nodal staging with sentinel node biopsy (SNB) and completion lymph node dissection (CLND) provides prognostic information to patients with melanoma and their physicians. It is not known whether the timing of CLND is associated with survival outcome and/or CLND tumour load. This study investigated whether CLND timing is associated with CLND tumour load, disease-free survival (DFS) and/or melanoma-specific survival (MSS). ⋯ The time interval between diagnosis of melanoma and CLND did not influence CLND tumour load, DFS or MSS.
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Quality assurance is acknowledged as a crucial factor in the assessment of oncological surgical care. The aim of this study was to develop a composite measure of multiple outcome parameters defined as 'textbook outcome', to assess quality of care for patients undergoing oesophagogastric cancer surgery. ⋯ Most patients did not achieve a textbook outcome and there was wide variation between hospitals.
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Multicenter Study Observational Study
Effectiveness of early administration of tranexamic acid in patients with severe trauma.
A reduction in mortality with the early use of tranexamic acid has been demonstrated in severely injured patients who are bleeding. However, the modest treatment effect with no reduction in blood transfusion has raised concerns. The aim of the present study was to estimate the effectiveness of regular use of tranexamic acid in severely injured patients. ⋯ Early tranexamic acid use was associated with reduced mortality in severely injured patients, in particular those with a primary brain injury.