The British journal of surgery
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Observational Study
Metabolic nodal response as a prognostic marker after neoadjuvant therapy for oesophageal cancer.
The ability to predict recurrence and survival after neoadjuvant chemotherapy (NAC) and surgery for oesophageal cancer remains elusive. This study evaluated the role of [18 F]fluorodeoxyglucose (FDG) PET-CT in assessing tumour and nodal response as a prognostic marker. ⋯ mNR is a novel prognostic factor, independent of conventional N status. Primary and nodal tumours may respond discordantly and patients with FDG-avid nodes after NAC have a poor prognosis.
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Acute high-risk abdominal (AHA) surgery carries a very high risk of morbidity and mortality and represents a massive healthcare burden. The aim of the present study was to evaluate the effect of a standardized multidisciplinary perioperative protocol in patients undergoing AHA surgery. ⋯ The introduction of a multidisciplinary perioperative protocol was associated with a significant reduction in postoperative mortality in patients undergoing AHA surgery. NCT01899885 (http://www.clinicaltrials.gov).
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Few studies have been conducted on patterns of recurrence after resection for distal cholangiocarcinoma (DCC). The aim of this study was to investigate the incidence and pattern of recurrence after resection of DCC, and to evaluate prognostic factors for time to recurrence and recurrence-free survival (RFS). ⋯ More than half of patients with DCC experienced recurrence after R0 resection, usually within 5 years. Perineural invasion, pancreatic invasion and positive nodal involvement are risk factors for recurrence.
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Transjugular intrahepatic portasystemic stent shunt (TIPSS), instead of surgical shunt, has become the standard treatment for patients with complicated portal hypertension. This study compared outcomes in patients who underwent TIPSS or surgical shunting for complicated portal hypertension. ⋯ Surgical shunting achieved better results than TIPSS in patients with complicated portal hypertension and low MELD scores.
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Biography Historical Article
The Osteology Lesson of Sebastiaen Egbertszn (1619).
In 1619 the Amsterdam Guild of Surgeons commissioned a recognized Dutch painter to make a group portrait of the governors. This masterpiece is known as The Osteology Lesson of Sebastiaen Egbertszn. Egbertszn, praelector anatomiae (lecturer in anatomy), is depicted while demonstrating the human bones using the skeleton of an English pirate. ⋯ Sebastiaen Egbertszn, who was the praelector anatomiae (lecturer in anatomy) at that time, is depicted demonstrating human bone anatomy using the skeleton of an executed pirate. Egbertszn died during a plague epidemic only 2 years after the painting was delivered and the identity of the artist remains contentious to this day. It is exhibited in the Amsterdam Museum in Amsterdam, The Netherlands.