The British journal of surgery
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Multicenter Study Observational Study
Development and validation of the Surgical Outcome Risk Tool (SORT).
Existing risk stratification tools have limitations and clinical experience suggests they are not used routinely. The aim of this study was to develop and validate a preoperative risk stratification tool to predict 30-day mortality after non-cardiac surgery in adults by analysis of data from the observational National Confidential Enquiry into Patient Outcome and Death (NCEPOD) Knowing the Risk study. ⋯ The SORT allows rapid and simple data entry of six preoperative variables, and provides a percentage mortality risk for individuals undergoing surgery.
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Randomized Controlled Trial Comparative Study
Influence of visual force feedback on tissue handling in minimally invasive surgery.
Force feedback might improve surgical performance during minimally invasive surgery. This study sought to determine whether training with force feedback shortened the tissue-handling learning curve, and examined the influence of real-time visual feedback compared with postprocessing feedback. ⋯ The tissue-handling skills of medical students improved significantly when they were given force feedback of their performance. This effect was seen mainly during the knot-tying phase of the suturing task.
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Randomized Controlled Trial Comparative Study
Oncological outcome of malignant colonic obstruction in the Dutch Stent-In 2 trial.
The Stent-In 2 trial randomized patients with malignant colonic obstruction to emergency surgery or stent placement as a bridge to elective surgery. The aim of this study was to compare the oncological outcomes. ⋯ ISRCTN46462267 ( http://www.controlled-trials.com).
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Revisions in terminology of fluid collections in acute pancreatitis have necessitated reanalysis of their evolution and outcome. The course of fluid collections in patients with acute pancreatitis was evaluated prospectively. ⋯ Pancreatic pseudocysts develop infrequently in oedematous acute pancreatitis. Only one-quarter of ANCs either require intervention or persist beyond 6 months, whereas more than one-half of WONs resolve without any intervention within 6 months of onset. Baseline diameter of ANC(s) is an important predictor of outcome.
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Comparative Study Observational Study
Outcomes after implementing a tailored endoscopic step-up approach to walled-off necrosis in acute pancreatitis.
The aim of the study was to compare the outcomes of patients with pancreatic or peripancreatic walled-off necrosis by endoscopy using the conventional approach versus an algorithmic approach based on the collection size, location and stepwise response to intervention. ⋯ An algorithmic approach to pancreatic and peripancreatic walled-off necrosis, based on the collection size, location and stepwise response to intervention, resulted in an improved rate of treatment success compared with conventional endoscopic management.