The British journal of surgery
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Transperitoneal rectal stump resection is a complicated procedure with risk of inadvertent bowel, vascular and nerve injury. This study analysed the feasibility and safety of the use of transanal endoscopic microsurgery (TEM) to excise rectal stumps that would otherwise require a combined transabdominal and perineal approach. ⋯ TEM appeared to be a useful and safe approach for close rectal dissection and removal of a rectal stump while avoiding an abdominal approach for pelvic dissection.
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Postoperative chylous ascites following abdominal surgery is uncommon. It potentially induces malnutrition and immunodeficiency, contributing to increased mortality. In the field of hepatopancreatobiliary (HPB) surgery, no large studies have been conducted that focused on postoperative chylous ascites. The aim of this study was to determine the incidence, risk factors and management of chylous ascites following HPB surgery, with particular emphasis on pancreatic resection. ⋯ Chylous ascites is a rare complication following HPB surgery. It is more common after pancreatic resection. Treatment with octreotide combined with total parenteral nutrition is recommended.
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As patients with basal-like breast cancer (BLBC) have a poor prognosis and there is no specifically tailored therapy, molecular biological characterization of BLBC is necessary. c-Kit is a transmembrane receptor tyrosine kinase known to play important roles in various solid cancers. This study classified BLBCs from patients with breast carcinoma, and addressed the significance of c-Kit expression in these tumours. ⋯ c-Kit might be a prognostic marker and possible molecular target for therapy in patients with BLBC.
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Papillary thyroid carcinoma (PTC) frequently metastasizes to regional lymph nodes. Metastasis to the posterior neck, level V, is uncommon, and level V lymphadenectomy may lead to spinal accessory nerve injury and associated postoperative morbidities. The aim of this study was to assess the diagnostic efficiency of preoperative ultrasonography and to identify predictors of level V metastasis in patients with PTC. ⋯ Preoperative ultrasonography frequently failed to detect level V metastasis in patients with metastatic PTC. Level V lymphadenectomy may be considered in patients with lymph node metastasis in the ipsilateral lateral neck with macroscopic extranodal extension.
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Complication rates of living-donor right hepatectomy remain a matter of major concern. The aim of this study was to achieve near-zero morbidity for living-donor right hepatectomy in a single centre. ⋯ This study suggests that near-zero morbidity may be reached after right hepatectomy in carefully selected living donors by continuous refinement of surgical technique and management.