Canadian journal of surgery. Journal canadien de chirurgie
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Editorial Comment Historical Article
Plus ça change, plus c'est la même chose: Canadian medical officers in Bosnia and the Second World War.
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The authors review the principles of reconstructive surgery for lower limb salvage after severe lower limb trauma to determine factors that have been used as decision-making criteria for limb salvage or amputation in severe lower extremity injuries and the methods of reconstruction and their outcome. The use of scoring systems and their value in acute decision making (primary amputation or limb salvage) are described. ⋯ It is essential for the physician to make a good initial decision on the need for primary amputation or limb salvage. A multidisciplinary approach is fundamental to successful salvage.
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Review Comparative Study
Diagnostic peritoneal lavage versus abdominal computed tomography in blunt abdominal trauma: a review of prospective studies.
To determine whether abdominal computed tomography (CT) or diagnostic peritoneal lavage (DPL) should be used in the evaluation of hemodynamically stable patients with blunt abdominal trauma and equivocal findings on physical examination. ⋯ DPL should be performed if there are no contraindications and no associated injuries that would be better delineated by CT, in which case abdominal CT is indicated.
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Comparative Study
Laparoscopic appendectomy versus open appendectomy: retrospective assessment of 200 patients.
To compare laparoscopic appendectomy (LA) with traditional methods as the primary treatment for acute appendicitis. ⋯ LA is a safe and viable treatment alternative for acute appendicitis. Prospective randomized studies are needed to confirm its potential advantages.
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Clinical Trial
The role of extracorporeal shock-wave lithotripsy in the treatment of symptomatic cholelithiasis.
To determine the effectiveness of extracorporeal shock-wave lithotripsy (ESWL) and adjuvant bile-salt therapy for the treatment of symptomatic cholelithiasis. ⋯ ESWL with bile salts as treatment for symptomatic cholelithiasis is not recommended for routine use.