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British Journal of Surgery

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https://www.readbyqxmd.com/read/27901287/randomized-trial-of-roux-en-y-gastric-bypass-versus-sleeve-gastrectomy-in-achieving-excess-weight-loss
#1
M Ignat, M Vix, I Imad, A D'Urso, S Perretta, J Marescaux, D Mutter
BACKGROUND: Robust data on quality of life (QoL) after different techniques of bariatric surgery are sparse. This RCT compared excess weight loss (EWL) and QoL after sleeve gastrectomy versus Roux-en-Y gastric bypass (RYGB). METHODS: Obese patients were assigned randomly to RYGB or sleeve gastrectomy. The primary outcome measure was EWL. Secondary outcomes included QoL, co-morbidity, adverse events, vitamin and glycolipid status. QoL was assessed before and annually after surgery, using the Moorehead-Ardelt Quality of Life Questionnaire II (M-A-QoLQII) and Gastrointestinal Quality of Life Index (GIQLI)...
November 30, 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27901277/negative-pressure-wound-therapy-for-prevention-and-treatment-of-surgical-site-infections-after-vascular-surgery
#2
REVIEW
S Acosta, M Björck, A Wanhainen
BACKGROUND: Indications for negative-pressure wound therapy (NPWT) in vascular surgical patients are expanding. The aim of this review was to outline the evidence for NPWT on open and closed wounds. METHODS: A PubMed, EMBASE and Cochrane Library search from 2007 to June 2016 was performed combining the medical subject headings terms 'wound infection', 'abdominal aortic aneurysm (AAA)', 'fasciotomy', 'vascular surgery' and 'NPWT' or 'VAC'. RESULTS: NPWT of open infected groin wounds was associated with shorter duration of wound healing by 47 days, and was more cost-effective than alginate dressings in one RCT...
November 30, 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27901264/meta-analysis-of-lower-perioperative-blood-glucose-target-levels-for-reduction-of-surgical-site-infection
#3
REVIEW
F E E de Vries, S L Gans, J S Solomkin, B Allegranzi, M Egger, E P Dellinger, M A Boermeester
BACKGROUND: There is a clear association between hyperglycaemia and surgical-site infection (SSI). Intensive glucose control may involve a risk of hypoglycaemia, which in turn results in potentially severe complications. A systematic review was undertaken of studies comparing intensive versus conventional glucose control protocols in relation to reduction of SSI and other outcomes, including hypoglycaemia, mortality and stroke. METHODS: PubMed, Embase, CENTRAL, CINAHL and WHO databases from 1 January 1990 to 1 August 2015 were searched...
November 30, 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27879993/randomized-clinical-trial-of-preoperative-skin-antisepsis-with-chlorhexidine-gluconate-or-povidone-iodine
#4
H M Park, S-S Han, E C Lee, S D Lee, H M Yoon, B W Eom, S H Kim, K W Ryu, S-J Park, Y W Kim, B Park
BACKGROUND: Skin antiseptic agents are used to prevent surgical-site infection (SSI); few trials have reported the superiority of any specific agent in clean-contaminated abdominal surgery. This RCT was designed to compare the effectiveness of chlorhexidine gluconate and povidone-iodine. METHODS: Consecutive patients who underwent clean-contaminated upper gastrointestinal or hepatobiliary-pancreatic open surgery between 2011 and 2014 were assigned randomly to either chlorhexidine gluconate or povidone-iodine...
November 23, 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27864927/indications-for-major-hepatectomy-and-combined-procedures-for-advanced-gallbladder-cancer
#5
Y Yamamoto, T Sugiura, R Ashida, Y Okamura, T Ito, K Uesaka
BACKGROUND: The clinical impact of major hepatectomy for advanced gallbladder cancer is currently unclear. METHODS: Patients who underwent resection for stage II, III or IV gallbladder cancer were enrolled. The surgical outcomes of patients who underwent major hepatectomy were compared with those of patients treated with minor hepatectomy and those with unresectable gallbladder cancer. The clinical impact of major hepatectomy and combined advanced procedures such as portal vein resection or pancreatoduodenectomy for advanced gallbladder cancer were evaluated...
November 16, 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27859017/patterns-of-recurrence-after-oesophagectomy-and-postoperative-chemoradiotherapy-versus-surgery-alone-for-oesophageal-squamous-cell-carcinoma
#6
P-K Hsu, H-S Chen, C-S Huang, C-C Liu, C-C Hsieh, H-S Hsu, Y-C Wu, S-C Wu
BACKGROUND: Patterns of recurrence after surgery with postoperative chemoradiotherapy (S-CCRT) or surgery alone in patients with oesophageal squamous cell carcinoma (SCC) may differ. This might influence the nature and timing of subsequent management strategies. METHODS: Patients with SCC who had undergone R0 resection were included. Propensity score matching was used to select matched groups. Survival and recurrence were compared by Kaplan-Meier analysis. Univariable and multivariable Cox regression analyses were used to identify prognostic factors for overall and disease-free survival...
November 15, 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27861758/method-of-breast-reconstruction-and-the-development-of-lymphoedema
#7
K-T Lee, S I Bang, J-K Pyon, J H Hwang, G-H Mun
BACKGROUND: Several studies have demonstrated an association between immediate autologous or implant-based breast reconstruction and a reduced incidence of lymphoedema. However, few of these have focused specifically on whether the reconstruction method affects the development of lymphoedema. The study evaluated the potential impact of breast reconstruction modality on the incidence of lymphoedema. METHODS: Outcomes of women with breast cancer who underwent mastectomy and immediate reconstruction using an autologous flap or a tissue expander/implant between 2008 and 2013 were reviewed...
November 14, 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27861745/clinical-signs-of-fibrosis-in-small-intestinal-neuroendocrine-tumours
#8
K Daskalakis, A Karakatsanis, P Stålberg, O Norlén, P Hellman
BACKGROUND: In patients with small intestinal neuroendocrine tumours (SI-NETs), serotonin and other cytokines released from tumour cells may induce fibrosis, leading to carcinoid heart disease and abdominal fibrotic reactions. The aim of this study was to assess the prevalence, clinical complications and management of this reaction in the abdomen. METHODS: This was a retrospective cohort study of patients with SI-NETs diagnosed between 1985 and 2015. Clinical data, outcomes, radiological findings, and surgical and radiological interventions were reviewed...
November 10, 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27861766/role-of-staging-laparoscopy-in-the-stratification-of-patients-with-perihilar-cholangiocarcinoma
#9
N Bird, M Elmasry, R Jones, M Elniel, M Kelly, D Palmer, S Fenwick, G Poston, H Malik
BACKGROUND: Cholangiocarcinoma is a rare cancer with a poor prognosis. Radical surgical resection is the only option for curative treatment. Optimal determination of resectability is required so that patients can be stratified into operative or chemotherapeutic treatment cohorts in an accurate and time-efficient manner. Staging laparoscopy is utilized to determine the presence of radiologically occult disease that would preclude further surgical treatment. The aim of this study was to analyse the utility of staging laparoscopy in a contemporary cohort of patients with perihilar cholangiocarcinoma...
November 8, 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27809337/circumferential-suction-assisted-lipectomy-in-the-treatment-of-primary-and-secondary-end-stage-lymphoedema-of-the-leg
#10
D-A A Lamprou, H G J Voesten, R J Damstra, O R M Wikkeling
BACKGROUND: The treatment of end-stage lymphoedema of the leg is challenging, especially when conservative treatment fails and there is a large volume difference between the affected and unaffected legs. Circumferential suction-assisted lipectomy (CSAL) has been described as a treatment option for end-stage lymphoedema of the leg. Here, the long-term results of CSAL in end-stage primary and secondary lymphoedema of the leg were analysed. METHODS: This was a descriptive study of patients treated with CSAL for unilateral chronic irreversible lymphoedema of the leg...
November 3, 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27802358/risk-of-second-primary-cancer-in-patients-treated-with-radiotherapy-for-rectal-cancer
#11
A Martling, K E Smedby, H Birgisson, H Olsson, F Granath, A Ekbom, B Glimelius
BACKGROUND: Many patients with rectal cancer receive radiotherapy (RT) to reduce the risk of local recurrence. Radiation may give rise to adverse effects, including second primary cancers. In view of the divergent results of previous studies, the present study evaluated the risk of second primary cancer following RT in all randomized RT rectal cancer trials conducted in Sweden and in the Swedish ColoRectal Cancer Registry (SCRCR). METHODS: Patients included in five randomized trials and the SCRCR were linked to the Swedish Cancer Registry...
November 1, 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27779312/randomized-clinical-trial-of-sacral-nerve-stimulation-for-refractory-constipation
#12
F Zerbib, L Siproudhis, P-A Lehur, C Germain, F Mion, A-M Leroi, B Coffin, A Le Sidaner, V Vitton, C Bouyssou-Cellier, G Chene
BACKGROUND: Open studies have reported favourable results for sacral nerve stimulation in the treatment of refractory constipation. Here, its efficacy was assessed in a double-blind crossover RCT. METHODS: Patients with at least two of the following criteria were included: fewer than three bowel movements per week; straining to evacuate on more than 25 per cent of attempts; or sensation of incomplete evacuation on more than 25 per cent of occasions. Response to therapy was defined as at least three bowel movements per week and/or more than 50 per cent improvement in symptoms...
October 25, 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27778329/potential-value-of-routine-contralateral-patent-processus-vaginalis-repair-in-children-with-unilateral-inguinal-hernia
#13
J Zhao, Y Chen, J Lin, Y Jin, H Yang, F Wang, H Zhong, J Zhu
BACKGROUND: The development of laparoscopy as a means of evaluation and treatment of inguinal hernia in children has raised the question of whether simultaneous closure of a contralateral patent processus vaginalis (CPPV) is justified. The present study aimed to determine the rate of metachronous inguinal hernia (MIH) in children with CPPV. METHODS: Children with unilateral inguinal hernia from two hospitals underwent either open or laparoscopic repair, and were followed up for MIH...
October 25, 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27763685/long-term-outcomes-of-a-randomized-clinical-trial-of-supervised-exercise-percutaneous-transluminal-angioplasty-or-combined-treatment-for-patients-with-intermittent-claudication-due-to-femoropopliteal-disease
#14
F A K Mazari, J A Khan, N Samuel, G Smith, D Carradice, P C McCollum, I C Chetter
BACKGROUND: The aim was to compare the long-term outcomes of percutaneous transluminal angioplasty (PTA), a supervised exercise programme (SEP) and combined treatment (PTA + SEP) in patients with intermittent claudication owing to femoropopliteal disease. METHODS: Patients recruited to an RCT comparing these treatments were invited for long-term follow-up from 2010 to 2011. Indicators of limb ischaemia were recorded (ankle : brachial pressure index (ABPI) and treadmill walking distances)...
October 20, 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27763684/incidence-risk-factors-and-clinical-implications-of-chyle-leak-after-pancreatic-surgery
#15
O Strobel, S Brangs, U Hinz, T Pausch, F J Hüttner, M K Diener, L Schneider, T Hackert, M W Büchler
BACKGROUND: Chyle leak is a well known but poorly characterized complication after pancreatic surgery. Available data on incidence, risk factors and clinical significance of chyle leak are highly heterogeneous. METHODS: For this cohort study all patients who underwent pancreatic surgery between January 2008 and December 2012 were identified from a prospective database. Chyle leak was defined as any drainage output with triglyceride content of 110 mg/dl or more...
October 20, 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27762448/cost-effectiveness-of-emergency-versus-delayed-laparoscopic-cholecystectomy-for-acute-gallbladder-pathology
#16
A J Sutton, R S Vohra, M Hollyman, P J Marriott, A Buja, D Alderson, S Pasquali, E A Griffiths
BACKGROUND: The optimal timing of cholecystectomy for patients admitted with acute gallbladder pathology is unclear. Some studies have shown that emergency cholecystectomy during the index admission can reduce length of hospital stay with similar rates of conversion to open surgery, complications and mortality compared with a 'delayed' operation following discharge. Others have reported that cholecystectomy during the index acute admission results in higher morbidity, extended length of stay and increased costs...
October 20, 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27762435/ecspect-prospective-multicentre-registry-for-single-port-laparoscopic-colorectal-procedures
#17
H Weiss, R Zorron, K-H Vestweber, B Vestweber, L Boni, W Brunner, C Sietses, S Morales Conde, O Bulut, K Gash, A R Dixon, C Mittermair, A Klaus, O Stanger, M Weiss, A Muratore, T Hell
BACKGROUND: The international multicentre registry ECSPECT (European Consensus of Single Port Expertise in Colorectal Treatment) was established to evaluate the general feasibility and safety of single-port colorectal surgery with regard to preoperative risk assessment. METHODS: Consecutive patients undergoing single-port colorectal surgery were enrolled from 11 European centres between March 2010 and March 2014. Data were analysed to assess patient-, technique- and procedure-dependent parameters...
October 20, 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27762434/randomized-open-label-phase-ii-study-comparing-oxycodone-naloxone-with-oxycodone-in-early-return-of-gastrointestinal-function-after-laparoscopic-colorectal-surgery
#18
F Creamer, A Balfour, S Nimmo, I Foo, J D Norrie, L J Williams, K C Fearon, H M Paterson
BACKGROUND: Combined oral modified-release oxycodone-naloxone may reduce opioid-induced postoperative gut dysfunction. This study examined the feasibility of a randomized trial of oxycodone-naloxone within the context of enhanced recovery for laparoscopic colorectal resection. METHODS: In a single-centre open-label phase II feasibility study, patients received analgesia based on either oxycodone-naloxone or oxycodone. Primary endpoints were recruitment, retention and protocol compliance...
October 20, 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27762432/oncological-impact-of-anastomotic-leakage-after-laparoscopic-mesorectal-excision
#19
E Hain, L Maggiori, G Manceau, C Mongin, J Prost À la Denise, Y Panis
BACKGROUND: The effect of anastomotic leakage on oncological outcomes after total mesorectal excision (TME) is controversial. This study aimed to assess the influence of symptomatic and asymptomatic anastomotic leakage on oncological outcomes after laparoscopic TME. METHODS: All patients who underwent restorative laparoscopic TME for rectal adenocarcinoma with curative intent from 2005 to 2014 were identified from an institutional database. Asymptomatic anastomotic leakage was defined by CT performed systematically 4-8 weeks after rectal surgery, with no relevant clinical symptoms or laboratory examination findings during the postoperative course...
October 20, 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27748962/population-based-cohort-study-of-variation-in-the-use-of-emergency-cholecystectomy-for-benign-gallbladder-diseases
#20
(no author information available yet)
BACKGROUND: The aims of this prospective population-based cohort study were to identify the patient and hospital characteristics associated with emergency cholecystectomy, and the influences of these in determining variations between hospitals. METHODS: Data were collected for consecutive patients undergoing cholecystectomy in acute UK and Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing the performance of emergency cholecystectomy were analysed by means of multilevel, multivariable logistic regression modelling using a two-level hierarchical structure with patients (level 1) nested within hospitals (level 2)...
October 17, 2016: British Journal of Surgery
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