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randomised controlled trial surgery

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https://www.readbyqxmd.com/read/28431186/unfractionated-heparin-versus-low-molecular-weight-heparins-for-avoiding-heparin-induced-thrombocytopenia-in-postoperative-patients
#1
REVIEW
Daniela R Junqueira, Liliane M Zorzela, Edson Perini
BACKGROUND: Heparin-induced thrombocytopenia (HIT) is an adverse drug reaction presenting as a prothrombotic disorder related to antibody-mediated platelet activation. It is a paradoxical immune reaction resulting in thrombin generation in vivo, which leads to a hypercoagulable state and the potential to initiate venous or arterial thrombosis. A number of factors are thought to influence the incidence of HIT including the type and preparation of heparin (unfractionated heparin (UFH) or low molecular weight heparin (LMWH)) and the heparin-exposed patient population, with the postoperative patient population at higher risk...
April 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28429876/iodine-131-meta-iodobenzylguanidine-therapy-for-patients-with-newly-diagnosed-high-risk-neuroblastoma
#2
REVIEW
Kathelijne Cjm Kraal, Elvira C van Dalen, Godelieve Am Tytgat, Berthe Lf Van Eck-Smit
BACKGROUND: Patients with newly diagnosed high-risk (HR) neuroblastoma (NBL) still have a poor outcome, despite multi-modality intensive therapy. This poor outcome necessitates the search for new therapies, such as treatment with (131)I-meta-iodobenzylguanidine ((131)I-MIBG). OBJECTIVES: To assess the efficacy and adverse effects of (131)I-MIBG therapy in patients with newly diagnosed HR NBL. SEARCH METHODS: We searched the following electronic databases: the Cochrane Central Register of Controlled Trials (CENTRAL; the Cochrane Library 2016, Issue 3), MEDLINE (PubMed) (1945 to 25 April 2016) and Embase (Ovid) (1980 to 25 April 2016)...
April 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28429473/surgery-for-limited-stage-small-cell-lung-cancer
#3
REVIEW
Hayley Barnes, Katharine See, Stephen Barnett, Renée Manser
BACKGROUND: Current treatment guidelines for limited-stage small-cell lung cancer (SCLC) recommend concomitant platinum-based chemo-radiotherapy plus prophylactic cranial irradiation, based on the premise that SCLC disseminates early, and is chemosensitive. However, although there is usually a favourable initial response, relapse is common and the cure rate for limited-stage SCLC remains relatively poor. Some recent clinical practice guidelines have recommended surgery for stage 1 (limited) SCLC followed by adjuvant chemotherapy, but this recommendation is largely based on the findings of observational studies...
April 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28420801/the-impact-of-laparoscopic-ovarian-drilling-on-amh-ovarian-reserve-a-meta-analysis
#4
Saad Aks Amer, Tarek T El Shamy, Cathryn James, Ali H Yosef, Ahmed Aboelfadle Mohamed
Laparoscopic ovarian drilling (LOD) has been widely utilised as an effective treatment in anovulatory women with polycystic ovarian syndrome (PCOS). However, there has been a growing concern over a possible damaging effect of this procedure on ovarian reserve. The objective of this study was to investigate the hypothesis that LOD compromises ovarian reserve as measured by post-operative changes in circulating anti-Müllerian hormone (AMH). This meta-analysis included all cohort studies as well as randomised controlled trials investigating serum AMH concentrations and other ovarian reserve markers in PCOS women undergoing LOD...
April 18, 2017: Reproduction: the Official Journal of the Society for the Study of Fertility
https://www.readbyqxmd.com/read/28420664/the-uk-cardiac-and-vascular-surgery-interventional-anaemia-response-caviar-study-protocol-for-an-observational-cohort-study-to-determine-the-impact-and-effect-of-preoperative-anaemia-management-in-cardiac-and-vascular-surgical-patients
#5
Marisa Chau, Toby Richards, Caroline Evans, Anna Butcher, Timothy Collier, Andrew Klein
INTRODUCTION: Preoperative anaemia is linked to poor postsurgical outcome, longer hospital stays, greater risk of complications and mortality. Currently in the UK, some sites have developed anaemia clinics or pathways that use intravenous iron to correct iron deficiency anaemia prior to surgery as their standard of care. Although intravenous iron has been observed to be effective in a variety of patient settings, there is insufficient evidence in its use in cardiac and vascular patients...
April 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28420629/dexamethasone-versus-standard-treatment-for-postoperative-nausea-and-vomiting-in-gastrointestinal-surgery-randomised-controlled-trial-dreams-trial
#6
(no author information available yet)
Objectives To determine whether preoperative dexamethasone reduces postoperative vomiting in patients undergoing elective bowel surgery and whether it is associated with other measurable benefits during recovery from surgery, including quicker return to oral diet and reduced length of stay.Design Pragmatic two arm parallel group randomised trial with blinded postoperative care and outcome assessment.Setting 45 UK hospitals.Participants 1350 patients aged 18 or over undergoing elective open or laparoscopic bowel surgery for malignant or benign pathology...
April 18, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28419712/comparison-of-safety-and-efficacy-of-image-guided-enema-reduction-techniques-for-paediatric-intussusception-a-review-of-the-literature
#7
Renny Chew, Michael Ditchfield, Eldho Paul, Stacy K Goergen
INTRODUCTION: There is variable international practice regarding the technique used for image-guided enema reduction in paediatric intussusception. A recent meta-analysis found pneumatic reduction to be more effective than hydrostatic techniques. Clinical practice variation may impact on perforation rates, ionizing radiation exposure and requirement for surgery. The aim of this study was to review the literature regarding the efficacy and safety of fluoroscopically guided pneumatic reduction (FGPR) compared to ultrasound (US) guided intussusception reduction (USGIR) techniques for paediatric intussusception treatment...
April 17, 2017: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/28417153/laparoscopic-sacrocolpopexy-compared-with-open-abdominal-sacrocolpopexy-for-vault-prolapse-repair-a-randomised-controlled-trial
#8
Anne-Lotte W M Coolen, Anique M J van Oudheusden, Ben Willem J Mol, Hugo W F van Eijndhoven, Jan-Paul W R Roovers, Marlies Y Bongers
INTRODUCTION AND HYPOTHESIS: The objective was to evaluate the functional outcome after laparoscopic sacrocolpopexy versus open sacrocolpopexy in women with vault prolapse. METHODS: A multicentre randomised controlled trial was carried out at four teaching and two university hospitals in the Netherlands in women with symptomatic vault prolapse requiring surgical treatment. Participants were randomised for laparoscopic or open sacrocolpopexy. Primary outcome was disease-specific quality of life measured using the Urinary Distress Inventory (UDI) questionnaire at 12 months' follow-up...
April 17, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28412960/a-randomised-controlled-trial-to-determine-the-clinical-and-cost-effectiveness-of-thulium-laser-transurethral-vaporesection-of-the-prostate-thuvarp-versus-transurethral-resection-of-the-prostate-turp-in-the-national-health-service-nhs-the-unblocs-trial-a-study
#9
Jo Worthington, Hilary Taylor, Paul Abrams, Sara T Brookes, Nikki Cotterill, Sian M Noble, Tobias Page, K Satchi Swami, J Athene Lane, Hashim Hashim
BACKGROUND: Transurethral resection of the prostate (TURP) has been the standard operation for benign prostatic obstruction (BPO) for 40 years, with approximately 25,000 procedures performed annually, and has remained largely unchanged. It is generally a successful operation, but has well-documented risks for the patient. Thulium laser transurethral vaporesection of the prostate (ThuVARP) vaporises and resects the prostate using a surgical technique similar to TURP. The small amount of study data currently available suggests that ThuVARP may have certain advantages over TURP, including reduced blood loss and shorter hospital stay, earlier return to normal activities, and shorter duration of catheterisation...
April 17, 2017: Trials
https://www.readbyqxmd.com/read/28404548/the-tip-apex-distance-in-the-x-bolt-dynamic-plating-system
#10
M A Fernandez, A Aquilina, J Achten, N Parsons, M L Costa, X L Griffin
OBJECTIVES: The Sliding Hip Screw (SHS) is commonly used to treat trochanteric hip fractures. Fixation failure is a devastating complication requiring complex revision surgery. One mode of fixation failure is lag screw cut-out which is greatest in unstable fracture patterns and when the tip-apex distance of the lag screw is > 25 mm. The X-Bolt Dynamic Hip Plating System (X-Bolt Orthopaedics, Dublin, Ireland) is a new device which aims to reduce this risk of cut-out. However, some surgeons have reported difficulty minimising the tip-apex distance with subsequent concerns that this may lead to an increased risk of cut-out...
April 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28404197/mercaptopurine-versus-placebo-to-prevent-recurrence-of-crohn-s-disease-after-surgical-resection-toppic-a-multicentre-double-blind-randomised-controlled-trial
#11
Craig Mowat, Ian Arnott, Aiden Cahill, Malcolm Smith, Tariq Ahmad, Sreedhar Subramanian, Simon Travis, John Morris, John Hamlin, Anjan Dhar, Chuka Nwokolo, Cathryn Edwards, Tom Creed, Stuart Bloom, Mohamed Yousif, Linzi Thomas, Simon Campbell, Stephen J Lewis, Shaji Sebastian, Sandip Sen, Simon Lal, Chris Hawkey, Charles Murray, Fraser Cummings, Jason Goh, James O Lindsay, Naila Arebi, Lindsay Potts, Aileen J McKinley, John M Thomson, John A Todd, Mhairi Collie, Malcolm G Dunlop, Ashley Mowat, Daniel R Gaya, Jack Winter, Graham D Naismith, Holly Ennis, Catriona Keerie, Steff Lewis, Robin J Prescott, Nicholas A Kennedy, Jack Satsangi
BACKGROUND: Up to 60% of patients with Crohn's disease need intestinal resection within the first 10 years of diagnosis, and postoperative recurrence is common. We investigated whether mercaptopurine can prevent or delay postoperative clinical recurrence of Crohn's disease. METHODS: We did a randomised, placebo-controlled, double-blind trial at 29 UK secondary and tertiary hospitals of patients (aged >16 years in Scotland or >18 years in England and Wales) who had a confirmed diagnosis of Crohn's disease and had undergone intestinal resection...
December 2016: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28404155/survival-outcomes-following-laparoscopic-versus-open-d3-dissection-for-stage-ii-or-iii-colon-cancer-jcog0404-a-phase-3-randomised-controlled-trial
#12
Seigo Kitano, Masafumi Inomata, Junki Mizusawa, Hiroshi Katayama, Masahiko Watanabe, Seiichiro Yamamoto, Masaaki Ito, Shuji Saito, Shoichi Fujii, Fumio Konishi, Yoshihisa Saida, Hirotoshi Hasegawa, Tomonori Akagi, Kenichi Sugihara, Takashi Yamaguchi, Tadahiko Masaki, Yosuke Fukunaga, Kohei Murata, Masazumi Okajima, Yoshihiro Moriya, Yasuhiro Shimada
BACKGROUND: Although benefits of laparoscopic surgery compared with open surgery have been suggested, the long-term survival of patients undergoing laparoscopic surgery for colon cancer requiring Japanese D3 dissection remains unclear. We did a randomised controlled trial to establish non-inferiority of laparoscopic surgery to open surgery. METHODS: We did an open-label, multi-institutional, randomised, two-arm phase 3 trial in 30 hospitals in Japan. Patients aged 20-75 years who had histologically proven colon cancer; tumours located in the caecum or ascending, sigmoid, or rectosigmoid colon; T3 or deeper lesions without involvement of other organs, node stages N0-2, and metastasis stage M0; and tumour size of 8 cm or smaller were included...
April 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28404154/active-observation-versus-interval-appendicectomy-after-successful-non-operative-treatment-of-an-appendix-mass-in-children-china-study-an-open-label-randomised-controlled-trial
#13
Nigel J Hall, Simon Eaton, Michael P Stanton, Agostino Pierro, David M Burge
BACKGROUND: Despite a scarcity of supporting evidence, most surgeons recommend routine interval appendicectomy after successful non-operative treatment of an appendix mass in children. We aimed to compare routine interval appendicectomy with active observation. METHODS: We enrolled participants in the CHildren's INterval Appendicectomy (CHINA) study, a multicentre, open-label, randomised controlled study at 19 specialist paediatric surgery centres, 17 of which were in the UK, one in Sweden, and one in New Zealand...
April 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28404067/continuous-wound-infiltration-versus-epidural-analgesia-after-hepato-pancreato-biliary-surgery-pop-up-a-randomised-controlled-open-label-non-inferiority-trial
#14
Timothy H Mungroop, Denise P Veelo, Olivier R Busch, Susan van Dieren, Thomas M van Gulik, Tom M Karsten, Steve M de Castro, Marc B Godfried, Bram Thiel, Markus W Hollmann, Philipp Lirk, Marc G Besselink
BACKGROUND: Epidural analgesia is the international standard for pain treatment in abdominal surgery. Although some studies have advocated continuous wound infiltration with local anaesthetics, robust evidence is lacking, especially on patient-reported outcome measures. We aimed to determine the effectiveness of continuous wound infiltration in hepato-pancreato-biliary surgery. METHODS: In this randomised controlled, open label, non-inferiority trial (POP-UP), we enrolled adult patients undergoing hepato-pancreato-biliary surgery by subcostal or midline laparotomy in two Dutch hospitals...
October 2016: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28404008/surgery-versus-conservative-management-for-recurrent-and-ongoing-left-sided-diverticulitis-direct-trial-an-open-label-multicentre-randomised-controlled-trial
#15
Bryan J M van de Wall, Marguerite A W Stam, Werner A Draaisma, R Stellato, Willem A Bemelman, Marja A Boermeester, Ivo A M J Broeders, Eric J Belgers, Boudewijn R Toorenvliet, Hubert A Prins, Esther C J Consten
BACKGROUND: Patients with recurrent or persisting complaints after an episode of left-sided diverticulitis are managed with either conservative measures or elective sigmoidectomy. To date, there are no data from randomised trials. We aimed to establish which treatment leads to a better quality of life for patients with diverticulitis. METHODS: We did an open-label, multicentre, randomised controlled trial (DIRECT trial) in 24 teaching and two academic hospitals in the Netherlands...
January 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28403868/the-use-of-viscoelastic-haemostatic-assays-in-goal-directing-treatment-with-allogeneic-blood-products-a-systematic-review-and-meta-analysis
#16
REVIEW
Mathilde Fahrendorff, Roberto S Oliveri, Pär I Johansson
BACKGROUND: Management of the critically bleeding patient can be encountered in many medical and surgical settings. Common for these patients is a high risk of dying from exsanguination secondary to developing coagulopathy. The purpose of this meta-analysis was to systematically review and assess randomised controlled trials (RCTs) performed on patients in acute need for blood transfusions due to bleeding to evaluate the effect of viscoelastic haemostatic assay (VHA) guidance on bleeding, transfusion requirements and mortality...
April 13, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28403859/managing-uncertainty-a-qualitative-study-of-surgeons-decision-making-for-one-stage-and-two-stage-revision-surgery-for-prosthetic-hip-joint-infection
#17
Andrew J Moore, Ashley W Blom, Michael R Whitehouse, Rachael Gooberman-Hill
BACKGROUND: Approximately 88,000 primary hip replacements are performed in England and Wales each year. Around 1% go on to develop deep prosthetic joint infection. Between one-stage and two-stage revision arthroplasty best treatment options remain unclear. Our aims were to characterise consultant orthopaedic surgeons' decisions about performing either one-stage or two-stage revision surgery for patients with deep prosthetic infection (PJI) after hip arthroplasty, and to identify whether a randomised trial comparing one-stage with two-stage revision would be feasible...
April 12, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28403675/advances-in-the-use-of-surgery-and-multimodality-treatment-for-n2-non-small-cell-lung-cancer
#18
Paul E Van Schil, Krishan Yogeswaran, Jeroen M Hendriks, Patrick Lauwers, Corinne Faivre-Finn
stage IIIA-N2 non-small cell lung cancer (NSCLC) represents a heterogeneous group of bronchogenic carcinomas with locoregional involvement. Different categories of N2 disease exist, ranging from unexpectedly encountered N2 involvement after detailed preoperative staging or "surprise" N2, to potentially resectable disease treated within a combined modality setting, and finally, bulky N2 involvement treated by chemoradiation. Areas covered: Large randomised controlled trials and meta-analyses on stage IIIA-N2 NSCLC have been published but their implications for treatment remain a matter of debate...
April 12, 2017: Expert Review of Anticancer Therapy
https://www.readbyqxmd.com/read/28403408/systemic-lidocaine-fails-to-improve-postoperative-morphine-consumption-postoperative-recovery-and-quality-of-life-in-patients-undergoing-posterior-spinal-arthrodesis-a-double-blind-randomized-placebo-controlled-trial
#19
G Dewinter, P Moens, S Fieuws, B Vanaudenaerde, M Van de Velde, S Rex
Background.: It is inconclusive whether the perioperative administration of systemic lidocaine provides effective postoperative analgesia and enhances recovery in major orthopaedic surgery. We hypothesised that in adolescent and adult patients undergoing posterior spinal arthrodesis, a perioperative lidocaine infusion would reduce opioid requirements during the first 24 postoperative h. Methods.: 70 patients undergoing posterior arthrodesis were enrolled in this prospective, randomised, double-blind, placebo-controlled clinical trial...
April 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28403018/prophylactic-atropine-administration-attenuates-the-negative-haemodynamic-effects-of-induction-of-anaesthesia-with-propofol-and-high-dose-remifentanil-a-randomised-controlled-trial
#20
Marieke Poterman, Thomas W L Scheeren, Marieke I van der Velde, Pieter L Buisman, Silvie Allaert, Michel M R F Struys, Alain F Kalmar
BACKGROUND: Induction of anaesthesia with propofol and remifentanil often induces unwanted bradycardia and hypotension, raising concerns regarding tissue oxygenation. The electrophysiological cardiac effects of remifentanil can be reversed by atropine. OBJECTIVE: To investigate if prophylactic administration of atropine can attenuate the negative haemodynamic effects of propofol and a high dose of remifentanil during induction of anaesthesia. DESIGN: A double-blind, randomised controlled trial...
April 11, 2017: European Journal of Anaesthesiology
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