32,652 results match your criteria Annals Of Surgery[Journal]


Moderate to Severe Soft Tissue Diabetic Foot Infections: A Randomized, Controlled, Pilot Trial of Post-Debridement Antibiotic Treatment for 10 versus 20 days.

Ann Surg 2021 Sep 15. Epub 2021 Sep 15.

Service of Infectious Diseases.

Background: The optimal duration of antibiotic therapy for soft-tissue infections of the diabetic foot (ST-DFI) remains unknown.

Objective: We determine if antibiotic therapy after debridement for a short (10 days), compared with a long (20 days), duration for ST-DFI results in similar rates of clinical remission and adverse events (AE).

Summary Background Data: The optimal duration of systemic antibiotic therapy, after successful debridement, for soft tissue infections of diabetic patients is unknown. Read More

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September 2021

Transcatheter Treatment of Ascending Aortic Pathology: Are we there Yet?

Ann Surg 2022 May 13. Epub 2022 May 13.

Division of Cardiovascular Medicine, Massachusetts General Hospital, Boston, MA.

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Mulholland and Greenfield's Surgery.

Ann Surg 2022 May 25;275(5):e735. Epub 2022 Jan 25.

Brigham and Women's Hospital, Boston, MA.

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The Effects of Dexmedetomidine on Perioperative Neurocognitive Outcomes After Cardiac Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Ann Surg 2022 May 27;275(5):864-871. Epub 2021 Aug 27.

Department of Anesthesia, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.

Objective: The purpose of this systematic review and meta-analysis is to examine the effect of DEX on delayed dNCR (cognitive dysfunction ≥ 1 week postoperative) after cardiac surgery.

Background: DEX has salutary effects on cognitive outcomes following cardiac surgery, however, studies are limited by inconsistent assessment tools, timing, and definitions of dysfunction. It is imperative to identify accurate point estimates of effect of DEX on clinically relevant changes in cognitive function. Read More

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American Society of Anesthesiologists-Physical Status Classification As An Independent Risk Factor of Surgical Site Infection After Infra-Inguinal Arterial Bypass.

Ann Surg 2021 Aug 20. Epub 2021 Aug 20.

Hospices Civils de Lyon, Hopital Louis Pradel, Service de Chirurgie Vasculaire et Endovasculaire, Bron cedex, France.

Objectives: The present study aimed to assess whether high-risk American Society of Anesthesiologists (ASA)-Physical Status was an independent risk factor for the development of surgical site infection (SSI) after infra-inguinal lower extremity bypass (LEB).

Summary Of Background Data: The ASA-Physical Status Classification System assesses the overall physical status preoperatively. ASA-Physical Status is associated with postoperative morbidity and mortality. Read More

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Discrimination Towards Women in Surgery: A Systematic Scoping Review.

Ann Surg 2022 Mar 10. Epub 2022 Mar 10.

Colorectal and Pelvic Floor Department, Guy's and St Thomas NHS foundation Trust, Westminster Bridge road, SE17EH, London, UK Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, Padova, Italy Division of Thoracic Surgery, Ospedale Maggiore della Carita' di Novara, Novara Department of General Surgery, St'Andrea Hospital, Massa Marittima, Grosseto Department of General Surgery, Ospedale San Giovanni di Dio di Orbetello, Grosseto, Italy Department of General Surgery, Bergamo Ovest Hospital, Bergamo, Italy Department of General surgery, Mirano Hospital, Venice, Italy Pancreatic Surgical Unit, Pederzoli Hospital, Peschiera del Garda (VR), Italy Department of Surgical Oncology, Yvelines-Nord Region Department de Chirurgie Visceral, Centre Hospitalier Intercommunal de Poissy/Saint German-en-Laye.

Background: Over the past twenty years explicit gender bias towards women in surgery has been replaced by more subtle barriers, which represent indirect forms of discrimination and prevents equality.

Objective: The aim of our scoping review is to summarize the different forms of discrimination towards women in surgery.

Methods: The database search consisted of original studies regarding discrimination towards female surgeons. Read More

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Intraoperative Redosing of Surgical Antibiotic Prophylaxis in Addition to Preoperative Prophylaxis Versus Single-dose Prophylaxis for the Prevention of Surgical Site Infection: A Meta-analysis and GRADE Recommendation.

Ann Surg 2022 Jun 11;275(6):1050-1057. Epub 2022 Mar 11.

Department of Surgery, Amsterdam UMC (location AMC), Amsterdam Gastroenterology Endocrinology & Metabolism (AGEM), University of Amsterdam, The Netherlands.

Objective: The aim of this study was to determine the effect of preoperative surgical antibiotic prophylaxis (SAP) with additional intraoperative redosing compared to single-dose preoperative surgical antibiotic prophylaxis on the incidence of surgical site infections (SSI).

Summary Background Data: Preoperative SAP is standard care for the prevention of SSI. During long surgical procedures, additional intraoperative redosing of SAP is advised, but there is great variability in redosing strategies and compliance rates. Read More

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Biomarkers for the Early Diagnosis of Sepsis in Burns: Systematic Review and Meta-analysis.

Ann Surg 2022 04;275(4):654-662

School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.

Objective: The aim of this study was to evaluate the diagnostic performance of all biomarkers studied to date for the early diagnosis of sepsis in hospitalized patients with burns.

Background: Early clinical diagnosis of sepsis in burns patients is notoriously difficult due to the hypermetabolic nature of thermal injury. A considerable variety of biomarkers have been proposed as potentially useful adjuncts to assist with making a timely and accurate diagnosis. Read More

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Surgical Performance Anxiety and Wellbeing Among Surgeons: A Cross-sectional Study in the United Kingdom.

Ann Surg 2022 04;275(4):632-639

Surgical Psychology and Performance Group, U.K.

Objective: This national cross-sectional study aims to establish the prevalence and potential impact of performance anxiety among surgeons and investigate its association with psychological traits and wellbeing.

Summary And Background Data: Despite a growing awareness that human factors, non-technical skills and wellbeing in healthcare affect patient outcomes, an area that has remained unexplored is surgical performance anxiety (SPA).

Methods: A prospectively registered, cross-sectional study using mixed methods was conducted across the United Kingdom. Read More

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Liver Transplantation Outcomes From Controlled Circulatory Death Donors: SCS vs in situ NRP vs ex situ NMP.

Ann Surg 2022 Jun 3;275(6):1156-1164. Epub 2022 Mar 3.

The Roy Calne Transplant Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Trust, Cambridge, UK.

Objective: To compare the outcomes of livers donated after circulatory death (DCD) and undergoing either in situ normothermic regional perfusion (NRP) or ex situ normothermic machine perfusion (NMP) with livers undergoing static cold storage (SCS).

Summary Of Background Data: DCD livers are associated with increased risk of primary nonfunction, poor function, and nonanastomotic strictures (NAS), leading to underutilization.

Methods: A single center, retrospective analysis of prospectively collected data on 233 DCD liver transplants performed using SCS, NRP, or NMP between January 2013 and October 2020. Read More

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Results of a Phase II Study on the Use of Neoadjuvant Chemotherapy (FOLFIRINOX or GEM/nab-PTX) for Borderline-resectable Pancreatic Cancer (NUPAT-01).

Ann Surg 2022 Jun 3;275(6):1043-1049. Epub 2022 Mar 3.

Surgical Oncology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8560, Japan.

Objective: Given the frequent adverse events with multidrug chemotherapy, not only the survival benefit but also the feasibility of using neoadjuvant chemotherapy to treat pancreatic cancer need to be clarified.

Summary Of Background Data: Although the development of multidrug chemotherapy regimens has improved the survival outcomes of patients with unresectable pancreatic cancer, the benefits of these treatments in the neo-adjuvant setting remain controversial.

Methods: Patients with borderline-resectable pancreatic cancer were enrolled and randomly assigned to receive neoadjuvant chemotherapy with either FOLFIRINOX or gemcitabine with nab-paclitaxel (GEM/nab-PTX). Read More

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A Multidimensional Bioinformatic Platform for the Study of Human Response to Surgery.

Ann Surg 2022 Jun 3;275(6):1094-1102. Epub 2022 Mar 3.

Department of Surgery, Duke University; Durham, NC.

Objective: To design and establish a prospective biospecimen repository that integrates multi-omics assays with clinical data to study mechanisms of controlled injury and healing.

Background: Elective surgery is an opportunity to understand both the systemic and focal responses accompanying controlled and well-characterized injury to the human body. The overarching goal of this ongoing project is to define stereotypical responses to surgical injury, with the translational purpose of identifying targetable pathways involved in healing and resilience, and variations indicative of aberrant peri-operative outcomes. Read More

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The Longitudinal Course of Low-Anterior Resection Syndrome: An Individual Patient Meta-Analysis.

Ann Surg 2022 02 17. Epub 2022 Feb 17.

Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand

Objective: We aimed to better understand the longitudinal course of LARS to guide patient expectations and identify those at risk of persisting dysfunction.

Summary Background Data: LARS describes disordered bowel function after rectal resection that significantly impacts quality of life.

Methods: MEDLINE, EMBASE, CENTRAL, and CINAHL databases were systematically searched for studies that enrolled adults undergoing anterior resection for rectal cancer and used the LARS score to assess bowel function ≥2 postoperative time points. Read More

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February 2022

Working Definitions of "Critical Portions": Results from Qualitative Interviews with 51 Academic Surgeons.

Ann Surg 2022 Feb 17. Epub 2022 Feb 17.

Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, Nashville, TN.

Objective: Identify the considerations academic surgeons use when determining which portions of a procedure are "critical" and necessitate their presence.

Background: Teaching physicians are required to be present for the "critical portion" of surgical procedures, but the definition of what constitutes a critical portion remains elusive. Current guidelines defer to surgeons' expert judgment in identifying critical portion(s) of a procedure; little is known about what concepts surgeons apply when deciding what parts of a procedure are critical. Read More

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February 2022

Followership: The Missing Link in Surgical Leadership.

Ann Surg 2022 Jun 17;275(6):e740-e742. Epub 2022 Feb 17.

Department of Anesthesia, McMaster university, Hamilton, ON, Canada.

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Association between Surgery, Anesthesia and Obstetric (SAO) Workforce and Emergent Surgical and Obstetric Mortality among United States Hospital Referral Regions.

Ann Surg 2022 Feb 17. Epub 2022 Feb 17.

Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA Center for Surgery and Public Health, Department of Surgery, Brigham & Women's Hospital, Harvard Medical School, Boston, MA Tufts University School of Medicine, Boston, MA Epidemiology, Department for Sport and Health Sciences, Technical University of Munich, Munich, Germany Department of Obstetrics & Gynecology, University of Alberta, Edmonton, Canada Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA Department of Surgery, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA.

Objective: To determine the association between SAO workforce and mortality from emergent surgical and obstetric conditions within US HRRs.

Background: SAO workforce per capita has been identified as a core metric of surgical capacity by the Lancet Commission on Global Surgery, but its utility has not been assessed at the subnational level for a high-income country.

Methods: The number of practicing surgeons, anesthesiologists, and obstetricians per capita was estimated for all HRRs using the US Health Resources & Services Administration Area Health Resource File Database. Read More

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February 2022

Insurance and Transformation of Risk.

Authors:
Bruce L Hall

Ann Surg 2022 Jun 17;275(6):1080-1084. Epub 2022 Feb 17.

Professor of Surgery, Professor of Healthcare Management, Washington University in Saint Louis; Vice President and System Chief Medical Officer, BJC Healthcare, BJC Learning Institute, St Louis, MO.

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Comment on "Gastrectomy Versus Esophagectomy For Gastroesophageal Junction Tumors: Short- And Long-term Outcomes From the Dutch Upper GI Cancer Audit".

Ann Surg 2022 Feb 17. Epub 2022 Feb 17.

Peritoneal Tumours Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy.

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February 2022

Colonoscopic-Assisted Laparoscopic Wedge Resection for Colonic Lesions: A Prospective Multicenter Cohort Study (LIMERIC-Study).

Ann Surg 2022 May 17;275(5):933-939. Epub 2022 Feb 17.

Department of Surgery, Rijnstate, Arnhem, The Netherlands.

Objective: The aim of this study was to evaluate the safety and efficacy of a modified CAL-WR.

Summary Background Data: The use of segmental colectomy in patients with endoscopically unresectable colonic lesions results in significant morbidity and mortality. CAL-WR is an alternative procedure that may reduce morbidity. Read More

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Professionalism of Admitting and Consulting Services and Trauma Patient Outcomes.

Ann Surg 2022 May 17;275(5):883-890. Epub 2022 Feb 17.

Department of Surgery, Stanford University, Palo Alto, CA.

Objective: To determine whether trauma patients managed by an admitting or consulting service with a high proportion of physicians exhibiting patterns of unprofessional behaviors are at greater risk of complications or death.

Summary Background Data: Trauma care requires high-functioning interdisciplinary teams where professionalism, particularly modeling respect and communicating effectively, is essential.

Methods: This retrospective cohort study used data from 9 level I trauma centers that participated in a national trauma registry linked with data from a national database of unsolicited patient complaints. Read More

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Indocyanine Green Fluorescence Imaging as an Indispensable Tool for Modern Liver Surgery.

Authors:
Norihiro Kokudo

Ann Surg 2022 Jun 17;275(6):1035-1036. Epub 2022 Feb 17.

National Center for Global Health and Medicine, Tokyo, Japan.

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Vein Bypass versus Nitinol Stent in Long Femoropopliteal Lesions: 4-Year Results of a Randomized Controlled Trial.

Ann Surg 2022 Feb 17. Epub 2022 Feb 17.

Department of Vascular Surgery, Medical University of Innsbruck, Austria Department of Cardiac, Vascular and Endovascular Surgery, Paracelsus Medical University Salzburg, Austria Research and Innovation (FMTT) (biostatistics), Paracelsus Medical University Salzburg, Austria, - Department of Ophthalmology and Optometry, Paracelsus Medical University Salzburg, Austria, - Research Program Experimental Ophthalmology and Glaucoma Research, Paracelsus Medical University, Austria Department of Anesthesiology, Paracelsus Medical University, Salzburg, Austria.

Objectives: The aim of this study was to compare technical success, patency rates and clinical outcomes of vein bypass (VBP) with angioplasty and nitinol stents (NS) in femoropopliteal Trans-Atlantic Intersociety Consensus (TASC) II C and D lesions.

Summary Background Data: Guidelines widely recommend an endovascular-first strategy for long femoropopliteal lesions without sufficient data comparing it with vein bypass surgery.

Methods: A single-center prospective, randomized controlled trial (RCT) was performed, after approval of the local ethics committee, with technical success, primary and secondary patency as primary endpoints. Read More

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February 2022

Positron Emission Tomography/Magnetic Resonance Imaging Versus the Standard of Care Imaging in the Diagnosis of Peritoneal Carcinomatosis.

Ann Surg 2022 Feb 17. Epub 2022 Feb 17.

Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA Athinoula A Martinos Center for Biomedical Imaging, Harvard Medical School, Charlestown, MA Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA Division of Hematology & Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA. Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA Hospital of Avellino, Avellino, Italy Biostatistics Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA.

Objective: To compare positron emission tomography (PET)/magnetic resonance imaging (MRI) to the standard of care imaging (SCI) for the diagnosis of peritoneal carcinomatosis (PC) in primary abdominopelvic malignancies.

Summary Background Data: Identifying PC impacts prognosis and management of multiple cancer types.

Methods: Adult subjects were prospectively and consecutively enrolled from 4/2019 to 1/2021. Read More

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February 2022

Favourable outcomes after Retro-Rectus (Rives-Stoppa) Mesh Repair as Treatment for Non-Complex Ventral Abdominal Wall Hernia, a Systematic Review and Meta-Analysis.

Ann Surg 2022 Feb 18. Epub 2022 Feb 18.

Department of Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands Department of Surgery, IJsselland Ziekenhuis, Capelle aan den IJssel, The Netherlands Department of Surgery, Algemeen Ziekenhuis Maria Middelares, Ghent, Belgium Department of Neuroscience, Erasmus University Medical Center, Rotterdam, The Netherlands Department of Surgery, Maastricht University Medical Center.

Objective: To assess prevalence of hernia recurrence, surgical site infection (SSI), seroma, serious complications, and mortality after retro-rectus repair.

Summary Background Data: Ventral abdominal wall hernia is a common problem, tied to increasing frailty and obesity of patients undergoing surgery. For non-complex ventral hernia, retro-rectus (Rives-Stoppa) repair is considered the gold standard treatment. Read More

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February 2022

Effect of Adjuvant Steroid Therapy in type 3 Biliary Atresia: A Single-Center, Open-Label, Randomized Controlled Trial.

Ann Surg 2022 Feb 16. Epub 2022 Feb 16.

Departments of Pediatric Surgery and Clinical Trial Unit (CTU), Children's Hospital of Fudan University, Shanghai, China.

Objective: To evaluate the efficacy and side effects of additional postoperative steroid therapy for type 3 biliary atresia (BA) versus the current routine care.

Summary Background Data: Whether steroid therapy post-Kasai portoenterostomy improves the outcomes of biliary atresia remains controversial. Clinical evidence from two randomized trials in the UK and USA do not support the routine use of steroid in the treatment of biliary atresia. Read More

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February 2022

An Early Prospective Clinical Study to Evaluate the Safety and Performance of the Versius Surgical System in Robot-Assisted Cholecystectomy.

Ann Surg 2022 Feb 15. Epub 2022 Feb 15.

Deenanath Mangeshkar Hospital and Research Center, Pune, Maharashtra, India Department of Molecular Oncology, Barts Cancer Institute, Queen Mary University London, London, UK CMR Surgical, Cambridge, UK.

Objective: The aim of this study was to demonstrate the ability of the Versius Surgical System to successfully and safely complete cholecystectomy.

Background: The system has been developed in-line with surgeon feedback to overcome limitations of conventional laparoscopy to enhance surgeon experience and patient outcomes. Here we present results from the cholecystectomy cohort from a completed early clinical trial, which was designed to broadly align with Stage 2b of the Idea, Development, Exploration, Assessment, Long-term follow-up framework for surgical innovation. Read More

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February 2022

Validation of the IASLC Residual Tumor Classification in Patients with Stage III-N2 Non-small Cell Lung Cancer Undergoing Neoadjuvant Chemoradiotherapy Followed by Surgery.

Ann Surg 2022 Feb 15. Epub 2022 Feb 15.

Department of Thoracic and Cardiovascular Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea Centre for Clinical Epidemiology, Sungkyunkwan University, Samsung Medical Center, Seoul, Korea Departments of Epidemiology and Medicine, and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health. Baltimore, Maryland, USA Patient-Centered Outcomes Research Institute, Samsung Medical Center, Seoul, Korea.

Objective: To validate the International Association for the Study of Lung Cancer (IASLC) residual tumor classification in patients with stage III-N2 non-small cell lung cancer (NSCLC) undergoing neoadjuvant concurrent chemoradiotherapy (nCCRT) followed by surgery.

Background: As adequate nodal assessment is crucial for determining prognosis in patients with clinical N2 NSCLC undergoing nCCRT followed by surgery, the new classification may have better prognostic implications.

Methods: Using a registry for thoracic cancer surgery at a tertiary hospital in Seoul, Korea, between 2003 and 2019, we analyzed 910 patients with stage III-N2 NSCLC who underwent nCCRT followed by surgery. Read More

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February 2022

Patient-Reported Bowel, Urinary and Sexual Outcomes After Laparoscopic-Assisted Resection or Open Resection for Rectal Cancer: The Australasian Laparoscopic Cancer of the Rectum Randomized Clinical Trial (ALaCart).

Ann Surg 2022 Feb 15. Epub 2022 Feb 15.

NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia. Australasian Gastro-Intestinal Trials Group NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia Institute of Academic Surgery, Royal Prince Alfred Hospital, University of Sydney, Sydney, Australia Wesley Hospital, Brisbane, Queensland, Australia The Queen Elizabeth Hospital, Adelaide, Australia University of Queensland, Brisbane, Queensland, Australia. Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia Auckland Hospital, Auckland, New Zealand John Flynn Hospital, Queensland, Australia. Tweed Heads Hospital, Tweed Heads, NSW, Australia Bankstown-Lidcombe Hospital, Sydney, Australia. Prince of Wales Private Hospital, Sydney, Australia. Sydney South West Private Hospital, Sydney, Australia University of Queensland, Brisbane, Queensland, Australia. Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia. NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia.

Objective: To compare patient-reported urinary, bowel and sexual functioning of ALaCaRT Trial participants randomised to Open or Laparoscopic surgery for rectal cancer.

Summary Bakground Data: The primary endpoint, non-inferiority of laparoscopic surgical resection adequacy, was not established.

Methods: Participants completed QLQ-CR29 at baseline, three and 12-months post-surgery. Read More

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February 2022