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Diamond-Shaped Mini-Craniotomy: A New Concept in Neurosurgery.

J Neurol Surg A Cent Eur Neurosurg 2021 Aug 3. Epub 2021 Aug 3.

Department of Neurosurgery, Cannizzaro Hospital, Catania, Italy.

Background:  We describe, step by step, a modified, less invasive, diamond-shaped mini-craniotomy that optimizes dural opening and can be performed in elderly patients affected by acute subdural or intracerebral hematomas, in therapy with antiplatelets or anticoagulants.

Methods:  We retrospectively analyzed the clinical records of 67 patients (mean age of 78.5 years) treated in our institution, during a period of 10 years, with this novel diamond-shaped craniotomy. Read More

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ABO-incompatible living donor liver transplantation with high preoperative antibody titer: A case report.

Int J Surg Case Rep 2021 Jul 31;85:106260. Epub 2021 Jul 31.

Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.

Introduction And Importance: ABO-incompatible living donor liver transplantation (ABOi-LDLT) is essential for expanding the donor pool. ABOi-LDLT prognosis has improved since desensitization treatment with rituximab; however, patients with high antibody titers are considered to be at high risk of antibody mediated rejection (AMR). Nevertheless, the preoperative antibody titer cutoff levels that preclude ABOi-LDLT have not yet been determined. Read More

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Comparison of Drug-Coated Balloons to Bare Metal Stents in the Treatment of Symptomatic Vertebral Artery-Origin Stenosis: A Prospective Randomized Trial.

World Neurosurg 2021 Jul 31. Epub 2021 Jul 31.

The affiliated Tumour Hospital of Harbin Medical University No.150 Haping Road, Harbin, China. Electronic address:

Objective: To compare the angiographic and clinical outcomes of drug-coated balloon (DCB) with distal embolic protection devices (EPD) vs bare metal stent (BMS) without EPD in the treatment of symptomatic vertebral artery origin stenosis (VAOS).

Methods: Between January 2017 and December 2018, a prospective randomized trial was conducted involving 95 patients with symptomatic VAOS randomly assigned to treatment with DCB + EPD (n=49) or BMS without EPD (n=46). Target vessel restenosis (RS) >50% detected by computed tomography angiography (CTA) was the primary endpoint. Read More

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Short-term outcomes of robot-assisted versus thoracoscopic-assisted minimally invasive esophagectomy.

Ann Thorac Surg 2021 Jul 31. Epub 2021 Jul 31.

Department of Anesthesiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, China. Electronic address:

Background: Robot-assisted (RA) and thoracoscopic-assisted (TA) minimally invasive esophagectomy (MIE) are surgical techniques for the treatment of esophageal cancer. This study aims to compare short-term outcomes of RAMIE to TAMIE.

Methods: We conducted a single-center retrospective analysis between January 2016 and December 2019, including 1012 consecutive patients who underwent MIE, 437 in the RAMIE group and 575 in the TAMIE group. Read More

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Role of Brain Natriuretic Peptide in the Prediction of Early Postoperative Seizures Following Surgery for Traumatic Acute Subdural Hematoma: A Prospective Study.

Neurol Ther 2021 Aug 3. Epub 2021 Aug 3.

Department of Neurosurgery and Spine Surgery, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany.

Introduction: Brain natriuretic peptide (BNP) is a reliable biomarker in the acute phase of traumatic brain injury. However, the relationship between BNP and traumatic acute subdural hematoma (aSDH) has not yet been addressed. This study aimed to analyze BNP levels on admission in surgically treated patients and assess their relationship with early postoperative seizures (EPS) and functional outcomes. Read More

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Hemiarthroplasty of the hip using the direct anterior approach.

Oper Orthop Traumatol 2021 Aug 3. Epub 2021 Aug 3.

Department of Orthopedic Surgery, Medical University Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria.

Objective: Minimally invasive approach in total hip arthroplasty for the treatment of femoral neck fractures with a hemiarthroplasty.

Indications: Femoral neck fractures of patients without hip osteoarthritis where the acetabulum is still intact.

Contraindications: Lesions and infections of the skin in the approach area; hip osteoarthritis; surgeon's lack of experience with the technique. Read More

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An International, Multicenter Retrospective Observational Study to Assess Technical Success and Clinical Outcomes of Patients Treated with an Endovascular Aneurysm Sealing Device for Type III Endoleak.

J Endovasc Ther 2021 Aug 3:15266028211031933. Epub 2021 Aug 3.

Department of Vascular Surgery, Rijnstate, Arnhem, The Netherlands.

Introduction: Type III endoleaks post-endovascular aortic aneurysm repair (EVAR) warrant treatment because they increase pressure within the aneurysm sac leading to increased rupture risk. The treatment may be difficult with regular endovascular devices. Endovascular aneurysm sealing (EVAS) might provide a treatment option for type III endoleaks, especially if located near the flow divider. Read More

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Hemorrhagic shock caused by primary splenic pregnancy with spontaneous splenic rupture.

J Obstet Gynaecol Res 2021 Aug 2. Epub 2021 Aug 2.

China-Japan Union Hospital of Jilin University, Changchun, China.

The subject, splenic pregnancy, is very rare and interesting with about a few cases reported to date. This case report describes a healthy 17-year-old girl admitted to our hospital who complained of amenorrhea for 30 days, intermittent abdominal pain for 3 days and worsening for 1 h. The serum human chorionic gonadotropin (hCG) was greater than 10000. Read More

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Effectiveness of Repair of Aortic Coarctation in Neonates: A Long-Term experience.

Pediatr Cardiol 2021 Aug 2. Epub 2021 Aug 2.

Pediatric and Congenital Cardiac Surgery, Department of Cardiothoracic and Vascular Sciences and Public Health, University of Padova, Padova, Italy.

To evaluate early and long-term results of surgical treatment of aortic coarctation (CoAo) in neonates. This is a retrospective clinical review of neonates with CoAo, who underwent surgery between 1995 and 2019. Data were retrieved from our institutional database, to identify preoperative and postoperative characteristics. Read More

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A pilot study evaluating the effect of early physical therapy on pain and disabilities after breast cancer surgery: Prospective randomized control trail.

Breast 2021 Jul 21;59:286-293. Epub 2021 Jul 21.

Department of Surgery, Assuta Medical Center, Tel Aviv, Israel; Faculty of Medicine, Ben Gurion University of the Negev, Beer Sheva, Israel. Electronic address:

Background: Morbidity of the shoulders after breast cancer (BC) surgery is a common side effect that includes; persistent pain, function limitation, and decreased range of motion (ROM). This study examines the effect of early physical therapy (PT) and patient's education on these morbidities.

Methods: A prospective, randomized clinical trial was conducted at a single medical center from October 2018 until April 2019. Read More

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Transfusion Guidelines in Adult Spine Surgery: A Systematic Review and Critical Summary of Currently Available Evidence.

Spine J 2021 Jul 30. Epub 2021 Jul 30.

University of Texas Southwestern Medical Center, Department of Neurological Surgery, Dallas, TX, USA 75235; University of Texas Southwestern Medical Center, Spine Center, Dallas, TX, USA 75235.

Background Context: Red blood cell transfusion can be associated with complications in medical and surgical patients. Acute anemia in ambulatory patients undergoing surgery can also impede wound healing and independent self-care. Current transfusion threshold guidelines are still based on evidence derived from critically-ill intensive care unit medical patients and may not apply to spine surgery candidates. Read More

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Evaluation of an Enhanced Recovery After Surgery Protocol (ERAS) for Same-Day discharge and Reduction of Opioid Use Following Bimaxillary Orthognathic Surgery.

J Oral Maxillofac Surg 2021 Jul 8. Epub 2021 Jul 8.

Partner, Southern California Permanente Medical Group; Attending Anesthesiologist, Department of Anesthesiology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA.

Purpose: This study sought to evaluate the impact of implementation of a comprehensive enhanced recovery after surgery (ERAS) protocol upon patients undergoing maxillary and mandibular osteotomy (MMO).

Methods: This study was a retrospective, observational study of patients undergoing MMO. The study intervention group consisted of patients who underwent MMO with utilization of ERAS protocol compared to control group without ERAS. Read More

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Risk factors for postoperative delirium and subsyndromal delirium in older patients in the surgical ward: A prospective observational study.

PLoS One 2021 2;16(8):e0255607. Epub 2021 Aug 2.

Department of Nursing, Graduate School of Medicine, Yokohama City University, Yokohama, Japan.

Postoperative delirium (POD) and subsyndromal delirium (SSD) among older patients is a common, serious condition associated with a high incidence of negative outcomes. However, there are few accurate methods for the early detection of POD and SSD in surgical wards. This study aimed to identify risk factors of POD and SSD in older patients who were scheduled for surgery in a surgical ward. Read More

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Robotic versus laparoscopic right hemicolectomy: a case-matched study.

J Robot Surg 2021 Aug 2. Epub 2021 Aug 2.

Department of Colorectal Surgery, University Hospital Limerick, St Nessan's Road, Dooradoyle Co, Limerick, Ireland.

The current gold standard surgical treatment for right colonic malignancy is the laparoscopic right hemicolectomy (LRH). However, laparoscopic surgery has limitations which can be overcome by robotic surgery. The benefits of robotics for rectal cancer are widely accepted but its use for right hemicolectomy remains controversial. Read More

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A novel electrosurgical divider: performance in a self-controlled tonsillectomy study.

Eur Arch Otorhinolaryngol 2021 Aug 2. Epub 2021 Aug 2.

Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.

Purpose: Tonsillectomies are among the most common surgeries in otorhinolaryngology. A novel electrosurgical temperature-controlled instrument (device) promises rapid tonsillectomies and might reduce postoperative pain, but comparative studies to assess performance are warranted.

Methods: This randomized self-controlled clinical trial was conducted from October 2019 to October 2020 at the Department of Otorhinolaryngology, Head and Neck Surgery of the Medical University of Vienna. Read More

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Serial assessment of inflammatory parameters for prediction of septic complications following surgery for colorectal endometriosis : A descriptive, retrospective study.

Wien Klin Wochenschr 2021 Aug 2. Epub 2021 Aug 2.

Department of Gynecology, Center for Endometriosis, Hospital St. John of God Vienna, Vienna, Austria.

Purpose: To assess whether C‑reactive protein (CRP), white blood cell count (WBC) and body temperature changes are suitable parameters for the early detection of septic complications following resection of colorectal deep endometriosis (DE).

Methods: Retrospective data analysis of CRP, WBC and body temperature courses following colorectal surgery for DE at a tertiary referral center for endometriosis.

Results: Out of 183 surgeries performed, 10 major surgical complications were observed, including 4 anastomotic leakages (AL 2%) and 2 rectovaginal fistulae (RVF 1%). Read More

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Evaluation of physician-modified endografts for the treatment of thoraco-abdominal and pararenal aortic pathologies at a single institution.

J Cardiovasc Surg (Torino) 2021 Aug 2. Epub 2021 Aug 2.

Department of Vascular Surgery, Drum Tower Hospital, Affiliated to School of Medicine, Nanjing University, Nanjing, Jiangsu, China -

Background: This study aimed to describe the outcomes of high-risk patients with symptomatic or impending ruptured pararenal aneurysm and thoraco-abdominal aortic aneurysm with comorbidities unsuitable for conventional open surgery, using physician-modified endografts (PMEGs).

Methods: A single-center retrospective analysis was conducted on 59 patients (mean age: 75 years; 47 males) treated with PMEGs between 2017 and 2020. Data on baseline characteristics, procedures, and clinical follow up were collected to retrospectively analyze early (technical success, perioperative mortality, and major adverse events) and late (patency, endoleak, intervention, aneurysm thrombosis, and survival) outcomes. Read More

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Robotic-assisted proximal gastrectomy using the double-flap technique for early gastric cancer with situs inversus totalis: a case report.

Surg Case Rep 2021 Aug 2;7(1):172. Epub 2021 Aug 2.

Department of Gastrointestinal Surgery, Kansai Rosai Hospital, Amagasaki, Japan.

Background: The robotic system has been applied in the treatment of gastric cancer (GC), and the procedure has been found to be safe and feasible. Situs inversus totalis (SIT) is a relatively rare autosomal recessive congenital anomaly. We successfully performed robot-assisted proximal gastrectomy (RAPG) and handsewn double-flap esophagogastrostomy for GC in a patient with SIT. Read More

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Impact of preoperative antithrombotic therapy in patients undergoing elective isolated coronary artery bypass grafting.

Interact Cardiovasc Thorac Surg 2021 Jul 31. Epub 2021 Jul 31.

Cardiothoracic surgery department, Catharina Heart Centre, Catharina Hospital, ZA Eindhoven, Netherlands.

Objectives: The objective of this retrospective study was to assess differences in clinical outcomes between patients on acetylsalicylic acid (ASA) monotherapy and patients on other antithrombotic (AT) regimens undergoing elective coronary artery bypass grafting (CABG).

Methods: Patients who underwent elective isolated CABG between 2017 and 2019 at the Catharina Hospital Eindhoven were eligible for this study. The primary end points were re-exploration for bleeding and postoperative blood product transfusion. Read More

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Effectiveness of Flexible Ureterorenoscopy Versus Extracorporeal Shock Wave Lithotripsy for Renal Calculi of 5-15 mm: Results of a Randomized Controlled Trial.

Eur Urol Open Sci 2021 Mar 2;25:5-10. Epub 2021 Feb 2.

Department of Urology, University Hospital, University of Zurich, Zurich, Switzerland.

Background: Primary flexible ureterorenoscopy (URS) and extracorporeal shock wave lithotripsy (SWL) are treatment options in patients with renal calculi of 5-15 mm.

Objective: To compare effectiveness, complication rates, and pain scores between primary URS and SWL.

Design Setting And Participants: Between 2011 and 2016, patients with renal calculi between 5 and 15 mm were randomized to undergo either primary URS or SWL. Read More

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Intensified and Standardized Digital Communication with Cystectomy Patients as a Potentially Simple and Effective Modality for Early Detection of Postoperative Complications: Results from a Pilot Study.

Eur Urol Open Sci 2020 Dec 24;22:3-8. Epub 2020 Oct 24.

Urologie St. Anna, Luzern, Switzerland.

Background: Postoperative readmission rates following radical cystectomy remain significant. Early identification of emerging complications could potentially allow for immediate institution of therapy.

Objective: To intensify postoperative patient-physician communication via a cellphone-based health care application (CHA) and to evaluate its potential for early detection of complications. Read More

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December 2020

Cerebral Infarction in Childhood-Onset Craniopharyngioma Patients: Results of KRANIOPHARYNGEOM 2007.

Front Oncol 2021 14;11:698150. Epub 2021 Jul 14.

Department of Pediatrics and Pediatric Hematology/Oncology, University Children's Hospital, Carl von Ossietzky University, Klinikum Oldenburg AöR, Oldenburg, Germany.

Background: Cerebral infarction (CI) is a known vascular complication following treatment of suprasellar tumors. Risk factors for CI, incidence rate, and long-term prognosis are unknown for patients with childhood-onset craniopharyngioma (CP).

Methods: MRI of 244 CP patients, recruited between 2007 and 2019 in KRANIOPHARYNGEOM 2007, were reviewed for CI. Read More

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Focal Neurologic Deficit After Epidural Catheter Removal Leads to Meningioma Diagnosis.

Cureus 2021 Jun 29;13(6):e16015. Epub 2021 Jun 29.

Anesthesiology, State University of New York Upstate Medical University, Syracuse, USA.

We present an unusual case of a 60-year-old female who developed subtle, new-onset left upper and lower extremity weakness on day five of perioperative thoracic epidural placement. The onset of a focal neurological deficit after epidural placement usually raises suspicion for the presence of an epidural hematoma, abscess, or traumatic cord lesion. However, in this patient, brain imaging revealed a large, previously undiagnosed intracranial mass. Read More

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Efficacy of PPV Combined with Air Tamponade for Treatment of Inferior Retinal Breaks.

J Ophthalmol 2021 21;2021:9597584. Epub 2021 Jul 21.

Department of Ophthalmology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China.

Purpose: To observe the efficacy and safety of pars plana vitrectomy (PPV) combined with filtered air tamponade in the treatment of rhegmatogenous retinal detachment (RRD) with inferior retinal breaks.

Methods: This retrospective study included 20 patients (20 eyes) with inferior retinal breaks in RRD; all underwent PPV combined with filtered air tamponade. Preoperative examinations included BCVA, IOP, anterior segment, fundus and locations, numbers, and sizes of retinal breaks and ocular B-mode ultrasonography. Read More

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Development of a novel atrophic non-union model in rabbits: A preliminary study.

Ann Med Surg (Lond) 2021 Aug 14;68:102558. Epub 2021 Jul 14.

Division of Surgery, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, India.

Background And Aim: The currently available atrophic non-union models rely on wide segmental excision of bone diaphysis to impede the process of healing but lack resemblance to the clinical scenario. The present study focused on developing an model of atrophic non-union fracture in rabbit radius that can replicate the clinical scenario.

Materials And Methods: The atrophic non-union fracture model was developed by creating a 10 mm segmental bone defect in the radial diaphysis of five adult New Zealand White rabbits. Read More

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Attitude of the surgical approach in hyperparathyroidism: A retrospective study.

Exp Ther Med 2021 Sep 7;22(3):959. Epub 2021 Jul 7.

Department of Thoracic Surgery, 'Dr. Carol Davila' Central Military Emergency University Hospital, 010825 Bucharest, Romania.

The present study constitutes a retrospective study for patients with hyperparathyroidism surgically operated on at the Department of Thoracic Surgery of the Central Military Emergency University Hospital 'Dr. Carol Davila', Bucharest, Romania (SUUMC), over a period of 6 years. The study aimed to elucidate the diagnostic and surgical attitude for an effective treatment, practiced at SUUMC, Romania. Read More

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September 2021

Performing Multiple Posterior Spinal Fusions in 1 Day: A Comparison of Perioperative Outcomes Between Morning and Afternoon Cases.

J Pediatr Orthop 2021 Aug 2. Epub 2021 Aug 2.

Departments of Orthopaedic Surgery Anesthesiology, Boston Children's Hospital Harvard Medical School, Boston, MA.

Background: High-volume centers for idiopathic scoliosis (IS) have difficulty in scheduling posterior spinal fusions (PSFs) due to operating room availability, particularly during school vacation. A solution is for 1 surgeon to perform 2 PSF cases back-to-back. This study aims to compare morning and afternoon PSF cases performed by the same surgeon for perioperative outcomes. Read More

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Preemptive Endoluminal Vacuum Therapy to Reduce Morbidity after Minimally Invasive Ivor Lewis Esophagectomy: Including a Novel Grading System For Postoperative Endoscopic Assessment of GI-Anastomoses.

Ann Surg 2021 Jul 29. Epub 2021 Jul 29.

Department of Visceral and Transplant Surgery, University Hospital Zurich, Switzerland Department Gastroenterology, University Hospital Zurich, Switzerland Department of HPB Surgery and Liver Transplantation, Royal Free Hospital and University College London, London, United Kingdom.

Objective: Preemptive endoluminal vacuum therapy (pEVT) is a novel concept to reduce postoperative morbidity and has the potential to disrupt current treatment paradigms for patients undergoing esophagectomy.

Summary Background Data: Endoluminal vacuum therapy is an accepted treatment for anastomotic leakage (AL) after esophagectomy.

Methods: Retrospective analysis of patients undergoing minimally invasive Ivor Lewis esophagectomy (MILE) with pEVT between 11/2017 and 10/2020. Read More

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Hypothermic Oxygenated Machine Perfusion (HOPE) Reduces Early Allograft Injury and Improves Post-Transplant Outcomes in Extended Criteria Donation (ECD) Liver Transplantation from Donation After Brain Death (DBD): Results from a Multicenter Randomized Controlled Trial (HOPE ECD-DBD).

Ann Surg 2021 Jul 29. Epub 2021 Jul 29.

Department of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen, Germany Department of Surgery, Campus Charité Mitte | Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Germany Department of Transplantation Surgery, Institute for Clinical and Experimental Medicine, Prague, Czech Republic Department of General, Visceral, and Transplant Surgery, Ludwig-Maximilians-University Munich, Munich, Germany Department of HPB Surgery and Liver Transplantation, Royal Free Hospital, London, UK University College London, London, UK Department of Hepatology, Maastricht University Medical Center (MUMC), Maastricht, The Netherlands Department of Internal Medicine III, University Hospital RWTH Aachen, Aachen, Germany Institute for Laboratory Animal Science and Experimental Surgery, University Hospital RWTH Aachen, Aachen, Germany Institute for Biometry and Clinical Epidemiology, Charité-Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany Department of Hepatology and Gastroenterology, Campus Charité Mitte | Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Germany Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Germany Department of General Surgery and Liver transplantation, Fundeni Clinical Institute, Bucharest, Romania Department for General, Visceral and Transplant Surgery, Hannover Medical School, Hannover, Germany Department of Anesthesiology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA.

Objective: To evaluate peak serum alanine aminotransferase (ALT) and postoperative clinical outcomes after hypothermic oxygenated machine perfusion (HOPE) versus static cold storage (SCS) in extended criteria donation (ECD) liver transplantation (LT) from donation after brain death (DBD).

Background: HOPE might improve outcomes in LT, particularly in high-risk settings such as ECD organs after DBD, but this hypothesis has not yet been tested in a randomized controlled clinical trial (RCT).

Methods: Between 09/2017-09/2020 46 patients undergoing ECD-DBD LT from four centers were randomly assigned to HOPE (n=23) or SCS (n=23). Read More

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Outcomes of Esophagogastric Cancer Surgery during eight Years of Surgical Auditing by the Dutch Upper Gastrointestinal Cancer Audit (DUCA).

Ann Surg 2021 Jul 29. Epub 2021 Jul 29.

Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Centre Amsterdam, Amsterdam, the Netherlands Scientific Bureau, Dutch Institute for Clinical Auditing, Leiden, the Netherlands Department of Surgery, Gelre Hospital, Apeldoorn, the Netherlands Department of Surgery, Erasmus MC - University Medical Center Rotterdam, Rotterdam, the Netherlands Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, the Netherlands Department of Medical Oncology, Amsterdam UMC, University of Amsterdam, Cancer Centre Amsterdam, Amsterdam, the Netherlands Department of Surgical Oncology, Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands Department of Surgery, University Medical Centre Utrecht, Utrecht, the Netherlands.

Objective: To evaluate changes in treatment and outcomes of esophagogastric cancer surgery after introduction of the Dutch Upper gastrointestinal Cancer Audit (DUCA). In addition, the presence of risk-averse behavior was assessed.

Summary Background Data: Clinical auditing is seen as an important quality improvement tool; however, its long-term efficacy remains largely unknown. Read More

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