Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 or #4)
Latest & greatest articles for surgery
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on surgery or other clinical topics then use Trip today.
This page lists the very latest high quality evidence on surgery and also the most popular articles. Popularity measured by the number of times the articles have been clicked on by fellow users in the last twelve months.
What is Trip?
Trip is a clinical search engine designed to allow users to quickly and easily find and use high-quality research evidence to support their practice and/or care.
Trip has been online since 1997 and in that time has developed into the internet’s premier source of evidence-based content. Our motto is ‘Find evidence fast’ and this is something we aim to deliver for every single search.
As well as research evidence we also allow clinicians to search across other content types including images, videos, patient information leaflets, educational courses and news.
For further information on Trip click on any of the questions/sections on the left-hand side of this page. But if you still have questions please contact us via firstname.lastname@example.org
Systematic Review - Comparative Effectiveness of Multifocal, Accommodative, and Monofocal Intraocular Lenses for Cataract Surgery and Lens Replacement 4 July 2019 Prepared for: Department of Veterans Affairs Veterans Health Administration Health Services Research & Development Service Washington, DC 20420 Prepared by: Evidence Synthesis Program (ESP) Center West Los Angeles VA Medical Center Los Angeles, CA Paul G. Shekelle, MD, PhD, Director Comparative Effectiveness of Multifocal (...) , Accommodative, and Monofocal Intraocular Lenses for Cataract Surgery and Lens Replacement 4 Authors: Principal Investigator: Paul Shekelle, MD, PhD Co-Investigators: Sumitra S. Khandelwal, MD Jason Jun, MD, MPP Research Associates: Selene Mak, PhDc Roberta Shanman, MLS Jessica M. Beroes, BS Marika Suttorp Booth, MS Evidence Synthesis Program Intraocular Lenses for Cataract Surgery and Lens Replacement Evidence Synthesis Program i PREFACE The VA Evidence Synthesis Program (ESP) was established in 2007
MitraClip transcatheter mitral valve repair in patients with moderate-to-severe or severe mitral regurgitation who are not eligible for surgery SHTG Advice | 1 SHTG Advice 05-19 August 2019 In response to an enquiry from the National Advisory Committee on Heart Disease MitraClip® transcatheter mitral valve repair in patients with moderate-to-severe or severe mitral regurgitation who are not eligible for surgery Advice for NHSScotland MitraClip® transcatheter mitral valve repair should (...) be considered for patients with moderate-to- severe (grade 3+) or severe (grade 4+) mitral regurgitation who are not eligible for open mitral valve repair surgery. Decisions should be made by a multi-disciplinary team with experience of performing this procedure, taking into account individual patients’ level of risk, comorbidities, preferences and quality of life. The annual procedure volume per centre for MitraClip® should be maximised to support optimal patient outcomes and ensure clinical experience
Perioperative FOLFOX 4 Versus FOLFOX 4 Plus Cetuximab Versus Immediate Surgery for High-Risk Stage II and III Colon Cancers: A Phase II Multicenter Randomized Controlled Trial (PRODIGE 22) Perioperative chemotherapy has proven valuable in several tumors, but not in colon cancer (CC).The aim of this study was to evaluate the efficacy and safety of perioperative chemotherapy in patients with locally advanced nonmetastatic CC.This is a French multicenter randomized phase II trial in patients (...) with resectable high-risk T3, T4, and/or N2 CC on baseline computed tomography (CT) scan. Patients were randomized to receive either 6 months of adjuvant FOLFOX after colectomy (control) or perioperative FOLFOX for 4 cycles before surgery and 8 cycles after (FOLFOX peri-op). In RAS wild-type patients, a third arm testing perioperative FOLFOX-cetuximab was added. Tumor Regression Grade (TRG1) of Ryan et al was the primary endpoint. Secondary endpoints were toxicity, perioperative morbidity, and quality
Safe Delivery of paediatric ENT surgery in the UK- a national strategy 1 SAFE DELIVERY OF PAEDIATRIC ENT SURGERY IN THE UK: A NATIONAL STRATEGY A Report of a Combined Working Party of the British Association for Paediatric Otolaryngology (BAPO), ENT UK, The Royal College of Anaesthetists (RCoA) and the Association of Paediatric Anaesthetists of Great Britain and Ireland (APAGBI) 3 Safe Delivery of Paediatric ENT Surgery in the UK: A National Strategy A Report of a Combined Working Party (...) Definitions Secondary Centre A secondary care centre is a district general hospital without paediatric intensive care facilities. It is recognised that some of the secondary care centres have a higher level of high dependency provision and therefore can accept a wider range of children for surgery. These are referred to as high acuity secondary centres and incorporate PICS Level 2 Critical Care. (2) Tertiary Centre A tertiary care centre is a hospital with full paediatric facilities including PICS Level 3
HemaClear for bloodless surgical field during limb surgery HemaClear for bloodless surgical field during HemaClear for bloodless surgical field during limb surgery limb surgery Medtech innovation briefing Published: 15 July 2019 www.nice.org.uk/guidance/mib187 pathways Summary Summary The technology technology described in this briefing is HemaClear. It is used for limb exsanguination during limb surgery to provide a bloodless surgical field. The inno innovativ vative aspects e aspects (...) are that it is a single-use sterile device, which the company claims is quicker and simpler to use and reduces the number of adverse events compared with existing devices. It may also be used outside of the operating theatre (for example, in a procedure room for minor cases). The intended place in ther place in therap apy y would be as an alternative to the pneumatic tourniquet system in people needing limb surgery where a bloodless field is needed. The main points from the e main points from the evidence vidence
Robot-assisted thoracic surgery Robot-assisted thoracic surgery - Health Technology Wales > Robot-assisted thoracic surgery Robot-assisted thoracic surgery Topic Status Incomplete Robot-assisted thoracic surgery. Summary Health Technology Wales researchers searched for evidence on the clinical and cost effectiveness of robot assisted thoracic surgery compared to other types of thoracic surgery. Based on the evidence identified, HTW’s Assessment Group concluded to progress this topic to Evidence
Selection pressures of vancomycin powder use in spine surgery: a meta-analysis Surgical site infection (SSI) is a serious and costly complication of spine surgery. Many surgeons apply vancomycin powder to the surgical wound to prevent SSIs. While multiple studies have reported reduced rates of SSI, others have suggested that widespread use of intrawound vancomycin may increase the incidence of vancomycin-resistant, gram-negative, or polymicrobial spinal infections.To systematically review (...) the current literature on vancomycin powder in spine surgery and its impact on SSI culture profiles.Meta-analysis.We included observational studies, retrospective chart reviews, and randomized controlled trials of patients who underwent spine surgeries with and without vancomycin powder application to surgical wounds and reported SSI rates.The primary outcome was postoperative SSIs. Subgroup analyses compared rates of postoperative SSIs.We performed a comprehensive search of numerous electronic databases
Paravertebral Dexmedetomidine in Video-Assisted Thoracic Surgeries for Acute and Chronic Pain Prevention Video-assisted thoracoscopic surgery (VATS) is considered as one of the minimally invasive surgeries. Early postoperative pain alleviation is very important to avoid complications, at the same time, proper early pain control is an established fact to decrease the incidence of chronic pain.To evaluate the efficacy of thoracic paravertebral block (PVB) by a bupivacaine/ dexmedetomidine mixture (...) on acute and chronic post-thoracoscopic surgery pain in patients undergoing VATS.A randomized prospective double-blinded trial.Assiut University Hospitals, Orman Cardiology Hospital.Sixty adult patients underwent elective VATS surgery under general anesthesia randomly allocated into 2 groups; Group I received thoracic PVB with isobaric bupivacaine 0.5% (0.3 mL/kg) and Group II received PVB with isobaric bupivacaine 0.5% (0.3 mL/kg) and dexmedetomidine (1 mcg/kg). Postoperative pain (at rest, with cough
Septoplasty with or without concurrent turbinate surgery versus non-surgical management for nasal obstruction in adults with a deviated septum: a pragmatic, randomised controlled trial. Septoplasty (surgical correction of the deviated nasal septum) is the most frequently performed ear, nose, and throat operation in adults, but no randomised controlled trials or non-randomised comparative studies on the effectiveness of septoplasty have been published. Consequently, health-care providers, health (...) septoplasty with or without concurrent turbinate surgery or non-surgical management. Patients were stratified by sex, age (<35 years or ≥35 years), and deviation severity (mild, moderate, or severe). The primary outcome was health-related quality of life, measured with the validated Glasgow Health Status Inventory at 12 months. Analyses were done on an intention-to-treat basis. The trial is registered with the Netherlands Trial Register, number NTR3868.Between Sept 2, 2013, and Dec 12, 2016, we randomly
Bariatric surgery: an HTA report on the efficacy, safety and cost-effectiveness 2019 www.kce.fgov.be KCE REPORT 316 BARIATRIC SURGERY: AN HTA REPORT ON THE EFFICACY, SAFETY AND COST-EFFECTIVENESS 2019 www.kce.fgov.be KCE REPORT 316 HEALTH TECHNOLOGY ASSESSMENT BARIATRIC SURGERY: AN HTA REPORT ON THE EFFICACY, SAFETY AND COST-EFFECTIVENESS PETER LOUWAGIE, MATTIAS NEYT, DORIEN DOSSCHE, CÉCILE CAMBERLIN, BELINDA TEN GEUZENDAM, KOEN VAN DEN HEEDE, HANS VAN BRABANDT COLOPHON Title: Bariatric surgery (...) Médical Pédiatrique Clairs Vallons and Dr. Leen Verleye (KCE) for the methodological support. Reported interests: ‘All experts and stakeholders consulted within this report were selected because of their involvement in the topic of Bariatric Surgery. Therefore, by definition, each of them might have a certain degree of conflict of interest to the main topic of this report’ Membership of a stakeholder group on which the results of this report could have an impact: Thierry Lafullarde (President
Association of Unrecognized Obstructive Sleep Apnea With Postoperative Cardiovascular Events in Patients Undergoing Major Noncardiac Surgery. Unrecognized obstructive sleep apnea increases cardiovascular risks in the general population, but whether obstructive sleep apnea poses a similar risk in the perioperative period remains uncertain.To determine the association between obstructive sleep apnea and 30-day risk of cardiovascular complications after major noncardiac surgery.Prospective cohort (...) study involving adult at-risk patients without prior diagnosis of sleep apnea and undergoing major noncardiac surgery from 8 hospitals in 5 countries between January 2012 and July 2017, with follow-up until August 2017. Postoperative monitoring included nocturnal pulse oximetry and measurement of cardiac troponin concentrations.Obstructive sleep apnea was classified as mild (respiratory event index [REI] 5-14.9 events/h), moderate (REI 15-30), and severe (REI >30), based on preoperative portable
Ultrasound-guided serratus anterior plane block for analgesia after thoracic surgery Patients who undergo surgical procedures that impair the integrity of the chest wall frequently experience extremely severe postoperative pain. Opiates and weaker analgesics, such as nonsteroidal anti-inflammatory drugs (NSAIDs), are not sufficiently effective in achieving control of severe pain and might cause respiratory and gastrointestinal complications. In the past decade, there has been an increased (...) interest in the use of regional nerve blocks for post-thoracoscopy and post-thoracotomy analgesia.This is a prospective, randomized, double-blind and single-center study. We recruited 104 patients who underwent elective thoracoscopy. Prior to surgery, the participating patients were randomized into one of two study groups: Group 1- the "standard control group" that received standard postoperative pain control with intravenous opioids, NSAIDs and acetaminophen (paracetamol) and Group 2- the "block group
Effect of ultra-short-term treatment of patients with iron deficiency or anaemia undergoing cardiac surgery: a prospective randomised trial. Anaemia and iron deficiency are frequent in patients scheduled for cardiac surgery. This study assessed whether immediate preoperative treatment could result in reduced perioperative red blood cell (RBC) transfusions and improved outcome.In this single-centre, randomised, double-blind, parallel-group controlled study, patients undergoing elective cardiac (...) surgery with anaemia (n=253; haemoglobin concentration (Hb) <120 g/L in women and Hb <130 g/L in men) or isolated iron deficiency (n=252; ferritin <100 mcg/L, no anaemia) were enrolled. Participants were randomly assigned (1:1) with the use of a computer-generated range minimisation (allocation probability 0·8) to receive either placebo or combination treatment consisting of a slow infusion of 20 mg/kg ferric carboxymaltose, 40 000 U subcutaneous erythropoietin alpha, 1 mg subcutaneous vitamin B12
Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH): a stepped-wedge cluster-randomised trial. Emergency abdominal surgery is associated with poor patient outcomes. We studied the effectiveness of a national quality improvement (QI) programme to implement a care pathway to improve survival for these patients.We did a stepped-wedge cluster-randomised trial of patients aged 40 years or older undergoing emergency open major (...) abdominal surgery. Eligible UK National Health Service (NHS) hospitals (those that had an emergency general surgical service, a substantial volume of emergency abdominal surgery cases, and contributed data to the National Emergency Laparotomy Audit) were organised into 15 geographical clusters and commenced the QI programme in a random order, based on a computer-generated random sequence, over an 85-week period with one geographical cluster commencing the intervention every 5 weeks from the second
Types of materials for frontalis sling surgery for congenital ptosis. Congenital ptosis is a drooping of one or both eyelids at birth, often due to poor development of the levator palpebrae superioris muscle. This can result in amblyopia, astigmatism, and ocular torticollis and therefore may necessitate surgical intervention in early childhood if visual development is compromised. Patients may have varied levels of levator function. Those with moderate to good function may elect to first (...) attempt ptosis repair with external levator advancement or mullerectomy/Fasanella-Servat procedures. For those with poor function, those procedures are less likely to be effective, so they may undergo frontalis sling surgery, in which the tarsal plate is coupled to the frontalis muscle, so that movement of the brow and forehead result in movement of the eyelid. The optimal material to use in this surgery is unknown.To evaluate the comparative effectiveness and safety of various materials used
Antifibrinolytic therapy for preventing oral bleeding in patients with haemophilia or Von Willebrand disease undergoing minor oral surgery or dental extractions. Minor oral surgery or dental extractions (oral or dental procedures) are widely performed and can be complicated by hazardous oral bleeding, especially in people with an inherited bleeding disorder such as haemophilia or Von Willebrand disease (VWD). The amount and severity of singular bleedings depend on disease-related factors (...) . However, a systematic review of trials reporting outcomes after oral surgery or a dental procedure in people with an inherited bleeding disorder, with or without, the use of antifibrinolytic agents has not been performed to date. This is an update of a previously published Cochrane Review.Primarily, we aim to assess the efficacy of antifibrinolytic agents to prevent bleeding complications in people with haemophilia or VWD undergoing oral or dental procedures.Secondary objectives are to assess
Robot-assisted surgery in gynaecology. This is an updated merged review of two originally separate Cochrane reviews: one on robot-assisted surgery (RAS) for benign gynaecological disease, the other on RAS for gynaecological cancer. RAS is a relatively new innovation in laparoscopic surgery that enables the surgeon to conduct the operation from a computer console, situated away from the surgical table. RAS is already widely used in the United States for hysterectomy and has been shown (...) to be feasible for other gynaecological procedures. However, the clinical effectiveness and safety of RAS compared with conventional laparoscopic surgery (CLS) have not been clearly established and require independent review.To assess the effectiveness and safety of RAS in the treatment of women with benign and malignant gynaecological disease.For this update, we searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE via Ovid, and EMBASE via Ovid, on 8 January 2018. We searched
Transition from acute to chronic pain after surgery. Over the past decade there has been an increasing reliance on strong opioids to treat acute and chronic pain, which has been associated with a rising epidemic of prescription opioid misuse, abuse, and overdose-related deaths. Deaths from prescription opioids have more than quadrupled in the USA since 1999, and this pattern is now occurring globally. Inappropriate opioid prescribing after surgery, particularly after discharge, is a major cause (...) of this problem. Chronic postsurgical pain, occurring in approximately 10% of patients who have surgery, typically begins as acute postoperative pain that is difficult to control, but soon transitions into a persistent pain condition with neuropathic features that are unresponsive to opioids. Research into how and why this transition occurs has led to a stronger appreciation of opioid-induced hyperalgesia, use of more effective and safer opioid-sparing analgesic regimens, and non-pharmacological interventions