International journal of surgery
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Review Meta Analysis
Preoperative infliximab use and postoperative complications in Crohn's disease: a systematic review and meta-analysis.
Infliximab revolutionized the treatment paradigm of Crohn's disease (CD), but did not reduce the need for surgery. The impact of biologic agents on surgical complication rates remains debated. The aim of this study was to determine the effect of preoperative infliximab use on early postoperative complications in patients with CD undergoing abdominal surgery. ⋯ Preoperative infliximab use modestly increases the risk of total early postoperative complications, and particularly infectious complications in CD patients.
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Simulation, if appropriately integrated into surgical training, may provide a time efficient, cost effective and safe method of training. The use of simulation in urology training is supported by a growing evidence base for its use, leading many authors to call for it to be integrated into the curriculum. ⋯ There is also evidence that non-technical skills affect patient outcomes in the operating room and that high fidelity team based simulation training can improve non-technical skills and surgical team performance. This evidence has strengthened the argument of surgical educators who feel that simulation should be formally incorporated into the urology training curriculum to develop both technical and non-technical skills with the aim of optimising performance and patient safety.
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Randomized Controlled Trial
Comparison of tissue damages caused by endoscopic lumbar discectomy and traditional lumbar discectomy: a randomised controlled trial.
This study aimed to compare the clinical efficacies of percutaneous endoscopic lumbar discectomy (PELD) and traditional open lumbar discectomy (OD). ⋯ The PELD had less damage to human tissues than the traditional OD. PELD has a clear promotional value in clinical.
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The impact of postoperative complications after Major Abdominal Surgery (MAS) is substantial, especially when socio-economical aspects are taken into account. This systematic review focuses on the effects of preoperative exercise therapy (PEXT) on physical fitness prior to MAS, length of hospital admission and postoperative complications in patients eligible for MAS, and on what is known about the most effective kind of exercise regime. ⋯ Preoperative exercise therapy might be effective in improving the physical fitness of patients prior to major abdominal surgery, and preoperative chest physiotherapy seems effective in reducing pulmonary complications. However consensus on training method is lacking. Future research should focus on the method and effect of PEXT before high-risk surgical procedures.
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Randomized Controlled Trial
Fast track for elderly patients: is it feasible for colorectal surgery?
Fast-track program has been applied in several surgical fields. However, currently many surgical patients are elderly over 70 years of age, and discussion about the application of such protocols for elderly patients is inadequate. ⋯ Fast-track after laparoscopic colorectal surgery can be safely applied in carefully selected elderly patients older than age 70 years. The fast-track recovery program resulted in a more rapid postoperative recovery, earlier discharge from hospital and fewer general complications compared with a conventional postoperative protocol.