International journal of surgery
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Review Meta Analysis
A systematic review of laparoscopic versus open abdominal incisional hernia repair, with meta-analysis of randomized controlled trials.
Development of an incisional hernia after abdominal surgery is a common complication following laparotomy. Following recent advancements in laparoscopic and open repair a literature review has demonstrated no difference in the short term outcomes between open and laparoscopic repair, concluding there was no favourable method of repair over the other and that both techniques are appropriate methods of surgical repair. However, long term outcomes in the available literature between these two approaches were not clearly analysed or described. The objective of this study is to assess the effectiveness and safety of laparoscopic versus open abdominal incisional hernia repair, and to evaluate the short and long term outcomes in regards to hernia recurrence using meta-analysis of all randomised controlled trials from 2008 to end of 2013. ⋯ Five randomized controlled trials (RCTs) were identified and included in the final analysis with a total number of 611 patients randomized. Three hundreds and six patients were in the laparoscopic group and 305 patients in the open repair group. The range of follow up in the studies was two months to 35 months. The recurrence rate was similar (P = 0.30), wound infection was higher in the open repair group (P < 0.001), length of hospital stay was not statistically different (P = 0.92), and finally the operation time was longer in the laparoscopic group but did not reach statistical significance (P = 0.05) CONCLUSION: The short and long-term outcomes of laparoscopic and open abdominal wall hernia repairs are equivalent; both techniques are safe and credible and the outcomes are very comparable.
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Randomized Controlled Trial
Safety and efficacy of intra-articular tranexamic acid injection without drainage on blood loss in total knee arthroplasty: A randomized clinical trial.
Major blood loss is unavoidable after primary total knee arthroplasty (TKA). The aim of this study was to determine if tranexamic acid (TXA) can reduce major blood loss following TKA. ⋯ TXA treatment without drainage during TKA reduces the amount of blood transfusions required without increasing the rate of adverse events.
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Randomized Controlled Trial
The late effect of intraoperative wound infiltration with local anaesthetic in surgical patients; is there any? A randomized control trial.
Intraoperative wound infiltration with local anaesthetic is commonly used. Apart from the obvious immediate action it has been supported that a possible down regulation of pain receptors may lead to longer effects. Our aim was to compare the use of local anaesthetic versus placebo in order to assess if indeed there is a late beneficial effect. ⋯ Intraoperative local infiltration of the wound with local anaesthetic offers no further benefit for the general surgery apart from that of the immediate PO period. There is no late effect for pain control. Considering that during the immediate postoperative period stronger systematic painkillers are given the intraoperative, infiltration of the wound with the local anaesthetic under study offers no obvious benefit.
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To assess the correlation of preoperative FibroScan value and postoperative ascites in patients undergoing liver resection for hepatitis B virus-related hepatocellular carcinoma (HBV-related HCC). ⋯ FibroScan value was a reliable surrogate marker for predicting postoperative ascites should be routinely performed in patients with HBV-related HCC undergoing liver resection.