International journal of surgery
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Randomized Controlled Trial Comparative Study
Irrigation versus suction alone during laparoscopic appendectomy; A randomized controlled equivalence trial.
The objective of this study was to compare operative peritoneal irrigation versus suction alone during laparoscopic appendectomy in adult patients; our hypothesis was that the two methods are equivalent in terms of rate of post-operative intra-abdominal abscess. There has been only one prospective, randomized, superiority trial in children, that showed non-significant difference in the rate of intra-abdominal abscess comparing irrigation to suction alone during laparoscopic appendectomy for perforated appendicitis. Non-significant difference in a superiority trial does not imply equivalence. ⋯ In patients with suppurative or perforated appendicitis, the rate of intra-abdominal abscess is equivalent between groups treated with peritoneal irrigation and suction alone.
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Life expectancies in the UK are increasing and with this there is an increasing elderly population with more complex co-morbidity. Emergency surgery in the elderly is challenging in terms of decision making, managing co-morbidity and post-operative rehabilitation with high morbidity and mortality. To optimise service design and development, it is important to understand the changing pattern of emergency surgical care for this group. ⋯ The workload of emergency general surgery in the elderly is becoming more complex. This challenge is already being addressed with improvements in outcomes. The data presented here reinforces the need for new models of care with increased multidisciplinary geriatric care input into elderly surgical patient care in the perioperative period.
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Hand and wrist research has recently shown obvious progress. The quantity and quality of publications from different nations, however, have not been analyzed. In our study, we aimed to assess the characteristics of worldwide productivity in hand and wrist literature using highly cited subspecialty journals. ⋯ The number of publications of hand and wrist research shows a significant increase during the past 10 years. The United States is the most productive country in hand and wrist literature. However, some European countries and Australia may have higher quality of articles according to mean 5y-IF and mean citations per article.