International journal of surgery
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Review Meta Analysis
Suprapatellar versus infrapatellar approach for tibia intramedullary nailing: A meta-analysis.
This meta-analysis was performed to determine the efficacy of suprapatellar versus infrapatellar approach for tibia intramedullary nailing (IMN). ⋯ For tibia IMN, suprapatellar approach might be superior to infrapatellar approach with shorter fluoroscopy time, less knee pain, better knee function recovery, and more accurate fracture reduction. Meanwhile, no increased risk of postoperative complications was identified. More RCTs are required for further research.
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Review Meta Analysis
Balanced crystalloids vs 0.9% saline for adult patients undergoing non-renal surgery: A meta-analysis.
Fluid maintenance and resuscitation is an important strategy during major surgeries. There has been a debate on the choice of crystalloids over the past decades. 0.9% saline (normal saline) is more likely to cause hyperchloremic acidosis when compared to balanced crystalloids with low chloride content. Meta-analyses comparing these two kinds of crystalloids have been performed in renal transplantations. We aim to compare the safety of balanced crystalloids to normal saline among adult patients undergoing non-renal surgery. ⋯ Comparing to normal saline, balanced crystalloids are more beneficial in keeping postoperative electrolytes and acid-base balance among adult patients undergoing non-renal surgery. Future researches should pay more attention to meaningful clinical outcomes concerning the safety of balanced crystalloids and normal saline.
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Few studies on the uncinate process-first approach in laparoscopic pancreaticoduodenectomy (LPD) have been reported. The aim of this study is to compare the perioperative outcomes of LPD to open pancreaticoduodenectomy (OPD) in terms of feasibility, safety, and efficacy using the uncinate process-first approach. ⋯ LPD with the uncinate process-first approach combines the benefits of laparoscopy with a low risk of postoperative complications and high rate of curative resection.
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Adequate venous thromboembolism (VTE) prophylaxis is essential after trauma, especially in patients with lower extremity and/or pelvic fractures. We sought to investigate if prophylactic enoxaparin dosed by anti-Xa trough levels could reduce clinically evident VTE in trauma patients with lower extremity or pelvic injury. ⋯ Prophylactic enoxaparin adjusted by anti-factor Xa level may lead to a decreased rate of clinically evident VTE among trauma patients with lower extremity and/or pelvic fractures. Our findings indicate that the initial dose of enoxaparin was frequently too low.
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Small pulmonary nodules (SPNs) often cannot be accurately located during video-assisted thoracoscopic (VATS) resection, and preoperative computed tomography (CT)-guided localization performed using hook wire placement can be helpful. However, recent studies revealed a trend towards more frequent and severe complications occurring in association with hook wire insertion. The aim of this study is to reevaluate the safety, and reliability of the preoperative CT-guided hook wire localization technique and also identify the risk factors for localization-related pneumothorax. ⋯ CT-guided hook wire localization is a safe, reliable and convenient technique and can be applied widely to facilitate the resection of SPNs. Simultaneous localization for multiple nodules in ipsilateral lung may be associated with a higher risk of localization-related pneumothorax.