International journal of surgery
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Noncardiac vascular surgery (VS) patients have comorbidities that increase the risk of death after surgery. Assessing that risk is important to allocate the necessary resources and improve quality of care. We aimed to evaluate the incidence and predictors of 30-day post-operative mortality (POM) after VS and compare the performance of existing risk scores. ⋯ Observed POM was similar to predicted by V-POSSUM or POSPOM. Age, PAD, CKD, atrial fibrillation and intraoperative RBC transfusion were independent risk factors for POM. Score V-POSSUM performed better than POSPOM, CCI or Surgical Apgar.
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Review Meta Analysis Comparative Study
Comparative analysis for the effect of Roux-en-Y gastric bypass vs sleeve gastrectomy in patients with morbid obesity: Evidence from 11 randomized clinical trials (meta-analysis).
Laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) are the most common procedures performed during bariatric surgery and both of them have been demonstrated having significant efficacy for morbid obesity. However, the comparative analysis of the effect of them has not been well studied. Thus, this comparative analysis was conducted to determine whether LRYGB and LSG are equivalent for mid- and long-term weight loss, resolution of comorbidities and adverse events (AEs). ⋯ The present meta-analysis indicated that both LRYGB and LSG are equivalent for excess weight loss and T2DM resolution. However, patients receiving LSG experienced fewer postoperative complications and reoperation rate than those who underwent LRYGB. LRYGB may be superior in dyslipidemia, hypertension and gastroesophageal reflux disease (GERD) remission.
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Meta Analysis Comparative Study
Continuous adductor canal block is a better choice compared to single shot after primary total knee arthroplasty: A meta-analysis of randomized controlled trials.
The advantages of continuous adductor canal block (CACB) over single shot ACB (SACB) are still debatable for pain management after total knee arthroplasty (TKA). The aim of this study was to investigate which ACB method provides better pain relief after TKA. ⋯ Compared with SACB, CACB provides better analgesia after TKA. Therefore, CACB is recommended as an analgesic method for early postoperative pain treatment after TKA.
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Since its introduction in 2016, the Sepsis-3 guidelines, with emphasis on the quick Sequential Organ Failure Assessment (qSOFA) score, have generated much debate and controversy. It is recognised that the new definitions require validation in specific clinical settings and have yet to be universally adopted. We aim to validate new Sepsis-3 guidelines in acute hepatobiliary infection. ⋯ The SIRS criteria has high sensitivity and the qSOFA score has high specificity in predicting outcomes of patients with acute hepatobiliary infection.
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Laparoscopic pancreatic surgery still represents a challenge for surgeons. However, in recent decades the experience is expanding. Recent systematic reviews and meta-analyses confirm that laparoscopic pancreatic resection (LPR) is safe, feasible and worthwhile. This study analyses the first 100 consecutive LPRs in our centre. ⋯ Our results confirm that LPR is a feasible and safe alternative to open pancreatic surgery. Safe implementation with a clear strategy is fundamental to gain experience and overcome the learning curve of this technically demanding procedures.