International journal of surgery
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Review Meta Analysis
Negative-pressure therapy versus conventional therapy on split-thickness skin graft: A systematic review and meta-analysis.
To compare the clinical outcomes of negative-pressure wound therapy (NPWT) versus conventional therapy on split-thickness skin after grafting surgery. ⋯ Compared with conventional therapy, NPWT significantly increases the rate of graft take and reduces the rate of reoperation when applied to cover the wound bed with split-thickness skin graft. No significant impact on wound infection was found in this study.
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Randomized Controlled Trial
Intraoperative endoscopy prevents technical defect related leaks in laparoscopic Roux-en-Y gastric bypass: A randomized control trial.
Postoperative anastomotic leaks, bleeding and stenosis are major causes of morbidity after laparoscopic Roux-en-Y gastric bypass (LRYGB). Retrospective studies suggest that intraoperative endoscopy reduces the incidence of these complications. ⋯ This study specifically provides evidence that air leak test performed by intraoperative endoscopy is superior to simple visual inspection in preventing technical defect related leaks after laparoscopic Roux-en-Y gastric bypass.
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Review
Enhanced recovery after surgery for pancreaticoduodenectomy: Review of current evidence and trends.
Pancreaticoduodenectomy (PD) remains a morbid procedure. The use of Enhanced Recovery After Surgery (ERAS) pathways has proven to reduce care time and post-operative complications after colorectal surgery. There is a high potential for reducing morbidity associated with PD by utilizing ERAS. ⋯ The purpose of this review is to examine the current evidence for ERAS in preoperative, intraoperative and post-operative setting of care for PD patients and to propose ERAS evidence-based protocol for patients undergoing PD. Evidence indicates that ERAS protocols may be implemented in PD without compromising patient safety or increasing length of stay. ERAS in the context of PD should be standardized based on the best available evidence, and ERAS programmes involving multiple centers should be performed.
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The aim of this study was to evaluate the clinical and radiologic results of multisegmental transforaminal enlarged decompression (TED) plus posterior pedicle screw fixation in the treatment of multilevel lumbar spinal canal stenosis (LSCS) with lumbar instability (MLSCSI). ⋯ Satisfactory clinical and radiological outcomes can be achieved with the use of multisegmental TED plus lumbar fusion for the treatment of MLSCSI. This technique can reduce surgically induced instability and obviously improve the symptoms and signs of the patients, suggesting a safe and effective therapeutic procedure for MLSCSI.
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Review Meta Analysis
Efficiency and safety of ketamine for pain relief after laparoscopic cholecystectomy: A meta-analysis from randomized controlled trials.
This meta-analysis aims to evaluate the effectiveness of intravenous infusion of ketamine for pain control after laparoscopic cholecystectomy (LC). ⋯ Intravenous ketamine infusion significantly reduced postoperative pain scores and opioid consumption after LC. In addition, there were fewer adverse effects in the ketamine groups. Higher quality RCTs are still required for further research.