International journal of surgery
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Review Meta Analysis
Adductor canal block versus continuous femoral nerve block in primary total knee arthroplasty: A meta-analysis.
Continuous femoral nerve block (CFNB) is considered the preferred analgesia after TKA. However, it may weaken quadriceps muscle strength, subsequently increasing the risk of falling. Adductor canal block (ACB) is a new sensory block technique that effectively relieves postoperative pain while preserving quadriceps strength. Thias meta-analysis was conducted to determine whether ACB of CFNB provides better pain relief and functional recovery after TKA. ⋯ Compared with CFNB, ACB provides equally effective analgesia after TKA. ACB results in fast pain relief and early ambulation while decreasing post-operative nausea. ACB thus has the potential to replace CFNB as the gold standard for pain management in TKA patients.
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Review Comparative Study
Low vs. standard dose computed tomography in suspected acute appendicitis: Is it time for a change?
Clinical diagnosis is accurate in only 80% of patients with suspected appendicitis with negative appendectomy rates of up to 21%. In the UK the use of standard-dose CT (SDCT) is conservative due to concerns over radiation exposure and resource implications. The use of low dose computer tomography (LDCT) instead of standard dose computer tomography (SDCT) may partially address these concerns. ⋯ LDCT is not inferior to SDCT in the diagnosis of acute appendicitis and proposing alternative diagnoses. Further studies are recommended to further assess the potential role of LDCT & its cost effectiveness. Its use may improve the current management of patients with suspected acute appendicitis.
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Randomized Controlled Trial Comparative Study
Subxiphoid vs intercostal single-incision video-assisted thoracoscopic surgery for spontaneous pneumothorax: A randomised controlled trial.
The conventional video-assisted thoracoscopic surgery (VATS) is performed through the intercostals incisions. In this study, we reported our current experience of thoracoscopic surgery using a subxiphoid single-incision and compared it with the intercostal uniport VATS in the operation time and postoperative pain for spontaneous pneumothorax. ⋯ Subxiphoid single-incision VATS, as a new method for bullectomy, could provide a good choice of the incision position for these young patients with spontaneous pneumothorax.
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Skeletal muscle depletion predicts poor prognosis of patients with certain cancers. However, the correlation between low skeletal muscle index (SMI) and the prognosis of hepatocellular carcinoma (HCC) is not well understood. ⋯ Low-SMI was an independent adverse prognostic factor for CRR in patients with BMI ≥22. Therefore, preventing muscle wasting may improve the CRR of patients with HCC.
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HCV recurrence after liver transplant is nearly universal and results in progressive fibrosis, cirrhosis, graft loss, retransplantation and mortality. There are very few studies comparing impact of pretransplant HCC therapies either as a bridge to transplant or to downstage like TACE, hepatectomy, RFA, PEI on HCV recurrence post transplant. Primary aim of the study was studying prognostic factors associated with HCV recurrence including pre transplant HCC therapies. ⋯ Prior TACE do not increase post transplant HCV recurrence but may be beneficial for it.