International journal of surgery
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A best evidence topic in surgery was written according to a structured protocol. The question addressed whether there is any benefit in treating infected laparotomy wounds with negative pressure wound therapy (NPWT). ⋯ The evidence on this subject is limited; there is a single non-randomised controlled trial, 2 prospective cohort studies, and 1 retrospective cohort study discussed in this paper. From the available literature, the use of NPWT in infected laparotomy wounds does reduce the length of hospital stay, the number of dressing changes required and promote faster wound healing.
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Randomized Controlled Trial
Preoperative intravenous parecoxib reduces length of stay on ambulatory laparoscopic cholecystectomy.
The complexity of pain after laparoscopic cholecystectomy (LC) needs multi-module analgesia. Opioids are widely used for perioperative pain but associated with numerous adverse effects. We investigated the effect of parecoxib administrated preoperatively and postoperatively for analgesia after ambulatory laparoscopic cholecystectomy. ⋯ Preoperative administration of parecoxib for postoperative analgesia provided significant effect on reducing PACU length of stay (LOS) and discharge time, and improving patient outcome after ambulatory LC.
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Randomized Controlled Trial
Fast track for elderly patients: is it feasible for colorectal surgery?
Fast-track program has been applied in several surgical fields. However, currently many surgical patients are elderly over 70 years of age, and discussion about the application of such protocols for elderly patients is inadequate. ⋯ Fast-track after laparoscopic colorectal surgery can be safely applied in carefully selected elderly patients older than age 70 years. The fast-track recovery program resulted in a more rapid postoperative recovery, earlier discharge from hospital and fewer general complications compared with a conventional postoperative protocol.
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Gallbladder cancer (GBC) is the fifth most common neoplasm of the gastrointestinal tract and the most common cancer of the biliary tract. GBC is suspected preoperatively in only 30-40% of patients. The other 60-70% are discovered incidentally (IGBC) by the pathologist on a gallbladder specimen following cholecystectomy for benign diseases such as polyps, gallstones, and cholecystitis. ⋯ Laparoscopic cholecystectomy does not affect survival if implemented properly. Reoperation should have two objectives: R0 resection and clearance of the lymph nodes.
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Comparative Study
Hemostatic efficacy of a novel, PEG-coated collagen pad in clinically relevant animal models.
Currently available hemostatic pads are effective in treating oozing bleeds, but otherwise ineffective in more severe bleeding. This study investigates the hemostatic efficacy of a new hemostatic pad with advanced sealing properties using protein-reactive polyethylene glycol-coated collagen (PCC, Hemopatch) versus an oxidized regenerated cellulose (ORC, Tabotamp/Surgicel Original) in a leporine arterial bleeding model of vascular reconstruction and a porcine hepatic model of general surgery. ⋯ PCC provided faster hemostasis than ORC in a vascular and hepatic surgical model with impaired coagulation.