World journal of surgery
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World journal of surgery · Nov 2008
Randomized Controlled TrialRoutine suction of intercostal drains is not necessary after lobectomy: a prospective randomized trial.
The decision to proceed to simple underwater seal drainage or apply active suction to the underwater seal after lung resection is mostly based on surgeon preference. The purpose of this study was to test whether routine application of active suction is necessary after lobectomy. ⋯ Routine application of active drain suction to the underwater seal is not necessary after lobectomy. However, it could be useful in persistent pneumothorax with sufficient air entry in the lung and clear airways. It is of no help in persistent air leaks when the lung is expanded.
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World journal of surgery · Nov 2008
Comparative StudyComparison between open and laparoscopic repair of perforated peptic ulcer disease.
The place of laparoscopic repair of perforated peptic ulcer followed by peritoneal toilet has been established, although it is not routinely practiced. This prospective study compared laparoscopic and open repair of perforated peptic ulcer disease. We evaluated whether the early results from laparoscopic repair resulted in improved patient outcome compared with conventional open repair. ⋯ Laparoscopic repair is a viable and safe surgical option for patients with perforated peptic ulcer disease and should be considered for all patients, providing that the necessary expertise is available.
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World journal of surgery · Nov 2008
Inspection of safety and accuracy of D2 lymph node dissection in laparoscopy-assisted distal gastrectomy.
There is a consensus on the indication of laparoscopy-assisted distal gastrectomy (LADG) for early gastric cancer that needs D1 + alpha or D1 + beta lymph node dissection. However, many gastrointestinal surgeons consider D2 lymph node dissection in LADG to be difficult, therefore, only a few medical institutions have performed D2 lymph node dissection in LADG. We examined the safety and accuracy of D2 dissection in LADG by comparing with open distal gastrectomy (ODG), as the first step to operate on advanced gastric cancer. ⋯ D2 dissection in LADG can be performed without problems with safety and accuracy, if the surgical team is skilled in the procedures of LADG.
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World journal of surgery · Nov 2008
Role of activated protein C on wound healing process in left colonic anastomoses in the presence of intra-abdominal sepsis induced by cecal ligation and puncture: an experimental study in the rat.
Activated protein C (APC) is a serine protease with anticoagulant and anti-inflammatory activities. The delaying effects of intra-abdominal sepsis on wound healing process in colonic anastomoses have been previously demonstrated. This study was designed to investigate the role of APC on wound healing process in left colonic anastomoses in the presence of intra-abdominal sepsis. ⋯ This study clearly showed that APC treatment prevented the delaying effects of intra-abdominal sepsis on colonic anastomotic wound healing process. Further clinical studies are required to determine whether APC has a useful role in the enhancement of anastomotic healing during particular surgeries in which sepsis-induced injury occurs.