Surgical endoscopy
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Comparative Study Clinical Trial Controlled Clinical Trial
Acute appendicitis--a clear-cut case in men, a guessing game in young women. A prospective study on the role of laparoscopy.
The aggressive surgical approach to patients suspected of having acute appendicitis for fear of perforation, and the inaccuracy of available diagnostic methods lead to an unacceptably high negative appendicectomy rate, especially in young women, in whom gynecological disorders frequently mimic appendicitis. Our objectives were to determine the value of diagnostic laparoscopy in women of child-bearing age to reduce the number of negative laparotomies and establish the correct diagnosis to allow prompt and appropriate treatment. ⋯ All women of child-bearing age suspected of having acute appendicitis should undergo diagnostic laparoscopy prior to the planned appendicectomy, regardless of the certainty of the preoperative diagnosis. This is currently the only way to reduce the negative appendicectomy rate and establish a correct diagnosis allowing prompt and appropriate treatment. In male patients and postmenopausal women one may proceed directly to emergency appendicectomy.
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Comparative Study
The optimum pneumoperitoneum pressure for laparoscopic surgery in the rat model. A detailed cardiorespiratory study.
There is increasing interest in the rat model of laparoscopic surgery. This study evaluates the cardiorespiratory effects of increasing CO2 pneumoperitoneum (PP) in the rat. ⋯ CO2 PP pressures above 10 mmHg in rat should be avoided when performing laparoscopic surgery in the rat model.