Surgical endoscopy
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Controlled Clinical Trial
Laparoscopically assisted peritoneal shunt insertion in hydrocephalus: a prospective controlled study.
Shunting of cerebrospinal fluid to the peritoneal cavity is standard therapy for the management of hydrocephalus. Common problems, however, are infection and shunt malfunction, which frequently is related to the peritoneal end of the catheter. Laparoscopic revision of distal shunt malfunction has become popular, but endoscopic techniques for primary placement of the peritoneal catheter are not performed often. This study aimed to compare laparoscopically assisted peritoneal catheter placement with the conventional minilaparotomy technique. ⋯ The findings from this prospective controlled study indicate that the risk for long-term complications attributable to distal shunt malfunction is reduced when laparoscopic techniques are used to place the peritoneal end of the shunt catheter.
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There is great controversy regarding the choice of procedure for perforated duodenal ulcer patients. The purpose of this study was to compare the early outcome results of laparoscopic and open repair and to propose which risk factors influence the outcome. ⋯ Independent Boey risk factors, patient age, and large perforation size have a negative impact on patient recovery. Both laparoscopic and open repair are equally safe and effective in perforated duodenal ulcer patients with a Boey score of 0 or 1.
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Laparoscopically assisted distal gastrectomy (LADG) with limited lymph node dissection (D1+alpha) has been used to treat a subset of patients with early gastric cancer. Technical advances have expanded indications for LADG to more advanced gastric cancers. However, little data are available on the feasibility or advantages of LADG with standard radical D2 lymph node dissection for patients with gastric cancer. ⋯ According to this study, LADG with D2 lymph node dissection is feasible and provides several advantages similar to those of limited lymph node dissection (D1+alpha). Depending on surgeons' technical proficiency, LADG can be used with standard radical lymph node dissection for patients with gastric cancers.