Surgical endoscopy
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Randomized Controlled Trial
Preoperative administration of controlled-release oxycodone as a transition opioid for total intravenous anaesthesia in pain control after laparoscopic cholecystectomy.
The complexity of pain from laparoscopic cholecystectomy and the need for treating incident pain provide rationale for multipharmacological analgesia. We investigated the preoperative administration of controlled-release (CR) oxycodone as transition opioid from remifentanil infusion for pain after laparoscopic cholecystectomy. ⋯ We demonstrated the success of a multipharmacological treatment including opioid premedication with CR oxycodone used as transition opioid for TCI remifentanil infusion; the treatment group showed lower pain scores and rescue analgesic consumption, shorter time to discharge from recovery room and from surgical ward, and the same incidence of side effects, comparably to controls.
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Comparative Study
Comparison of early outcomes for laparoscopic ventral hernia repair between nonobese and morbidly obese patient populations.
Obesity predisposes to incisional herniation and increased the incidence of recurrence after conventional open repair. Only sparse data on the safety and security of laparoscopic ventral hernia repair (LVHR) for morbidly obese patients are available. This study compared the incidence of perioperative complications and early recurrence after LVHR between morbidly obese and non-morbidly obese patients. ⋯ No significant difference in the incidence of perioperative complications or recurrence after LVHR was observed between the morbidly obese patients and the non-morbidly obese patients.
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The natural history of colostomies and ileostomies for colonic disease is not well described. This study aimed to identify factors that have an impact on colostomy and ileostomy reversal among patients with colonic diseases. ⋯ Colostomy or ileostomy creation is a basic skill in the armamentarium of the general surgeon for treating complex diseases of the colon. Age, race, and type of ostomy creation are significant predictors for reversal. This data may be useful for consulting patients preoperatively regarding postoperative expectations.