Surgical endoscopy
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Randomized Controlled Trial
Effect of pre-emptive pregabalin on pain intensity and postoperative morphine consumption after laparoscopic cholecystectomy.
Postoperative pain is the dominant complaint and the most common cause of delayed discharge after laparoscopic cholecystectomy. The aim of this study is to evaluate the potential of preoperative administration of pregabalin to reduce postoperative pain and opioid consumption. ⋯ Administration of 600 mg pregabalin per os, divided in two preoperative doses, significantly reduces postoperative pain as well as opioid consumption in patients undergoing laparoscopic cholecystectomy, at the cost of increased incidence of dizziness.
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Randomized Controlled Trial
Ten-year outcome after minilaparotomy versus laparoscopic cholecystectomy: a prospective randomised trial.
Laparoscopic cholecystectomy (LC) and minilaparotomy cholecystectomy (MC) are the two most commonly performed mini-invasive surgical techniques for the treatment of symptomatic gallstone disease, but the long-term outcome after these two procedures has not been compared in prospective clinical trials. We therefore investigated the outcome after LC and MC in 127 patients operated at Kuopio University Hospital. ⋯ Our results suggest a relatively similar long-term outcome after MC and LC.
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Randomized Controlled Trial
The efficacy of laparoscopic skills training in a Mobile Simulation Unit compared with a fixed site: a comparative study.
Laparoscopic skills development via simulation-based medical education programs has gained support in recent years. However, the impact of training site type on skills acquisition has not been examined. The objective of this research was to determine whether laparoscopic skills training outcomes differ as a result of training in a Mobile Simulation Unit (MSU) compared with fixed simulation laboratories. ⋯ Mobile Simulation Unit-delivered laparoscopic simulation training is not inferior to fixed-site training.
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Randomized Controlled Trial
Comparison of results from a randomized trial 1 year after laparoscopic Nissen and Toupet fundoplications.
The fundoplication of choice for the surgical treatment of gastroesophageal reflux disease (GERD) still is debated. Multichannel intraluminal impedance monitoring (MII) has not been used to compare objective data, and comparative subjective data on laparoscopic Nissen and Toupet fundoplications are scarce. ⋯ Both procedures proved to be equally effective in improving quality of life and GERD symptoms. However, the reoperation and dysphagia rates were lower and the ability to belch was higher after LTF than after LNF.
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Several techniques are described in the literature about laparoscopic treatment of the right colon. Among them, laparoscopic-assisted colectomy (LAC) with creation of an extracorporeal ileocolonic anastomosis remains the favourite approach in most centers. So far, total laparoscopic colectomy (TLC) with intracorporeal anastomosis is not widely performed, because it requires adequate skills and competence in the use of mechanical linear staplers and laparoscopic manual sutures. The purpose of this study was to determine prospectively if TLC offers some advantages in short-term outcomes over LAC. ⋯ No evidence of relevant differences in terms of functional and safety outcomes between the two laparoscopic procedures. TLC determines less abdominal manipulation and shorter incision length, but clear advantages must be still demonstrated. Larger series are necessary to test the superiority of totally laparoscopic procedures for right colectomy.