Surgical endoscopy
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Over the past decade an increasing demand for uterine-sparing treatment to manage symptomatic uterine myomas has become apparent in women's health care. A preliminary report showed that radiofrequency ablation (RFA) of uterine fibroids under laparoscopic guidance was a safe and effective minimally invasive approach with encouraging short-term results. The purpose of this study was to evaluate the midterm outcomes of radiofrequency ablation (RFA) of uterine myomas in terms of durability of symptom control and level of health-related quality of life. ⋯ RFA of symptomatic fibroids seems a valuable alternative to major surgery, with durable symptom relief for most patients and a low chance of recurrence at midterm.
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Comparative Study
Flexible versus rigid endoscopy for treatment of foreign body impaction in the esophagus.
The use of either flexible endoscopy (FE) or rigid endoscopy (RE) for removal of ingested foreign bodies (FBs) impacted in the esophagus is still discussed controversially. ⋯ A tailored approach to treatment of FB impaction is recommended. Because of the lower rate of severe complications, better patient comfort with a lower rate of dysphagia, and lack of requirement for general anesthesia, FE should be the "first line" approach to FBs, although RE has its place as the "second line" therapy.
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Randomized Controlled Trial
The effects of preoperative rofecoxib, metoclopramide, dexamethasone, and ondansetron on postoperative pain and nausea in patients undergoing elective laparoscopic cholecystectomy.
No trial to date has evaluated the combined effect of preoperative Rofecoxib, Metoclopramide, Dexamethasone, and Ondansetron on postoperative pain and nausea in patients undergoing laparoscopic cholecystectomy (LC). ⋯ The use of this preoperative regimen resulted in decreased LOS, maximum pain, and nausea ratings. Patients in the intervention group required less postoperative anti-emetics.
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Randomized Controlled Trial
Effect of intercostals neural blockade with Marcaine (bupivacaine) on postoperative pain after laparoscopic cholecystectomy.
Postoperative pain experienced by patients who undergo laparoscopic cholecystectomy may aggravate surgical complications, prevent early discharge, and cause readmission. This study aimed to evaluate the effectiveness of an intraoperative intercostals neural blockade for the control of postoperative pain after laparoscopic cholecystectomy. ⋯ Intercostals neural blockade may safely be used to reduce the postoperative pain after laparoscopic cholecystectomy.