Surgical endoscopy
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Advanced age, major orthopedic surgery, neoplastic disease, prolonged operations, varicose veins, immobilization, estrogen-containing medications, and obesity are known risk factors for the development of postoperative thromboembolic complications. Perioperative heparin is useful for reducing the incidence of deep venous thrombosis (DVT), but it is associated with a discrete bleeding rate. The purpose of this study was to determine the incidence of clinically evident DVT in morbidly obese patients after laparoscopic Roux-en-Y gastric bypass when a pneumatic compression hose is used as the only prophylaxis against DVT instead of anticoagulants. ⋯ The incidence of clinically evident DVT after laparoscopic Roux-en-Y gastric bypass is low when the procedure is accomplished with a relatively short operative time, with the initiation of calf-length pneumatic compression hose before the induction of anesthesia, and with routine early ambulation. No form of heparin anticoagulation is mandatory when these conditions can be met.
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Meta Analysis Comparative Study
Laparoscopic repair of perforated peptic ulcer: a meta-analysis.
Laparoscopic repair of perforated peptic ulcer has been gaining popularity in recent years, but few data exist to support the superiority of the laparoscopic approach over open repair. The objective of the current study was to compare the safety and efficacy of open and laparoscopic repair of perforated peptic ulcer in an evidence-based approach using meta-analytical techniques. ⋯ Evidence suggests that laparoscopic repair of perforated peptic ulcer confers superior short-term benefits in terms of postoperative pain and wound morbidity. This approach is as safe and effective as open repair. Laparoscopic Graham-Steele patch repair of perforated duodenal or justapyloric ulcer is beneficial for patients without Boey's risk factors.
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Randomized Controlled Trial Comparative Study Clinical Trial
Preperitoneal bupivacaine attenuates pain following laparoscopic inguinal hernia repair.
Laparoscopic preperitoneal inguinal hernia repair is associated with a short hospital stay and an early return to normal activity. Therefore, early postoperative pain control is important. The aim of this study was to evaluate the effect of preperitoneal Bupivacaine instilled into the preperitoneal cavity on pain following laparoscopic mesh repair of inguinal hernia. ⋯ Preperitoneal Bupivacaine attenuates pain following laparoscopic inguinal hernia repair and should be considered in these cases.
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Review Comparative Study
Laparoscopic appendectomy for complicated appendicitis: an evaluation of postoperative factors.
The use of laparoscopic appendectomy for complicated appendicitis is controversial. Outcomes were compared between patients who had complicated appendicitis and those who had uncomplicated appendicitis. ⋯ The minimally invasive laparoscopic technique is safe and efficacious. It should be the initial procedure of choice for most cases of complicated appendicitis.
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Review Comparative Study
Gastric motility after laparoscopically assisted distal gastrectomy, with or without preservation of the pylorus, for early gastric cancer, as assessed by digital dynamic x-ray imaging.
This study aimed to evaluate the usefulness of digital x-ray imaging for measuring gastric motility in patients subjected to laparoscopically assisted distal gastrectomy without preservation of the pylorus (LADG) or laparoscopically assisted pylorus-preserving gastrectomy (LAPPG) for early gastric cancer. Between April 1998 and February 2002, 52 patients with preoperative stage IA gastric cancer underwent laparoscopically assisted distal gastrectomy, with 26 receiving LADG for tumors in the lower third of the stomach and 26 receiving LAPPG for tumors in the middle third of the stomach. ⋯ The motility index was 2.65% +/- 2.54% for LADG and 8.13% +/- 2.46% for LAPPG ( p < 0.001). In conclusion, LAPPG results in better motility than LADG for patients with early gastric cancer arising in the middle third of the stomach.