Surgical endoscopy
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Many methods have been advocated for control of pain in patients suffering from chronic pancreatitis. Some patients may be considered for pancreatic denervation. This study was performed to evaluate the effect of thoracoscopic splanchnicetomy (TS) on pain intensity and many of the common daily functions in patients with intractable pain due to chronic pancreatitis. ⋯ Thoracoscopic splanchnicectomy is a simple, minimally invasive, save procedure that appears to offer relief from pain, allow recovery of daily activities and improve the adequacy of the analgesic management.
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Randomized Controlled Trial Clinical Trial
A randomized controlled trial to determine the effect of humidified carbon dioxide (CO2) insufflation on postoperative pain following thoracoscopic procedures.
It has previously been shown that the insufflation of humidified gas during laparoscopy results in less postoperative pain than is observed following the use of dry gas. Experimental evidence also suggests that dry gas insufflation during thoracoscopy results in greater structural injury to the pleura than occurs with the use of humidified gas. The present study was designed to determine the effect of humidified gas insufflation on postoperative pain following thoracoscopic procedures. ⋯ The use of humidified gas appears to reduce postoperative pain but not the rate of respiratory complications.
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Randomized Controlled Trial Clinical Trial
Hemodynamic and pulmonary changes during open, carbon dioxide pneumoperitoneum and abdominal wall-lifting cholecystectomy. A prospective, randomized study.
Carbon dioxide (CO2) pneumoperitoneum effects are still controversial. The aim of this study was to investigate cardiopulmonary changes in patients subjected to different surgical procedures for cholecystectomy. ⋯ Cardiopulmonary adverse effects of general anesthesia were significant but transitory and normalized during surgery. Carbon dioxide pneumoperitoneum caused a significant impairment in cardiopulmonary functions. In high-risk patients, gasless laparoscopy may be preferred for reliability and absence of cardiopulmonary alterations.
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Upper thoracoscopic sympathectomy, obtained either by ablation or resection of the appropriate ganglia, is now the preferred treatment for primary palmar hyperhidrosis. Therefore, we undertook a review to compare the relative efficacy of these two techniques. ⋯ Resection yields superior results, yet the majority of surgeons ablate, probably because it is easier, requires a shorter operating time, leads to fewer cases of Horner's syndrome, and because resympathectomy eventually overcomes initial failure.