Techniques in coloproctology
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Randomized Controlled Trial
Randomized clinical trial of ropivacaine wound infusion following laparoscopic colorectal surgery.
Wound infusions with local anaesthesia have been used with varying success following laparotomy for colonic resections. This trial sought to determine the efficacy of ropivacaine wound infusion following laparoscopic colonic surgery. ⋯ In this study, local anaesthetic wound infusion with ropivacaine following elective laparoscopic colorectal surgery improves early respiratory function, but does not appear to provide an improvement in postoperative analgesia or other clinically relevant postoperative outcomes.
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Conventional abdominoperineal excision (APE) of the rectum is associated with higher circumferential resection margin (CRM) involvement, increased local recurrence, and reduced survival compared to anterior resection. A more radical extralevator APE (ELAPE) technique may improve oncological outcome. However, this technique may confer additional morbidity, and little comparative data on short-term outcomes have been reported. This study compares short-term outcomes and quality of life (QOL) after open and laparoscopic ELAPE, laparoscopic APE (LAPE), and open APE (OAPE). ⋯ The results of this study suggest that ELAPE is not associated with deterioration in short-term outcomes or QOL when compared with LAPE or OAPE.
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Randomized Controlled Trial Multicenter Study Comparative Study
The influence of mechanical bowel preparation in elective colorectal surgery for diverticulitis.
Mechanical bowel preparation (MBP) has been shown to have no influence on the incidence of anastomotic leakage in overall colorectal surgery. The role of MBP in elective surgery in combination with an inflammatory component such as diverticulitis is yet unclear. This study evaluates the effects of MBP on anastomotic leakage and other septic complications in 190 patients who underwent elective surgery for colonic diverticulitis. ⋯ Mechanical bowel preparation has no influence on the incidence of anastomotic leakage, or other septic complications, and may be safely omitted in case of elective colorectal surgery for diverticulitis.