Journal of laparoendoscopic & advanced surgical techniques. Part A
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J Laparoendosc Adv Surg Tech A · Nov 2018
Leakage Rate After Laparoscopic Ileocolic Intracorporeal Anastomosis.
The prevailing technique in laparoscopic resection of the right colon has been laparoscopic-assisted procedure with externalization of the bowel for extracorporeal creation of the ileocolic anastomosis. The total laparoscopic technique performing all steps intracorporeally, however, has gained increasing interest. The purpose of this study was to describe our experience with creation of an ileocolic intracorporeal anastomosis (IIA) and to determine anastomotic leakage (AL) rate and short-term outcome of performing IIA. ⋯ IIA was found to be a feasible and safe technique in laparoscopic resections of the right colon with an AL rate of 4.2%.
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J Laparoendosc Adv Surg Tech A · Oct 2018
Comparative StudyFrom Laparoscopic Right Colectomy with Extracorporeal Anastomosis to Robot-Assisted Intracorporeal Anastomosis to Totally Robotic Right Colectomy for Cancer: The Evolution of Robotic Multiquadrant Abdominal Surgery.
Intracorporeal anastomosis (IA) in right colectomies shows many advantages over extracorporeal anastomosis (EA). Many difficulties encountered in laparoscopic IA can be overcome with hybrid robot-assisted IA or recently with totally robotic procedures. In the literature, few works have been published comparing laparoscopic, hybrid, and totally robotic right colectomies. The aim of this study is to retrospectively analyze the improvements brought on by the evolution of robotic surgery at our specialized center. ⋯ We confirmed the clinical advantages of RRC with IA over LRC with EA in postoperative recovery outcomes and complication rate. Furthermore, our preliminary analysis in a cohort of 30 TRRC shows promising results.
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J Laparoendosc Adv Surg Tech A · Oct 2018
Multicenter StudyInfectious Complications After Laparoscopic Appendectomy in Pediatric Patients with Perforated Appendicitis: Is There a Difference in the Outcome Using Irrigation and Suction Versus Suction Only? Results of a Multicentric International Retrospective Study.
Analyzing the recent literature, it seems that the use of irrigation increases the incidence of intra-abdominal abscesses (IAAs) and infectious complications in perforated appendicitis. The aim of this study was to compare peritoneal irrigation and suction versus suction only during laparoscopic appendectomy (LA) for perforated appendicitis in children. ⋯ In contrast with the most recent literature on this topic, our results demonstrated that peritoneal irrigation and suction were associated with a lower rate of postoperative IAA formation compared with the suction-only approach in children with perforated appendicitis. In such cases, peritoneal irrigation and abdominal drainage should be the preferred methods for peritoneal toilette, with no increase in operative time and postoperative morbidity.
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J Laparoendosc Adv Surg Tech A · Oct 2018
Postoperative Pain Outcomes After Nuss Procedures: Comparison of Epidural Analgesia, Continuous Infusion of Local Anesthetic, and Preoperative Self-Hypnosis Training.
The Nuss procedure to correct pectus excavatum is associated with severe postoperative pain. The purpose of this retrospective study was to compare pain management outcomes of thoracic epidural analgesia and continuous infusion of local anesthetic (CILA) with and without preoperative self-hypnosis training (SHT) after Nuss procedure (4 treatment groups). ⋯ SHT before pectus excavatum repair by Nuss procedure results in less postoperative pain and requires less morphine equivalents over time for postoperative pain management. Opioid-sparing CILA, when paired with SHT, results in shorter LOS.
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J Laparoendosc Adv Surg Tech A · Sep 2018
Randomized Controlled TrialEffect of Topical Lidocaine Patch on Postoperative Pain Management in Laparoscopic Appendectomy: A Randomized, Double-Blind, Prospective Study.
Adequate pain control is a major concern in the immediate postoperative period. In multiple strategies for postoperative pain management, topical analgesics have significant advantages of minimizing severe side effects caused by oral and parenteral administration and drug-drug interactions. Therefore, we studied the effect of lidocaine patch on postoperative pain control in laparoscopic appendectomy. ⋯ The results of this study suggest that lidocaine patch application to the trocar site after laparoscopic appendectomy may have a positive effect on the management of postoperative pain and can eliminate the need to inject additional analgesics for further postoperative pain control.