Journal of laparoendoscopic & advanced surgical techniques. Part A
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J Laparoendosc Adv Surg Tech A · Jul 2018
Randomized Controlled Trial Comparative StudyComparison of Intraperitoneal Nebulization of Ropivacaine with Ropivacaine-Fentanyl Combination for Pain Control Following Laparoscopic Cholecystectomy: A Randomized, Double-Blind, Placebo-Controlled Trial.
Intraperitoneal local anesthetic nebulization is a new and novel technique for providing pain relief following laparoscopic cholecystectomy. We compared the analgesic efficacy of intraperitoneal ropivacaine-fentanyl nebulization with ropivacaine nebulization alone for providing pain relief following laparoscopic cholecystectomy Materials and Methods: This prospective, randomized, double-blind, placebo-controlled trial included 75 American Society of Anesthesiologists I/II patients, 18-60 years old, scheduled to undergo laparoscopic cholecystectomy under general anesthesia. Patients were randomly allocated to one of the three groups of 25 patients each to receive intraperitoneal nebulization using normal saline (group I), 30 mg of 0.75% ropivacaine (group II), or 30 mg of 0.75% ropivacaine with 100 μg fentanyl (group III). Visual analogue scale (VAS) scores for pain during rest and movement, shoulder pain, nausea or vomiting, and sedation were recorded for 48 hours postoperatively. Time to providing first rescue analgesia and 48-hour tramadol consumption were also noted. ⋯ Nebulization results in better and uniform dispersion of analgesic drug intraperitoneally. Following laparoscopic cholecystectomy surgeries, ropivacaine nebulization of intraperitoneal cavity, with or without fentanyl, provides highly effective postoperative analgesia, with decreased incidence of shoulder pain. Furthermore, addition of fentanyl to ropivacaine prolongs the duration of analgesia.
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J Laparoendosc Adv Surg Tech A · Jul 2018
Clinical and Economic Impact of an Enhanced Recovery Pathway for Open and Laparoscopic Rectal Surgery.
The short-term benefits of laparoscopy for rectal surgery are equivocal. The objective of this study was to determine the clinical and economic impact of an enhanced recovery pathway (ERP) for laparoscopic and open rectal surgery. ⋯ ERPs reduced LOS after rectal resections, and the combination of laparoscopy and ERPs significantly reduced overall costs compared to when neither strategy was used.
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J Laparoendosc Adv Surg Tech A · Jun 2018
Short-Term and Long-Term Outcomes of Laparoscopic Versus Open Surgery for Low Rectal Cancer.
To compare the short-term and long-term outcomes of laparoscopic versus open surgery for low rectal cancer. ⋯ Laparoscopic surgery is safe and has equivalent long-term oncologic outcomes for low rectal cancer when compared to open surgery. Furthermore, large-scale, prospective randomized clinical trials are needed to confirm the present findings.
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J Laparoendosc Adv Surg Tech A · May 2018
Review Meta Analysis Comparative StudyLaparoscopic Versus Conventional Open Abdominoperineal Resection for Rectal Cancer: An Updated Systematic Review and Meta-Analysis.
Laparoscopic abdominoperineal resection (LAPR) for rectal cancer (RC) treatment is still controversial, so we conducted this meta-analysis comparing LAPR with conventional open abdominoperineal resection (OAPR) to explore the safety and feasibility of LAPR for RC treatment. ⋯ LAPR can reduce postoperative complications, lead faster postoperative recovery. In addition, LAPR is not inferior to OAPR in terms of oncological clearance, recurrence rate, and long-time survivals. So LAPR is safe and feasible for RC treatment. Further, more perspective randomized trials can be conducted to compare LAPR and OAPR in the future.
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J Laparoendosc Adv Surg Tech A · May 2018
Comparative StudyRobotic Versus Laparoscopic Stapler Use for Rectal Transection in Robotic Surgery for Cancer.
This study was designed to compare the operative and short-term postoperative outcomes of the robotic and laparoscopic staplers in patients undergoing rectal surgery for cancer. ⋯ This is the first study evaluating the role of robotic stapler specifically for rectal transection in comparative manner. The use of robotic stapler for rectal transection was safe and feasible in rectal surgery for cancer.