Journal of laparoendoscopic & advanced surgical techniques. Part A
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J Laparoendosc Adv Surg Tech A · Mar 2021
Laparoscopic Management of Common Bile Duct Stones: Stratifying Risks, a District Hospital Experience.
Background: Management of bile duct stones is variable. Selection of the appropriate treatment modality based on identifiable risk factors can increase the chances of a successful outcome. The aim of this study is to identify factors affecting outcomes of a laparoscopic bile duct exploration. ⋯ Three patients had retained stones treated by postoperative ERCP. Conclusion: Emergency procedures, increasing number and size of stones, previous failed ERCP are factors that contribute to the outcomes of a laparoscopic bile duct exploration. The chances of a successful exploration can be improved by appropriate patient and procedure selection and preparation based on identification of these factors.
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J Laparoendosc Adv Surg Tech A · Mar 2021
Comparative StudyElastomeric Pain Pumps as an Adjunct for Postoperative Pain Control After Minimally Invasive Repair of Pectus Excavatum.
Introduction: Pectus excavatum is a common congenital anomaly in the pediatric population. During the postoperative period, pain control is one of the top priorities. As a result, multiple techniques for pain control have been developed, including thoracic epidural analgesia, multimodal analgesia (MM), and elastomeric pain pump (EPP) placement. ⋯ We found no significant difference between subpleural versus subcutaneous placement of the infusion catheters. Conclusion: The use of subpleural EPP as an adjunct to MM is an effective way to reduce pain and opioid use after MIRPE without increased risk of complications. Type of Study: Retrospective study with comparison group.
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J Laparoendosc Adv Surg Tech A · Mar 2021
A Retrospective Analysis of the Trends in Acute Appendicitis During the COVID-19 Pandemic.
Background: The corona virus disease of 2019 (COVID-19) imposed new public health constraints that deterred people from coming to the hospital. The outcome of patients who developed appendicitis during mandated COVID-19 quarantine has yet to be examined. The main objective was to establish whether there was an increased rate of perforated appendicitis seen during COVID-19 quarantine. ⋯ Patients who perforated had an increased length of stay and rate of complication. Conclusion: There was an overall increased rate of perforated appendicitis seen during quarantine compared with the previous year. Patients with perforated appendicitis had an increased length of stay, longer operative time, and increased rate of complications. Thus, although people were staying home due to public health safety orders, it negatively impacted those who developed appendicitis who may have presented to the hospital otherwise sooner.
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J Laparoendosc Adv Surg Tech A · Mar 2021
Emergency Abdominal Laparoscopic Surgery During the Coronavirus Disease 2019 Pandemic: Experience in a Private Center in Peru.
Background: During the Health Emergency due to coronavirus disease 2019 (COVID-19) in Peru, elective surgeries were suspended and only emergency surgeries were allowed. Conservative management was considered as an alternative and laparoscopic surgery was indicated following safety recommendations. Surgically operated patients were at higher risk of becoming infected with COVID-19 due to hospital exposure, being more susceptible to complications. ⋯ No surgeon at the institution was infected with the virus during the study period. Conclusions: The degree of severity of abdominal surgical pathologies in this time of pandemic has not increased compared with the previous year. Likewise, the laparoscopic approach to emergency surgery was safe and effective during the pandemic.
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J Laparoendosc Adv Surg Tech A · Jan 2021
ReviewOperating Room Setup: How to Improve Health Care Professionals Safety During Pandemic COVID-19-A Quality Improvement Study.
Background: COVID-19 is a terrific pandemic and a potential risk for every health care professional (HCP), especially during emergency conditions where the right timing is essential for the correct treatment. During surgery the correct setting of operative room (OR) is mandatory to reduce the risk of contamination. Personal protection equipment (PPE), specific devices, and planned OR setting are essential during surgery in pandemic COVID-19. Methods: Medline, PubMed, Scientific societies recommendations, and guidelines were consulted to identify articles reporting the setup of OR during pandemic COVID-19. Results: OR must have a high-efficiency particulate air (HEPA) filter with negative pressure and a high air exchange cycle rate. ⋯ During laparoscopy low pneumoperitoneum pressures and aspiration systems must be provided. Conclusions: Emergency surgery during pandemic COVID-19 increases the risk for every HCP in the OR. A theoretical risk of transmission from the surgical field exists. It is mandatory the adoption of strong strategies to reduce the risk of contamination in the OR.