Journal of laparoendoscopic & advanced surgical techniques. Part A
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J Laparoendosc Adv Surg Tech A · Jun 2005
Case ReportsRemoval of an unexpected tracheal foreign body after five months.
Foreign body aspiration can produce serious pulmonary diseases. Timely diagnosis and appropriate treatment is important to prevent long-term complications in affected children. We report the case of a 15-month-old child with a 5-month history of regurgitation, vomiting, recurrent tracheobronchitis, and pneumonia. ⋯ The laryngotracheal endoscopy revealed a rabbit vertebra partially obstructing the airway at the level of the cricoid cartilage. With a rigid bronchoscope and forceps equipped with a telescope, it was possible to disengage and extract the foreign body. Six months later endoscopic control revealed no residual alterations in the larynx and trachea.
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J Laparoendosc Adv Surg Tech A · Apr 2005
Randomized Controlled Trial Comparative Study Clinical TrialThe effect of low-flow sevoflurane and desflurane on pulmonary mechanics during laparoscopic surgery.
This study was designed to investigate the effects of inhaled anesthetic agents on respiratory mechanics with low flow anesthesia in laparoscopic abdominal surgery. Two inhaled anesthetics, desflurane and sevoflurane, have a lower solubility in blood and tissues than all previous volatile anesthetics, and have become the preferred volatile anesthetics for routine surgical procedures. ⋯ We concluded that respiratory mechanics were affected by desflurane with low flow anesthesia in patients undergoing laparoscopic abdominal surgery. No significant influence on respiratory mechanics was seen with sevoflurane anesthesia.
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J Laparoendosc Adv Surg Tech A · Feb 2005
Randomized Controlled Trial Clinical TrialHeated and humidified insufflation during laparoscopic gastric bypass surgery: effect on temperature, postoperative pain, and recovery outcomes.
Controversy exists regarding the efficacy of heated and humidified intraperitoneal gases in maintaining core body temperature. We performed a sham-controlled study to test the hypothesis that active warming and humidification of the insufflation gas reduces intraoperative heat loss and improves recovery outcomes. ⋯ The Insuflow device modestly reduced shivering and heat loss, as well as the need for opioid analgesics in the early postoperative period. However, it failed to improve laparoscopic visualization due to fogging, and provided improvement in the quality of recovery only on postoperative day 2.
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J Laparoendosc Adv Surg Tech A · Feb 2005
Case ReportsLaparoscopic removal of a swallowed sewing needle that migrated into the greater omentum without clinical evidence.
We report a case of a sewing needle, presumably originating from the transverse colon or the ligament of Treitz, that migrated to the greater omentum. A 24-year-old woman was referred to our clinic with a complaint of abdominal pain which was exacerbated by breathing or any physical activity. Abdominal plain x-ray showed a needle in the left upper abdominal area. ⋯ An accurate and rapid diagnosis of a perforation in the gastrointestinal tract as the result of an ingested foreign body is difficult in the absence of peritonitis or abscess formation. In such cases, the virtual colonoscopy is useful if there is uncertainty whether the foreign body is in the lumen. Perioperative fluoroscopy can be useful to overcome the lack of tactile discrimination in laparoscopy, in patients who have been scheduled for surgery who have no signs of the localization of the foreign body (such as abscess or solid organ migration).
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J Laparoendosc Adv Surg Tech A · Dec 2004
Randomized Controlled Trial Comparative Study Clinical TrialLaparoscopic-assisted vs. open colectomy for colon cancer: a prospective randomized trial.
Although laparoscopic-assisted colectomy (LAC) has evolved as a technical option in the treatment of benign colonic diseases, its role in the treatment of malignancies remains controversial. The purpose of this prospective randomized trial was to compare perioperative parameters and outcomes between LAC vs. open colectomy (OC) in patients with stage I-III colon cancer. ⋯ Short-term outcomes revealed that LAC could be performed safely and has therapeutic results similar to OC for colon cancer. Conversion of LAC to an open procedure was frequent but was not associated with a negative outcome.