Int Surg
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Randomized Controlled Trial
Intravenous lidocaine for effective pain relief after a laparoscopic colectomy: a prospective, randomized, double-blind, placebo-controlled study.
A perioperative intravenous lidocaine infusion has been reported to decrease postoperative pain. The goal of this study was to evaluate the effectiveness of intravenous lidocaine in reducing postoperative pain for laparoscopic colectomy patients. Fifty-five patients scheduled for an elective laparoscopic colectomy were randomly assigned to 2 groups. ⋯ The CRP level tended to be lower in group L than group C, especially on postoperative day 1 and 2 and appeared to be statistically significant. The satisfaction score was higher in group L than group C (P = 0.024). Intravenous lidocaine infusion during an operation reduces pain after a laparoscopic colectomy.
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Review Case Reports
Complete abdominal wall disruption with herniation following blunt injury: case report and review of the literature.
Acute traumatic abdominal wall hernia (TAWH) is a rare type of hernia that occurs after a low- or high-velocity impact of the abdominal wall against a blunt object. With few cases reported, a consensus in diagnosis and management has not been established in the literature. A systematic review of the literature for adult cases of traumatic abdominal wall hernia due to blunt abdominal trauma was undertaken. ⋯ A staging system for TAWH can facilitate appropriate management priorities and treatment. CT scanning is crucial in the diagnosis of TAWH, and aids in definitive management of these patients. The literature supports immediate surgical exploration for most TAWH.
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The aims of the present study were to: (1) assess surgical site infection (SSI) incidence in a cohort of surgical patients and (2) estimate the compliance with national guidelines for perioperative antibiotic prophylaxis (PAP). SSIs, among the most common health care-associated infections, are an important target for surveillance and an official priority in several European countries. SSI commonly complicates surgical procedures in older people and is associated with substantial attributable mortality and costs. ⋯ Overall, only infection risk index ≥ 1 was confirmed as a significant risk factor for SSI (odds ratio, 6.65; 95% confidence interval, 1.04-42.59; P = 0.045). When only older patients (age >65 years) were considered, no significant risk factors for SSI were identified. Our study indicates an overall inadequate compliance with PAP recommendations, thus highlighting the need to develop multimodal and targeted intervention programs to improve compliance with PAP guidelines.
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The relationship between postoperative percentage fall of platelet (PLT) counts and graft dysfunction after living donor liver transplantation (LDLT) in recipients with small-for-size (SFS) graft has not been fully evaluated. We retrospectively studied 50 adult-to-adult LDLT recipients with a graft-to-recipient weight ratio of <0.8% between 1999 and 2011. Graft dysfunction was defined as the presence of hyperbilirubinemia, coagulopathy, or ascites on 3 consecutive days during the first postoperative week. ⋯ Fourteen of 20 patients (70%) with a dysfunction score of 2 or 3 and 11 of 30 patients (37%) with a dysfunction score of 0 or 1 showed a fall in PLT count >56% at POD 3 (P = 0.021). Grade 2 to 5 complications were more observed in patients with a dysfunction score of 2 or 3 than in patients with a dysfunction score of 0 or 1 (P < 0.001). The fall of PLT count at POD 3 >56% is an ominous sign that can predict the graft dysfunction after LDLT in recipients with SFS graft.
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Cronkhite-Canada syndrome (CCS) is a very rare disease which may cause malignant transformation. A combination regimen including corticosteroids are common therapy for CCS, however the decrease of medicine may lead to CCS relapse and also may contribute to malignant transformation of the polyps in gastrointestinal tract. ⋯ We believe close follow-up should be taken when CCS patients are making medicine dosage alteration and tumor marker such as CEA may be included in the surveillance examination. When improvement using conservative treatment can be neither obtained nor is expected, the use of surgery should be considered.