Chinese Med J Peking
-
Chinese Med J Peking · Nov 2012
Meta Analysis Comparative StudyMeta-analysis of pancreaticoduodenectomy prospective controlled trials: pancreaticogastrostomy versus pancreaticojejunostomy reconstruction.
Pancreaticogastrostomy (PG) has been proposed as an alternative to pancreaticojejunostomy (PJ), assuming that postoperative complications are less frequent. The aim of this research was to compare the safety of PG with PJ reconstruction after pancreaticoduodenectomy. ⋯ Meta-analysis of six prospective controlled trials (including randomized controlled trials (RCT) and non-randomized prospective trial) revealed significant difference between PJ and PG regarding overall postoperative complications, pancreatic fistula, and intra-abdominal fluid collection. Meta-analysis of four RCT revealed significant difference between PJ and PG with regard to intra-abdominal fluid collection. The results suggest that PG may be as safe as PJ.
-
Chinese Med J Peking · Nov 2012
Randomized Controlled TrialEpidural fentanyl decreases the minimum local analgesic concentration of epidural lidocaine.
Epidural lidocaine can be used when regional anesthesia needs to be established quickly, but the effect of co-administering epidural fentanyl on the minimum local analgesic concentration (MLAC) of lidocaine is not known. We compared the MLAC of epidural lidocaine in combination with different doses of fentanyl for epidural anesthesia in adults. ⋯ Epidural fentanyl significantly reduces the dose of lidocaine required for effective epidural analgesia in adults without causing adverse side effects.
-
Chinese Med J Peking · Nov 2012
Randomized Controlled TrialUltrasound facilitates identification of combined spinal-epidural puncture in obese parturients.
The palpation method is widely used in clinical practice to identify the puncture site of combined spinal-epidural (CSE) blocks, but it is usually difficult to accurately locate the puncture site in obese parturients. Accurate identification of the puncture site is crucial for successful CSE block. The objective of this study was to evaluate the impact of ultrasound imaging on the success rate of CSE puncture in obese parturients. ⋯ Ultrasound imaging improves the rate of successful puncture at the first puncture site and decreases the number of puncture attempts. It facilitates CSE puncture in obese parturients.
-
Chinese Med J Peking · Nov 2012
Comparison of Topping-off and posterior lumbar interbody fusion surgery in lumbar degenerative disease: a retrospective study.
Topping-off surgery is a newly-developed surgical technique which combines rigid fusion with an interspinous process device in the adjacent segment to prevent adjacent segment degeneration. There are few reports on Topping-off surgery and its rationality and indications remains highly controversial. Our study aims to investigate the short-term and mid-term clinical results of Topping-off surgery in preventing adjacent segment degeneration when mild or moderate adjacent segment degeneration existed before surgery. ⋯ Compared with single segment PLIF surgery, Topping-off surgery can achieve similar symptomatic improvement in cases with pre-existing mild or moderate adjacent segment degeneration, restrict the adjacent segment's ROM in extension and prevent excessive olisthesis of adjacent segment in both extension and flexion.
-
Chinese Med J Peking · Nov 2012
Minimally invasive transforaminal lumbar interbody fusion aided with computer-assisted spinal navigation system combined with electromyography monitoring.
Minimally invasive techniques are gaining wide-spread application in lumbar fusion surgery, because they may have advantage over conventional open surgery in approach-related morbidity. This research was aimed to evaluate the safety and accuracy of the techniques of minimally invasive transforaminal lumbar interbody fusion by using a computer-assisted spinal navigation system combined with electromyography monitoring. ⋯ The combination of navigation system and real-time electromyography monitoring can make the minimally invasive operation more safe and accurate while decreasing radiation exposure time of the medical staff and patient and minimizing the chance and the degree of the pedicle screw misplacement.