European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Aug 2019
Case ReportsEASY (endoscopic approach to the symphysis): a new minimally invasive approach for the plate osteosynthesis of the symphysis and the anterior pelvic ring-a cadaver study and first clinical results.
Minimally invasive surgical approaches to reduce approach-associated morbidity are an interdisciplinary goal in surgery. In principle, the endoscopic approach for the extraperitoneal repair of groin hernias is the minimally invasive variant of the modified Stoppa-approach, which is used for the treatment of pelvic ring injuries in traumatology. ⋯ The plate osteosynthesis of the anterior pelvic ring via the minimally invasive variant of the modified Stoppa-approach is feasible with existing standard laparoscopic instruments.
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Eur J Trauma Emerg Surg · Aug 2019
Review Meta AnalysisThe use of polymeric clips in securing the appendiceal stump during laparoscopic appendicectomy: a systematic review.
A key step during laparoscopic appendicectomy is securing the appendiceal stump. This has traditionally been achieved using vicryl endoloops, but increasing evidence suggests that the use of polymeric clips (Hem-o-lok) may be a safe and viable method. Current evidence for its clinical use in laparoscopic appendicectomy is unknown. We performed a systematic review of the literature examining the clinical outcomes of laparoscopic appendicectomy using polymeric clips compared to other methods of stump closure. ⋯ Current evidence suggests that polymeric clips are an effective and cost-efficient method for stump closure in laparoscopic appendicectomy for acute appendicitis. Further high-quality evidence is required before polymeric clips can be recommended as the gold standard for appendiceal stump closure.
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Eur J Trauma Emerg Surg · Aug 2019
Multicenter Study Comparative StudyRib fixation versus non-operative treatment for flail chest and multiple rib fractures after blunt thoracic trauma: a multicenter cohort study.
Over the years, a trend has evolved towards operative treatment of flail chest although evidence is limited. Furthermore, little is known about operative treatment for patients with multiple rib fractures without a flail chest. The aim of this study was to compare rib fixation based on a clinical treatment algorithm with nonoperative treatment for both patients with a flail chest or multiple rib fractures. ⋯ No advantage could be demonstrated for operative fixation of rib fractures. Future studies are needed before rib fixation is embedded or abandoned in clinical practice.