Surgical laparoscopy, endoscopy & percutaneous techniques
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Surg Laparosc Endosc Percutan Tech · Feb 2013
Review Meta Analysis Comparative StudyLaparoscopy versus open distal gastrectomy for advanced gastric cancer: a systematic review and meta-analysis.
Laparoscopy-assisted distal gastrectomy (LADG) is one of the most accepted laparoscopic procedures in the field of gastric surgery. However, currently this procedure for the advanced gastric cancer (AGC) has still not reached the area of the popularization. The aim of this study was to compare laparoscopy with open distal gastrectomy in AGC patients using the meta-analytical techniques. ⋯ The oncologic outcomes of LADG for AGC patients were comparable with open approach. Although open distal gastrectomy may be associated with shorter operative time, patients undergoing laparoscopic approach may be benefitted from a shorter hospital stay and a faster resumption without translation into an increase in both postoperative morbidity and mortality. Nevertheless, further prospective, controlled studies, and extended follow-up are needed for a more comprehensive comparison between the 2 procedures.
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Surg Laparosc Endosc Percutan Tech · Feb 2013
Review Meta Analysis Comparative StudyComparison of the efficacy of ondansetron and granisetron to prevent postoperative nausea and vomiting after laparoscopic cholecystectomy: a systematic review and meta-analysis.
Our purpose was to assess the prophylactic antiemetic effects of ondansetron versus granisetron for laparoscopic cholecystectomy. ⋯ Ondansetron is equivalent to granisetron for preventing early and total incidence of PONV after laparoscopic cholecystectomy.
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Surg Laparosc Endosc Percutan Tech · Feb 2013
Randomized Controlled Trial Comparative StudyLaparoscopic interval appendectomy versus open interval appendectomy: a prospective randomized controlled trial.
This was a prospective randomized controlled study designed to compare laparoscopic and open interval appendectomy and involved 100 patients of appendicular phlegmon. After initial conservative management, patients were divided into 2 groups of 50 each and interval appendectomy was performed by laparoscopy in one of the groups and by open method in the other. Mean operative time in open surgery was 33.9 minutes and that in laparoscopic surgery was 57.64 minutes (P < 0.05). ⋯ Mean pain scores on the first postoperative day were 5.14 in the laparoscopic group and 6.01 in the open group (P < 0.05). Patients in the laparoscopic group had a shorter duration of ileus, postoperative stay, and returned to work earlier (P < 0.05). We conclude that laparoscopy offers a number of advantages over open interval appendectomy.
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Surg Laparosc Endosc Percutan Tech · Feb 2013
Randomized Controlled Trial Comparative StudyPostoperative pain after laparoscopic cholecystectomy: a randomized clinical trial comparing intraperitoneal bupivacaine versus intravenous pethidine.
Pain is the most common complaint of patients on the first day after laparoscopic cholecystectomy (LC). This clinical trial compared the effects of intraperitoneal (IP) bupivacaine and intravenous (IV) pethidine on this pain. Forty-eight patients who underwent LC were randomly assigned to 2 groups of IP bupivacaine and IV pethidine. ⋯ Patients who received IP bupivacaine showed a significantly lower pain score (P = 0.022) and improved peak expiratory flow rate (P = 0.006), and received lower doses of ibuprofen (P = 0.003) within the first 24 hours after surgery. Likewise, the presence of nausea/vomiting was significantly lower in bupivacaine groups 1 and 4 hours after surgery (P = 0.003 and 0.005, respectively). Our results indicate that IP instillation of bupivacaine is more beneficial than traditional IV pethidine for pain reduction after LC.
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Surg Laparosc Endosc Percutan Tech · Feb 2013
Randomized Controlled Trial Comparative StudyA prospective randomized comparison of single-port laparoscopic procedure with open and standard 3-port laparoscopic procedures in the treatment of acute appendicitis.
This prospective randomized study aimed to evaluate the surgical outcomes of single-incision laparoscopic appendectomy (SILA) comparing with open appendectomy (OA) and standard 3-port laparoscopic appendectomy (SLA) in the treatment of acute appendicitis (AA). ⋯ Either SLA or SILA offer patients faster recovery period with acceptable complications than OA. Hence, laparoscopic approach might be considered as first option in the treatment of AA. However, all 3 techniques provide equivalent clinical outcomes despite the significant findings. Therefore, technique selection is based on surgeon's decision, experience, and availability of laparoscopic instruments.