Surgical laparoscopy, endoscopy & percutaneous techniques
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Surg Laparosc Endosc Percutan Tech · Feb 2014
ReviewBibliometric analysis of scientific contributions in minimally invasive general surgery.
Publication of scientific articles in peer-reviewed medical journals is considered as a measure of research productivity. The aim of the present study was to quantify the research contributions of different countries in minimally invasive surgery and to critically discuss the results under the prism of recent socioeconomic developments. The electronical archives of 4 major surgical journals (Annals of Surgery, British Journal of Surgery, Journal of the American College of Surgeons, and Surgical Endoscopy) were searched between 2009 and 2012. ⋯ Although the United States dominates in terms of absolute number of publications, several smaller countries were more prolific, when the number of inhabitants was taken into account. The recent financial crisis is expected to undermine international collaborative conditions in the field of minimally invasive surgery. The need for a stepped-up international scientific collaboration is hereto highlighted.
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Surg Laparosc Endosc Percutan Tech · Feb 2014
Review Meta Analysis Comparative StudySingle-port laparoscopic appendectomy versus conventional laparoscopic appendectomy: evidence from randomized controlled trials and nonrandomized comparative studies.
Single-port laparoscopic appendectomy (SPLA) has gained widespread acceptance and is increasingly performed. The evidence assessing the safety and efficacy of SPLA compared with conventional laparoscopic appendectomy (CLA) is growing; however, very few randomized trials exist and individual studies often have small patient numbers with varying results. We integrated the available data to enhance the current literature by comparing these techniques. ⋯ SPLA shows no benefit over CLA, including even parameters such as postoperative pain and cosmetic results, and, therefore, there is no indication to use this approach over standard laparoscopic appendectomy. SPLA does take longer to perform. Further studies are needed to confirm that the procedure is more costly.
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Surg Laparosc Endosc Percutan Tech · Feb 2014
Comparative StudyComparison of outcomes after laparoscopic versus posterior retroperitoneoscopic adrenalectomy: a pilot study.
Posterior retroperitoneoscopic adrenalectomy (PRA) was popularized by Walz and colleagues as an alternative approach to minimally invasive adrenalectomy, offering less postoperative pain and faster return to normal activity compared with laparoscopic transperitoneal adrenalectomy (LA). The authors have recently changed from LA to PRA in suitable patients and audited their outcomes. ⋯ Our initial results supports previously published findings that PRA is a safe procedure, with a relatively short learning curve, resulting in reduced postoperative analgesia use, and reduced length of hospital stay when compared with the laparoscopic transperitoneal approach.
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Surg Laparosc Endosc Percutan Tech · Feb 2014
Early rise in C-reactive protein is a marker for infective complications in laparoscopic colorectal surgery.
Infective complications are the most significant cause of morbidity associated with elective colorectal surgery. It can sometimes be difficult to differentiate complications from the normal postoperative course. C-reactive protein (CRP) is an acute phase reactant which has been reported to be predictive of postoperative infective complications. ⋯ CRP is effective as an early predictor of infective complications after laparoscopic colorectal surgery and may be a useful adjunct in conjunction with an enhanced recovery program in reducing morbidity. A CRP of >148 mg/mL on postoperative day 3 or a persistently elevated CRP should heighten clinical suspicion of an infective complication.
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Surg Laparosc Endosc Percutan Tech · Feb 2014
How to improve the efficacy of endoscopic ultrasound-guided celiac plexus neurolysis in pain management in patients with pancreatic cancer: analysis in a single center.
Visceral pain secondary to pancreatic cancer is often difficult to control and poses a challenge to the physician. We retrospectively analyzed the efficacy and safety of endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN) in patients with unresectable pancreatic cancer. Forty-one patients with severe pain despite treatment with opioids underwent EUS-CPN with absolute alcohol. ⋯ Of all the patients, 19 patients reported substantial improvement and 4 patients showed complete disappearance of pain. Complication appeared in 2 patients with transient hypotension. In our study, EUS-CPN is a safe and effective form of treatment for intractable pain secondary to advanced pancreatic cancer.