Surgical laparoscopy, endoscopy & percutaneous techniques
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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.
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Surg Laparosc Endosc Percutan Tech · Feb 2013
Clinical outcomes of laparoscopy-assisted gastrectomy for patients with heart disease.
Laparoscopy-assisted gastrectomy (LG) is an established treatment for early gastric cancer. However, CO2 pneumoperitoneum during laparoscopic surgery can adversely affect cardiac function in the presence of heart disease (HD). We performed LG in 546 patients and conventional open gastrectomy (OG) in 448 patients. ⋯ Postoperative cardiac complications did not differ between the groups (8.3% vs. 13.6%, P = 0.51). The HD-LG group had significantly more cardiac and abdominal complications than the NR-LG group (P = 0.0011 and 0.0070, respectively). LG was tolerated in patients with gastric cancer and mild or moderate HD, similar to OG.
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Surg Laparosc Endosc Percutan Tech · Feb 2013
Outpatient laparoscopic appendectomy in children: a single center experience with 92 cases.
The purpose of this study was to present the possibility of laparoscopic appendectomy (LA) in children as an outpatient procedure. ⋯ We recommend that an LA can be performed safely as an outpatient procedure in children with uncomplicated appendicitis.