Surgical laparoscopy, endoscopy & percutaneous techniques
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Surg Laparosc Endosc Percutan Tech · Aug 2009
Different perception of surgical risks between physicians and patients undergoing laparoscopic cholecystectomy.
Data on the quality of communication during informed consent for surgery is sparse; we investigated this issue in a cohort of patients undergoing laparoscopic cholecystectomy (LC). ⋯ Although informed consent for surgical procedures requires that the procedures are explained and that the patient understands the procedures and risks, our data suggest different perceptions of the quality of information provided during this process between patients and physicians. Physicians should be aware that surgical risks might be perceived differently by patients and this perception might be influenced, for example, by patients' age and education. Major efforts should be directed to improve communications skills in surgical laparoscopy.
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Surg Laparosc Endosc Percutan Tech · Aug 2009
Meta Analysis Comparative StudyShort-term evaluation of laparoscopy-assisted distal gastrectomy for predictive early gastric cancer: a meta-analysis of randomized controlled trials.
In recent decade, laparoscopy-assisted distal gastrectomy (LADG) has been introduced to treatment of early gastric cancer (EGC). Previous meta-analyses included the randomized controlled trial (RCT) apparently contaminated with advanced gastric cancer. Besides, more RCTs enrolling the predictive EGC are available. The present meta-analysis was aimed to compare LADG with open distal gastrectomy (ODG) by updating the literature search and repooling the RCTs of only predictive EGC with improved methodology. ⋯ LADG could bring the patients with EGC slight benefits by decreasing intraoperative blood loss and postoperative early morbidity, but unfavorably, might increase the operation time and decease the number of harvested lymph nodes. The long-term survival benefit is still eager to be proven by further outcomes of RCTs.
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Surg Laparosc Endosc Percutan Tech · Aug 2009
Randomized Controlled TrialEvaluation of intravenous paracetamol administration on postoperative pain and recovery characteristics in patients undergoing laparoscopic cholecystectomy.
In this study, the effects of intravenous paracetamol treatment on early postoperative period analgesia and recovery characteristics after laparoscopic cholecystectomy have been evaluated. ⋯ Beside its effective analgesic properties, paracetamol administration during per operative period supports effective and faster recovery.
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Surg Laparosc Endosc Percutan Tech · Jun 2009
Case ReportsDirect percutaneous endoscopic duodenostomy: a case report.
A 78-year-old male, who had undergone left upper lobectomy because of traumatic pulmonary contusion at the age of 25 years, succumbed to left hemiplegia with impaired consciousness that was caused by right putaminal hemorrhage. Aspiration pneumonia was complicated and he was set on tracheostomy and tube feeding through a nasogastric tube. Although it was apparent that enteral nutrition through the percutaneous endoscopic gastrostomy was appropriate for him, performing a percutaneous endoscopic gastrostomy seemed impossible as the computed tomography revealed that the elevated stomach was located behind the heart. In this patient, we successfully performed a direct percutaneous endoscopic duodenostomy without any complication.
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Surg Laparosc Endosc Percutan Tech · Jun 2009
Randomized Controlled Trial Comparative StudyA prospective randomized, controlled study comparing low pressure versus high pressure pneumoperitoneum during laparoscopic cholecystectomy.
The increase in intra-abdominal pressure by insufflation of carbon dioxide during laparoscopy brings certain changes in function of organ systems and also leads to postoperative pain. Degree of intra-abdominal pressure is directly related with such change. Laparoscopic cholecystectomy can be performed at low pressure pneumoperitoneum. However, available space for dissection is less than the high pressure pneumoperitoneum. ⋯ An uncomplicated gall stone disease can be treated by low pressure laparoscopic cholecystectomy with reasonable safety by an experienced surgeon. Though surgeons experience more difficulty in dissection during low pressure pneumoperitoneum, it is significantly advantageous in terms of postoperative pain, use of analgesics, preservation of pulmonary function, and hospital stay.