International journal of surgery
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Randomized Controlled Trial
Intraoperative endoscopy prevents technical defect related leaks in laparoscopic Roux-en-Y gastric bypass: A randomized control trial.
Postoperative anastomotic leaks, bleeding and stenosis are major causes of morbidity after laparoscopic Roux-en-Y gastric bypass (LRYGB). Retrospective studies suggest that intraoperative endoscopy reduces the incidence of these complications. ⋯ This study specifically provides evidence that air leak test performed by intraoperative endoscopy is superior to simple visual inspection in preventing technical defect related leaks after laparoscopic Roux-en-Y gastric bypass.
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Review
Enhanced recovery after surgery for pancreaticoduodenectomy: Review of current evidence and trends.
Pancreaticoduodenectomy (PD) remains a morbid procedure. The use of Enhanced Recovery After Surgery (ERAS) pathways has proven to reduce care time and post-operative complications after colorectal surgery. There is a high potential for reducing morbidity associated with PD by utilizing ERAS. ⋯ The purpose of this review is to examine the current evidence for ERAS in preoperative, intraoperative and post-operative setting of care for PD patients and to propose ERAS evidence-based protocol for patients undergoing PD. Evidence indicates that ERAS protocols may be implemented in PD without compromising patient safety or increasing length of stay. ERAS in the context of PD should be standardized based on the best available evidence, and ERAS programmes involving multiple centers should be performed.
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Sacroiliac joint disruption (SJD) is a common cause of pelvic ring instability. Clinically, percutaneous unilateral S1 sacroiliac screw and anterior plating are always applied to manage SJD. The objective of this study is to elaborate their respective therapeutic traits. ⋯ Compared with anterior plating, percutaneous unilateral S1 sacroiliac screw usage is less invasive; however, more intraoperative X-ray exposure and permanent neurologic damage may accompany this procedure.
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Review Meta Analysis
Minimally invasive versus extensile lateral approach for sanders type II and III calcaneal fractures: A meta-analysis of randomized controlled trials.
The use of less-invasive techniques in the treatment of displaced intra-articular calcaneal fractures (DIACFs) remains controversial. No prior meta-analysis has considered the influence of differences in the fracture type. Thus, our meta-analysis aimed to investigate the efficacy and safety of minimally invasive (MI) in Sanders type II and III fractures. ⋯ Our meta-analysis suggests that MI and ELA are equally effective treating Sanders type II and III fractures. However, MI is effective in improving the AOFAS score (Sanders type II); reducing the rate of wound complications; and shortening the time to surgery, duration of surgery and length of hospital stay.
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Review Meta Analysis
Efficacy of intravenous lidocaine on pain relief in patients undergoing laparoscopic cholecystectomy: A meta-analysis from randomized controlled trials.
Whether intravenous lidocaine has a beneficial role in controlling acute pain after a laparoscopic cholecystectomy (LC) in currently unknown. We performed a meta-analysis from randomized controlled trials (RCTs) to determine the efficacy and safety of intravenous lidocaine for the treatment of acute postoperative pain after LC. ⋯ Intravenous use of lidocaine was able to reduce acute postoperative pain, total opioid requirements and opioid-related adverse effects following a LC. Further studies should determine whether lidocaine has a positive role in improving the postoperative function after a LC.