International journal of surgery
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Meta Analysis Comparative Study
Is laparoscopic lavage safe in purulent diverticulitis versus colonic resection? A systematic review and meta-analysis.
Diverticulitis is one of the most common gastrointestinal diseases in western population. Colonic resection is recommended by international guidelines as a routinely used technique for purulent diverticulitis. Laparoscopic lavage was introduced as a non-resection alternative. The studies available so far have shown contradictory results. This meta-analysis aims to compare laparoscopic lavage versus colonic resection in patients with Hinchey Ⅲ-Ⅳ diverticulitis. ⋯ Laparoscopic lavage for patients with Hinchey Ⅲ to Ⅳ diverticulitis does provide similar mortality, shorter operative time and hospital stay. However, the evidence so far suggests that it might be inadequate for sepsis control and may result in more unplanned reoperations. Further studies are needed to standardize the formal indication for laparoscopic lavage.
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To evaluate comparative outcomes of laparoscopic repair of groin hernia with and without mesh fixation. ⋯ Avoiding mesh fixation with a stapler or tacker during laparoscopic groin hernia repair may reduce postoperative pain and procedure time. Future studies are encouraged to evaluate cost effectiveness of each approach.