International journal of surgery
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Review Comparative Study
Absorbable versus non-absorbable tacks for mesh fixation in laparoscopic ventral hernia repair: A systematic review and meta-analysis.
To investigate the outcomes of absorbable versus non-absorbable tacks in patients undergoing laparoscopic ventral hernia repair. ⋯ We found no difference in clinical outcomes between absorbable and non-absorbable tacks for mesh fixation in patients undergoing laparoscopic ventral hernia repair. The quality of the available evidence is moderate with a possibility of type 2 error. High quality RCTs with adequate statistical power are required to provide more robust basis for definite conclusions. Considering the similarity of both techniques in terms of clinical outcomes, the cost-effectiveness of each technique would be an important outcome determining which technique should be used; this needs to be considered as an outcome of interest in future studies.
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Observational Study
Assessing the costs of disposable and reusable supplies wasted during surgeries.
The management of disposable and reusable supplies might have an impact on the cost efficiency of the Operating Room (OR). This study aimed to evaluate the cost and reasons for wasted supplies in the OR during surgical procedures. ⋯ This study showed the OR is a major source of wasted hospital expenditure and an area wherein an intervention would have a significant impact. Reducing wasted supplies could improve the cost efficiency of the OR and also decrease its ecological impact.
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Choledocholithiasis occurs in 10-15% of patients with cholecystolithiasis. Despite the existence of many therapeutic options for the treatment of cholecystocholedocholithiasis, a sequential treatment in which pre-operative ERCP is combined with intraoperative cholangiography (IOC) and laparoscopic cholecystectomy (LC), is the most commonly accepted strategy. However, use of IOC in the "splitting treatment" of cholecystocholedocholithiasis is controversial. The aim of the present study is to investigate the utility of IOC in detecting residual stones in patients undergoing LC in the sequential treatment of common biliary duct or gallbladder stones. ⋯ This study demonstrates that IOC is particularly effective in detecting residual stones in patients undergoing LC in sequential treatment of common biliary duct and/or gallbladder stones, and may be used on a routine basis in the sequential treatment of cholecystocholedocholithiasis.
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Pre-operative anaemia and the need for intra-operative transfusion have been associated with increased morbidity and mortality following cardiac and major non-cardiac surgery. Anaemia is highly prevalent in patients with severe chronic liver disease. Whether this correlates with an altered morbidity and mortality following liver transplant has not been established.
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Comparative Study
Fibrin glue versus staple mesh fixation in single-port laparoscopic totally extraperitoneal inguinal hernia repair: A propensity score-matched analysis.
Mesh fixation minimizes the risk of recurrence following laparoscopic inguinal hernia repair. Mesh fixation using staples has been implicated as a cause of chronic inguinal pain. We investigated whether fibrin glue mesh fixation reduces acute or chronic postoperative pain in patients undergoing single-port laparoscopic totally extraperitoneal inguinal hernia repair (SP TEP). ⋯ The short-term outcomes of SP TEP were comparable regardless of the mesh fixation method, but the immediate postoperative analgesia requirement was significantly less for those in the fibrin glue group. The time to resume ADLs was shorter for the fibrin glue group. Fibrin glue for mesh fixation during SP TEP may be an efficacious alternative to stapling during minimally invasive inguinal hernia repair.