International journal of surgery
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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
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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The aim of this study was to evaluate the clinical and radiologic results of multisegmental transforaminal enlarged decompression (TED) plus posterior pedicle screw fixation in the treatment of multilevel lumbar spinal canal stenosis (LSCS) with lumbar instability (MLSCSI). ⋯ Satisfactory clinical and radiological outcomes can be achieved with the use of multisegmental TED plus lumbar fusion for the treatment of MLSCSI. This technique can reduce surgically induced instability and obviously improve the symptoms and signs of the patients, suggesting a safe and effective therapeutic procedure for MLSCSI.
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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
Efficiency and safety of ketamine for pain relief after laparoscopic cholecystectomy: A meta-analysis from randomized controlled trials.
This meta-analysis aims to evaluate the effectiveness of intravenous infusion of ketamine for pain control after laparoscopic cholecystectomy (LC). ⋯ Intravenous ketamine infusion significantly reduced postoperative pain scores and opioid consumption after LC. In addition, there were fewer adverse effects in the ketamine groups. Higher quality RCTs are still required for further research.