Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
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Robotic liver resection can overcome some of the limitations of laparoscopic liver surgery; therefore, it is a promising tool to increase the proportion of minimally invasive liver resections. The present article gives an overview of the current literature. Furthermore, the results of a nationwide survey on robotic liver surgery among hospitals in Germany with a DaVinci system used in general visceral surgery and the perioperative results of two German robotic centers are presented.
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Review Meta Analysis
[Survival, mortality and quality of life after pylorus-preserving or classical Whipple operation. A systematic review with meta-analysis].
Two surgical procedures are mainly performed for the treatment of pancreatic head cancer and periampullary carcinoma: the classical Whipple operation and the pylorus-preserving Whipple operation. ⋯ Mortality, survival and QoL were not significantly different between the classical Whipple and the pylorus-preserving Whipple operations. Given the poor quality of the underlying trials a pragmatic RCT is recommended to prove the findings of this systematic review.
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Meta Analysis Comparative Study
[Conventional and minimally invasive surgical methods for gastroesophageal reflux].
The introduction of minimally invasive techniques has had great influence on the indication and surgical therapy for gastroesophageal reflux disease. This analysis is an overview of the current evidence-based status and a critical reprisal of open and laparoscopic antireflux surgery. ⋯ The analysis of randomized trials showed an advantage for patients after laparoscopy for total and partial fundoplication because of reduced morbidity, shorter postoperative hospitalization due to faster recovery, and significantly fewer scar and wound problems. The functional results of open and laparoscopic techniques were similar. Five-year follow-up results for the latter showed effective reflux control in at least 85% of patients. Randomized trials regarding technical variations did not show an advantage for division of the short gastric vessel. A bougie for the cardia calibration can prevent postoperative dysphagia after fundoplication.
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Meta Analysis
[The displaced proximal humeral fracture: is there evidence for therapeutic concepts?].
There is no general agreement on the operative treatment of displaced proximal humeral fractures. While T-plate fixation was the method of choice until the end of the 1980s, minimally invasive techniques have been favoured during the past decade. The indication for primary shoulder prosthesis is controversial. The purpose of this report was to evaluate the scientific evidence of current treatment recommendations. ⋯ We conclude from our analysis that the scientific evidence for treatment recommendations of displaced proximal humeral fractures is still limited.