Surgical endoscopy
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Review Meta Analysis Comparative Study
Lightweight versus heavyweight mesh in laparoscopic inguinal hernia repair: a meta-analysis.
Reinforcement of inguinal hernia repair with prosthetic mesh is standard practice but can cause considerable pain and stiffness around the groin and affect physical functioning. This has led to various types of mesh being engineered, with a growing interest in lighter-weight mesh. Minimally invasive approaches have also significantly reduced postoperative recovery from inguinal hernia repair. The aim of this systematic review was to compare the outcomes after laparoscopic inguinal repair using new lightweight or traditional heavyweight mesh in published randomised controlled trials. ⋯ Both mesh options appear to result in similar long- and short-term postoperative outcomes. Further long-term analysis may guide surgeon selection of mesh weight for laparoscopic inguinal hernia repair.
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Comparative Study
Robotic transaxillary endocrine surgery: a comparison with conventional open technique.
Robotic transaxillary (RT) endocrine surgery may improve cosmetic outcomes. We report our initial experience in RT thyroid and parathyroid surgery and the associated learning curve, and compare early surgical outcomes to those of open thyroidectomy (OT) and focal parathyroidectomy (FP). ⋯ RT thyroidectomy and parathyroidectomy can be performed safely by specialist endocrine surgeons, early in their learning curve, without an increased complication rate, albeit with significantly longer operating times.
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Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive procedure that proves burdensome to patients. Nevertheless, very little data are available on patient tolerance of this procedure that may improve practice guidelines and could aid in decreasing the burden of ERCP. This study therefore investigated the burden of ERCP performed with the patient under conscious sedation. ⋯ One-third to one-half of patients experience pain and discomfort during and immediately after ERCP when it is performed with conscious sedation for the patient. Other sedation strategies, such as the use of general anesthesia or propofol, may well reduce the burden of ERCP, particularly for patients with a higher EQ-5D score, younger age, or therapeutic ERCP treatment. However, randomized trials are warranted.
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The peer review process is the gold standard by which academic manuscripts are vetted for publication. However, some investigators have raised concerns regarding its unopposed supremacy, including lack of expediency, susceptibility to editorial bias and statistical limitation due to the small number of reviewers used. Post-publication review-in which the article is assessed by the general readership of the journal instead of a small group of appointed reviewers-could potentially supplement or replace the peer-review process. In this study, we created a computer model to compare the traditional peer-review process to that of post-publication reader review. ⋯ In a mathematical model of the peer review process, the accuracy of public reader-reviewers can surpass that of a small group of expert reviewers if the group of public reviewers is of sufficient size. Further study will be required to determine whether the mathematical assumptions of this model are valid in actual use.
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Randomized Controlled Trial
Ramosetron, dexamethasone, and their combination for the prevention of postoperative nausea and vomiting in women undergoing laparoscopic cholecystectomy.
In this randomized and controlled study, we evaluated the antiemetic efficacy of ramosetron combined with dexamethasone for postoperative nausea and vomiting (PONV) compared with that of dexamethasone or ramosetron alone in women who underwent laparoscopic cholecystectomy. ⋯ Antiemetic efficacy of the combination of ramosetron 0.3 mg and dexamethasone 8 mg for PONV was most superior, with 93% of the patients showing complete response at 12-24 h after surgery followed by ramosetron alone and dexamethasone alone.