Surgical endoscopy
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Review Meta Analysis Comparative Study
Systematic review with meta-analysis of studies comparing single-incision laparoscopic colectomy and multiport laparoscopic colectomy.
There is currently a paucity of research comparing the clinical outcomes of single-incision laparoscopic colectomy (SILC) with those obtained with multiport laparoscopic colectomy (MLC). This meta-analysis aimed to examine whether SILC shows real benefits over MLC, especially in terms of feasibility, safety, and oncological adequacy. ⋯ SILC could be considered as a safe and feasible alternative to MLC in experienced hands. Further evidence for this surgical procedure should be assessed in the form of high-quality RCTs, with additional focus on its use in low rectal cancer resection.
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Randomized Controlled Trial
Prospective, randomized and controlled trial on magnesium sulfate administration during laparoscopic gastrectomy: effects on surgical space conditions and recovery profiles.
The degree of neuromuscular blockade is one of the important factors that determine the condition of surgical space during laparoscopic surgery. Magnesium sulfate potentiates the actions of neuromuscular blocking agent, and we hypothesized that intraoperative magnesium sulfate infusion may improve surgical space condition during laparoscopic surgery. ⋯ Intraoperative administration of magnesium sulfate improved the quality of surgical space conditions and decreased neuromuscular blocking agent requirement and postoperative pain in patients undergoing laparoscopic gastrectomy.
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Controlled Clinical Trial
Local wound infiltration plus transversus abdominis plane (TAP) block versus local wound infiltration in laparoscopic colorectal surgery and ERAS program.
Few data are available on TAP block in laparoscopic colorectal surgery and ERAS program. The aim of this prospective study was to evaluate local wound infiltration plus TAP block compared to local wound infiltration in the management of postoperative pain, nausea and vomiting, ileus and use of opioids in the context of laparoscopic colorectal surgery and ERAS program. ⋯ TAP block plus local wound infiltration in the setting of laparoscopic colorectal surgery and ERAS program guarantees a reduced use of opioid analgesics and good pain control allowing the improvement of essential items of enhanced recovery pathways.
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Randomized trials show similar outcomes after open surgery and laparoscopy for colon cancer, and confirmation of outcomes after implementation in routine practice is important. While some studies have reported long-term outcomes after laparoscopic surgery from single institutions, data from large patient cohorts are sparse. We investigated short- and long-term outcomes of laparoscopic and open surgery for treating colon cancer in a large national cohort. ⋯ Nationwide implementation of laparoscopic colectomy for colon cancer was safe and achieved results comparable to those from previous randomized trials.
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Randomized Controlled Trial
Etomidate plus propofol versus propofol alone for sedation during gastroscopy: a randomized prospective clinical trial.
Sedation with propofol alone during gastroscopy has many side effects. Etomidate has advantages in terms of circulation and respiration compared to propofol. We hypothesized that etomidate plus propofol during gastroscopy would be more safe and effective than propofol alone. ⋯ Etomidate plus propofol had few effects on respiration and circulation in patients undergoing gastroscopy and was more safe and effective than propofol alone.