Surgical endoscopy
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Randomized Controlled Trial Clinical Trial
Gastrointestinal transit after laparoscopic versus open colonic resection.
Multimodal rehabilitation with epidural analgesia, early oral nutrition and mobilization, and laxative use has decreased the duration of ileus after colonic surgery to about 2 days, as compared with the usual 3 to 5 days of rehabilitation required after open surgery and the slightly shorter time required with laparoscopic surgery. Gastrointestinal transit after colonic resection with laparoscopy or laparotomy was assessed. ⋯ Postoperative ileus and gastrointestinal transit normalized within 48 h after colonic resection in the patients who received multimodal rehabilitation. No significant difference was observed between the patients who underwent the laparoscopic procedure and those who underwent the open procedure.
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Randomized Controlled Trial Comparative Study Clinical Trial
A prospective randomized study of prophylactic antibiotics in elective laparoscopic cholecystectomy.
Elective laparoscopic cholecystectomy (LC) has a low risk for infective complications, but many surgeons still use prophylactic antibiotics. The use of prophylactic antibiotics for LC is inconsistent and varies widely among surgeons. ⋯ In patients undergoing elective LC, antibiotic prophylaxis is justified only in high-risk patients. In all other patients, antibiotic prophylaxis does not seem to affect the incidence of postoperative infective complications. In low-risk patients, eliminating the unnecessary use of prophylactic antibiotics would result in a cost reduction; moreover, it would lower the risk of adverse reaction and reduce microbial resistance.
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Randomized Controlled Trial Comparative Study Clinical Trial
Two-port versus four-port laparoscopic cholecystectomy.
Two-port laparoscopic cholecystectomy has been reported to be safe and feasible. However, whether it offers any additional advantages remains controversial. This study reports a randomized trial that compared the clinical outcomes of two-port laparoscopic cholecystectomy versus conventional four-port laparoscopic cholecystectomy. ⋯ Two-port laparoscopic cholecystectomy resulted in less individual port-site pain and similar clinical outcomes but fewer surgical scars compared to four-port laparoscopic cholecystectomy. Thus, it can be recommended as a routine procedure in elective laparoscopic cholecystectomy.
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Randomized Controlled Trial Comparative Study Clinical Trial
T lymphocyte subsets and Th1/Th2 balance after laparoscopy-assisted distal gastrectomy.
Laparoscopic surgery provides for a less invasive procedure than open surgery in patients with gastric cancer, but the immune responses after laparoscopic surgery for early gastric cancer remain unknown. ⋯ When compared with ODG, LADG contributes to the preservation of postsurgical Th1 cell-mediated immune function.
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Randomized Controlled Trial Comparative Study Clinical Trial
Randomized controlled study of laparoscopic total extraperitoneal versus open Lichtenstein inguinal hernia repair.
Whereas open anterior inguinal herniorrhaphy is a time-tested, safe, and well-understood operation with a high success rate, laparoscopic techniques of inguinal hernia repair are fairly recent. Consequently, short- and long-term outcomes are still being evaluated. Few studies have compared laparoscopic extraperitoneal inguinal hernia repair with tension-free open hernia repair. The current study was conducted to compare complications, operative time, postoperative pain, length of hospital stay, and return to work between open tension-free mesh Lichtenstein (open) repair and laparoscopic total extraperitoneal (TEP) repair. ⋯ In terms of complications and short-term recurrence, TEP repair is comparable with open repair. Moreover, TEP is significantly less painful in the early postoperative period, leading to earlier ambulation than open repair. Additionally, TEP results in significantly earlier return to work and better cosmetic results. Currently, TEP seems to be a better alternative than the existing open repair, provided the long-term recurrence rates are comparable. Despite the fact that TEP was a new procedure for the surgeon and the study was conducted during the learning phase, the results are comparable with those in the world literature.