Surgery today
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Review Meta Analysis
Minimally invasive esophagectomy performed with the patient in a prone position: a systematic review.
We reviewed the surgical results of minimally invasive esophagectomy for esophageal cancer, performed with the patient in a prone position (MIE-PP), to assess its benefits. ⋯ Theoretically, the operative results of MIE-PP might be better than those of MIE-LP for patients with esophageal cancer; however, studies have not yet verified this. Further clinical studies are required to establish whether the advantages of MIE-PP can be translated into clinical outcome.
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We conducted this meta-analysis to establish whether pancreaticogastrostomy (PG) or pancreaticojejunostomy (PJ) is the better method of reconstruction for reducing the risk of postoperative pancreatic fistula (POPF). ⋯ This meta-analysis shows that PG is superior to PJ for reducing the incidence of POPF, but there were no differences in other complications or mortality. Therefore, it may be considered as an alternative to PJ and further RCTs are needed to prove our findings.
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Review Meta Analysis
Preoperative carbohydrate loading for elective surgery: a systematic review and meta-analysis.
It is unclear whether the preoperative administration of oral carbohydrates (CHO) is safe and effective, and therefore we herein evaluated the efficacy and adverse events associated with CHO for elective surgery. ⋯ CHO appears to be safe, and may attenuate postoperative insulin resistance as compared to placebo. However, the quality of most of the published trials has been poor, and the evidence levels for most outcomes were low, so rigorous and larger RCTs are needed in the future.
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Review Meta Analysis
Wound infection after a laparoscopic resection for colorectal cancer.
The aim of this study was to investigate whether the wound infection (WI) rate in laparoscopic surgery (LS) for colorectal cancer is lower than that in open surgery (OS), and to evaluate the influence of perioperative intravenous antibiotic prophylaxis on the development of WI in LS. ⋯ Laparoscopic surgery for colorectal cancer is considered a surgical technique that has a lower incidence of WI in comparison to OS. Well-designed prospective, randomized controlled trials should therefore be conducted to evaluate whether intraoperative repeated dosing or postoperative repeated dosing is effective in reducing WI in LS.
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Meta Analysis Comparative Study
Early versus delayed cholecystectomy for acute cholecystitis: a meta-analysis of randomized controlled trials.
We performed a meta-analysis of randomized controlled trials to determine the optimal timing of laparoscopic cholecystectomy and open cholecystectomy for acute cholecystitis. ⋯ There is no advantage to delaying cholecystectomy for acute cholecystitis on the basis of outcomes in mortality, morbidity, rate of conversion to open surgery, and mean hospital stay. Thus, early cholecystectomy should be performed for patients with acute cholecystitis.