Langenbeck's archives of surgery
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Langenbecks Arch Surg · Apr 2003
Randomized Controlled Trial Clinical TrialEffect of drainage on postoperative nausea, vomiting, and pain after laparoscopic cholecystectomy.
Laparoscopic cholecystectomy is associated with a high incidence of postoperative pain, nausea, and vomiting. Pneumoperitoneum created during the operation and residual gas after the operation are two of the factors in postoperative pain and nausea. We studied the effects of a subdiaphragmatic gas drain, which is intended to decrease the residual gas, on postoperative pain, nausea, and vomiting after laparoscopic cholecystectomy. ⋯ Subdiaphragmatic drain offers only minor, if any, benefit on postoperative pain, nausea, and vomiting after laparoscopic cholecystectomy, and this effect is probably clinically irrelevant.
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Langenbecks Arch Surg · Apr 2002
Randomized Controlled Trial Clinical TrialProphylactic nasal continuous positive airway pressure after major vascular surgery: results of a prospective randomized trial.
The efficacy of nasal continuous positive airway pressure (nCPAP) as a prophylactic method for preventing cardiopulmonary complications after major vascular surgery has not been investigated. ⋯ Prophylactic 12 h nCPAP significantly reduces the occurrence of postoperative oxygenation disturbances but has no effect on cardiac or pulmonary complications, need for intensive care, LOS or mortality after major vascular surgery.
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Langenbecks Arch Surg · Mar 2002
Randomized Controlled Trial Multicenter Study Clinical TrialEfficacy of oral UFT as adjuvant chemotherapy to curative resection of colorectal cancer: multicenter prospective randomized trial.
The purpose of this study is to evaluate the efficacy of postoperative adjuvant chemotherapy using uracil and tegafur (UFT) for colorectal cancer. ⋯ It is suggested that the consecutive administration of UFT at 400 mg/day was an effective and highly safe therapeutic method as postoperative adjuvant chemotherapy for rectal cancer.
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Langenbecks Arch Surg · Nov 2001
Randomized Controlled Trial Clinical TrialNasogastric tube versus gastrostomy tube for gastric decompression in abdominal surgery: a prospective, randomized trial comparing patients' tube-related inconvenience.
Perioperative decompression of the stomach is still a common procedure and can be achieved using either nasogastric tubes (NTs) or gastrostomy tubes (GTs). While both procedures appear to be equally effective, some authors believe that NTs are less convenient for patients than GTs. However, to date, no reliable prospective data are available on this issue. ⋯ This prospective randomized trial supports the clinical observation that NT causes more subjective inconvenience than GT. In cases when a prolonged postoperative ileus is expected, decisions for a prophylactic decompressing tube system have to weigh up the possibilities of different averse clinical as well as subjective outcomes. It is then preferable to include patients' preferences in the individual decision making process (shared-decision making).
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Langenbecks Arch Surg · Aug 2001
Randomized Controlled Trial Comparative Study Clinical TrialChanges in p(i)CO(2) reflect splanchnic mucosal ischaemia more reliably than changes in pH(i) during haemorrhagic shock.
Gastric tonometry is intended to reveal alterations in splanchnic perfusion and oxygenation. Based on the tonometric measurement of gastric mucosal partial pressure of carbon dioxide (pCO(2)) and the simultaneous determination of arterial blood gas parameters (bicarbonate concentration [HCO(3-)], pH and pCO(2)), several parameters can be calculated. ⋯ pH(i), pCO(2) gap and [H+] gap are considerably influenced by changes of systemic arterial blood gas values. This is demonstrated by lower P values of the corresponding arterial blood gas values in comparison with p(i)CO(2). Therefore pH(i), pCO(2) gap and [H+] gap seem to indicate more likely systemic changes, whereas p(i)CO(2) appears to reflect disturbances of regional gastric tissue perfusion and oxygenation more reliably than any other derived tonometric parameter.