Surgery
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The rationale for total pancreatectomy in painful, treatment refractory, chronic pancreatitis is pain control. Concomitant islet cell autotransplantation can prevent the loss of islet cell function. This study aimed to systematically examine the impact of total pancreatectomy with islet cell autotransplantation on pain and quality of life. ⋯ In selected patients with painful, treatment refractory, chronic pancreatitis, evidence shows that total pancreatectomy with islet cell autotransplantation is effective for pain control in almost two-thirds of patients, whereas the insulin-free rate is relatively low.
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Review Meta Analysis Comparative Study
Comparison of self-gripping mesh and sutured mesh in open inguinal hernia repair: A meta-analysis of long-term results.
Complications after inguinal hernioplasty pose a significant burden on individual patients and society because of high numbers of repair procedures. Recently, the long-term results of a self-gripping ProGrip mesh for open inguinal hernia repair have become available. The aim of this meta-analyses was to compare these long-term results with the results of a Lichtenstein hernioplasty with a sutured mesh focusing on chronic pain, recurrence rate, foreign body sensation, and operation duration. ⋯ The self-gripping mesh has comparable results with a sutured mesh regarding the incidence of chronic postoperative inguinal pain, recurrence and foreign body sensation. However, long-term results still are based on relatively small patient numbers and outcomes measures are heterogenic. The main advantage of the self-gripping mesh is the consistently significantly reduced operation time.
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Review Meta Analysis Comparative Study
Self-gripping versus sutured mesh fixation methods for open inguinal hernia repair: A systematic review of clinical trials and observational studies.
We performed this systematic review and meta-analysis to compare the outcomes of Lichenstein hernia repair using either self-gripping mesh or techniques of sutured mesh fixation. ⋯ Data from our analysis did not favor either of the two fixation techniques over the other in terms of recurrence or postoperative chronic groin pain. Decreased operative time in the self-gripping mesh group cannot justify a recommendation for its routine use. Longer follow-up studies are needed to compare the risk of long-term recurrence for both meshes.
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Review Meta Analysis
Does prophylactic mesh placement in elective, midline laparotomy reduce the incidence of incisional hernia? A systematic review and meta-analysis.
Operative intervention to correct incisional hernia affects 150,000 patients annually, with 1 in 3 repairs recurring within 9 years. The aim of this study was to compare the incidence of incisional hernia and postoperative complications in elective midline laparotomy patients after the use of prophylactic mesh placement and primary suture closure. ⋯ Prophylactic mesh placement is associated with an 85% postoperative incisional hernia risk reduction when compared to primary suture closure in at-risk patients undergoing elective, midline laparotomy closure. This technique appears to be safe with comparable complication profiles, barring an increased risk of seroma, especially with the onlay technique, and the possibility for an increased risk of chronic pain. Despite this verification, evidence from large domestic trials that sufficiently addresses major knowledge gaps is simply lacking.
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Review Meta Analysis Comparative Study
The ability of prehabilitation to influence postoperative outcome after intra-abdominal operation: A systematic review and meta-analysis.
Preoperative physical fitness is predictive of postoperative outcome. Patients with lesser aerobic capacity are at greater risk of postoperative complications, longer hospital stays, and mortality. Prehabilitation may improve physical fitness, but it is unknown whether enhanced fitness translates to an improvement in postoperative outcome. ⋯ Prehabilitation appears to be beneficial in decreasing the incidence of postoperative complications; however, more high-quality studies are needed to validate its use in the preoperative setting.