Surgical laparoscopy, endoscopy & percutaneous techniques
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Surg Laparosc Endosc Percutan Tech · Feb 2013
Clinical outcomes of laparoscopy-assisted gastrectomy for patients with heart disease.
Laparoscopy-assisted gastrectomy (LG) is an established treatment for early gastric cancer. However, CO2 pneumoperitoneum during laparoscopic surgery can adversely affect cardiac function in the presence of heart disease (HD). We performed LG in 546 patients and conventional open gastrectomy (OG) in 448 patients. ⋯ Postoperative cardiac complications did not differ between the groups (8.3% vs. 13.6%, P = 0.51). The HD-LG group had significantly more cardiac and abdominal complications than the NR-LG group (P = 0.0011 and 0.0070, respectively). LG was tolerated in patients with gastric cancer and mild or moderate HD, similar to OG.
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Surg Laparosc Endosc Percutan Tech · Feb 2013
Randomized Controlled Trial Comparative StudyPostoperative pain after laparoscopic cholecystectomy: a randomized clinical trial comparing intraperitoneal bupivacaine versus intravenous pethidine.
Pain is the most common complaint of patients on the first day after laparoscopic cholecystectomy (LC). This clinical trial compared the effects of intraperitoneal (IP) bupivacaine and intravenous (IV) pethidine on this pain. Forty-eight patients who underwent LC were randomly assigned to 2 groups of IP bupivacaine and IV pethidine. ⋯ Patients who received IP bupivacaine showed a significantly lower pain score (P = 0.022) and improved peak expiratory flow rate (P = 0.006), and received lower doses of ibuprofen (P = 0.003) within the first 24 hours after surgery. Likewise, the presence of nausea/vomiting was significantly lower in bupivacaine groups 1 and 4 hours after surgery (P = 0.003 and 0.005, respectively). Our results indicate that IP instillation of bupivacaine is more beneficial than traditional IV pethidine for pain reduction after LC.
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Surg Laparosc Endosc Percutan Tech · Feb 2013
Outpatient laparoscopic appendectomy in children: a single center experience with 92 cases.
The purpose of this study was to present the possibility of laparoscopic appendectomy (LA) in children as an outpatient procedure. ⋯ We recommend that an LA can be performed safely as an outpatient procedure in children with uncomplicated appendicitis.
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Surg Laparosc Endosc Percutan Tech · Feb 2013
Review Meta Analysis Comparative StudyComparison of the efficacy of ondansetron and granisetron to prevent postoperative nausea and vomiting after laparoscopic cholecystectomy: a systematic review and meta-analysis.
Our purpose was to assess the prophylactic antiemetic effects of ondansetron versus granisetron for laparoscopic cholecystectomy. ⋯ Ondansetron is equivalent to granisetron for preventing early and total incidence of PONV after laparoscopic cholecystectomy.
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Surg Laparosc Endosc Percutan Tech · Feb 2013
Review Meta Analysis Comparative StudyLaparoscopy versus open distal gastrectomy for advanced gastric cancer: a systematic review and meta-analysis.
Laparoscopy-assisted distal gastrectomy (LADG) is one of the most accepted laparoscopic procedures in the field of gastric surgery. However, currently this procedure for the advanced gastric cancer (AGC) has still not reached the area of the popularization. The aim of this study was to compare laparoscopy with open distal gastrectomy in AGC patients using the meta-analytical techniques. ⋯ The oncologic outcomes of LADG for AGC patients were comparable with open approach. Although open distal gastrectomy may be associated with shorter operative time, patients undergoing laparoscopic approach may be benefitted from a shorter hospital stay and a faster resumption without translation into an increase in both postoperative morbidity and mortality. Nevertheless, further prospective, controlled studies, and extended follow-up are needed for a more comprehensive comparison between the 2 procedures.