Surgical laparoscopy, endoscopy & percutaneous techniques
-
Surg Laparosc Endosc Percutan Tech · Jun 2017
Review Meta AnalysisSystematic Review and Meta-Analysis of Perioperative Outcomes of Peroral Endoscopic Myotomy (POEM) and Laparoscopic Heller Myotomy (LHM) for Achalasia.
Laparoscopic Heller myotomy (LHM) is the preferred surgical method for treating achalasia. However, peroral endoscopic myotomy (POEM) is providing good short-term results. The objective of this systematic review and meta-analysis was to compare the safety and efficacy of LHM and POEM. ⋯ POEM compares favorably to LHM for achalasia treatment in short-term perioperative outcomes. However, there was a significantly higher clinical treatment failure rate for LHM on short-term postoperative follow-up. Presently long-term postoperative follow-up data for POEM beyond 1 year are unavailable and eagerly awaited.
-
Surg Laparosc Endosc Percutan Tech · Feb 2017
Review Meta Analysis Comparative StudyThe Comparison of Etomidate and Propofol Anesthesia in Patients Undergoing Gastrointestinal Endoscopy: A Systematic Review and Meta-Analysis.
Etomidate and propofol played an important role in the sedation of patients undergoing gastrointestinal endoscopy. We conducted a systematic review and meta-analysis to compare their efficacy and safety. ⋯ Between etomidate and propofol, no significant difference was revealed regarding anesthesia duration, recovery time, mean arterial pressure at intubation, heart pulse at intubation, SPO2 at intubation, patient satisfaction, hypotension, changes of heart rate and nausea-vomiting. Compared with propofol, etomidate showed reduced apnea or hyoxemia, and injection pain, but with an increased myoclonus.
-
Surg Laparosc Endosc Percutan Tech · Apr 2016
Review Meta AnalysisLimited Evidence for Robot-assisted Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
To evaluate available evidence on robot-assisted surgery compared with open and laparoscopic surgery. ⋯ At this point there is not enough evidence to support the significantly higher costs with the implementation of robot-assisted surgery.
-
Surg Laparosc Endosc Percutan Tech · Apr 2016
Review Meta AnalysisLimited Evidence for Robot-assisted Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
To evaluate available evidence on robot-assisted surgery compared with open and laparoscopic surgery. ⋯ At this point there is not enough evidence to support the significantly higher costs with the implementation of robot-assisted surgery.
-
Surg Laparosc Endosc Percutan Tech · Aug 2015
ReviewMuscle Relaxation in Laparoscopic Surgery: What is the Evidence for Improved Operating Conditions and Patient Outcome? A Brief Review of the Literature.
When neuromuscular blocking agents (NMBA) were introduced into clinical practice in 1942, the event was called the "second revolution in anesthesia." Despite some significant side effects, NMBAs have remained in the anesthetists' repertoire, not at least because muscle relaxation has been claimed to allow or facilitate many surgical procedures. Aim of this literature review was to investigate the evidence for the use of NMBA as well as the optimum depth of neuromuscular blockade during laparoscopic surgery. ⋯ However, the decision to utilize deeper than standard muscle relaxation should currently be based on a risk-benefit analysis for each individual patient. Thus good communication between surgeon and anesthetist remains crucial to achieve best outcomes.