Surgical laparoscopy, endoscopy & percutaneous techniques
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Surg Laparosc Endosc Percutan Tech · Jun 2013
Review Meta AnalysisSingle-access laparoscopic cholecystectomy versus classic laparoscopic cholecystectomy: a systematic review and meta-analysis of randomized controlled trials.
Single-incision laparoscopic surgery has been proposed as a minimally invasive technique with the advantages of fewer scars and reduced pain. The aim of this study was to perform a systematic review and meta-analysis of prospective randomized clinical trials of single-access laparoscopic cholecystectomy (SALC) versus classic laparoscopic cholecystectomy (CLC). ⋯ SALC required longer operative times than CLC without significant benefits in patient overall satisfaction, postoperative pain, and hospital stay. Only satisfaction with the cosmetic result showed a significantly higher preference towards SALC.
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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.
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Surg Laparosc Endosc Percutan Tech · Dec 2012
Review Meta AnalysisSingle-incision versus conventional laparoscopic cholecystectomy in patients with uncomplicated gallbladder disease: a meta-analysis.
Laparoscopic cholecystectomy is the gold standard treatment for cholecystectomy. Recently, single-incision laparoscopic cholecystectomy (SILC) has been suggested as an alternative technique. ⋯ The current evidence shows that patients with uncomplicated cholelithiasis or polypoid lesions of the gallbladder who prefer a better cosmetic outcome, SILC offers a safe alternative to CLC. Further high-powered randomized trials are need to determine whether SILC truly offer any advantages, especially be focused on failure of technique, adverse events, cosmesis, and quality of life.
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Surg Laparosc Endosc Percutan Tech · Dec 2012
Review Meta Analysis Comparative StudyLower recurrence rates after mesh-reinforced versus simple hiatal hernia repair: a meta-analysis of randomized trials.
Mesh hiatoplasty has been postulated to reduce recurrence rates, it is however prone to esophageal stricture, and early-term and mid-term dysphagia. The present meta-analysis was designed to compare the outcome between mesh-reinforced and primary hiatal hernia repair. The databases of Medline, EMBASE, and the Cochrane Library were searched; only randomized controlled trials entered the meta-analytical model. ⋯ Pooled analysis demonstrated increased risk of recurrence in primary hiatal closure (odds ratio, 4.2; 95% confidence interval, 1.8-9.5; P=0.001). Mesh-reinforced hiatal hernia repair is associated with an approximately 4-fold decreased risk of recurrence in comparison with simple repair. The long-term results of mesh-augmented hiatal closure remain to be investigated.