ANZ journal of surgery
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ANZ journal of surgery · Jan 2015
Review Meta AnalysisEpidural versus local anaesthetic infiltration via wound catheters in open liver resection: a meta-analysis.
This meta-analysis was designed to systematically analyse all published studies comparing local anaesthetic infiltration with wound catheters and epidural catheters in open liver resection. ⋯ Local anaesthetic infiltration via wound catheters combined with patient-controlled opiate analgesia provides comparable pain relief to epidural catheters except for the first POD. Both techniques are associated with similar hospital stay and opioid use with wound catheters associated with lower complication rate.
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ANZ journal of surgery · Dec 2013
Review Meta AnalysisEffectiveness of massive transfusion protocols on mortality in trauma: a systematic review and meta-analysis.
The effectiveness of massive transfusion protocols (MTPs) has been assumed from low quality studies with multiple biases. This review aimed to (i) evaluate the association between the institution of an MTP and mortality and (ii) determine the effect of MTPs on transfusion practice post trauma. ⋯ Despite the popularity of MTPs and directives mandating their use in trauma centres, in before-after studies, MTPs have not always been associated with improved mortality. Evidence-based standardization of MTPs, improved compliance and analysis of broader endpoints were identified as areas for further research.
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ANZ journal of surgery · Oct 2013
Meta Analysis Comparative StudyMeta-analysis of intermittent Pringle manoeuvre versus no Pringle manoeuvre in elective liver surgery.
Intermittent Pringle manoeuvre (IPM) is frequently used during liver surgery. This meta-analysis aimed to review the impact on blood loss, operating time and morbidity and mortality with and without use of IPM. ⋯ There is no evidence that the routine use of IPM improves perioperative and post-operative outcomes compared to no Pringle manoeuvre and its routine may not be recommended.
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ANZ journal of surgery · Jan 2012
Meta Analysis Comparative StudyA meta-analysis comparing laparoscopic partial versus Nissen fundoplication.
For proven gastro-oesophageal reflux disease, partial fundoplication is considered as effective as Nissen, but with fewer side effects. The aim of this meta-analysis was to compare the effect of laparoscopic partial fundoplication (LPF) with laparoscopic Nissen fundoplication (LNF). ⋯ Both LPF and LNF are effective for the treatment of proven gastro-oesophageal reflux disease. LPF enables a decreased post-operative dysphagia and gas-related side effects, while LNF is more successful in controlling reflux symptoms, particularly heartburn, than LPF. A balance should be found between anti-reflux and side effects.
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ANZ journal of surgery · Sep 2009
Review Meta Analysis Comparative StudyLinezolid versus vancomycin for MRSA skin and soft tissue infections (systematic review and meta-analysis).
This review aims to compare the effectiveness of linezolid to vancomycin for the treatment of Methicillin Resistant Staphylococcus Aureus (MRSA) skin and soft tissue infections (SSTIs) in inpatients. ⋯ With the current available data no difference could be detected between the two treatments, but a trend towards higher effectiveness of linezolid was observed. More data will be required to determine if linezolid is superior to vancomycin for the treatment of MRSA SSTIs. Further systematic reviews are needed to look at other outcomes (length of hospital stay, safety and tolerability, cost-effectiveness) and at MRSA infections at other sites.