共查询到20条相似文献,搜索用时 31 毫秒
1.
Amanda Pinter Carvalheiro da SILVA Valdir TERCIOTI-JUNIOR Luiz Roberto LOPES Jo?o de Souza COELHO-NETO Laura BERTANHA Paulo Rodrigo de Faria RODRIGUES Nelson Adami ANDREOLLO 《Brazilian archives of digestive surgery》2014,27(2):92-95
Background
Asthma, laryngitis and chronic cough are atypical symptoms of the gastroesophageal reflux disease.Aim
To analyze the efficacy of laparoscopic surgery in the remission of extra-esophageal symptoms in patients with gastroesophageal reflux, related to asthma.Methods
Were reviewed the medical records of 400 patients with gastroesophageal reflux disease submitted to laparoscopic Nissen fundoplication from 1994 to 2006, and identified 30 patients with extra-esophageal symptoms related to asthma. The variables considered were: gender, age, gastroesophageal symptoms (heartburn, acid reflux and dysphagia), time of reflux disease, treatment with proton pump inhibitor, use of specific medications, treatment and evolution, number of attacks and degree of esophagitis. Data were subjected to statistical analysis, comparing the pre- and post-surgical findings.Results
The comparative analysis before surgery (T1) and six months after surgery (T2) showed a significant reduction on heartburn and reflux symptoms. Apart from that, there was a significant difference between the patients with daily crises of asthma (T1 versus T2, 45.83% to 16.67%, p=0.0002) and continuous crises (T1, 41.67% versus T2, 8.33%, p=0.0002).Conclusion
Laparoscopic Nissen fundoplication was effective in improving symptoms that are typical of reflux disease and clinical manifestations of asthma. 相似文献2.
Tahir Qayyum Jennifer M. Willder Paul G. Horgan Joanne Edwards Mark A. Underwood 《Current Urology》2013,7(1):24-27
Aims
To evaluate whether the number of biopsies performed via transrectal ultrasound (TRUS) accurately predicts pathological parameters such as Gleason sum, prostatic intraepithelial neoplasia and perineural invasion of the final prostatectomy specimen.Materials and Methods
The cohort consisted of 99 patients whom had undergone radical prostatectomy. Comparisons were made between the number of biopsies utilised and the presence of the pathological parameters from tissue at time of diagnosis and tissue from the final prostatectomy.Results
A significant difference was noted between Gleason sum, prostatic intraepithelial neoplasia and perineural invasion from tissue at time of diagnosis irrespective of the number of biopsies utilised and tissue from the radical specimen (p < 0.001, p < 0.001, p < 0.001 respectively). No difference was noted in the mean Gleason sum when 11-14 biopsies were utilised at TRUS and the Gleason sum from the radical specimen.Conclusion
We have demonstrated that the number of biopsies utilised at time of TRUS for diagnosis predicts the accuracy of pathological parameters in the final radical prostatectomy specimen. We believe that 11-14 biopsies should be utilised at time of TRUS as this allows a higher accuracy in the Gleason sum and therefore allows optimum treatment plans to be devised.Key Words: Radical prostatectomy, Prostate cancer, Transrectal ultrasound biopsy 相似文献3.
Aaron M. Bernie Arthur A. Caire Sarah P. Conley Mathew Oommen Ugur Boylu Raju Thomas Benjamin R. Lee 《JSLS, Journal of the Society of Laparoendoscopic Surgeons》2010,14(4):520-524
Background and Objectives:
Our goal was to evaluate posterior reconstruction of the rhabdosphincter during robot-assisted radical prostatectomy and determine whether this technique decreased anastomotic time of a surgeon in training to perform vesicourethral reconstruction.Methods:
We reviewed the first 25 robot-assisted prostatectomies performed by 2 urology surgeons in training (surgeon 1 and surgeon 2). The patient populations were matched for age, Gleason score, clinical stage, and PSA. Whereas surgeon 1 performed the vesicourethral anastomosis without posterior reconstruction, surgeon 2 reapproximated Denonvilliers'' fascia of the posterior bladder to the rhabdosphincter. Time for each surgeon to complete the anastomosis and clinical factors was compared.Results:
Surgeon 1 had a median anastomosis time of 25 minutes (range, 17 to 48), whereas surgeon 2 had a median anastomosis time of 15 minutes (range, 10 to 30) (P<0.001). Biopsy Gleason score, pathological tumor stage, perineural invasion, median age at the time of surgery, PSA, prostate weight, and estimated blood loss were not significantly different between surgeons (P>0.05). Pathological Gleason score (P=0.045) and total console time (surgeon 1=216 minutes, surgeon 2=176 minutes; P=0.002) were significantly different between surgeons.Conclusion:
Posterior reconstruction prior to anastomosis decreases anastomosis time for robotic surgeons in training. 相似文献4.
Renan Kleber Costa TEIXEIRA Vitor Nagai YAMAKI Ruy Victor Sim?es PONTES Marcus Vinicius Henriques BRITO José Antonio Cordero da SILVA 《Brazilian archives of digestive surgery》2015,28(4):247-249
Background:
The instructions to authors are the only means of communication between researchers and the editorial standards of a scientific journal. One of the mandatory items to be contained therein is about the ethical part, to prevent new research to carry out abuses with the enrolled on the research are published and stimulated.Aim:
To verify the ethical questions on the guidelines of Brazilian surgical journalsMethod:
Thirteen selected journals were divided into two groups: general surgery (n=3), and surgical specialty (n=10). The instructions to authors were analyzed by the quote of ethical requirements based on a specific research protocol, ranging from zero to six points.Results:
The average score of the general surgery group was similar than that of the surgical specialty group (3.66±0.57 vs 3.30±1.15, p=0.6154). When each ethical requirement was compared between the groups, there was no significant difference between the ethical requirements (p<0.05).Conclusion:
There was respect for most ethical questions evaluated, with no difference between the journals of general or specialty surgery. 相似文献5.
João Paulo Lemos da Silveira Santos Carla Jorge Machado Eduardo Paulino Junior João Bernardo Sancio Rocha Rodrigues Paula Teixeira Vidigal Vivian Resende 《Journal of gastrointestinal surgery》2018,22(7):1171-1178
Objectives
To investigate immunohistochemical predictors for intestinal and pancreatobiliary types of adenocarcinoma of ampulla of Vater and identify clinicopathological characteristics associated with the histological types and patient survival.Methods
Immunohistochemical markers included MUC1, MUC2, MUC5AC, CDX2, CK7, and CK20. The data were analyzed by univariate and multivariate methods. The two-step cluster method was used to determine the best immunohistochemical markers to discriminate the intestinal from the pancreatobiliary type.Results
This study identified 9 (33.3%) intestinal and 21 (66.7%) pancreatobiliary tumors. CK7 and CDX2 achieved the highest value (=?1) as predictor markers, while CK20, MUC1, and MUC2 showed degrees of importance equal to 0.77, 0.71, and 0.68, respectively. MUC5AC did not reach 0.50 of importance. In the univariate analysis, lymph node involvement, staging (TNM), and angiolymphatic and perineural invasions were associated with histological types. The independent clinicopathological variable in the multivariate model to predict the histological type was angiolymphatic invasion (p?=?0.005), OR?=?17 (95% CI 2.33 to 123.83). The final model showed positive nodes (N1) associated with shorter survival (HR?=?9.5; p?=?0.006). Overall survival at 12, 36, and 60 months was 88.5, 67.0, and 47.6%, respectively.Conclusions
CDX2 and CK7 were the immunohistochemical markers that best discriminated the intestinal from the pancreatobiliary type. Lymph node involvement had a high impact on survival and proved to be more frequent in the pancreatobiliary type.6.
Sergio Renato PAIS-COSTA José Francisco de Matos FARAH Ricardo ARTIGIANI-NETO Sandro José MARTINS Alberto GOLDENBERG 《Brazilian archives of digestive surgery》2014,27(2):126-132
Background
Gallbladder carcinoma presents a dismal prognosis. Choice treatment is surgical resection that is associated a high levels of both morbidity and mortality. Best knowledgement of prognostic factors may result a better selection of patients either for surgical or multimodal treatment.Aim
To evaluate tecidual immunoexpression of P53, E-cadherin, Cox-2, and EGFR proteins and to correlate these findings with resected gallbladder adenocarcinoma survival.Methods
Clinical, laboratorial, surgical, and anatomopathological reports of a series of gallbladder adenocarcinoma patients were collected by individualized questionary. Total sample was 42 patients. Median of age was 72 years (35-87). There were seven men and 35 women. Lesion distribuition in according TNM state was the following: T1 (n=2), T2 (n=5), T3 (n=31), T4 (n=4). Twenty-three patients underwent radical resection (R0), while 19 palliative surgery (R1-R2). A block of tissue microarray with neoplasic tissue of each patient was confected. It was performed evaluation of P53, E-Caderine, COX-2, and EGFR proteins imunoexpression. These findings were correlated with overall survival.Results
Five-year survival was 28%. The median of global survival was eight months. Only immunoexpression of EGFR protein was considered independent variable at multivariated analysis.Conclusion
Final prognosis was influenced by over-expression of EGFR protein in tumoral tissue. 相似文献7.
Ascêncio Garcia LOPES-JUNIOR Vanessa BELEBECHA Carlos Eduardo JACOB 《Brazilian archives of digestive surgery》2014,27(1):47-52
Background
Hepatic resection has evolved to become safer, thereby making it possible to expand the indications.Aim
To assess the results from a group of patients presenting these expanded indications.Method
Were prospectively studied all the hepatectomy procedures performed for hepatic tumor resection. Patients with benign and malignant primary and secondary tumors were included. Were included variables such as age, gender, preoperative diagnosis, preoperative treatment, type of operation performed, need for transfusion, final anatomopathological examination and postoperative evolution. The patients were divided into two groups: group A, with a traditional indication for hepatectomy; and group B, with an expanded indication (tumors in both hepatic lobes, extensive resection encompassing five or more segments, cirrhotic livers and postoperative chemotherapy using hepatotoxic drugs).Results
Were operated 38 patients, and 40 hepatectomies were performed: 28 patients in group A and 10 in group B. The mean age was 57.7 years, and 25 patients were women. Three in group B were operated as two separate procedures. Groups A and B received means of 1.46 and 5.5 packed red blood cell units per operation, respectively. There were three cases with complications in group A (10.7%) and six in group B (60%). The mortality rate in group A was 3.5% (one patient) and in groups B, 40% (four patients). The imaging examinations were sensitive for the presence of tumors but not for defining the type of tumor. The blood and derivative transfusion rates, morbidity and mortality were greater in the group with expanded indications and more extensive surgery.Conclusion
The indications for liver biopsy and portal vein embolization or ligature can be expanded, with special need of cooperation of the anesthesiology department and the use of hepatic resection devices to diminish blood transfusion. 相似文献8.
Francisco Santaolalla Cosme Ere?o Agustin Martínez Ana Sánchez del Rey Aitor Zabala 《Breast care (Basel, Switzerland)》2009,4(3):192-194
Summary
Background
Metastatic tumors account for less than 1% of all malignant tumors occurring in the oral cavity.Case Report
The clinical case of a 94-year-old patient with a mandibular tumor is reported here. The patient had undergone bilateral mastectomy more than 25 years before. An immunohistochemical study found hormone receptors in signet ring cells, suggesting a diagnosis of breast cancer metastasis.Conclusion
Immunohistochemical diagnosis and antineoplastic hormone therapy is the cornerstone in the management of this clinical case.Key Words: Mandible, Metastasis, Breast cancer, Signet ring cells 相似文献9.
Soraya Souto da SILVA Gerson Suguiyama NAKAJIMA Ricardo Alexandre GUIMAR?ES Flávia da Costa MOUR?O 《Brazilian archives of digestive surgery》2015,28(4):255-257
Background:
Many researchers studied human Papillomavirus infection in the anal area supposing it represents a risk factor for precursor lesions of anal cancer.Aim:
To study the association between histological findings suggestive of injury by the virus in hemorrhoidectomy specimens.Method:
Prevalence study was carried out based on histopathological analysis of hemorrhoidectomy specimens to find viral cytopathic effects. These findings were compared with anal condyloma acuminata that had no relationship with hemorrhoidectomy for microscopic comparison.Results:
Of the 91 hemorroidectomies analyzed, eight had findings suggestive of viral cytopathic effects, with the presence of irregular acanthosis in 63%, koilocytes in 50% and other indirect viral cytopathic effects, such as hyperkeratosis (38%), parakeratosis (25% ) and papillomatosis (13%).Conclusion:
This study was unable to conclude that there is an association between these two pathologic entities. 相似文献10.
Background:
The lactate is a product of anaerobic metabolism; it can be used as a marker on demand and availability of oxygen. Changes in lactate levels can be effectively used as a marker in resuscitation maneuvers, even in patients with stable vital signs.Aim:
To verify the lactate clearance as a predictor of mortality in trauma patients, in need of intensive care.Method:
A total of 851 patients were admitted in ICU, in which 146 were victims of multiple trauma; due to the exclusion criteria, were included 117.Results:
Patients were 87% male, mean age 32.4 years, motorcycle drivers, Glasgow coma scale between 3-8, affected by cranial trauma, followed by abdominal trauma. Was verified mortality up to 48 h and global mortality, that did not show statistical relationship between lactate clearance and mortality (p=0.928).Conclusion:
There is no correlation between admission lactate or lactate clearance and mortality in patients treated with multiple trauma. 相似文献11.
Croider Franco LACERDA Paulo Anderson BERTULUCCI Ant?nio Talvane Torres de OLIVEIRA 《Brazilian archives of digestive surgery》2014,27(3):191-195
Background
Despite the increasing number of laparoscopic hepatectomy, there is little published experience.Aim
To evaluate the results of a series of hepatectomy completely done with laparoscopic approach.Methods
This is a retrospective study of 61 laparoscopic liver resections. Were studied conversion to open technique; mean age; gender, mortality; complications; type of hepatectomy; surgical techniques applied; and simultaneous operations.Results
The conversion to open technique was necessary in one case (1.6%). The mean age was 54.7 years (17-84), 34 were men. Three patients (4.9%) had complications. One died postoperatively (mortality 1.6%) and no deaths occurred intraoperatively. The most frequent type was right hepatectomy (37.7%), followed by bisegmentectomy (segments II-III and VI-VII). Were not used hemi-Pringle maneuvers or assisted technic. Six patients (8.1%) underwent simultaneous procedures (hepatectomy and colectomy).Conclusion
Laparoscopic hepatectomy is feasible procedure and can be considered the gold standard for various conditions requiring liver resections for both benign to malignant diseases. 相似文献12.
Klaus STEINBRüCK Jefferson ALVES Reinaldo FERNANDES Marcelo ENNE Lúcio Filgueiras PACHECO-MOREIRA 《Brazilian archives of digestive surgery》2014,27(3):204-205
Background
Portal vein embolization is an accepted procedure that provides hypertrophy of the future remnant liver in order to reduce post-hepatectomy complications.Aim
To present a series submitted to portal vein embolization using an adapted hysterosalpingography catheter via transileocolic route.Methods
Were performed right portal branch embolization in 19 patients using hysterosalpingography catheter. For embolizing the vessel, was used Gelfoam® powder with absolute alcohol solution. Indications for hepatectomy were colorectal liver metastases in all cases.Results
An adequate growth of the future remnant liver was achieved in 15 patients (78.9%) and second time hepatectomy could be done in 14 (73.7%). In one patient (5.2%), tumor progression prevented surgery. One patient presented acute renal failure after portal embolization.Conclusions
The hysterosalpingography catheter is easy to handle and can be introduced into the portal vein with a wire guide. There were no major post-embolization complication. Its use is safe, cheap and effective. 相似文献13.
Naruna Pereira ROCHA Renata Costa FORTES 《Brazilian archives of digestive surgery》2015,28(3):193-196
Background:
Early detection of changes in nutritional status is important for a better approach to the surgical patient. There are several nutritional measures in clinical practice, but there is not a complete method for determining the nutritional status, so, health professionals should only choose the best method to use.Aim:
To evaluate the total lymphocyte count and albumin as predictors of identification of nutritional risk in surgical patients.Methods:
Prospective longitudinal study was conducted with 69 patients undergoing surgery of the gastrointestinal tract. The assessment of nutritional status was evaluated by objective methods (anthropometry and biochemical tests) and subjective methods (subjective global assessment).Results:
All parameters used in the nutritional assessment detected a high prevalence of malnutrition, with the exception of BMI which detected only 7.2% (n=5). The albumin (p=0.01), the total lymphocytes count (p=0.02), the percentage of adequacy of skinfolds (p<0.002) and the subjective global assessment (p<0.001) proved to be useful as predictors of risk of postoperative complications, since the smaller the values of albumin and lymphocyte count and higher the score the subjective global assessment were higher risks of surgical complications.Conclusions:
A high prevalence of malnutrition was found, except for BMI. The use of albumin and total lymphocyte count were good predictor for the risk of postoperative complications and when used with other methods of assessing the nutritional status, such as the subjective global assessment and the percentage of adequacy of skinfolds, can be useful for identification of nutritional risk and postoperative complications. 相似文献14.
Stella Roushias Nikhil Vasdev Bhaskar Ganai Sebastian Mafeld David Rix David Thomas Naeem Soomro 《Current Urology》2013,7(2):90-97
Aim
We evaluate whether the preoperative R.E.N.A.L Nephrometry Score (RNS) can predict the postoperative outcomes in patients undergoing either an open or laparoscopic partial nephrectomy.Patients and Methods
We retrospectively calculated the RNS of 128 patients who underwent either an open partial nephrectomy (OPN) (n = 38) or laparoscopic partial nephrectomy (LPN) (n = 90) between 2003 and 2011. Patients were categorized into low, moderate or high complexity groups based on RNSs. Intra-operative warm ischemic time (WIT), peri-operative surgical outcomes using the Clavien-Dindo classification, postoperative histology, positive surgical margin rates were correlated to the RNS.Results
The RNS was associated with the length of the WIT in OPN (low vs. moderate vs. high: 11.4 vs. 13.1 vs. 23.4 minutes, p = 0.025) and blood loss in LPN (low vs. moderate 319 vs. 498 ml, p = 0.009). The positive surgical margins were greater in high versus moderate RNS lesions (40 vs. 7.4%, p = 0.045). No differences were seen in complications, hospital stay or transfusion rates. The RNS was significantly higher in OPN versus LPN (7.45 vs. 6.2, p = 0.0002).Conclusion
An Increasing RNS was associated with increased WIT in OPN and blood loss in LPN, supporting RNS relationship to tumor complexity. A higher RNS in OPN indicate it may corroborate procedure choice. RNS should allow comparisons between treatment modalities for similar complexity lesions and with further research could aid stratification of individual risk preoperatively.Key Words: Partial nephrectomy, RENAL score 相似文献15.
Dimitrios A. Linos Vassilios Spiridon C. Avlonitis Kosmas Iliadis 《JSLS, Journal of the Society of Laparoendoscopic Surgeons》1998,2(3):291-293
Background and Objectives:
Patients with adrenal metastases from bronchogenic carcinoma are considered incurable and any surgical treatment is usually excluded. A review of the few cases of adrenalectomy for metastases from lung cancer that have been reported in the literature shows that good results can be achieved in selected patients. We propose a laparoscopic approach to perform the adrenalectomy in these patients.Methods:
A right laparoscopic adrenalectomy for metastasis from lung adenocarcinoma was performed. The right adrenal was resected using the anterior transperitoneal laparoscopic approach.Results:
The tumor was resected in total. The operating time was two hours. One year after surgery the patient remains well.Conclusions:
The current indications for laparoscopic adrenalectomy can include the removal of small metastatic adrenal lesions in selected cases. 相似文献16.
Antonio Moreira MENDES-FILHO Joaquim Prado Pinto MORAES-FILHO Ary NASI Jaime Natan EISIG Tomas Navarro RODRIGUES Ricardo Correa BARBUTTI Josemberg Marins CAMPOS Décio CHINZON 《Brazilian archives of digestive surgery》2014,27(1):3-8
Background
Gastroesophageal reflux disease is a worldwide prevalent condition that exhibits a large variety of signs and symptoms of esophageal or extra-esophageal nature and can be related to the esophagic adenocarcinoma. In the last few years, greater importance has been given to the influence of physical exercises on it. Some recent investigations, though showing conflicting results, point to an exacerbation of gastroesophageal reflux during physical exercises.Aim
To evaluate the influence of physical activities in patients presenting with erosive and non erosive disease by ergometric stress testing and influence of the lower esophageal sphincter tonus and body mass index during this situation.Methods
Twenty-nine patients with erosive disease (group I) and 10 patients with non-erosive disease (group II) were prospectively evaluated. All the patients were submitted to clinical evaluation, followed by upper digestive endoscopy, manometry and 24 h esophageal pH monitoring. An ergometric testing was performed 1 h before removing the esophageal pH probe. During the ergometric stress testing, the following variables were analyzed: test efficacy, maximum oxygen uptake, acid reflux duration, gastroesophageal reflux symptoms, influence of the lower esophageal sphincter tonus and influence of body mass index in the occurrence of gastroesophageal reflux during these physical stress.Results
Maximum oxigen consumption or VO 2 max, showed significant correlation when it was 70% or higher only in the erosive disease group, evaluating the patients with or without acid reflux during the ergometric testing (p=0,032). The other considered variables didn''t show significant correlations between gastroesophageal reflux and physical activity (p>0,05).Conclusions
1) Highly intensive physical activity can predispose the occurrence of gastroesophageal reflux episodes in gastroesophageal reflux disease patients with erosive disease; 2) light or short sessions of physical activity have no influence on reflux, regardless of body mass index; 3) the lower esophageal sphincter tonus does not influence the occurrence of reflux disease episodes during exercise testing. 相似文献17.
Yu Okazawa Rina Takahashi Kosuke Mizukoshi Kazuhiro Takehara Shun Ishiyama Kiichi Sugimoto Makoto Takahashi Yutaka Kojima Michitoshi Goto Atsushi Okuzawa Yuichi Tomiki Takashi Yao Kazuhiro Sakamoto 《International journal of surgery case reports》2014,5(12):979-983
INTRODUCTION
Malignant transformation of intestinal endometriosis occurring in the extraovarian sites is extremely rare. We report a very rare case of clear cell adenocarcinoma arising from endometriosis of the rectum.PRESENTATION OF CASE
An 83-year-old woman was admitted with the complaint of hematochezia. Colonoscopy revealed a tumor around about half of the rectal circumference. Biopsy of the tumor revealed a well-differentiated adenocarcinoma. Low anterior resection was undergone laparoscopically under the diagnosis of rectal carcinoma. Histopathological examination revealed clear cell adenocarcinoma, invading the sub-serosa of the rectum, but no metastasis of the lymph nodes. Immunohistochemical staining showed strong positivity for cytokeratin 7, but no staining for cytokeratin 20 and CDX2. The tumor existed adjacent to the endometrial glands, which were stained positive for Estrogen receptor. Ultimately, the patient was diagnosed with clear cell adenocarcinoma arising from endometriosis. Eighteen months after surgery, there are no signs of tumor recurrence.DISCUSSION
Clear cell adenocarcinoma arising from intestinal endometriosis has been reported in 7 cases, including our case. Careful observation is required because the prognosis of endometriosis after malignant transformation remains poor.CONCLUSION
We report a very rare case of clear cell adenocarcinoma arising from endometriosis of the rectum treated by laparoscopic surgery. 相似文献18.
《Brazilian archives of digestive surgery》2015,28(4):222-230
Background
: Liver metastases of colorectal cancer are frequent and potentially fatal event in the evolution of patients with these tumors.Aim
: In this module, was contextualized the clinical situations and parameterized epidemiological data and results of the various treatment modalities established.Method:
Was realized deep discussion on detecting and staging metastatic colorectal cancer, as well as employment of imaging methods in the evaluation of response to instituted systemic therapy.Results
: The next step was based on the definition of which patients would have their metastases considered resectable and how to expand the amount of patients elegible for modalities with curative intent.Conclusion
: Were presented clinical, pathological and molecular prognostic factors, validated to be taken into account in clinical practice. 相似文献19.
Paula Marcela Vilela CASTRO Denise AKERMAN Carolina Brito MUNHOZ Iara do SACRAMENTO M?nica MAZZURANA Guines Antunes ALVAREZ 《Brazilian archives of digestive surgery》2014,27(2):148-153
Introduction
A introdução da técnica laparoscópica em 1985 foi um fator importante na colecistectomia por representar técnica menos invasiva, resultado estético melhor e menor risco cirúrgico comparado ao procedimento laparotômico.Aim
To compare laparoscopic and minilaparotomy cholecystectomy in the treatment of cholelithiasis.Methods
A systematic review of randomized clinical trials, which included studies from four databases (Medline, Embase, Cochrane and Lilacs) was performed. The keywords used were "Cholecystectomy", "Cholecystectomy, Laparoscopic" and "Laparotomy". The methodological quality of primary studies was assessed by the Grade system.Results
Ten randomized controlled trials were included, totaling 2043 patients, 1020 in Laparoscopy group and 1023 in Minilaparotomy group. Laparoscopic cholecystectomy dispensed shorter length of hospital stay (p<0.00001) and return to work activities (p<0.00001) compared to minilaparotomy, and the minilaparotomy shorter operative time (p<0.00001) compared to laparoscopy. Laparoscopy decrease the risk of postoperative pain (NNT=7) and infectious complications (NNT=50). There was no statistical difference between the two groups regarding conversion (p=0,06) and surgical reinterventions (p=0,27), gall bladder''s perforation (p=0,98), incidence of common bile duct injury (p=1.00), surgical site infection (p=0,52) and paralytic ileus (p=0,22).Conclusion
In cholelithiasis, laparoscopic cholecystectomy is associated with a lower incidence of postoperative pain and infectious complications, as well as shorter length of hospital stay and time to return to work activities compared to minilaparotomy cholecystectomy. 相似文献20.