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Can serum basal cortisol values predict successful operations for bariatric surgery patients?
CONCLUSIONS: In obese patients undergoing LSG, serum basal cortisol level may not predict the success of operation. However, the result of 1 mg DST may predict the operation success.PMID:36111929 | DOI:10.26355/eurrev_202209_29652
Source: Pharmacological Reviews - September 16, 2022 Category: Drugs & Pharmacology Authors: D Öztürk M Keskin A O Koca H Bulus Source Type: research

Surgery for the treatment of obesity in children and adolescents
CONCLUSIONS: Laparoscopic gastric banding led to greater body weight loss compared to a multi-component lifestyle program in one small study with 50 participants. These results have very limited application, primarily due to more recent recommendations derived from observation studies to avoid the use of banding in youth due to long-term reoperation rates. This systematic review update still highlights the lack of RCTs in this field. The authors are concerned that there may be ethical barriers to RTCs in this field, despite the lack of other effective therapies for severe obesity in children and adolescents and the signifi...
Source: Cochrane Database of Systematic Reviews - September 8, 2022 Category: General Medicine Authors: Gabriel Torbahn Jana Brauchmann Emma Axon Ken Clare Maria-Inti Metzendorf Susanna Wiegand Janey Sa Pratt Louisa J Ells Source Type: research

Abdominal drainage to prevent intra-peritoneal abscess after appendectomy for complicated appendicitis
CONCLUSIONS: The certainty of the currently available evidence is low to very low. The effect of abdominal drainage on the prevention of intraperitoneal abscess or wound infection after open appendectomy is uncertain for patients with complicated appendicitis. The increased rates for overall complication rate and hospital stay for the drainage group compared to the no-drainage group are based on low-certainty evidence. Consequently, there is no evidence for any clinical improvement with the use of abdominal drainage in patients undergoing open appendectomy for complicated appendicitis. The increased risk of mortality with ...
Source: Cochrane Database of Systematic Reviews - August 17, 2021 Category: General Medicine Authors: Zhuyin Li Zhe Li Longshuan Zhao Yao Cheng Nansheng Cheng Yilei Deng Source Type: research

Meta-Analysis of Spinal Anesthesia Versus General Anesthesia During Laparoscopic Total Extraperitoneal Repair of Inguinal Hernia
Objectives: To evaluate comparative outcomes of spinal anesthesia (SA) and general anesthesia (GA) during laparoscopic total extraperitoneal (TEP) repair of inguinal hernia. Methods: We systematically searched MEDLINE, EMBASE, CINAHL, CENTRAL, the World Health Organization International Clinical Trials Registry, ClinicalTrials.gov, ISRCTN Register, and bibliographic reference lists. We applied a combination of free text and controlled vocabulary search adapted to thesaurus headings, search operators and limits in each of the above databases. Postoperative pain assessed by visual analogue scale (VAS), individual and ov...
Source: Surgical Laparoscopy, Endoscopy and Percutaneous Techniques - August 1, 2020 Category: Surgery Tags: Review Articles Source Type: research

Surgical treatment of fibroids for subfertility.
CONCLUSIONS: There is limited evidence to determine the role of myomectomy for infertility in women with fibroids as only one trial compared myomectomy with no myomectomy. If the decision is made to have a myomectomy, the current evidence does not indicate a superior method (laparoscopy, laparotomy or different electrosurgical systems) to improve rates of live birth, preterm delivery, clinical pregnancy, ongoing pregnancy, miscarriage, or caesarean section. Furthermore, the existing evidence needs to be viewed with caution due to the small number of events, minimal number of studies and very low-quality evidence. PMID...
Source: Cochrane Database of Systematic Reviews - January 28, 2020 Category: General Medicine Authors: Metwally M, Raybould G, Cheong YC, Horne AW Tags: Cochrane Database Syst Rev Source Type: research

Prolonged thromboprophylaxis with low molecular weight heparin for abdominal or pelvic surgery.
CONCLUSIONS: Prolonged thromboprophylaxis with LMWH significantly reduces the risk of VTE compared to thromboprophylaxis during hospital admittance only, without increasing bleeding complications or mortality after major abdominal or pelvic surgery. This finding also holds true for DVT alone, and for both proximal and symptomatic DVT. The quality of the evidence is moderate and provides moderate support for routine use of prolonged thromboprophylaxis. Given the low heterogeneity between studies and the consistent and moderate evidence of a decrease in risk for VTE, our findings suggest that additional studies may help refi...
Source: Cochrane Database of Systematic Reviews - August 25, 2019 Category: General Medicine Authors: Felder S, Rasmussen MS, King R, Sklow B, Kwaan M, Madoff R, Jensen C Tags: Cochrane Database Syst Rev Source Type: research

Perioperative intravenous ketamine for acute postoperative pain in adults.
CONCLUSIONS: Perioperative intravenous ketamine probably reduces postoperative analgesic consumption and pain intensity. Results were consistent in different operation types or timing of ketamine administration, with larger and smaller studies, and by higher and lower pain intensity. CNS adverse events were little different with ketamine or control. Perioperative intravenous ketamine probably reduces postoperative nausea and vomiting by a small extent, of arguable clinical relevance. PMID: 30570761 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - December 20, 2018 Category: General Medicine Authors: Brinck EC, Tiippana E, Heesen M, Bell RF, Straube S, Moore RA, Kontinen V Tags: Cochrane Database Syst Rev Source Type: research

Laparoscopic versus open surgery for suspected appendicitis.
CONCLUSIONS: Except for a higher rate of intra-abdominal abscesses after LA in adults, LA showed advantages over OA in pain intensity on day one, wound infections, length of hospital stay and time until return to normal activity in adults. In contrast, LA showed advantages over OA in wound infections and length of hospital stay in children. Two studies reported better quality of life scores in adults. No study reported this outcome in children. However, the quality of evidence ranged from very low to moderate and some of the clinical effects of LA were small and of limited clinical relevance. Future studies with low risk o...
Source: Cochrane Database of Systematic Reviews - November 28, 2018 Category: General Medicine Authors: Jaschinski T, Mosch CG, Eikermann M, Neugebauer EA, Sauerland S Tags: Cochrane Database Syst Rev Source Type: research

Prolonged thromboprophylaxis with low molecular weight heparin for abdominal or pelvic surgery.
CONCLUSIONS: Prolonged thromboprophylaxis with LMWH significantly reduces the risk of VTE compared to thromboprophylaxis during hospital admittance only, without increasing bleeding complications after major abdominal or pelvic surgery. This finding also holds true for DVT alone, and for both proximal and symptomatic DVT. The quality of the evidence is moderate and provides moderate support for routine use of prolonged thromboprophylaxis. Given the low heterogeneity between studies and the consistent and moderate evidence of a decrease in risk for VTE, our findings suggest that additional studies may help refine the degree...
Source: Cochrane Database of Systematic Reviews - November 27, 2018 Category: General Medicine Authors: Felder S, Rasmussen MS, King R, Sklow B, Kwaan M, Madoff R, Jensen C Tags: Cochrane Database Syst Rev Source Type: research

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