جستجوی مقالات مرتبط با کلیدواژه « laparoscopic » در نشریات گروه « پزشکی »

Given the alterations in definitions and the varied, at times entirely contradictory results, the need for new studies regarding the factors influencing the occurrence of Surgical Site Infections (SSIs) is increasingly felt. This study aims to investigate the role of prophylactic antibiotics in reducing surgical site infections (SSIs) following Laparoscopic Cholecystectomy (LC) in low-risk patients.

In this clinical trial, 120 patients underwent laparoscopic cholecystectomy as per the inclusion criteria. Between September 2021 and May 2022, within the Department of Surgery at Birjand Medical University, candidates slated for elective laparoscopic cholecystectomy were systematically allocated into two distinct groups: one receiving prophylactic antibiotics and the other not. The principal outcome measured was the incidence of postoperative infectious complications. Data were analyzed in SPSS (Version 23) software using Mann-Whitney, t-test, Fisher's Exact, and Chi-square tests. The level of significance was set to P <0.05.

A total of 120 patients underwent laparoscopic cholecystectomy, divided into two groups: 59 received preoperative prophylactic antibiotics (Antibiotic Group, AG) and 61 did not (No Antibiotic Group, NAG), with no significant differences in clinical characteristics like gender, age, body mass index (BMI) and operation times. Surgical site infection (SSI) occurred in two patients (3.4%) in the AG and four patients (6.7%) in the NAG, with no significant overall difference in SSI incidence between the groups (P=0.679). The study found no significant differences in preoperative WBC, hemoglobin, or creatinine levels between patients with and without SSI, indicating similar preoperative conditions across both groups.

The outcomes of our study revealed no substantial disparities between patients administered prophylactic antibiotics and those not during laparoscopic cholecystectomy (LCC). Consequently, the utilization of prophylactic antibiotics in elective LCC is not requisite for low-risk patients.

The aim of this study was to describe the female to male (FTM)transgenders demographic, epidemiologic characteristics and outcomes after laparoscopic hysterectomy and bilateral oophorectomy surgery by one surgeon in FTM transgender people.

This retrospective cohort study on FTM patients that referred to one of the referral centers for transgender surgeries in the capital of Iran (Tehran) since 2016 and 2022. Consecutive method used for sampling method. Data analyzing was done by SPSS, descriptive statistical, Pearson correlation coefficient and t-test.

We identified 105 FTM transgender patients undergoing laparoscopic hysterectomy and bilateral oophorectomy. The mean age was 24.74±5.41 years, and the mean age of first experience of transgender was10.51±3.68 years. There was a significant correlation between transgender and marital status (P<0.04, r= 0.2) and unemployment (P<0.05, r= 0.5). There was a significant correlation between age of first experiences of transgender and educational status (P<0.05, r= -0.1).49.5%of patients have complications after surgery.

Hysterectomy and bilateral oophorectomy by laparoscopic approach may have appropriate outcomes for reassignment surgery. Also, this study suggests that probably less educational, occupational problems occur for transgender patients if they undergo gender reassignment surgery at a younger age.

 The aim of this retrospective study is to assess the long-term outcomes and safety of laparoscopic simple prostatectomy.

 Between 2012 and 2019 80 patients with prostates volumes ≥ 80 mL were treated with laparoscopic simple prostatectomy at our department. Uroflowmetry, post void residual volume and standardized questionnaires were assessed pre- and postoperatively.
Perioperative complications were categorized using the Clavien-Dindo classification.

 The mean specimen weight was 83 grams, and the mean operation time was 156 minutes. At a mean follow-up time of 40 months patients showed a significant improvement of Qmax (P = .002), IPSS (P < .001) and QoL (P < .001). Post void residual volumes decreased significantly.
Complications occurred in 11 patients (13.8%), nine had mild (grade 1 - 2) and two had severe (grade 3b - 4a) complications. One conversion to open surgery due to massive prostatic adherence from previous abscess formation was recorded and one patient needed blood transfusion intraoperatively.

 laparoscopic simple prostatectomy is an effective and safe procedure for large volume prostate glands with a significant and stable long term symptoms improvement.

 Morbid obesity may cause a restrictive condition. General anesthesia (GA) and supine posture both decrease lung capacity and functional residual capacity (FRC), altering the ventilation/perfusion ratio and raising the pulmonary shunt.

 To evaluate the impact of recruitment maneuver (RM) and transversus abdominis plane (TAP) block performed during laparoscopic bariatric surgery on spirometry, oxygenation, opioid requirements, and pain score assessed after surgery.

 This pilot prospective randomized controlled study included 80 patients scheduled for elective laparoscopic bariatric surgeries (e.g., laparoscopic sleeve gastrectomy and laparoscopic gastric bypass) under GA. Patients were divided into four equal groups. All patients received a standardized postoperative analgesia regimen. Group I (control group), group II received TAP block after intubation and before surgical incision, group III received RM after intubation and after pneumoperitoneal insufflation, and group IV received RM after intubation and after pneumoperitoneal exsufflation and TAP block after intubation and before surgical incision.

 Forced vital capacity (FVC) and forced expiratory volume (FEV1) were significantly higher after group IV operation than in other groups. Intraoperative PaO2 and PaO2/FiO2 were significantly higher in groups III and IV compared to other groups. The numerical rating scale (NRS) at 1, 2, 4, 6, and 12h was significantly decreased in groups II and IV compared to other groups. Morphine consumption was significantly lower in groups II and IV compared to other groups.

 TAP block combined with RM had better postoperative pulmonary function tests. Intraoperative oxygenation was higher in RM.

Gastrointestinal bleeding is one of the surgical emergencies that is routinelyvisited in emergency departments. Although most of these patients are managed withendoscopic modalities, some of them are managed with surgical interventions. Most ofemergency surgical interventions are done via laparotomy. With evolution in minimalinvasive surgery, the role of laparoscopic surgeries in emergency settings is on a rise.

In this report we describe a case of lower gastrointestinal bleedingthat was presented with melena and during workups no bleeding lesion was detectedin colon, stomach or duodenum. Further investigations revealed bleeding of proximaljejunum mass that was resected with the laparoscopic approach which is rarely used inthe emergency management of patients with gastrointestinal bleedings. Also, resectionand anastomosis of proximal jejunal loop was challenging in this case.

This report is intended to describe the feasibility of laparoscopy in proximalsmall bowel lesion resection in emergency settings as well as the role of CT angiography indetecting the source of obscure gastrointestinal bleeding

Postoperative shoulder pain is one of the complications after laparoscopic cholecystectomy (LC). Medications used to treat shoulder pain have side effects.

The aim of this study was to examine the effect of lavender oil aromatherapy on shoulder pain after LC.

In this single‑blind randomized controlled trial, 64 patients who underwent LC were randomly allocated into two groups to receive lavender oil aromatherapy or routine treatment. The intervention began in the recovery room after the patient responded to stimuli. First, the patient’s pain was assessed. Then, aromatherapy was started for the intervention group, and afterward, pain measurement was repeated at 5, 25, and 60 min after the intervention. The pain intensity was assessed using a visual analog scale. Patients in the control group received no intervention other than routine care and treatment, but their pain intensity was measured at the same time as patients in the intervention group. Data analysis was performed using the Chi‑square, independent‑samples and paired t‑tests, and repeated‑measures analysis.

The mean baseline pain severity of the control and aromatherapy groups was 6.26 ± 1.44 and 7.20 ± 1.44, respectively, and changed to 9.06 ± 0.65 and 3.73 ± 0.86 at the end of the study. Repeated‑measures analysis showed that over time, the mean pain intensity was decreasing in the intervention group (P < 0.05), while it had an increasing trend in the control group.

Lavender oil aromatherapy was effective in reducing the postsurgical shoulder pain after LC.

Esophagectomy is performed in all patients with resectable esophageal cancer. Transthoracic-Laparoscopic Esophagectomy (TLE) is a minimally invasive method and considered to be the most appropriate method. In this study, we aim to evaluate and compare the perioperative outcome, and 1-year overall survival of TLE and Transhiatal Esophagectomy (THE) approaches.

In this retrospective study, we reviewed the medical records of 108 patients with esophageal cancer undergoing TLE (n=44) or THE (n=64) between 2015 and 2018. The patients were followed for one year. The intraoperative and postoperative findings, as well as 1-year overall-survival, were compared between the two groups.

TLE compared to THE had a longer surgery duration (278.63±33.28 vs 223.28±33.99 min, P=0.001), a higher number of dissected lymph nodes (15.06±2.95 vs 10.21±2.58, P=0.001), less blood loss (345.45±178.76 vs 585.15±294.75 mL, P<0.001), and need for transfusion (20.5% vs 45.3%, P=0.006) during surgery as well as lower ICU stay (2.59±0.77 vs 3.90±0.83 days, P<0.001) and ward stay (8.77±0.96 vs 11.42±1.71 days, P<0.001). THE had somewhat higher complication than TLE, but with no significant differences.

TLE had a similar rate of complication to THE approach, but with lower blood loss and lower ICU and hospital stay, it is a more appropriate method for esophagectomy.

Postoperative pain is a major problem following laparoscopic cholecystectomy, and there is no general agreement on the effective method of pain relief. Rectal morphine suppositories are one of the newly released morphine forms. The aim of this study is to compare the impact of suppository morphine with placebo on pain relief after laparoscopic cholecystectomy.

Seventy patients scheduled for elective laparoscopic cholecystectomy under general anesthesia, were randomly allocated to two groups according to the drug used for postoperative analgesia: Group morphine suppository (MS ‑ 10 mg) just before induction of anesthesia And Group placebo suppository (PS) (the pills were made from cocoa butter, physically similar to the real drug). Pain intensity based on visual analog scale (VAS) and opioid consumption were assessed 30 and 60 min, and 2, 4, 8, 16, and 24 h after arrival of the patient to the recovery room.

VAS scores were significantly lower in MS group (from 3.8 ± 1 to 5.3 ± 1.6) compared with PS group (from 4.9 ± 0.9 to 6.7 ± 1) from 30 min after arrival to the recovery room until 16 h postoperatively (P < 0.05). There were no additional analgesic requirements in the first 2 h after the entrance of the patient to the recovery room in MS group. The number of patients requiring pethidine was significantly different between two groups (P < 0.05) in all periods except for 24 h postoperatively.

Suppository morphine administration is more effective than placebo to reduce pain and analgesic requirements after laparoscopic cholecystectomy.

The rising prevalence of obesity in today populations has led obese individuals to seek medical interventions. Aside from special diets, routine exercise and in some cases, medical treatment, most of the obese patients, favoring those with morbid or super obesity can benefit from bariatric surgery to lose weight. Laparoscopic sleeve gastrectomy (LSG) is relatively new method to limit the compliance of stomach. The consequent quick satiety during each meal results in gradual weight loss in patients. We investigated the efficacy and safety of this method among a group of our patients.

This cross‑sectional study was conducted in Isfahan, Iran, from January 2012 to January 2013. Thirty‑five cases of obesity that had undergone LSG were enrolled and their baseline data of weight, body mass index (BMI), blood sugar, lipid profile, liver function indexes and blood pressure were collected. The patients were followed up for 6 months. The 6‑month results were analyzed.

There was significant reduction in BMI, weight, blood sugar, blood pressure, liver enzymes and lipid profile components(P < 0.05), except for alkaline phosphatase (ALP) (P = 0.3). The average of excess weight loss percentage after 6 months was 69.2 ± 20.9%. No mortality occurred. Two of the patients had micro anastomotic leaks that were treated with nonoperative management. Acase of gross leakage was treated with tube jejunostomy.

Our study confirmed the efficacy and safety of LSG as a single surgical intervention for body weight reduction in morbidly and super obese patients.