scholarly journals Randomized Controlled Trial of Laparoscopic versus Open Radical Cystectomy in a Laparoscopic Naïve Center

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Waleed Mohamed Fadlalla ◽  
Ayman Hanafy ◽  
Mahmoud Abdelhakim ◽  
Hatem Aboulkassem ◽  
El Sayed Ashraf ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Blood Loss ◽  
Hospital Stay ◽  
Radical Cystectomy ◽  
Controlled Trial ◽  
Complication Rates ◽  
Randomized Controlled ◽  
Transfusion Requirements ◽  
Laparoscopic Cystectomy ◽  
Open Radical Cystectomy

Background. Laparoscopic radical cystectomy is a challenging surgical procedure; however, it has been largely abandoned in favor of the more intuitive robotic-assisted cystectomy. Due to the prohibitive cost of robotic surgery, the adoption of laparoscopic cystectomy is of relevance in low-resource institutes. Methodology. This is a randomized controlled trial comparing laparoscopic radical cystectomy (LRC) to open radical cystectomy (ORC) at a single institute. Each group included thirty patients. The trial was designed to compare both approaches regarding operative time, blood loss, transfusion requirements, length of hospital stay, time to oral intake, requirement of opioid analgesia, and complications. Results. LRC was associated with less hospital stay (9.8 vs. 13.8 days, P = 0.001 ), less time to oral solid intake (6 vs. 8.6 days, P = 0.031 ), and lower opioid requirements (23.3% vs. 53.3%, P = 0.033 ). There was a trend towards lower blood loss and transfusion requirements, but this did not reach statistical significance. Overall complication rates were comparable. Conclusion. Laparoscopic radical cystectomy was associated with comparable postoperative outcomes when compared to ORC in the first laparoscopic cystectomy experience in our center. Benefitting from the assistance of an experienced laparoscopic surgeon is recommended to shorten the learning curve.

scholarly journals Conventional versus small incision appendectomy: a retrospective randomized controlled trial study

2021 ◽  
Vol 8 (3) ◽  
pp. 949
Author(s):  
Rajasekar Selvarajan
Keyword(s):  
Randomized Controlled Trial ◽  
Blood Loss ◽  
Hospital Stay ◽  
Controlled Trial ◽  
Operating Time ◽  
Open Appendectomy ◽  
Small Incision ◽  
Duration Of Hospital Stay ◽  
Randomized Controlled ◽  
Pain Scores

Background: Open appendectomy is practiced for more than a century and in the recent times small incision appendectomy is also practiced frequently. The efficacy of conventional appendectomy and small incision appendectomy in terms of pain, operating time and duration of hospital stay and have produced conflicting results. Hence this study was conducted to assess the same.  Methods: A hospital based randomized controlled trial study was conducted among the patients with appendicitis undergoing surgical intervention for the same in department of general surgery in Sri Muthukumaran Medical College Hospital and Research Institute, Chennai, during the study period from January 2017 to December 2019. A total of eighty cases with acute appendicitis were included in the study. Group A (n=40) includes conventional open appendectomy cases and group B (n=40) includes small incision open appendectomy cases. Data entry was done using Microsoft excel and data was analyzed using SPSS version 17. Results: Blood loss, post-operative pain scores on day 1 and day 2, duration of hospital stay were found to be reduced in Small incision open appendectomy group compared to conventional open appendectomy group. Duration taken to resuming the normal activities and the complications were found to be similar in both conventional and small incision appendectomy group and small incision open appendectomy group.  Conclusions: Small incision open appendectomy is superior to conventional open appendectomy in terms of length of hospital stay, return to normal activity, blood loss and postoperative pain scores, which are considered the major advantages of minimally invasive surgery.   

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