Laparoscopic versus conventional appendectomy - a meta-analysis of randomized controlled trials

<p>Abstract</p> <p>Background</p> <p>Although laparoscopic surgery has been available for a long time and laparoscopic cholecystectomy has been performed universally, it is still not clear whether open appendectomy (OA) or laparoscopic appendectomy (LA) is the most appropriate surgical approach to acute appendicitis. The purpose of this work is to compare the therapeutic effects and safety of laparoscopic and conventional "open" appendectomy by means of a meta-analysis.</p> <p>Methods</p> <p>A meta-analysis was performed of all randomized controlled trials published in English that compared LA and OA in adults and children between 1990 and 2009. Calculations were made of the effect sizes of: operating time, postoperative length of hospital stay, postoperative pain, return to normal activity, resumption of diet, complications rates, and conversion to open surgery. The effect sizes were then pooled by a fixed or random-effects model.</p> <p>Results</p> <p>Forty-four randomized controlled trials with 5292 patients were included in the meta-analysis. Operating time was 12.35 min longer for LA (95% CI: 7.99 to 16.72, p < 0.00001). Hospital stay after LA was 0.60 days shorter (95% CI: -0.85 to -0.36, p < 0.00001). Patients returned to their normal activity 4.52 days earlier after LA (95% CI: -5.95 to -3.10, p < 0.00001), and resumed their diet 0.34 days earlier(95% CI: -0.46 to -0.21, p < 0.00001). Pain after LA on the first postoperative day was significantly less (p = 0.008). The overall conversion rate from LA to OA was 9.51%. With regard to the rate of complications, wound infection after LA was definitely reduced (OR = 0.45, 95% CI: 0.34 to 0.59, p < 0.00001), while postoperative ileus was not significantly reduced(OR = 0.91, 95% CI: 0.57 to 1.47, p = 0.71). However, intra-abdominal abscess (IAA), intraoperative bleeding and urinary tract infection (UIT) after LA, occurred slightly more frequently(OR = 1.56, 95% CI: 1.01 to 2.43, p = 0.05; OR = 1.56, 95% CI: 0.54 to 4.48, p = 0.41; OR = 1.76, 95% CI: 0.58 to 5.29, p = 0.32).</p> <p>Conclusion</p> <p>LA provides considerable benefits over OA, including a shorter length of hospital stay, less postoperative pain, earlier postoperative recovery, and a lower complication rate. Furthermore, over the study period it was obvious that there had been a trend toward fewer differences in operating time for the two procedures. Although LA was associated with a slight increase in the incidence of IAA, intraoperative bleeding and UIT, it is a safe procedure. It may be that the widespread use of LA is due to its better therapeutic effect.</p

Optimal warranty policy for a Pareto distributed products based on progressive censored sample

[[notice]]缺頁數[[conferencetype]]國際[[conferencedate]]20120708~20120711[[iscallforpapers]]Y[[conferencelocation]]Lithuania, Vilniu

4-[N,N-bis(2-hydroxyimino-2-phenylethyl)amino]-1,5-dimethyl-2-phenyl-2, 3-dihydro-1H-pyrazol-3-one monohydrate

The title compound, C27H27N5O 3·H2O, is built up from pyrazolinone, phenyl and acetophenone oxime moieties. The 2-phenyl substituent is nearly perpendicular to the pyrazolinone ring, with a dihedral angle of 87.66 (1)°. The acetophenone oxime moieties are twisted out of the pyrazolinonering plane by 47.04 (1)°. The molecules in the crystal pack in an antiparallel fashion and are held together by hydrogen-bonded water molecules and intermolecular O-H?O and O-H?N hydrogen bonds

4-[N,N-Bis(2-hydroxyimino-2-phenylethyl)amino]-1,5-dimethyl-2-phenyl-2,3-dihydro-1H-pyrazol-3-one monohydrate

WOS: 000223102800022PubMed: 15295180The title compound, C27H27N5O3.H2O, is built up from pyrazolinone, phenyl and acetophenone oxime moieties. The 2-phenyl substituent is nearly perpendicular to the pyrazolinone ring, with a dihedral angle of 87.66 (1)degrees. The acetophenone oxime moieties are twisted out of the pyrazolinone-ring plane by 47.04 (1)degrees. The molecules in the crystal pack in an antiparallel fashion and are held together by hydrogen-bonded water molecules and intermolecular O - H ... O and O - H ... N hydrogen bonds

Calcifying aponeurotic fibroma: a case report [Kalsifiye aponörotik fibrom: Olgu sunumu.]

Calcified aponeurotic fibroma is a rare benign fibrous tumor with well-characterized histopathologic features. It is usually seen in distal extremities of children and youngsters. A 23-year-old male patient underwent surgical excision of a free, painless soft tissue mass that developed in the palmar aspect of the left hand. Histopathologic examination showed fibroblastic proliferation areas and dense collagenous stroma surrounding calcifications and chondroid metaplasia. The diagnosis was made as calcified aponeurotic fibroma. No recurrences were detected within a year follow-up

N,N'-Bis[1-(pyrazin-2-yl)ethylidene]hydrazine

Molecules of the title compound, C12H12N6, contain both a diimine linkage and an N-N bond, and assume a planar structure. The compound lies about an inversion centre and there are three intramolecular C-H?N hydrogen bonds

N,N '-Bis[1-(pyrazin-2-yl)ethylidene]hydrazine

WOS: 000222429900044PubMed: 15237180Molecules of the title compound, C12H12N6, contain both a diimine linkage and an N - N bond, and assume a planar structure. The compound lies about an inversion centre and there are three intramolecular C - H...N hydrogen bonds

Spectroscopic and structural studies of 6-(1-methylbenzimidazol-2-yl)-1H- pyridin-2-one and of an unusual T4(2)7(2)6(2)7(2) water tape stabilized by the copper(II) coordination polymer

The solid-state structures of 6-(1-methylbenzimidazol-2-yl)-1H-pyridin-2- one (HL) and the copper(II) complex [Cu(L-)2(OH 2)]·2H2O (1) are established by X-ray crystallography and also by means of physicochemical and spectroscopic methods. The molecules of HL form a self-complementary head-to-tail hydrogen-bonded dimer through C-H?N and C-H?O contacts to give an infinite 1D chain. The copper(II) complex (1) is five-coordinate with distorted trigonal-bipyramidal (TBP) geometry of the N4O donor atoms. The electronic and EPR data are in agreement with the X-ray structure of 1, showing that HL coordinates to copper(II) centre as a mono-anionic ligand through deprotonated pyridone N atom and the tertiary benzimidazole nitrogen atom to form a neutral complex in which the water molecule occupies the fifth position. The 1D water tape, T4(2)7(2)6(2)7(2) is anchored to the host through hydrogen bonds between coordinated water molecule [O(3w)] as acting double H-donor, pyridone carbonyl groups [O(2) and O(1)] as double H-acceptor and the lattice water molecules [O(4w) and O(5w)] as double H-donor and single H-acceptor). © 2011 Elsevier Ltd. All rights reserved.2007/3-13-02-01 TBAG-2450, 104T060 Fundamental Research Fund of Shandong University Engineering and Physical Sciences Research Council Faculty of Arts and Social Sciences, Carleton UniversityThe authors are grateful to the Turkish Scientific and Technical Research Council [TBAG-2450 (104T060)] and also Zonguldak Karaelmas University for grant 2007/3-13-02-01. The authors also wish to acknowledge the UK Engineering and Physical Sciences Research Council for funding the National Crystallography Service, and the Faculty of Arts and Sciences Ondokuz Mayis University, for the Stoe IPDS-II diffractometer (purchased under grand F.279 of the University Research Fund). The authors gratefully thank to Dr. Lourdes Infantes for his valuable help on the water cluster nomenclature. Appendix

N-[3,5-Bis(trifluoromethyl)phenyl]salicylaldimine

The title compound, C15H9F6NO, is non-planar with a dihedral angle between the two aromatic rings of 29.57 (2)°. The central N=C bond distance of 1.276 (4) Å is typical for a double bond. There are intramolecular O-H···N and weak intermolecular C-H···F hydrogen bonds. © 2003 International Union of Crystallography Printed in Great Britain - all rights reserved

Spectroscopic and structural studies of 6,6'-bis(N-methylhydrazine)- 2,2'-bipyridine and its mononuclear copper(II) complex

The tetradentate ligand, 6,6'-bis(N-methylhydrazine)-2,2'- bipyridine (L) and its mononuclear copper(II) complex [Cu(L)](ClO 4)2] (1) have been synthesized and characterized. The crystal structures of L and 1 have been determined by single-crystal X-ray diffraction. Both crystallize in the centrosymmetric monoclinic space group with crystallographic inversion symmetry. The ligand adopts a planar transoid configuration in the solid state. In 1, the Cu(II) is six-coordinate octahedral, defined by N4O2 donors from ligand and two perchlorates. The molecular units are connected by intermolecular H-bonds between the hydrazino group of the one unit and coordinated perchlorate of the neighboring two units via N-H?O to furnish a 2-D network. Coordinated perchlorates also form an intramolecular H-bond with hydrazine influencing the crystal packing. © 2010 Taylor &amp; Francis.TBAG-2450, 104T060 2007/3-13-02-01The authors are grateful to the Turkish Scientific and Technical Research Council [TBAG-2450 (104T060)] and also Zonguldak Karaelmas University for providing grant 2007/3-13-02-01