ABSTRACT
PURPOSE: To determine the best treatment option for not complicated acute appendicitis (AA) in adult patients, between single incision laparoscopy (SIL) and conventional laparoscopy (CL), measured by morbidity associated with disease. METHODS: Systematic review. Articles of adults diagnosed with AA treated by SIL or CL were analyzed. Databases included: MEDLINE, LILACS, IBECS, Web of Science, Scopus and Cochrane, using MeSH terms and free words. The studies were analyzed using the MINCIR methodology. Variables included: conversion rate, morbidity, hospital stay, surgery duration, and methodological quality (MQ) of primary studies. Averages, medians and weighted averages were calculated. RESULTS: Thirteen articles were analyzed. For SIL and CL the conversion rate were 3.4% and 0.7 %, the morbidity were 8% and 6.5%, the hospital stay were 2.5 and 2.8 days, the surgery duration were 53.4 and 53.8 minutes, and the MQ were 14.3±6.6 and 16.0±6.9 points, respectively. CONCLUSION: With the exception of the conversion rate, there are no differences between single incision laparoscopy and conventional laparoscopy for the treatment of acute appendicitis in adults. .
Subject(s)
Adult , Female , Humans , Male , Appendectomy/methods , Appendicitis/epidemiology , Appendicitis/surgery , Laparoscopy/methods , Acute Disease , Conversion to Open Surgery/statistics & numerical data , Length of Stay/statistics & numerical data , Morbidity , Operative Time , Treatment OutcomeABSTRACT
OBJECTIVE: Respiratory muscle weakness is a functional repercussion of chronic lung disease (CLD). The objective of this study was to assess the effects of home-based respiratory muscle training (RMT) in children and adolescents with CLD or neuromuscular disease (NMD). METHODS: This was a quasi-experimental study involving children and adolescents with CLD or NMD. Before and after 6 months of home-based RMT, we measured respiratory muscle strength (MIP and MEP), PEF, and peak cough flow (PCF). We made statistical comparisons between the pre-RMT and post-RMT values, as well as evaluating the correlation between the duration and effect of RMT. RESULTS: The study included 29 patients, with a mean age of 12 years (range, 5-17 years), of whom 18 (62.1%) were male. The CLD group comprised 11 patients (37.9%), and the NMD group comprised 18 (62.1%). The mean duration of the RMT was 60 weeks (range, 46-90 weeks) in the CLD group and 39 weeks (range, 24-89 weeks) in the NMD group. In comparison with the pre-RMT values, the post-RMT values for MIP and MEP were significantly higher in both groups, whereas those for PEF and PCF were significantly higher only in the NMD group. We found no correlation between the duration and the effect of RMT. CONCLUSIONS: Home-based RMT appears to be an effective strategy for increasing respiratory muscle strength in children and adolescents with CLD or NMD, although it increased the ability to cough effectively only in those with NMD. .
OBJETIVO: A fraqueza muscular respiratória é uma repercussão funcional da doença pulmonar crônica (DPC). O objetivo deste estudo foi avaliar os efeitos do treinamento muscular respiratório (TMR) domiciliar em crianças e adolescentes com DPC ou doença neuromuscular (DNM). MÉTODOS: Estudo quasi-experimental com crianças e adolescentes com DPC ou DNM. Foram medidos a força muscular respiratória (PEmáx e PImáx) e o pico de fluxo da tosse (PFT) antes e depois de 6 meses de TMR domiciliar. Foram realizadas comparações estatísticas entre valores pré- e pós-TMR e foram avaliadas as correlações entre a duração e o efeito do TMR. RESULTADOS: Foram incluídos no estudo 29 pacientes, com média de idade de 12 anos (variação, 5-17 anos), dos quais 18 (62,1%) eram meninos. O grupo DPC consistiu em 11 pacientes (37,9%) e o grupo DNM, em 18 (62,1%). A média da duração do TMR foi de 60 semanas (variação, 46-90 semanas) no grupo DPC e de 39 semanas (variação, 24-89 semanas) no grupo DNM. Em comparação com os valores pré-TMR, os valores pós-TMR para PImáx e PEmáx foram significativamente maiores nos dois grupos, enquanto aqueles para PFE e PFT foram significativamente maiores apenas no grupo DNM. Não houve correlações entre a duração e o efeito do TMR. CONCLUSÕES: O TMR domiciliar parece ser uma estratégia eficaz para o aumento da força muscular respiratória em crianças e adolescentes com DPC ou DNM, embora aumente efetivamente a capacidade de tosse somente naqueles com DNM. .