Single Port Laparoscopic Appendectomy: Retrospective and Comparative Analysis of 55 Consecutive Cases: Report of Initial Experience / 대한내시경복강경외과학회지

PURPOSE: With the big increase in laparoscopic skills and technology, many surgeons have recently began to adopt single port laparoscopic surgery for treating appendicitis due to the increased patient satisfaction and improved cosmesis. We determined if conventional appendectomy or single port laparoscopic appendectomy is the better treatment modality figure out which one will be. METHODS: The data was prospectively collected and retrospectively analyzed for all the patients who underwent single port laparoscopic appendectomy at our institute and this data was compared with that of the patients who had undergone conventional laparoscopic appendectomy. RESULTS: 55 patients underwent single port laparoscopic appendectomy and we collected the data of 76 patients who underwent conventional laparoscopic appendectomy. There were few differences between single port laparoscopic appendectomy and conventional laparoscopic appendectomy for the operation results. CONCLUSION: Single port laparoscopy appendectomy is feasible and safe with several benefits. It can be a good treatment modality for the management of appendicitis. Surgeons familiar with conventional laparoscopy can switch to single port laparoscopy for performing appendectomy without need of special skills or training to get over the learning curve.

The Accuracy of a Simple Radiologic Study for Diagnosing Intra-articular Fractures of the Distal Radius

PURPOSE: To determine the accuracy of a simple radiologic images as a diagnostic tool for intra-articular fractures of the distal radius (IAF). METHODS: This study proceeded prospectively from April 2008 to December 2009. We let 25 ERs (emergency residents) interpret the radiologic images of 45 patients who had injuries of their wrists and presented to a hospital. We used surgical findings or multidetector computed tomography (MDCT) to confirm the final diagnosis of enrolled patients. Finally, we evaluated the sensitivity, specificity, and accuracy of simple radiologic images of IAF. We also compared test performance characteristics between the four grades of the ERs (1st, 2nd, 3rd, and 4th years) via Mann-Whitney and Kruskal-Wallis tests. We considered differences to be significant, if p<0.05 RESULTS: Of 45 patients, 40 (88.9%) had fractures of the distal radius; of the 40, 25 (62.5%) had IAF. There were no differences in sensitivity, specificity, or accuracy between the four grades of the ERs (p=0.86, 0.76, 0.49). The sensitivity of simple radiologic images for diagnosing IAF was 0.69; specificity was 0.77; accuracy was 0.72. CONCLUSION: In this study, we found that simple radiologic images as the primary diagnostic tool for intra-articular fractures of the distal radius were not completely adequate. Therefore, ERs should carefully consider using MDCT imaging to diagnose patients who suffer from wrist pain.