ABSTRACT
A 2-year retrospective study was carried out in a district general hospital to review the outcome of laparoscopic management versus laparotomy for the management of ectopic pregnancy. Outcome measures included operating time, postoperative analgesia requirements, complications, length of hospital stay, the post-ectopic intrauterine pregnancy rates and the recurrent ectopic pregnancy rates over an observational period of 16 months. Forty-nine consecutive women were seen. Twenty-six were managed laparoscopically and 23 were managed by laparotomy. There was no significant difference between the operating times and complications but the laparoscopy group had significantly fewer doses of opiate analgesia (P<0.05), shorter length of stay (P<0.05), and significantly higher post-ectopic intrauterine pregnancy rates (P<0.05) compared with the laparotomy group. Laparoscopic management of ectopic pregnancy is a viable alternative to conventional laparotomy in district general hospitals.
ABSTRACT
A randomized controlled trial was performed in 30 Sprague-Dawley white rats to compare the efficacy of the synthetic adhesion-barrier Interceed (Johnson & Johnson Medical Inc.) when fixed in place using 6/0 vicryl sutures or lying freely on damaged tissues. The rats were randomly assigned to 3 groups; control, Interceed (fixed) and Interceed (free). Adhesion formation was measured 2 weeks later, using a scoring system related to extent and density. There was no significant difference whether the adhesion-barrier was fixed in place with sutures or not, so that the fixation of Interceed to cover traumatized tissues does not appear to provide any benefits against adhesion formation in rats.
Subject(s)
Adnexal Diseases/prevention & control , Cellulose, Oxidized/pharmacology , Animals , Female , Postoperative Complications/prevention & control , Random Allocation , Rats , Rats, Sprague-Dawley , Tissue Adhesions/prevention & controlABSTRACT
Forty white rats were randomly assigned into four groups in which a standardized adhesion-forming lesion was created at laparotomy. Attempts to prevent adhesion formation were made in the presence of an artificial adhesion barrier, Interceed (free or fixed with 6/0 vicryl sutures) and Ringer's lactate versus a control group. Interceed freely placed on the site resulted in either very low or very high adhesion scores. This suggests that Interceed is an effective adhesion barrier but that a method which does not itself create tissue reaction must be devised to keep the barrier in place. Further research into an appropriate "tissue glue" is required (AU)
Subject(s)
Comparative Study , 21003 , Rats , Tissue Adhesions/prevention & controlABSTRACT
During the period January, 1990 to April, 1992, a total of 138 abdominal hysterectomies were performed. Of these, 73 patients were permitted traditional full-length hospital stay (mean 6.0 days) and 65 were scheduled to stay for a short post-operative recovery (mean 3.6 days). Indications for surgery and patient characteristics were similar in the two groups. Only two of the short-stay patients had to kept longer than planned. Post-operative complications were fewer in the short-stay group. It is concluded that significant economic benefits and improved bed-space availability can be achieved safely by the curtailment of the length of hospital stay in patients for routine hysterectomy (AU)
