scholarly journals Aesthetic Outcomes of Intra-Umbilical Incision vs Infra-Umbilical Incision in Postpartum Tubal Sterilization: A Randomized Controlled Trial

2019 ◽  
Vol 42 (1) ◽  
pp. 1-9
Author(s):  
Watcharin Chirdchim ◽  
Preecha Wanichsetakul ◽  
Jayanton Patumanond
Keyword(s):  
Randomized Controlled Trial ◽  
Statistical Tests ◽  
Controlled Trial ◽  
Operation Time ◽  
Skin Incision ◽  
Tubal Sterilization ◽  
Umbilical Incision ◽  
Randomized Controlled ◽  
Scar Assessment ◽  
Incision Wound

Background: An incision inside the umbilicus is popular used in single port surgery intra-umbilical skin incision surgeries have been proven efficient and safe. When compared to infra-umbilical skin incisions, an incision wound was invisible after the operation. Why not use intra-umbilical skin incision in postpartum tubal sterilization. Objective: To compare aesthetic scores of an incision wound, surgical time and complications in postpartum sterilization under infra-umbilical and intra-umbilical skin incision. Methods: This was a randomized controlled trial conducted in Prapokkhlo Hospital, Chanthaburi, Thailand. Patients (n = 58) with informed consents were randomly assigned to one of the two skin incision techniques for postpartum sterilization (n = 29 for each arm). Surgical times were recorded. Both the patients and an independent physician made wound aesthetic assessments one week after the operation using the Patient and Observer Scar Assessment Scores (POSAS), which compares the wound to the nearby skin. T tests and exact probability statistical tests were used for statistical analysis. Results: The surgeon’s POSAS scores in intra-umbilical incisions were significantly closer to normal skin than those in infra-umbilical incisions (6.8 ± 1.5 vs 12.5 ± 5.0; P < .001). A similar finding was observed for patient POSAS scores (6.5 ± 1.2 vs 15.4 ± 5.0; P < .001). The operation times were also shorter (9.1 ± 2.8 vs 11.8 ± 4.7 minutes; P = .009). Neither intra-abdominal injuries nor wound infections were observed. Conclusions: Postpartum sterilization using intra-umbilical skin incision was more efficient in regard to aesthetic concerns and operation time.

scholarly journals Single-Incision Versus Conventional Laparoscopic Appendectomy: A Multi-Center Randomized Controlled Trial (SCAR Trial)

2021 ◽  
Author(s):  
Sung Il Kang ◽  
In Teak Woo ◽  
Sung Uk Bae ◽  
Chun-Seok Yang
Keyword(s):  
Randomized Controlled Trial ◽  
Laparoscopic Appendectomy ◽  
Single Incision ◽  
Controlled Trial ◽  
Information Service ◽  
The Body ◽  
Research Information ◽  
Conventional Laparoscopic ◽  
Randomized Controlled ◽  
Scar Assessment

Abstract Background: Although single-incision laparoscopic appendectomy (SILA) was introduced decades ago, it is still considered a difficult technique to perform compared to conventional laparoscopic appendectomy (CLA). In addition, controversy about the benefits of SILA compared to CLA abounds and no definite criteria for choosing SILA over CLA in patients with appendicitis currently exist. Therefore, we have planned a multi-center randomized controlled trial to compare SILA with CLA in terms of cosmetic satisfaction and pain reduction. Methods: Patients diagnosed with appendicitis at the participating centers will be recruited and allocated into either a CLA or an SILA groups using a 1:1 randomization. Patients in the CLA group will receive a conventional 3-port laparoscopic appendectomy and patients in the SILA group will receive a laparoscopic appendectomy using a single-incision at the umbilicus. The primary trial endpoint is cosmetic satisfaction assessed using the Patients and Observer Scar Assessment Scale (POSAS) at 6 weeks after surgery. Secondary trial endpoints include cosmetic satisfaction assessed via the Body Image Questionnaire, pain levels assessed via the Visual Analog Scale and International Pain Outcomes questionnaire, and the presence of postoperative complications. The target sample size of this superiority trial is 120 patients, as this will provide 80% power at the 2.5% level of significance to detect a 3-point difference in POSAS. Discussion: The results of this planned multi-center randomized controlled trial will provide substantive evidence to help surgeons choose when to use SILA over CLA in patients with appendicitis.Trial registration: Clinical Research Information Service (CRIS), Registered on 21 May, 2020 (KCT0005048). https://cris.nih.go.kr/cris/en/search/search_result_st01.jsp?seq=16171

scholarly journals Effects of Acupuncture on Vascular Cognitive Impairment with No Dementia: A Randomized Controlled Trial

2021 ◽  
pp. 1-11
Author(s):  
Li Huang ◽  
Xuan Yin ◽  
Wei Li ◽  
Yan Cao ◽  
Yueqi Chen ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Statistical Tests ◽  
Controlled Trial ◽  
Depression Scale ◽  
Vascular Cognitive Impairment ◽  
Serious Adverse Events ◽  
Randomized Controlled ◽  
Over Time

Background: Acupuncture has been used for treating vascular cognitive impairment, but evidence for its effectiveness remains limited. Objective: This single-center, patient-accessor blinded, randomized controlled trial was designed to assess whether acupuncture could improve the cognitive function of patients with vascular cognitive impairment with no dementia (VCIND). Methods: 120 VCIND patients were randomly assigned to the electro-acupuncture (EA) or sham acupuncture (SA) group at a 1 : 1 ratio, with treatment conducted thrice weekly for 8 weeks. The primary outcome was the changes of cognitive function measured by the Montreal Cognitive Assessment (MoCA) from baseline to week 8. The secondary outcomes included the scores of the Mini-Mental State Examination (MMSE), the Modified Barthel Index (MBI) and the Self-rating Depression Scale (SDS). Follow-up assessments were performed with MoCA and MMSE at week 16 and 32. Linear mixed-effects models were used for analysis and all statistical tests were two-sided. Results: The results showed that patients in the EA group had a significantly greater improvement in MoCA score (23.85±4.18) than those in the SA group (21.48±4.44) at week 8 (95% CI = 0.81, 3.93, p = 0.04), as well as higher MoCA scores over time (p <  0.001 for interaction). Patients who received EA showed a greater increase in MMSE scores (26.42±3.47) than those who received SA (24.40±3.85) along 8 weeks (95% CI = 0.69, 3.34, p = 0.0036). However, results diminished over time. No serious adverse events occurred during the trial. Conclusion: EA is a safe and effective technique to improve cognition over the short term of 8 weeks in VCIND patients.

Simple Decompression or Anterior Subcutaneous Transposition for Ulnar Neuropathy at the Elbow: A Cost-minimization Analysis—Part 2

Neurosurgery ◽  
2005 ◽  
Vol 56 (3) ◽  
pp. 531-536 ◽  
Author(s):  
Ronald H.M.A. Bartels ◽  
Evelien H. Termeer ◽  
Gert Jan van der Wilt ◽  
Leo G.M. van Rossum ◽  
Jan Meulstee ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Sick Leave ◽  
Cost Minimization ◽  
Controlled Trial ◽  
Operation Time ◽  
Ulnar Neuropathy ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Subcutaneous Transposition ◽  
Simple Decompression

Abstract OBJECTIVE: A randomized controlled trial was reported recently, in which simple decompression and anterior subcutaneous transposition were compared for treatment of ulnaropathy at the elbow. Clinically, both surgical options seem to be equally effective. The objective of this study is to compare the costs, from a societal standpoint, of simple decompression versus anterior subcutaneous transposition in Euros. METHODS: Published and unpublished data from a randomized controlled trial that compared simple decompression and anterior subcutaneous transposition were used. The investigators tabulated the actual costs incurred for professional fees, use of the operating room, duration of sick leave, reintervention, and treatment of complications directly related to the surgical treatment. RESULTS: The total costs per group and per patient were statistically significantly less for those treated with simple decompression. The total median costs per patient were 1124 for simple decompression and 2730 for anterior subcutaneous transposition. The main difference was in the costs related to sick leave, which is significantly shorter for simple decompression. There also was a statistically significant difference in operation time in favor of simple decompression. A remarkable finding was that paid workers in both treatment groups returned to work much later than unpaid workers. CONCLUSION: Although clinically equally effective, simple decompression was associated with lower cost than anterior subcutaneous transposition for the treatment of ulnar neuropathy at the elbow. Compared with anterior subcutaneous transposition, we recommend simple decompression for the treatment of idiopathic ulnar neuropathy at the elbow.

Intrauterine lidocaine infusion for pain management during outpatient transcervical tubal sterilization: a randomized controlled trial

Contraception ◽  
2012 ◽  
Vol 85 (3) ◽  
pp. 275-281 ◽  
Author(s):  
Michelle M. Isley ◽  
Jeffrey T. Jensen ◽  
Mark D. Nichols ◽  
Amy Lehman ◽  
Paula Bednarek ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Pain Management ◽  
Controlled Trial ◽  
Tubal Sterilization ◽  
Randomized Controlled
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