Overcoming ischemia in the diabetic foot: Minimally invasive treatment options

Objective: To critically appraise the methodological rigour of the clinical practice guidelines (CPGs) vis-à-vis BPH surgery as used by specialist research associations in the US, Europe and UK, and to compare whether the guidelines cover all or only some of the available treatments. Methods: The current guidelines issued by the EUA, AUA and NICE associations have been analyzed by 4 appraisers using the AGREE-II instrument. We also compared the recommendations given in the guidelines for surgical and minimally invasive treatment to find out which of these CPGs include most of the available treatment options. Results: According to the AGREE II tool, the median scores of domains were: domain 1 scope and purpose 66.7%, domain 2 stakeholder involvement 50.0%, domain 3 rigor of development 65.1%, domain 4 clarity of presentation 80.6%, domain 5 applicability 33.3%, domain 6 editorial independence 72.9%. The overall assessment according to AGREE II is 83.3%. The NICE guideline scored highest on 5 out of 6 domains and the highest overall assessment score (91.6%). The EAU guideline scored lowest on 4 out of 6 domains and has the lowest overall assessment score (79.1%). Conclusions: The analyzed CPGs comprehensively highlight the minimally invasive and surgical treatment options for BPH. According to the AGREE II tool, the domains for clarity of presentation and editorial independence received the highest scores. The stakeholder involvement and applicability domains were ranked as the lowest. Improving the CPG in these domains may help to improve the clinical utility and applicability of CPGs.

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Complications of laparoscopic cholecystectomy: an analysis of 1,695 laparoscopic operations

International Surgery Journal ◽

10.18203/2349-2902.isj20173885 ◽

2017 ◽

Vol 4 (9) ◽

pp. 3049

Author(s):

Dasharadha Jatothu ◽

Rajkumar Sade ◽

Kirthana Sade ◽

. Taruni ◽

Nagababu Pyadala

Keyword(s):

Laparoscopic Cholecystectomy ◽

Conservative Treatment ◽

Minimally Invasive ◽

Treatment Options ◽

Gallstone Disease ◽

Minimally Invasive Treatment ◽

Medical Sciences ◽

Invasive Treatment ◽

Gold Standard Method ◽

Operative Complication

Background: Laparoscopic cholecystectomy (LCs) is the gold standard method to treat gallstone disease. But there are some complications which occur frequently as compared to open cholecystectomy.Methods: The prospective study was conducted in the Department of Surgery, Kamineni Institute of Medical Sciences, Telengana during the period of 2 years; March 2015 to February 2017. A total of 1,695 laparoscopic cholecystectomy cases were included in this study. Several treatment options such as, conservative treatment, minimally invasive treatment and open surgery was performed based on the severity of the disease.Results: Majority of patients were female (83.9%) and most common age group affected was above 40 years. Intra-operative and post-operative complication occurred in 4.5% and 1.9% patients respectively. Majority complications were treated by conservative treatment and minimally invasive treatment. So, in conclusion, we can use conservative and minimally invasive treatment to manage the complications from laparoscopic cholecystectomy.Conclusions: Conservative treatment options and minimally invasive treatment was more efficient to overcome the post-operative complication of laparoscopic cholecystectomy.

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