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6.
BMC Gastroenterol ; 19(1): 222, 2019 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-31864290

RESUMO

BACKGROUND: Endoscopic nasobiliary drainage (ENBD) is widely used for biliary decompression in patients with biliary disease. However, it is difficult to reposition a nasobiliary catheter from the mouth to nostril. We developed a new device, which has a curved flexible loop and bar-handle, for repositioning of ENBD catheter. The aim of this study was to evaluate the usefulness of the new loop-device for facilitating the repositioning of an ENBD catheter from the mouth to nostril. METHODS: Between January 2015 and December 2017, a comparative observational study was performed to evaluate the time taken for repositioning a nasobiliary catheter during endoscopic retrograde cholangiopancreatography (ERCP) and compare the results of ENBD procedure between the new loop-device and conventional techniques. In the subgroup analysis, we evaluated the occurrence of oral cavity injury and the time taken to transfer ENBD catheter from the mouth to nostril. RESULTS: In all, 145 ENBD procedures were performed using these two techniques. The procedure time was significantly shorter in the new technique group than in the conventional group. (44 s vs. 194 s, p < 0.001). The total success rate of new device technique was 97.3%. No complication, including oral cavity injury, was observed. CONCLUSIONS: The technique using our new loop-device was useful for repositioning a nasobiliary catheter from the mouth to nostril in ERCP. The new device does not require the removal of the mouthpiece before ENBD positioning, which can help perform the ENBD procedure rapidly and avoid the finger injury of endoscopists.


Assuntos
Colangiopancreatografia Retrógrada Endoscópica , Remoção de Dispositivo/instrumentação , Drenagem/instrumentação , Intubação/instrumentação , Nariz , Idoso , Bile , Distribuição de Qui-Quadrado , Remoção de Dispositivo/métodos , Remoção de Dispositivo/estatística & dados numéricos , Drenagem/métodos , Desenho de Equipamento , Feminino , Humanos , Intubação/métodos , Intubação/estatística & dados numéricos , Masculino , Ilustração Médica , Pessoa de Meia-Idade , Boca/lesões , Orofaringe/anatomia & histologia , Estatísticas não Paramétricas , Fatores de Tempo
7.
Int J Pediatr Otorhinolaryngol ; 126: 109595, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31351347

RESUMO

PURPOSE: Nasopharyngeal airways (NPA) are commonly used to relieve upper airway obstruction in children. They must be sized to extend posterior to the tongue base but remain above the epiglottis. To avoid obstruction from nasal secretions, frequent irrigation with saline is required. We hypothesized that NPAs would swell when exposed to saline irrigation. METHODS: Twenty-five green Rusch NPA size 12, 14, 16, 18 and 20 Fr were submerged in 2 L of normal saline for 15 days. Tube length, inner diameter, outer diameter and wall thickness were measured on days 1,2,3,4,5,10, and 15 and compared using two-way repeated measures ANOVA and paired t-tests with Bonferroni correction. RESULTS: All dimensions increased significantly with exposure to saline. Increases in length, inner diameter, outer diameter and wall thickness were dependent on original tube size (p < 0.05) and duration of exposure to saline (p < 0.001). The increase in tube length was greatest over the first five days. CONCLUSION: NPAs expand significantly when exposed to saline with the greatest increase in length occurring in the first five days. This could lead to gagging or airway obstruction in small children. Patients with NPAs should be monitored closely for these signs and new materials should be sourced to prevent these issues.


Assuntos
Obstrução das Vias Respiratórias/terapia , Falha de Equipamento , Intubação/instrumentação , Nasofaringe , Solução Salina/efeitos adversos , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Intubação/efeitos adversos
8.
Medicine (Baltimore) ; 98(26): e15832, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31261492

RESUMO

Cobra Perilaryngeal Airway (Cobra-PLA) is a relatively new single-use supraglottic device employed during general anesthesia. This meta-analysis includes randomized controlled trials (RCTs) yielding extensive comparison results among Cobra-PLA, Laryngeal Mask Airway (LMA)-Classic, and LMA-Unique.Two authors performed searches in EMBASE, CENTRAL, PubMed, and ScienceDirect to identify RCTs that compared Cobra-PLA with LMA-Classic and with LMA-Unique in patients undergoing general anesthesia. Both random- and fixed-effects models were used. Begg's funnel plot was used to evaluate publication bias.Twenty-two RCTs with a total of 1845 patients were included. Cobra-PLA offered significantly higher oropharyngeal leak pressure than LMA-Classic [mean difference (MD) = 3.56 (1.56, 5.55), P = .0005] and LMA-Unique [MD = 4.44 (2.12, 6.76), P = .0002]. First-insertion success rate, ease of insertion, insertion time, and reported complications among Cobra-PLA, LMA-Classic, and LMA-Unique were similar.Compared with the commonly used LMA-Classic and LMA-Unique, Cobra-PLA provides superior airway sealing.


Assuntos
Intubação/instrumentação , Anestesia Geral/instrumentação , Falha de Equipamento , Humanos , Orofaringe , Ensaios Clínicos Controlados Aleatórios como Assunto
9.
J Pediatr Ophthalmol Strabismus ; 56(3): 188-193, 2019 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-31116868

RESUMO

PURPOSE: To assess the success rate of external dacryocystorhinostomy (DCR) with silicone intubation for recurrent lacrimal abscess in children younger than 6 years. METHODS: A single-center retrospective analysis of 46 eyes of 40 children who underwent DCR with silicone tube intubation for recurrent lacrimal abscess was done. Probing done previously in these cases was unsuccessful. Only those children who underwent incision and drainage of the abscess at least once with antibiotic treatment were included in the study. In all cases, silicone tube removal was done after 3 months. A successful outcome was defined as the absence of subjective complaints of pain and swelling over the medial canthal area and watering and discharge at 6 months postoperatively. Objective assessment of patency of the lacrimal apparatus was done by sac syringing at 6 months postoperatively. RESULTS: The mean age at surgery was 4.93 ± 0.93 years (range: 3 to 6 years) and the mean follow-up duration was 11.80 ± 11.87 months (range: 6 to 84 months). Intra-operative difficulties encountered were excessive perisac adhesion (n = 28) and severe bleeding/hemorrhage (n = 24). A total of 82.61% cases had a successful outcome after DCR with silicon tube intubation. One child had granuloma formation at the wound. Spontaneous tube extrusion occurred in three children. CONCLUSIONS: DCR with silicone tube intubation is a safe and effective surgical approach with satisfactory outcomes for treating recurrent lacrimal abscess with congenital nasolacrimal duct obstruction in children younger than 6 years. [J Pediatr Ophthalmol Strabismus. 2019;56(3):188-193.].


Assuntos
Abscesso/cirurgia , Dacriocistorinostomia/métodos , Infecções Oculares Bacterianas/cirurgia , Intubação/instrumentação , Obstrução dos Ductos Lacrimais/congênito , Ducto Nasolacrimal/cirurgia , Elastômeros de Silicone , Abscesso/etiologia , Criança , Pré-Escolar , Infecções Oculares Bacterianas/etiologia , Feminino , Seguimentos , Humanos , Obstrução dos Ductos Lacrimais/complicações , Masculino , Ducto Nasolacrimal/anormalidades , Período Pós-Operatório , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento
11.
Clin Biomech (Bristol, Avon) ; 65: 73-80, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30991233

RESUMO

BACKGROUND: High flow nasal cannula therapy is a form of respiratory support which delivers high flow rates of heated, humidified gas to the nares via specialized cannula. Two primary mechanisms of action attributed to the therapy are the provision of positive airway pressure as well as clearance of CO2-rich exhaled gas from the upper airways. METHODS: Physiologically accurate nose-throat airway replicas were connected at the trachea to a lung simulator, where CO2 was supplied to mimic the CO2 content in exhaled gas. Cannula delivered either air, oxygen or heliox (80/20%volume helium/oxygen) to the replicas at flow rates ranging from 0 to 60 l/min. Five replicas and three cannulas were compared. Tracheal pressure and CO2 concentration were continuously measured. The lung simulator provided breaths with tidal volume of 500 ml and frequency of 18 breaths/min. Additional clearance measurements were conducted for tidal volume and breathing frequency of 750 ml and 27 breaths/min, respectively. FINDINGS: Cannula flow rate was the dominant factor governing CO2 concentration. Average CO2 concentration decreased with increasing cannula flow rate, but above 30 L/min this effect was less pronounced. Tracheal positive end-expiratory pressure increased with flow rate and was lower for heliox than for air or oxygen. A predictive correlation was developed and used to predict positive end-expiratory pressure for a given cannula size as a function of supplied flow rate and occlusion of the nares. INTERPRETATION: Compared with administration of air or oxygen, administration of heliox is expected to result in similar CO2 clearance from the upper airway, but markedly lower airway pressure.


Assuntos
Cânula , Dióxido de Carbono/metabolismo , Hélio/administração & dosagem , Intubação , Oxigenoterapia , Oxigênio/administração & dosagem , Adulto , Feminino , Humanos , Intubação/instrumentação , Intubação/métodos , Masculino , Nariz , Oxigenoterapia/instrumentação , Oxigenoterapia/métodos
12.
Rinsho Shinkeigaku ; 59(4): 177-184, 2019 Apr 25.
Artigo em Japonês | MEDLINE | ID: mdl-30930364

RESUMO

Levodopa-carbidopa intestinal gel (LCIG) therapy has been established as a device-aided treatment for advanced Parkinson's disease. We retrospectively investigated the issues related to LCIG therapy in patients with Parkinson's disease at our hospital from March 2014 to July 2018. The subjects were 18 patients including nine men and nine women. The mean duration of PD symptoms and motor fluctuation was 14.5 ± 5.9 and 7.2 ± 4.5 years, respectively. The mean age at initiation of LCIG was 60.1 ± 9.4 years and the mean treatment period was 21.1 ± 19.5 months. One hundred and sixteen LCIG-associated issues were observed, including pain at the gastrostomy site (23 cases), hypergranulation tissue (14 cases), skin redness and/or erosions (11 cases), cutaneous infections at the gastrostomy site (eight cases), percutaneous endoscopic gastrojejunostomy (PEG-J) tube occlusion in the gastrointestinal tract (19 cases), irremovable PEG-J tube (13 cases), dislocation of the PEG-J tube (six cases), and breakage of the connector (eight cases). The majority of these issues were easily diagnosed and could be managed by neurologists who are familiar with LCIG therapy.


Assuntos
Antiparkinsonianos/administração & dosagem , Carbidopa/administração & dosagem , Gastrostomia/efeitos adversos , Gastrostomia/instrumentação , Levodopa/administração & dosagem , Doença de Parkinson/tratamento farmacológico , Idoso , Combinação de Medicamentos , Feminino , Derivação Gástrica/efeitos adversos , Derivação Gástrica/instrumentação , Géis , Glicosídeos , Humanos , Bombas de Infusão/efeitos adversos , Intubação/efeitos adversos , Intubação/instrumentação , Masculino , Pessoa de Meia-Idade , Pregnanos , Estudos Retrospectivos , Dermatopatias Infecciosas/etiologia
13.
J Glaucoma ; 28(4): e64-e65, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30946278

RESUMO

PURPOSE: To describe an unusual case of glaucoma drainage tube blockage. PATIENTS: A 76-year-old woman presented with left endothelial graft failure. Her previous ocular history included primary open-angle glaucoma diagnosed for 15 years and Fuch's endothelial dystrophy. Three years before presentation, the left eye required a Descemet stripping endothelial keratoplasty followed by a trabeculectomy with mitomycin C and subsequent Baerveldt tube insertion 3 years previously. Intraocular pressures were right 9 and left 19 mm Hg. The endothelial graft demonstrated supra-temporal edema, in proximity to the sulcus placed tube tip. METHODS: A repeat endothelial keratoplasty was undertaken. During surgery, an attempt to flush the tube ab internally with balanced salt solution on a 27-G Rycroft cannula, resulted in extrusion of a long translucent tubular plug from within the silicone tube into the anterior chamber. This was removed with intraocular forceps and sent for histopathology. The endothelial keratoplasty was performed and an air bubble placed in the anterior chamber. RESULTS: The histopathology was reported as fibrinohemorrhagic material associated with refractile material, detected under polarized light microscopy. At 6 months follow-up, the graft was clearing well, the tube in situ and the intraocular pressure 6 mm Hg. CONCLUSIONS: One possible cause of the refractile material within the specimen is spalled particles of silicone, presumably from the tube. This finding potentially questions the long-term stability of silicone products in the eye and may be a cause of capsular fibrosis around the glaucoma drainage device plate.


Assuntos
Implantes para Drenagem de Glaucoma , Glaucoma de Ângulo Aberto/cirurgia , Intubação/instrumentação , Falha de Prótese , Idoso , Ceratoplastia Endotelial com Remoção da Lâmina Limitante Posterior , Feminino , Distrofia Endotelial de Fuchs/cirurgia , Rejeição de Enxerto/etiologia , Rejeição de Enxerto/cirurgia , Humanos , Pressão Intraocular/fisiologia , Microscopia de Polarização , Implantação de Prótese , Reoperação , Acuidade Visual/fisiologia
14.
Ophthalmology ; 126(9): 1324-1329, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-30953742

RESUMO

PURPOSE: To determine the efficacy and complication rates of monocanalicular stents in the setting of canalicular lacerations. METHODS: A literature search was performed in May 2018 in the PubMed database to identify all English-language reports of monocanalicular stenting to address canalicular lacerations. Studies that did not include at least 10 patients with at least 3 months of follow-up evaluation after surgery were excluded. Ninety-nine articles were identified, and 15 of these met criteria for data abstraction and were included in this assessment. The panel methodologist (V.K.A.) evaluated the quality of evidence and assigned a level-of-evidence rating to each of these studies. RESULTS: All 15 studies were rated as level III evidence. Anatomic and functional success rates after surgery ranged from 68% to 100% and 79% to 100%, respectively. Stents were generally well tolerated, although extrusion rates varied from 0% to 29%. CONCLUSIONS: Only level III evidence was available, and studies were not powered to detect differences between groups for rare complications or failure. Monocanalicular stents seem to be efficacious and well tolerated in the management of canalicular lacerations. Potential complications include extrusion (most commonly), tube displacement, granuloma, ectropion, slit punctum, fistula, and infection. Further comparative studies would help to identify the optimal time for device removal and to directly compare monocanalicular with bicanalicular stents.


Assuntos
Traumatismos Oculares/cirurgia , Pálpebras/lesões , Intubação/instrumentação , Lacerações/cirurgia , Aparelho Lacrimal/lesões , Stents , Avaliação da Tecnologia Biomédica , Academias e Institutos/organização & administração , Humanos , Procedimentos Cirúrgicos Oftalmológicos , Oftalmologia/organização & administração , Estudos Retrospectivos , Estados Unidos
15.
Ophthalmic Plast Reconstr Surg ; 35(5): 451-455, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30844917

RESUMO

PURPOSE: To evaluate the use of bicanalicular silicone intubation for the management of punctal stenosis and obstruction in patients with allergic conjunctivitis. METHODS: A retrospective interventional case series of patients with acquired epiphora due to stenotic or obstructed puncta as a result of allergic conjunctivitis was performed. Punctal dilation and bicanalicular silicone intubation were performed in all patients. Munk Scale for grading of epiphora along with grading of fluorescein dye disappearance test was used to evaluate the functional improvement. Grading of punctal stenosis using Kashkouli's grading system was applied to evaluate the anatomical improvement. Patients having canalicular or nasolacrimal duct obstruction, punctal stenosis, and obstruction due to other causes were excluded. RESULTS: Fifty-one patients met the inclusion criteria with male-female ratio of 1:1.55 and an average age of 46 years at presentation. High patient tolerances without complications with the use of tubes were reported. Significant improvement 6 months after tube removal in comparison to preoperative period was found with anatomical and functional success rate of 91.83% and 87.75%, respectively. Two patients had a recurrence of the punctal stenosis many months after stent removal because of the early tube prolapse and exacerbation of the allergic conjunctivitis. CONCLUSIONS: Bicanalicular silicone intubation seems to be a well-tolerated and effective tool in the management of acquired punctal stenosis or obstruction secondary to allergic conjunctivitis. Bicanalicular silicone intubation appears to be a good option as patients with allergic conjunctivitis typically present with bilateral involvement of both puncti.


Assuntos
Conjuntivite Alérgica/complicações , Dacriocistorinostomia/métodos , Intubação/instrumentação , Obstrução dos Ductos Lacrimais/terapia , Ducto Nasolacrimal/cirurgia , Stents , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
17.
West J Emerg Med ; 20(1): 117-121, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30643613

RESUMO

Introduction: Opportunities for chest tube placement in emergency medicine training programs have decreased, making competence development and maintenance with live patients problematic. Available trainers are expensive and may require costly maintenance. Methods: We constructed an anatomically-detailed model using a Halloween skeleton thorax, dress form torso, and yoga mat. Participants in a trial session completed a survey regarding either their comfort with chest tube placement before and after the session or the realism of Yogaman vs. cadaver lab, depending on whether they had placed <10 or 10 or more chest tubes in live patients. Results: Inexperienced providers reported an improvement in comfort after working with Yogaman, (comfort before 47 millimeters [mm] [interquartile ratio {IQR}, 20-53 mm]; comfort after 75 mm [IQR, 39-80 mm], p=0.01). Experienced providers rated realism of Yogaman and cadaver lab similarly (Yogaman 79 mm [IQR, 74-83 mm]; cadaver lab 78 mm [IQR, 76-89 mm], p=0.67). All evaluators either agreed or strongly agreed that Yogaman was useful for teaching chest tube placement in a residency program. Conclusion: Our chest tube trainer allowed for landmark identification, tissue dissection, pleura puncture, lung palpation, and tube securing. It improved comfort of inexperienced providers and was rated similarly to cadaver lab in realism by experienced providers. It is easily reusable and, at $198, costs a fraction of the price of available commercial trainers.


Assuntos
Tubos Torácicos , Educação/economia , Internato e Residência , Intubação/instrumentação , Manequins , Medicina de Emergência/educação , Humanos , Intubação/métodos
18.
Graefes Arch Clin Exp Ophthalmol ; 257(4): 799-804, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30610423

RESUMO

PURPOSE: This study compared the efficacy and safety of Ahmed glaucoma valve (AGV) implantation versus suprachoroidal silicone tube (SST) implantation after the injection of bevacizumab into the anterior chamber in patients with neovascular glaucoma. METHODS: Patients were randomly assigned to undergo AGV or SST implantation. Bevacizumab was injected into the anterior chamber at a dosage of 1.25 mg/0.1 mL, 1 week before surgery. Intraocular pressure (IOP) control, complication, and success rates were compared between the groups. Success was defined as a final IOP > 5 mmHg, < 22 mmHg with or without any antiglaucoma drug. RESULTS: A total of 23 patients were enrolled in the study, including 13 (56.5%) in the AGV group (group 1) and 10 (43.5%) in the SST group (group 2). The mean baseline IOP was 42.0 ± 9.1 mmHg in group 1 and 39.5 ± 10 mmHg in group 2 (p > 0.05). The mean IOP was 16.9 ± 7.0 mmHg in group 1 and 12.5 ± 6.7 mmHg in group 2 on the first day after surgery. After a mean follow-up period of 19.4 ± 5.2 months, success was achieved in 12 (92.3%) patients in group 1 and in 1 (10%) patient in group 2. There was a statistically significant difference in terms of the success rate between groups (p < 0.05). Complications included hyphema in three (23%) patients, obstruction of the AGV tube by iris tissue in one (7.7%) patient, and tube exposure in one patient (7.7%) in group 1. Suprachoroidal silicone tube dislocation to the anterior chamber was observed in one (10%) patient in group 2. CONCLUSION: AGV implantation after the injection of bevacizumab into the anterior chamber had a higher success rate than SST implantation. Complications were seen more frequently in the AGV group.


Assuntos
Inibidores da Angiogênese/uso terapêutico , Câmara Anterior/efeitos dos fármacos , Bevacizumab/uso terapêutico , Implantes para Drenagem de Glaucoma , Glaucoma Neovascular/terapia , Silicones , Inibidores da Angiogênese/administração & dosagem , Bevacizumab/administração & dosagem , Estudos de Casos e Controles , Terapia Combinada , Feminino , Seguimentos , Glaucoma Neovascular/tratamento farmacológico , Glaucoma Neovascular/fisiopatologia , Glaucoma Neovascular/cirurgia , Humanos , Injeções Intraoculares , Pressão Intraocular/fisiologia , Intubação/instrumentação , Masculino , Pessoa de Meia-Idade , Implantação de Prótese , Resultado do Tratamento , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Acuidade Visual/fisiologia
19.
Spinal Cord ; 57(4): 308-316, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30459468

RESUMO

STUDY DESIGN: A prospective, randomized crossover trial. OBJECTIVES: To evaluate the efficacy of the combination of incentive spirometry with oscillation (OIS) and positive expiratory pressure with oscillation (OPEP) to promote secretion clearance in intubated patients with cervical spinal cord injury. SETTING: Spinal cord unit, tertiary care hospital, North East Thailand. METHODS: Thirteen intubated patients (C4-7, AIS score C) with secretion retention performed three interventions randomly allocated on consecutive days, a Sham deep breathing, OPEP and OPEP + OIS breathing exercise. Secretions were collected by sterile suction for 3 h before, and 3 h after, each intervention and wet weight recorded. Cardiopulmonary parameters were measured before and after each intervention. RESULTS: The median (IQR) secretion wet weight pre-intervention was 2.61 g (2.21, 3.85) and in the 3 h after Sham there was an increase of 1.97 g (0.6, 3.6). The increase after OPEP was 2.67 g (1.7, 3.9) and after OPEP + OIS, 4.28 g (2.4, 6.7); all the increases being significant (p ≤ 0.007). The clearance after OPEP and OPEP + OIS were both greater than Sham while OPEP + OIS was greater than OPEP (p ≤ 0.019). There were no significant changes in cardiopulmonary measures following any intervention or when compared between interventions. CONCLUSIONS: Deep breathing with an oscillated and humidified air flow in a combination of OIS + OPEP more than doubled secretion clearance and was more effective than OPEP or Sham deep breathing. There were no adverse effects of the procedures which were well tolerated by the patients and may be used to complement existing methods for secretion clearance.


Assuntos
Secreções Corporais , Medula Cervical/lesões , Intubação , Respiração , Terapia Respiratória , Traumatismos da Medula Espinal/terapia , Adulto , Idoso , Estudos Cross-Over , Feminino , Humanos , Umidade , Intubação/instrumentação , Masculino , Pessoa de Meia-Idade , Ventilação Pulmonar , Terapia Respiratória/instrumentação , Terapia Respiratória/métodos , Traumatismos da Medula Espinal/fisiopatologia , Espirometria , Resultado do Tratamento
20.
Asian J Surg ; 42(1): 71-80, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30266465

RESUMO

This meta-analysis aimed to compare the effectiveness of the suprapubic drainage and urethral catheterization after robot-assisted radical prostatectomy (RARP). PubMed, EMBASE, Cochrane Library and China Biology Medicine disc were systematically researched from their inception to December 2017. We selected randomized controlled trials, cohort studies comparing suprapubic tube with urethral catheter drainage in RARP patients. A meta-analysis was performed using R software, and a random-effects model was used to pool the effect size. Ten studies met eligibility criteria (N = 1248), including 3 RCTs, 3 prospective studies and 4 retrospective studies. Suprapubic drainage was associated with a reduction in the penile pain (39.64% [44 of 111]) compared with the UC group (62% [106 of 171]) (pooled RR 0.57, 95% CI 0.31 to 1.02, P = 0.05). However, two groups showed similarity in the overall pain (Postoperative days 1-3: pooled MD -0.26, 95% CI 1.34 to 0.83, P = 0.64; Postoperative days 6-7: pooled MD -0.50, 95% CI -1.54 to 0.54, P = 0.34), urinary incontinence (pooled RR 0.80, 95% CI 0.56 to 1.15, P = 0.23), bladder neck contracture (pooled RR 0.77, 95% CI 0.39 to 1.53, P = 0.45), urinary retention (pooled RR 0.88, 95% CI 0.29 to 2.70, P = 0.82), anastomotic stricture (P = 0.15), urethral stricture (P = 0.84) and bacteriuria (P = 0.40). The present meta-analysis showed that suprapubic drainage may be associated with less penile pain, but there was no conclusive evidence that suprapubic drainage was advantaged in other outcomes. Due to the low quality and small quantity of the available comparative studies, more high-quality randomized trials are needed to provide stronger evidence of the benefits of the two routes.


Assuntos
Drenagem/instrumentação , Drenagem/métodos , Intubação/instrumentação , Intubação/métodos , Dor Pós-Operatória/prevenção & controle , Prostatectomia/métodos , Procedimentos Cirúrgicos Robóticos/métodos , Cateteres Urinários , Bases de Dados Bibliográficas , Humanos , Masculino , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como Assunto , Software , Fatores de Tempo
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