Independent Predictors of Increased Operative Time and Hospital Length of Stay Are Consistent Across Different Surgical Approaches to Pancreatoduodenectomy

SummarySelection of an appropriate surgical method for hysterectomy in an individual patient is currently an issue that remains open and debatable. This study aimed to analyze perioperative outcomes in gynecologic patients who underwent laparoscopic hysterectomy at a single institution during a 6-year period and to compare the data for simple hysterectomy patients treated with different surgical approaches. The study included a retrospective analysis of demographics, pre- and post-operative characteristics of 1,023 patients, operated on using four types of simple hysterectomy approaches: 635 laparoscopic hysterectomies (62.1%), 289 total abdominal hysterectomies (28.3%), 45 total vaginal hysterectomies (4.4%) and 54 robotic-assisted hysterectomies (5.3%). For the laparoscopic hysterectomy group, the mean operative time was shorter as compared to the abdominal and vaginal hysterectomy groups (p<0.05), as well as a significantly shorter hospital length-of-stay when compared to the abdominal, robotic or vaginal hysterectomy groups (p<0.05). Regression analysis revealed significant linear correlation between operative time and body-mass index of laparoscopic hysterectomy patients (R2 =0.008; p=0.026). Complications emergence and hemotransfusion often prolonged the mean operative time significantly by 17.8 min (p=0.002) and 15.5 min, respectively (p<0.001). The rate of major complications was significantly higher in the laparoscopic vs. abdominal groups (p<0.05). Clinical outcomes in patients operated on with laparoscopic hysterectomy were better than in those operated with total abdominal and vaginal hysterectomy in terms of operative time and hospital length-of-stay. Prospective randomized multi-center studies would be desirable to further define the place of the modern minimally invasive hysterectomy approaches.

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Similar Efficacy of Arthroscopy and Arthrotomy in Infection Eradication in the Treatment of Septic Knee: A Systematic Review and Meta-Analysis

Frontiers in Surgery ◽

10.3389/fsurg.2021.801911 ◽

2022 ◽

Vol 8 ◽

Author(s):

Zhimin Liang ◽

Xiaofan Deng ◽

Lingli Li ◽

Jing Wang

Keyword(s):

Mortality Rate ◽

Length Of Stay ◽

Septic Arthritis ◽

Operative Time ◽

Similar Efficacy ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Lower Complication ◽

Lower Complication Rate ◽

Infection Eradication

Aim: To compare the arthroscopy vs. arthrotomy for the treatment of native knee septic arthritis.Methods: Electronic databases of PubMed, Embase and Cochrane Library were searched for eligible studies. Retrospective comparative studies comparing arthroscopy or arthrotomy for patients with septic arthritis of the native knee were eligible for this review. The primary outcome was recurrence of infection after first procedure. The secondary outcomes included hospital length of stay, operative time, range of motion of the involved knee after surgery, overall complications and mortality rate,Results: Thirteen trials were included in this study. There were a total of 2,162 septic arthritis knees treated with arthroscopic debridement and irrigation, and 1,889 septic arthritis knees treated with open debridement and irrigation. Arthroscopy and arthrotomy management of the knee septic arthritis showed comparable rate of reinfection (OR = 0.85; 95% CI, 0.57–1.27; P = 0.44). No significant difference was observed in hospital length of stay, operative time and mortality rate between arthroscopy and arthrotomy management group, while arthroscopy treatment was associated with significantly higher knee range of motion and lower complication rate when compared with arthrotomy treatment.Conclusion: Arthroscopy and arthrotomy showed similar efficacy in infection eradication in the treatment of native septic knee. However, arthroscopy treatment was associated with better postoperative functional recovery and lower complication rate.

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Laparoscopic Shunt Revision Avoids Many Complications of Open Shunt Revision and Has Outcomes Similar to First-time Shunt Placement

The American Surgeon ◽

10.1177/000313481508100335 ◽

2015 ◽

Vol 81 (3) ◽

pp. 305-308

Author(s):

Heather Logghe ◽

John Maa ◽

Michael McDermott ◽

Michael Oh ◽

Jonathan Carter

Keyword(s):

Length Of Stay ◽

Retrospective Cohort ◽

Operative Time ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Shunt Revision ◽

Visceral Injury ◽

Shunt Placement ◽

Increased Risk ◽

First Time

Open revision of abdominal shunts is associated with increased risk of wound infection, visceral injury, hernia, and shunt complications. We hypothesized that laparoscopic revision mitigates these risks to a level similar to initial (i.e., first-time) shunt placement. This was a single-center, multisurgeon, retrospective cohort study of patients who underwent either laparoscopic initial shunt placement or laparoscopic shunt revision over a 5-year period. Outcomes were operative time, length of stay, and 30-day complication rate. Sixty-nine patients underwent laparoscopic shunt revision and 99 patients underwent laparoscopic initial shunt placement. Operative times were nearly identical (75 vs 73 minutes, P = 0.63). There were no significant differences in blood loss or hospital length of stay. Abdominal complications and total complications did not differ between groups. Laparoscopic shunt revision avoided many of the known complications of open shunt revision and had outcomes similar to initial laparoscopic shunt placement.

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Laparoendoscopic Single Site Cholecystectomy: The First 100 Patients

The American Surgeon ◽

10.1177/000313480907500808 ◽

2009 ◽

Vol 75 (8) ◽

pp. 681-686 ◽

Cited By ~ 12

Author(s):

Jonathan M. Hernandez ◽

Connor A. Morton ◽

Sharona Ross ◽

Michael Albrink ◽

Alexander S. Rosemurgy

Keyword(s):

Length Of Stay ◽

Pain Control ◽

Operative Time ◽

Hospital Length ◽

Single Site ◽

Hospital Length Of Stay ◽

Laparoendoscopic Single Site ◽

Small Series ◽

Time Period ◽

Median Operative Time

Laparoendoscopic single site (LESS) surgery promises improved cosmesis and possibly less pain. However, given the small series reported to date, true estimates of the advantages and possible disadvantages of LESS surgery remain unknown. This study was undertaken to evaluate the first 100 patients undergoing LESS cholecystectomy at our institution. Patients referred for cholecystectomy since November 2007 were considered for LESS cholecystectomy. Outcomes, including blood loss, operative time, complications, and length of stay, were recorded. Outcomes are compared with an uncontrolled concurrent group of patients undergoing multi-incision laparoscopic (i.e., conventional) cholecystectomy. One hundred patients with a median age of 44 years underwent LESS cholecystectomy; 30 patients with a median age of 46 years underwent conventional cholecystectomy over the same time period. Median operative time (70 vs 66 minutes, P = 0.67, Mann-Whitney) and hospital length of stay (1 vs 1 day, P = 0.81, Mann-Whitney) were not different for patients undergoing LESS or multi-incision cholecystectomies, respectively. Five patients undergoing LESS cholecystectomy had postoperative complications: cystic duct stump leak (one), pain control issues (three), and urinary retention (one). LESS cholecystectomy is a safe and effective alternative to conventional cholecystectomy. It can be undertaken without added operative time and provides patients with minimal, if any, scarring.

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Analysis of risk factors for unplanned reoperation following primary repair of gastrointestinal disorders in neonates

BMC Anesthesiology ◽

10.1186/s12871-021-01345-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yu Cui ◽

Rong Cao ◽

Jia Li ◽

Ling-mei Deng

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Length Of Stay ◽

Operative Time ◽

Primary Repair ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Gastrointestinal Disorders ◽

Factors Associated ◽

Link Type

Abstract Background The aim of our study was to identify the factors associated with unplanned reoperations among neonates who had undergone primary repair of gastrointestinal disorders. Methods A retrospective chart review was conducted for neonates who underwent primary gastrointestinal surgery between July 2018 and September 2020. The neonates were divided into two cohort, depending on whether they had an unplanned reoperation. The primary outcome was the occurrence of unplanned reoperation. The risk factors that associated the occurrence of unplanned reoperation were examined. Main results Two hundred ninety-six neonates fulfilled the eligibility criteria. The incidence of unplanned reoperation was 9.8%. Analyses of all patients with respect of developing unplanned reoperation showed that the length of operative time was an independent risk factor [Odds Ratio 1.02; 95% confidence interval 1.00, 1.04; p = 0.03]. Patients with unplanned reoperation had a longer postoperative hospital length-of-stay [19.9 ± 14.7 vs. 44.1 ± 32.1 days; p<0.01]. Conclusion The current study is the first analysis of risk factors associated with an unplanned reoperation in neonates undergoing primary repair of gastrointestinal disorders. The length of operative time is the only risk factor for an unplanned reoperation, and the unplanned reoperation can directly prolong the postoperative hospital length-of-stay. Trial registration This study was registered at http://www.chictr.org.cn/index.aspx with No. ChiCTR2000040260.

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The effect of operative time on in-hospital length of stay in revision total knee arthroplasty

Annals of Translational Medicine ◽

10.21037/atm.2019.01.54 ◽

2019 ◽

Vol 7 (4) ◽

pp. 66-66 ◽

Cited By ~ 7

Author(s):

Luke J. Garbarino ◽

Peter A. Gold ◽

Nipun Sodhi ◽

Hiba K. Anis ◽

Joseph O. Ehiorobo ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Length Of Stay ◽

Knee Arthroplasty ◽

Operative Time ◽

Revision Total Knee Arthroplasty ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Total Knee

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Unplanned Readmission Following Early Postoperative Complications After Fusion Surgery in Adult Spine Deformity: A Multicentric Study

Global Spine Journal ◽

10.1177/2192568221991101 ◽

2021 ◽

pp. 219256822199110

Author(s):

Gaston Camino-Willhuber ◽

Alfredo Guiroy ◽

Mariano Servidio ◽

Nelson Astur ◽

Fernando Nin-Vilaró ◽

...

Keyword(s):

Postoperative Complications ◽

Length Of Stay ◽

Spinal Deformity ◽

Adult Spinal Deformity ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Surgical Approaches ◽

Unplanned Readmission ◽

Multicentric Study ◽

Early Postoperative Complications

Study Design: Multicentric retrospective study, Level of evidence III. Objective: The objective of this multicentric study was to analyze the prevalence and risk factors of early postoperative complications in adult spinal deformity patients treated with fusion. Additionally, we studied the impact of complications on unplanned readmission and hospital length of stay. Methods: Eight spine centers from 6 countries in Latin America were involved in this study. Patients with adult spinal deformity treated with fusion surgery from 2017 to 2019 were included. Baseline and surgical characteristics such as age, sex, comorbidities, smoking, number of levels fused, number of surgical approaches were analyzed. Postoperative complications at 30 days were recorded according to Clavien-Dindo and Glassman classifications. Results: 172 patients (120 females/52 males, mean age 59.4 ± 17.6) were included in our study. 78 patients suffered complications (45%) at 30 days, 43% of these complications were considered major. Unplanned readmission was observed in 35 patients (20,3%). Risk factors for complications were: Smoking, previous comorbidities, number of levels fused, two or more surgical approaches and excessive bleeding. Hospital length of stay in patients without and with complications was of 7.8 ± 13.7 and 17 ± 31.1 days, respectively ( P 0.0001). Conclusion: The prevalence of early postoperative complications in adult spinal deformity patients treated with fusion was of 45% in our study with 20% of unplanned readmissions at 30 days. Presence of complications significantly increased hospital length of stay.

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