299. Management of temporary stoma after elective surgery in an Italian tertiary care referral center for rectal cancer “COMRE Group”

2014 ◽  
Vol 40 (11) ◽  
pp. S117-S118
Author(s):  
S. Scabini ◽  
E. Rimini ◽  
A. Massobrio ◽  
E. Romairone
Keyword(s):  
Rectal Cancer ◽  
Elective Surgery ◽  
Tertiary Care ◽  
Referral Center ◽  
Temporary Stoma

The Ferguson Operating Anoscope for Resection of T1 Rectal Cancer

2016 ◽  
Vol 82 (11) ◽  
pp. 1105-1108
Author(s):  
Kristin C. Turza ◽  
Thomas Brien ◽  
Steven Porbunderwala ◽  
Christopher M. Bell ◽  
Shauna Lorenzo-rivero ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Anal Verge ◽  
Tertiary Care ◽  
Primary Lung Cancer ◽  
Disease Free Survival ◽  
Rectal Tumors ◽  
Salvage Operation ◽  
T1 Rectal Cancer

The Ferguson Operating Anoscope (FOA) is a surgical instrument, which can facilitate transanal excision of appropriate rectal tumors within 15 cm of the anal verge. Previous work showed low recurrence (4.3%) for favorable T1 tumors (no lymphovascular invasion, well/moderate differentiation, negative margins). This follow-up study evaluates outcomes in rectal cancer excised with FOA at a tertiary care center. T1 rectal cancer patients were identified in a prospectively maintained database. Tumor pathology and patient characteristics were reviewed. Primary outcomes include tumor recurrence and patient and disease-free survival. Secondary outcomes are quality of excision (intact specimen). Twenty-eight patients had pathologic stage T1 rectal cancer (average 8 ± 2.6 cm from the anal verge). Final path demonstrated 14 per cent to be well differentiated, 82 per cent moderately differentiated, and 93 per cent without angiolymphatic invasion. All specimens removed were intact. One patient had a true local recurrence and underwent a salvage operation 24 months after her index operation. Patient survival was 96.4 per cent (n = one death from primary lung cancer) at median follow-up 64 ± 35 months. With appropriate tumor selection and quality of initial resection, FOA has demonstrated utility in achieving optimal oncologic resection of T1 rectal tumors.

scholarly journals Recurrence pattern of rectal cancer after surgical treatment. Analysis of 122 patients in a tertiary care center

2018 ◽  
Vol 38 (1) ◽  
pp. 18-23
Author(s):  
Gustavo Sevá-Pereira ◽  
Roberta Nascimento Cypreste ◽  
Joaquim José Oliveira Filho ◽  
Sandra Pedroso de Moraes ◽  
Paula Buozzi Tarabay
Keyword(s):  
Rectal Cancer ◽  
Surgical Treatment ◽  
Care Center ◽  
Tertiary Care ◽  
Recurrence Pattern ◽  
Tertiary Care Center ◽  
Treatment Analysis

scholarly journals Experiences of a “COVID protected” robotic surgical centre for colorectal and urological cancer in the COVID-19 pandemic

2021 ◽  
Author(s):  
Jeremy R. Huddy ◽  
Matthew Crockett ◽  
A Shiyam Nizar ◽  
Ralph Smith ◽  
Manar Malki ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Robotic Surgery ◽  
Length Of Stay ◽  
Elective Surgery ◽  
Standard Operating Procedure ◽  
Major Surgery ◽  
Renal Surgery ◽  
Increased Risk ◽  
Acute Hospitals ◽  
Da Vinci Si

AbstractThe recent COVID-19 pandemic led to the cancellation of elective surgery across the United Kingdom. Re-establishing elective surgery in a manner that ensures patient and staff safety has been a priority. We report our experience and patient outcomes from setting up a “COVID protected” robotic unit for colorectal and renal surgery that housed both the da Vinci Si (Intuitive, Sunnyvale, CA, USA) and the Versius (CMR Surgical, Cambridge, UK) robotic systems. “COVID protected” robotic surgery was undertaken in a day-surgical unit attached to the main hospital. A standard operating procedure was developed in collaboration with the trust COVID-19 leadership team and adapted to national recommendations. 60 patients underwent elective robotic surgery in the initial 10-weeks of the study. This included 10 colorectal procedures and 50 urology procedures. Median length of stay was 4 days for rectal cancer procedures, 2 days less than prior to the COVID period, and 1 day for renal procedures. There were no instances of in-patient coronavirus transmission. Six rectal cancer patients waited more than 62 days for their surgery because of the initial COVID peak but none had an increase T-stage between pre-operative staging and post-operative histology. Robotic surgery can be undertaken in “COVID protected” units within acute hospitals in a safe way that mitigates the increased risk of undergoing major surgery in the current pandemic. Some benefits were seen such as reduced length of stay for colorectal patients that may be associated with having a dedicated unit for elective robotic surgical services.

Clinical Features of Patients with Episcleritis and Scleritis in an Italian Tertiary Care Referral Center

2014 ◽  
Vol 24 (3) ◽  
pp. 293-298 ◽  
Author(s):  
Luigi Berchicci ◽  
Elisabetta Miserocchi ◽  
Maura Di Nicola ◽  
Carlo La Spina ◽  
Francesco Bandello ◽  
...  
Keyword(s):  
Clinical Features ◽  
Tertiary Care ◽  
Referral Center

Management of Insulinomas: Analysis from a Tertiary Care Referral Center in India

2008 ◽  
Vol 32 (4) ◽  
pp. 576-582 ◽  
Author(s):  
Thomas V. Paul ◽  
Jubbin J. Jacob ◽  
Senthil K. Vasan ◽  
Nihal Thomas ◽  
Simon Rajarathnam ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Referral Center

Outcomes of diuretic use in pre-dialysis CKD patients with moderate renal deterioration attending tertiary care referral center

2017 ◽  
Vol 21 (6) ◽  
pp. 1011-1023 ◽  
Author(s):  
Yusra Habib Khan ◽  
Azmi Sarriff ◽  
Azreen Syazril Adnan ◽  
Amer Hayat Khan ◽  
Tauqeer Hussain Mallhi
Keyword(s):  
Tertiary Care ◽  
Renal Deterioration ◽  
Referral Center

scholarly journals Severity and prognosis in intensive care: prospective application of the Apache II Index

1999 ◽  
Vol 117 (5) ◽  
pp. 205-214 ◽  
Author(s):  
Joel Isidoro Costa ◽  
José Luiz Gomes do Amaral ◽  
Masashi Munechika ◽  
Yara Juliano ◽  
José Gomes Bezerra Filho
Keyword(s):  
Intensive Care ◽  
Mortality Rate ◽  
Elective Surgery ◽  
Tertiary Care ◽  
Prognostic Index ◽  
Clinical Severity ◽  
Apache Ii ◽  
Sample Population ◽  
Significant Difference ◽  
Critical Patients

CONTEXT: The performance of each ICU needs to be assessed within the overall context of medical care, as well as by the institution which the ICU forms part of. Evaluation mechanisms in the field of intensive care have been developed that are recognized worldwide within the scientific literature. OBJECTIVE: To study outcomes from groups of critical patients and to compare their actual and estimated mortality rates. DESIGN: Prospective study of patients' outcomes. SETTING: A tertiary care unit for a period of 13 months (anesthesiology intensive care unit at the Escola Paulista de Medicina). PARTICIPANTS: 520 patients selected according to sex, age and nature of hospitalization. DIAGNOSTIC TEST: The modified APACHE II prognostic index was applied in order to assess clinical severity and anticipation of mortality in three groups who had non-surgical treatment, emergency surgery and elective surgery. MAIN MEASUREMENTS: The APACHE II index. RESULTS: The application of this index allowed patients to be stratified and expected death risks for both subgroups and the entire sample population to be calculated. The observed mortality rate was greater than the expected rate (28.5% versus 23.6%, respectively), with a statistically significant difference. The standardized mortality rate was 1.20. Patients who obtained scores above 25 presented a significant outcome towards death. The most severe and worst evolving cases were, in decreasing order: non-surgical, emergency surgical and scheduled surgical patients; the actual general mortality rate was higher than the expected one. CONCLUSIONS: The use of the APACHE II index made it possible to stratify critical patient groups according to the severity of their condition.

scholarly journals Early versus delayed cholecystectomy in acute cholecystitis: a comparative study in a tertiary care hospital

2020 ◽  
Vol 7 (8) ◽  
pp. 2656
Author(s):  
Jamal Uddin Ahmed ◽  
Subal Rajbongshi ◽  
Najim Hiquemat
Keyword(s):  
Acute Cholecystitis ◽  
Elective Surgery ◽  
Tertiary Care ◽  
Definitive Treatment ◽  
P Value ◽  
Care Hospital ◽  
Early Cholecystectomy ◽  
Delayed Cholecystectomy ◽  
Surgery Group ◽  
Duration Of Surgery

Background: For patients with acute cholecystitis the timing of operative intervention has two broad approaches- early cholecystectomy and elective or delayed cholecystectomy. The main advantage of early cholecystectomy is that, it offers a definitive treatment during the same admission and avoids the problem of failed conservative treatment. The present study is an endeavour to discuss and to compare the outcome of management of acute cholecystitis with early and delayed cholecystectomy.Methods: 100 patients with clinical diagnosis of acute cholecystitis, admitted in the surgical wards of Gauhati Medical College and Hospital during the period of 1st July 2017 to 30th June 2018 were selected for the study. 40 patients underwent early cholecystectomy (within 7 days of onset of symptoms) and 60 patients underwent elective or late cholecystectomy (after a gap of 6-8 weeks from the acute attack).Results: In the present series the average duration of surgery was 90.37±11.96 minutes in the early group and 65.3±7.83 minutes for the elective group which is found to be statistically significant (p value<0.05). In the early surgery group 8.33% required conversion to open surgery. In the elective surgery group 3.63% required conversion. Wound infection, biliary leakage, bile duct injury, and respiratory tract infection was found to be statistically not significant between the two groups.Conclusions: Early cholecystectomy is feasible and safe for acute cholecystitis and is better method of treatment because of its shorter hospital stay, which is a major economic benefit to both the patient and health care system.

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