Does operative time influence length of hospital stay following orthognathic surgery?

Author(s):  
H. Al-Ismaili ◽  
S. Al-Azri ◽  
A. Al-Hashmi ◽  
M. Al-Nabhani
2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
M. Carbonnel ◽  
H. Abbou ◽  
H. T. N’Guyen ◽  
S. Roy ◽  
G. Hamdi ◽  
...  

Objectives. A prospective study was carried out to compare vaginal hysterectomy (VH) and robotically assisted hysterectomy (RH) for benign gynecological disease.Materials and Methods. All patients who underwent hysterectomy from March 2010 to March 2012 for a benign disease were included. Patients’ demographics per and post surgery results were collected from medical files. A questionnaire was also conducted 2 months after surgery.Results. Sixty patients were included in the RH group and thirty four in the VH one. Operative time was significantly longer in the RH group ( versus  min; ). Blood loss and length of hospital stay were significantly reduced: versus  ml; , and versus days; , respectively. Less pain was reported at D1 and D2 by RH patients, and levels of analgesia were lower compared to those observed in the VH group. No differences were found regarding the rate of conversion to laparotomy, intra- or postoperative complications.Conclusion. Robotically assisted hysterectomy appears to reduce blood loss, postoperative pain, and length of hospital stay, but it is associated with longer operative time and higher cost. Specific indications for RH remain to be defined.


2020 ◽  
pp. 1-7
Author(s):  
Zhenhua Gu ◽  
Yucheng Yang ◽  
Rui Ding ◽  
Meili Wang ◽  
Jianming Pu ◽  
...  

<b><i>Background:</i></b> Advances in micro-percutaneous nephrolithotomy (PCNL) for kidney stones have made it an alternative approach to the retrograde intrarenal surgery (RIRS) approach. Nevertheless, the superiority of micro-PCNL over RIRS is still under debate. The results are controversial. <b><i>Objectives:</i></b> The purpose of this study was to systematically evaluate the clinical results in patients presenting with kidney stones treated with micro-PCNL or RIRS. <b><i>Methods:</i></b> A literature search was done for electronic databases to identify researches that compared micro-PCNL and RIRS till December 2019. The clinical outcome included complications, stone-free rates (SFRs), hemoglobin reduction, length of hospital stay, and operative time. <b><i>Results:</i></b> Five articles were included in our study. The pooled results revealed no statistical difference in the rate of complications (OR = 0.99, 95% CI = 0.57–1.74, <i>p</i> = 0.99), length of hospital stay (MD = −0.29, 95% CI = −0.82 to 0.24, <i>p</i> = 0.28), and operative time (MD = −6.63, 95% CI = −27.34 to 14.08, <i>p</i> = 0.53) between the 2 groups. However, significant difference was present in hemoglobin reduction (MD = −0.43, 95% CI = −0.55 to 0.30, <i>p</i> &#x3c; 0.001) and the SFRs (OR = 0.59, 95% CI = 0.36–0.98, <i>p</i> = 0.04) when comparing RIRS with micro-PCNL. <b><i>Conclusions:</i></b> Compared with micro-PCNL to treat kidney stones, RIRS is associated with better stone clearance and bearing higher hemoglobin loss. As the advantages of both technologies have been shown in some fields, the continuation of well-designed clinical trials may be necessary.


2019 ◽  
Vol 26 (6) ◽  
pp. 744-752
Author(s):  
Hailun Zhan ◽  
Chunping Huang ◽  
Tengcheng Li ◽  
Fei Yang ◽  
Jiarong Cai ◽  
...  

Objectives. The warm ischemia time (WIT) is key to successful laparoscopic partial nephrectomy (LPN). The aim of this study was to perform a meta-analysis comparing the self-retaining barbed suture (SRBS) with a non-SRBS for parenchymal repair during LPN. Methods. A systematic search of PubMed, Scopus, and the Cochrane Library was performed up to March 2018. Inclusion criteria for this study were randomized controlled trials (RCTs) and observational comparative studies assessing the SRBS and non-SRBS for parenchymal repair during LPN. Outcomes of interest included WIT, complications, overall operative time, estimated blood loss, length of hospital stay, and change of renal function. Results. One RCT and 7 retrospective studies were identified, which included a total of 461 cases. Compared with the non-SRBS, use of the SRBS for parenchymal repair during LPN was associated with shorter WIT ( P < .00001), shorter overall operative time ( P < .00001), lower estimated blood loss ( P = .02), and better renal function preservation ( P = .001). There was no significant difference between the SRBS and non-SRBS with regard to complications ( P = .08) and length of hospital stay ( P = .25). Conclusions. The SRBS for parenchymal repair during LPN can significantly shorten the WIT and overall operative time, decrease blood loss, and preserve renal function.


Author(s):  
Francesco Spinelli ◽  
Francesco Stilo ◽  
Michele La Spada ◽  
Filippo Benedetto ◽  
Giovanni De Caridi ◽  
...  

Objective In this study, we retrospectively evaluated our experience in minilaparotomy (MINI) and compared the results with conventional open repair (OPEN). Methods From January 2005 to December 2012, we surgically treated 234 consecutive patients with elective infrarenal abdominal aortic aneurysms, 195 men and 39 women, with a mean age of 74 years. Inclusion criteria for MINI were not ruptured abdominal aortic aneurysm, increased surgical risk, anatomical limits for endovascular repair, no previous surgical invasion of the abdominal cavity, and no requirement for concomitant abdominal surgical invasion. Surgical treatment was OPEN in 113 patients (48.3%) and MINI through an 8- to 14-cm incision in 121 patients (51.7%). Epidural anesthesia has been added in 26.5% and in 19.3% of the MINI and OPEN patients, respectively. Mortality, complications, aortic clamping time, operative time, need for postoperative morphine therapy, time to solid diet, and length of hospital stay were registered. Results The MINI has been performed in all patients selected, with 72 aortoaortic grafts and 49 aortobisiliac grafts. Early mortality was 1.6% versus 3.5% ( P > 0.5); 1-, 3-, and 5-year mortality were 7% versus 9%, 19% versus 22%, and 29% versus 34% ( P > 0.5); complications were 12.2% versus 26.6% ( P > 0.05); mean (SD) clamping time was 48 (12) versus 44 (14) minutes ( P > 0.5); mean (SD) operative time was 218.72 (41.95) versus 191.44 (21.73) minutes ( P > 0.025); mean (SD) estimated intraoperative blood loss was 425.64 (85.95) versus 385.30 (72.41) mL ( P > 0.1); mean (SD) morphine consumption in the group given epidural and the group not given epidural was 0 (2) and 2 (2) mg intravenously (IV) versus 2 (4) ( P < 0.5) and 4 (3) mg IV ( P > 0.1); mean (SD) ambulation was 2.1 (0.6) versus 4.1 (2.7) ( P < 0.5); mean (SD) time to solid diet was 2.1 (0.4) versus 3.5 (1.6) ( P < 0.5); and mean (SD) length of hospital stay was 4.9 (1.64) versus 7.35 (1.95) days ( P > 0.05), in the MINI and OPEN groups, respectively. Postoperative hernia at 3 years was 18% versus 23% in the MINI and OPEN groups ( P < 0.5), respectively. Conclusions The MINI gives the patients a significantly shorter period of recovery with the quality and safety of the OPEN. This experience suggested extending the indication to all surgical candidates without local limitations.


2016 ◽  
Vol 74 (1) ◽  
pp. 130-138 ◽  
Author(s):  
Kyle S. Ettinger ◽  
Yavuz Yildirim ◽  
Toby N. Weingarten ◽  
James M. Van Ess ◽  
Christopher F. Viozzi ◽  
...  

Author(s):  
Omer A. Marzoug

<p class="abstract">Symptomatic cholelithiasis (gallstone disease) is the most common biliary pathology that affects women predominantly around the world. Earlier open cholecystectomy was the gold standard of treatment of this disease before introduction of laparoscopic cholecystectomy. The aim of this study is to systematically review the most recent published data that compared laparoscopic with open cholecystectomy in symptomatic cholelithiasis in terms of operative and post-operative morbidity, mortality, operative time, length of hospital stay, and conversion rates. The Medline, Cochrane library, Embase, and PubMed databases were vigorously searched for trials that compared laparoscopic with open cholectstectomy in patients with symptomatic cholelithiasis, a systematic review of these comparative trials was performed. No mortality was detected in both groups; the conversion rate was 6.75%. The laparoscopic approach associated with significantly shorter hospital stay (2.31 versus 4.42 days, p value&gt;0.001), lower post-operative pain duration (30.5 versus 66.9 hours, p value&gt;0.001) and lower rate of post-operative wound infection (2.8% versus 10.5%, p value&gt;0.001). Regarding operative time it was significantly longer in laparoscopic approach (77.3 versus 67.1 min, p value&gt;0.001), there were no significant differences in the rates of bile duct injury (0.84% versus 0.25%, p value=0.08) and intra-operative bleeding (4.2% versus 3.5%, p value=0.81) between the two procedures. Post-operative wound infection and pain duration in addition to length of hospital stay in patients with symptomatic cholelithiasis were reduced with laparoscopic cholecystectomy. However, the laparoscopic approach associated with longer duration of surgery. No significant differences between the two procedures in the rates of bile duct injury and intra-operative bleeding.</p>


2021 ◽  
Author(s):  
Chaichant Soisrithong ◽  
Wit Viseshsindh ◽  
Wisoot Kongchareonsombat ◽  
Charoen Leenanupunth ◽  
Wachira Kochakarn ◽  
...  

Abstract Purpose: To compare perioperative and trifecta outcomes of open partial nephrectomy (OPN), laparoscopic partial nephrectomy (LPN), and robotic assisted laparoscopic partial nephrectomy (RPN) in patients with small renal mass at Ramathibodi Hospital, and to determine predictive factors in connection with trifecta. Methods: We retrospectively reviewed 141 patients who underwent partial nephrectomy by eight experienced surgeons from January 2009 to December 2018. Baseline preoperative characteristics, postoperative and trifecta outcomes of the three treatment modalities were compared and analyzed. Univariate analysis was performed to determine predictive factors for trifecta achievement. Results: A total of 70 patients had complete data available. 18 OPN, 11 LPN and 41 RPN cases were identified and reviewed. All preoperative and perioperative parameters were similar, except for operative time, which was significantly shorter in the OPN group compared with those undergoing LPN and RPN (135 vs 189 and 225 min, respectively; p-value = 0.001). Of these 70 patients, 59 were deemed eligible for and included in trifecta analysis, which revealed similar trifecta outcomes (64.29.%, 45.45%, and 64.71% in the OPN, LPN, and RPN groups, respectively; p-value = 0.388). Univariate analysis showed that length of hospital stay was a negative associated factor for trifecta achievement (p-value = 0.007, 95% CI =0.619 (0.44-0.88)).Conclusion: Although OPN displayed the shortest operative time, the trifecta achievement rate was not significantly different among the three groups. The sole parameter, which was negatively associated with trifecta outcome achievement, was the length of hospital stay.


2017 ◽  
Vol 4 (8) ◽  
pp. 2766
Author(s):  
Anandaravi B. N. ◽  
Krishna S. R. ◽  
Pradeep Kumar H. D. ◽  
Mayank Garg

Background: Appendicitis remains one of the most common diseases encountered by the surgeon in practice. Appendicectomy is the most common urgent or emergency general surgical operation performed. Emergency appendicectomy is believed to be the standard treatment protocol for patients with acute appendicitis. This study was conducted to verify whether acute non-perforated appendicitis requires immediate surgery or can be delayed to be taken up on elective basis.Methods: This is a retrospective study of all the cases undergoing appendicectomy for acute appendicitis over the period of January 2016 to December 2016 in K. R. hospital, Mysuru, Karnataka, India. The cases were divided into two comparison groups: emergency group (operated within 12 hours of admission) and delayed group (operated between 12-72 hours). Parameters like age, sex, duration of symptoms, total leucocytes count, temperature, haemoglobin, radiological investigations, operative procedure, operative time, length of hospital stay, length of post-operative stay were collected and the end points for comparison were: Operative time, perforation rate, post-operative complication, length of hospital stay, readmission rate. Cases of perforated appendicitis in preoperative diagnosis, interval appendicectomy and appendicectomy done in association with other abdominal conditions were excluded from the study.Results: During this one-year period 283 patients have undergone appendicectomy. Out of this 189 (66.8%) patients have undergone surgery within 12 hours of admission and 94 (33.2%) have undergone surgery between 12 to 72 hours of admission. There was no significant difference between the two groups in operative time, per operative perforation rate, post-operative complication rate, readmission rate. Length of the hospital stay was greater in delayed group as compared to emergency group. But there was no significant difference between the post-operative length of hospital stay.Conclusions: Acute appendicitis can be treated surgically in a delayed elective basis without increasing morbidity.  


Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 245-246
Author(s):  
John Thomas Pierce ◽  
Prateek Agarwal ◽  
Paul J Marcotte ◽  
William Charles Welch

Abstract INTRODUCTION Lumbar spine surgery can be successfully performed using various anesthetic techniques. Previous studies have shown varying results in selected outcomes when directly comparing spinal anesthesia (SA) to general anesthesia (GA) in lumbar surgery. We sought to elucidate the more expedient anesthetic technique. METHODS Following IRB approval, a retrospective review of patients undergoing elective lumbar decompression surgery using GA or SA was performed. Demographic data known to influence perioperative morbidity was collected as well as safety and efficiency parameters. After controlling for patient and procedure characteristics, simple linear and multivariate regression analyses were performed to identify differences in operative blood loss, operative time, time from entering the OR until incision, time from bandage placement to exiting the OR, total anesthesia time, time in the post-anesthesia care unit (PACU), and length of hospital stay. RESULTS >544 consecutive lumbar laminectomy and discectomy surgeries were identified with 183 undergoing GA and 361 undergoing SA. The following times were all shorter for patients receiving SA than GA: operative time (97.4 vs. 151.8 min., P < 0.001), total anesthesia time (145.6 vs. 217.5 min., P < 0.001), time from entering the OR until incision (38.3 vs. 46.8 min., respectively, P < 0.001), time from bandage placement until exiting the OR (10.2 vs. 17.2 min., P < 0.001), and length of hospital stay (1.5 vs. 3.1 days, P < 0.001). The mean PACU length of stay was longer in the SA group than the GA group (178.0 vs. 116.5 min., P < 0.001). Estimated blood loss was less in the SA group than the GA group (62.1 vs. 176.3 mL, P < 0.001). CONCLUSION Spinal anesthesia may be the more expedient method of anesthesia in lumbar spinal surgery for all perioperative time points except for time in the PACU.


Sign in / Sign up

Export Citation Format

Share Document