Paediatric tonsillectomy: bipolar electrodissection and dissection/snare compared

AbstractTonsillectomy is a common operation in children performed by a variety of techniques. Recently we have introduced a modified form of electrodissection tonsillectomy using bipolar diathermy. A prospective study was designed to evaluate this technique against the conventional dissection/snare technique. Sixty children were entered into each section of the study (total 120 children). There is a statistically significant shorter operating time (mean 11.2 minutes) and lower intraoperative blood loss (mean 5 ml) using the bipolar diathermy technique. Post-operatively, the children who had bipolar diathermy tonsillectomy were found to be able to drink and eat significantly earlier than the cold dissection group. There was no measurable difference in analgesia requirements before discharge and the time of discharge between the two methods. Post-operative haemorrhage occurred in two out of 60 (3.4 per cent) and one out of 60 (1.7 per cent children) in the conventional and bipolar diathermy dissection, respectively, but this was not statistically significant.

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Intraoperative blood loss during different stages of scoliosis surgery: A prospective study

Scoliosis ◽

10.1186/1748-7161-5-16 ◽

2010 ◽

Vol 5 (1) ◽

Cited By ~ 27

Author(s):

Hitesh N Modi ◽

Seung-Woo Suh ◽

Jae-Young Hong ◽

Sang-Heon Song ◽

Jae-Hyuk Yang

Keyword(s):

Blood Loss ◽

Prospective Study ◽

Scoliosis Surgery ◽

Intraoperative Blood Loss ◽

A Prospective Study

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Coblation tonsillectomy: our experience as a day care procedure

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20211566 ◽

2021 ◽

Vol 7 (5) ◽

pp. 764

Author(s):

Kripamoy Nath ◽

Ritu Gupta

Keyword(s):

Blood Loss ◽

Prospective Study ◽

Day Care ◽

Tertiary Care ◽

Operating Time ◽

Tertiary Care Centre ◽

Post Operative Pain ◽

Care Surgery ◽

A Prospective Study ◽

Care Procedure

Background: A prospective study to cite our experience in adult and pediatric patients undergoing coblation tonsillectomy. We emphasised on the intra operative and post operative morbidity in coblation tonsillectomy and its feasibility as a day care procedure.Methods: It is a prospective study done on both paediatric and adult cases presenting to our tertiary care centre between January 2018 to February 2020. Study was done to analyse operating time, intraoperative blood loss, post-operative pain, post-operative haemorrhage and post-operative return to home and normal diet.Results: 114 cases were selected where bilateral tonsillectomy was performed using Coblation technique. 83 were adult patients and 31 paediatric. 56 were females and 58 males. 1 case presented with secondary haemorrhage, none with primary haemorrhage. No other complications were noted.Conclusions: Coblation tonsillectomy yielded good results in reference to patient morbidity and low complication rate. It turned out to be a success as a day care procedure. Short operating time, minimal blood loss, less post-operative pain specially in the early post-operative period, minimal chance of complication and short stay at hospital as a day care surgery, Coblation tonsillectomy stood out as a hands down winner in our study. In this fast paced life, where consumerism demands everything instant, coblation tonsillectomy as a day care procedure provides good alternative to the patient requiring tonsillectomy. yroidectomies.

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Blood loss during and after transurethral resection of prostate: A prospective study

Kathmandu University Medical Journal ◽

10.3126/kumj.v6i3.1707 ◽

1970 ◽

Vol 6 (3) ◽

pp. 329-334 ◽

Cited By ~ 3

Author(s):

BM Shrestha ◽

K Prasopshanti ◽

SS Matanhelia ◽

WB Peeling

Keyword(s):

Blood Loss ◽

Prospective Study ◽

Transurethral Resection ◽

Operating Time ◽

Outlet Obstruction ◽

Prostatic Tissue ◽

Transurethral Resection Of Prostate ◽

Total Blood ◽

A Prospective Study ◽

Type Of Anaesthesia

Objectives: Transurethral resection of prostate (TURP) is the gold standard treatment for symptomatic prostatic bladder outlet obstruction. Haemorrhage during and after TURP can lead to significant morbidity and mortality. The purpose of this study was to assess the influence of anaesthesia, operating time, weight of resected prostatic tissue and its histology on blood loss during and after TURP and to revisit the available body of evidence in the literature of urology. Materials and methods: This is a prospective study of a cohort of 100 consecutive patients who had undergone TURP over a period of one year, where the data was collected on a performa specifically designed for the study, which included the type of anaesthesia administered, resection time, amount of blood lost during and after TURP, weight of the resected prostatic tissue and histology. Results: Sixty seven patients underwent TURP under spinal anaesthesia (SA) and 33 under general anaesthesia (GA). The median intraoperative (SA: 89.95 (5-936); GA: 105.40 (5-517) mls), postoperative (SA: 72.37 (15-387); GA: 136.43 (11-969) mls) and total (SA: 162.32 (29-1200); GA: 241.83 (21-1251) mls) blood losses were not significantly different between the two groups (95% C.I. -9.90 to 19.22, p= 0.46). The total operating time (SA: 29.70 (10-55); GA: 29.80 (10-65) minutes) and weight of resected prostate (SA: 21.90 (3-45); GA: 18.00 (4-60) gms) were similar between the two groups. There was a trend towards increased blood loss when BPH was associated with prostatitis (N=8). Of these, 3 patients required blood transfusion as compared to 1 patient in rest of the group, although this was not statistically significant (95% C.I - 67.2 to 1120.4, p = 0.87). Conclusions: The intraoperative, postoperative and total blood losses related to TURP were not influenced by the type of anaesthesia, resection time, weight of the resected prostate and the histology. Key Words: Transurethral resection of prostate, blood loss, anaesthesia, prostatitis, carcinoma, aspirin doi: 10.3126/kumj.v6i3.1707 Kathmandu University Medical Journal (2008), Vol. 6, No. 3, Issue 23, 329-334

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Severe intraoperative bleeding predicts the risk of perioperative blood transfusion after robot-assisted radical prostatectomy

Journal of Robotic Surgery ◽

10.1007/s11701-021-01262-z ◽

2021 ◽

Author(s):

Antonio Benito Porcaro ◽

Riccardo Rizzetto ◽

Nelia Amigoni ◽

Alessandro Tafuri ◽

Aliasger Shakir ◽

...

Keyword(s):

Radical Prostatectomy ◽

Blood Transfusion ◽

Blood Loss ◽

Univariate Analysis ◽

Operating Time ◽

Primary Treatment ◽

Intraoperative Blood Loss ◽

Robot Assisted ◽

Intraoperative Bleeding ◽

Perioperative Blood Transfusion

AbstractTo evaluate potential factors associated with the risk of perioperative blood transfusion (PBT) with implications on length of hospital stay (LOHS) and major post-operative complications in patients who underwent robot-assisted radical prostatectomy (RARP) as a primary treatment for prostate cancer (PCa). In a period ranging from January 2013 to August 2019, 980 consecutive patients who underwent RARP were retrospectively evaluated. Clinical factors such as intraoperative blood loss were evaluated. The association of factors with the risk of PBT was investigated by statistical methods. Overall, PBT was necessary in 39 patients (4%) in whom four were intraoperatively. Positive surgical margins, operating time and intraoperative blood loss were associated with perioperative blood transfusion on univariate analysis. On multivariate analysis, the risk of PBT was predicted by intraoperative blood loss (odds ratio, OR 1.002; 95% CI 1.001–1.002; p < 0.0001), which was associated with prolonged operating time and elevated body mass index (BMI). PBT was associated with delayed LOHS and Clavien–Dindo complications > 2. In patients undergoing RARP as a primary treatment for PCa, the risk of PBT represented a rare event that was predicted by severe intraoperative bleeding, which was associated with increased BMI as well as with prolonged operating time. In patients who received a PBT, prolonged LOHS as well as an elevated risk of major Clavien–Dindo complications were seen.

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Robotically Assisted Hysterectomy versus Vaginal Hysterectomy for Benign Disease: A Prospective Study

Minimally Invasive Surgery ◽

10.1155/2013/429105 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 3

Author(s):

M. Carbonnel ◽

H. Abbou ◽

H. T. N’Guyen ◽

S. Roy ◽

G. Hamdi ◽

...

Keyword(s):

Blood Loss ◽

Prospective Study ◽

Hospital Stay ◽

Vaginal Hysterectomy ◽

Operative Time ◽

Group Versus ◽

Length Of Hospital Stay ◽

Benign Disease ◽

Post Surgery ◽

A Prospective Study

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.

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Role of routine fluid replacement in children undergoing tonsillectomy

The Journal of Laryngology & Otology ◽

10.1017/s0022215100113933 ◽

1990 ◽

Vol 104 (10) ◽

pp. 801-802 ◽

Cited By ~ 4

Author(s):

P. S. Wilson ◽

D. G. Snow ◽

J. O'Connel ◽

D. W. Proops ◽

M. Barrow

Keyword(s):

Blood Loss ◽

Prospective Study ◽

Intravenous Infusion ◽

Intravenous Fluid ◽

Fluid Replacement ◽

Control Group ◽

A Prospective Study ◽

To Receive

AbstractIt has been suggested that children undergoing tonsillectomy would benefit from an intravenous infusion, to counteract the period of pre-operativefasting combined with the blood loss at operation.A prospective study of 50 children undergoing tonsillectomy was undertaken. The children were randomly allocated into two groups, one to receive an infusion and a control group.There were no significant differences between the two groups, although the children with an infusion had a longer mean post-operative stay.There would seem to be no role for routine intravenous fluid replacement in children undergoing uncomplicated tonsillectomy.

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Blood loss predictive factors and transfusion practice during percutaneous nephrolithotomy of kidney stones: a prospective study

F1000Research ◽

10.12688/f1000research.8993.1 ◽

2016 ◽

Vol 5 ◽

pp. 1550 ◽

Cited By ~ 4

Author(s):

Firtantyo Adi Syahputra ◽

Ponco Birowo ◽

Nur Rasyid ◽

Faisal Abdi Matondang ◽

Endrika Noviandrini ◽

...

Keyword(s):

Blood Loss ◽

Prospective Study ◽

Percutaneous Nephrolithotomy ◽

Predictive Factors ◽

Transfusion Practice ◽

Influential Factor ◽

Full Blood Count ◽

Baseline Serum ◽

Stone Burden ◽

A Prospective Study

Objectives Bleeding is the most common complication of percutaneous nephrolithotomy (PCNL). Injudicious transfusion is frequently performed in current practice, even though it is not always needed. This study aimed to identify the predictive factors of blood loss in the PCNL procedure and evaluate the perioperative transfusion practice. Methods A prospective study of PCNL was randomly performed by two consultants of endo-urology at our institution. The inclusion criteria were adults with kidney pelvic stones >20 mm or stone in inferior calyx >10 mm or staghorn stone. Those with coagulopathy, under anti-coagulant treatment or open conversion were excluded. A full blood count was taken at baseline and during 12, 24, 36, 72-hours post-operatively. Factors such as stone burden, sex, body surface area, shifting of hematocrit level and amount of blood transfused were analyzed statistically using line regression to identify the predictive factors of total blood loss (TBL). Results Eighty-five patients were enrolled in this study. Mean TBL was 560.92 ± 428.43 mL for both endo-urology surgeons. Stone burden was the most influential factor for TBL (p=0.037). Our results revealed that TBL (mL) = -153.379 + 0.229 × stone burden (mm2) + 0.203 x baseline serum hematocrit (%); thus considerably predicted the need for blood transfusion. A total of 87.1% patients did not receive perioperative transfusion, 3.5% received intra-operative transfusion, 7.1% received post-operative transfusion, 23% had both intra and post-operative transfusion, resulting in a cross-matched transfusion ratio of 7.72. Mean perioperative blood transfused was 356.00 ± 145.88 mL.

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A Retrospective Analysis of Peroperative Risk Factors Associated with Posttonsillectomy Reactionary Hemorrhage in a Teaching Hospital

International Archives of Otorhinolaryngology ◽

10.1055/s-0039-1696702 ◽

2019 ◽

Vol 23 (04) ◽

pp. e403-e407 ◽

Cited By ~ 1

Author(s):

Vinoth Manimaran ◽

Sanjeev Mohanty ◽

Satish Kumar Jayagandhi ◽

Preethi Umamaheshwaran ◽

Shivapriya Jeyabalakrishnan

Keyword(s):

Blood Loss ◽

Pulse Rate ◽

Tertiary Care ◽

Operating Time ◽

Positive Association ◽

Care Hospital ◽

Intraoperative Blood Loss ◽

Surgeon Experience ◽

Patients At Risk ◽

Risk Of Hemorrhage

Abstract Introduction Tonsillectomy is one of the most common otolaryngology procedures performed worldwide. It is also one of the first procedures learnt by residents during their training period. Although tonsillectomy is viewed relatively as a low-risk procedure, it can be potentially harmful because of the chance of posttonsillectomy hemorrhage. Objective The objective of the present study is to analyze the effects of peroperative factors and experience of the surgeon on the incidence and pattern of posttonsillectomy reactionary hemorrhage. Methods A retrospective review of medical charts was performed from 2014 to 2017 in a tertiary care hospital. A total of 1,284 patients who underwent tonsillectomy and adenoidectomy were included in the study. The parameters assessed were experience of the surgeon, operating time, intraoperative blood loss, difference in mean arterial pressure (MAP) and pulse rate. Results A total of 23 (1.79%) out of the 1,284 patients had reactionary hemorrhage. Out of those 23, 16 (69.5%) patients had been operated on by trainees, while 7 (30.5%) had been operated on by consultants (p = 0.033, odds ratio [OR] = 0.04). Operating time, intraoperative blood loss, difference in MAP and pulse rate were significantly higher in the reactionary hemorrhage group, and showed a positive association with risk of hemorrhage (p < 0.05; OR >1). Re-exploration to control the bleeding was required in 10 (76.9%) out of the 23 cases. Conclusion The experience of the surgeon experience and peroperative factors have an association with posttonsillectomy hemorrhage. Close surveillance and monitoring of the aforementioned peroperative factors will help in the identification of patients at risk of hemorrhage.

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Microendoscope-Assisted Decompression Surgery With Resection of Bony Fragment for Treating a Separation of Lumbar Posterior Ring Apophysis in Young Athletes

Global Spine Journal ◽

10.1177/2192568220929290 ◽

2020 ◽

pp. 219256822092929 ◽

Cited By ~ 1

Author(s):

Motohiro Okada ◽

Munehito Yoshida ◽

Akihito Minamide ◽

Kazunori Nomura ◽

Kazuhiro Maio ◽

...

Keyword(s):

Blood Loss ◽

Japanese Orthopaedic Association ◽

Operating Time ◽

Case Series ◽

Decompression Surgery ◽

Return To Sports ◽

Intraoperative Blood Loss ◽

Young Athletes ◽

The Mean ◽

Posterior Ring

Study Design: Case series. Objectives: To report the clinical outcomes of the decompression procedure using the microendoscopic discectomy system for the treatment of a separation of lumbar posterior ring apophysis in young active athletes. Methods: We retrospectively reviewed 17 cases that underwent the microendoscopic surgery to treat a symptomatic separated lumbar ring apophysis between 2001 and 2014 at our institute or our associated hospital. The cases consisted of 15 males and 2 females, with their ages ranging from 12 to 19 years. The surgeries were performed at total of 18 lumbar levels, including 15 L4/5 and 3 L5/S1 levels. All patients were young athletes. We evaluated the following: (1) the Japanese Orthopaedic Association (JOA) score for low back pain, (2) recovery rates using Hirabayashi’s method, (3) operating time, (4) intraoperative blood loss, (5) perioperative complications, (6) the status of comeback to sports, and (7) the period taken to return to sports. Results: The JOA score was improved after the surgery in all cases. Recovery rate was 92.0% ± 8.1%. The mean operating time per level was 89.2 ± 33.3 minutes. The mean intraoperative blood loss per level was 95.3 ± 93.1 mL. A pinhole size dural tear occurred in one case as a perioperative complication. All cases returned to sports. The mean period taken to return to sports was 10.9 ± 3.5 weeks. Conclusion: Microendoscopic decompression surgery is useful for treating a separation of lumbar posterior ring apophysis.

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