scholarly journals Short-term complication rate following orthopedic surgery in a tertiary care center in Argentina

SICOT-J ◽  
2018 ◽  
Vol 4 ◽  
pp. 26 ◽  
Author(s):  
Gaston Camino Willhuber ◽  
Joaquin Stagnaro ◽  
Matias Petracchi ◽  
Agustin Donndorff ◽  
Daniel Godoy Monzon ◽  
...  
Keyword(s):  
Orthopedic Surgery ◽  
Complication Rate ◽  
Care Center ◽  
Critical Role ◽  
Tertiary Care ◽  
Additional Treatment ◽  
Clinical Severity ◽  
Type I ◽  
Short Term ◽  
Start Time

Introduction: Registration of adverse events following orthopedic surgery has a critical role in patient safety and has received increasing attention. The purpose of this study was to determine the prevalence and severity of postoperative complications in the department of orthopedic unit in a tertiary hospital. Methods: A retrospective review from the postoperative complication registry of a cohort of consecutive patients operated in the department of orthopedic surgery from May 2015 to June 2016 was performed. Short-term complications (3 months after surgery), age gender, types of surgery (elective, scheduled urgency, non-scheduled urgency, and emergency), operative time, surgical start time (morning, afternoon or evening), American Society of Anesthesiologists score and surgeon's experience were assessed. Complications were classified based on their severity according to Dindo-Clavien system: Grade I complications do not require alterations in the postoperative course or additional treatment; Grade II complications require pharmacological treatment; Grade III require surgical, endoscopic, or radiological interventions without (IIIa) or with (IIIb) general anesthesia; Grade IV are life-threatening with single (IVa) or multi-organ (IVb) dysfunction(s), and require ICU management; and Grade V result in death of the patient. Complications were further classified in minor (Dindo I, II, IIIa) and major (Dindo IIIb, IVa, IVb and V), according to clinical severity. Results: 1960 surgeries were performed. The overall 90-day complication rate was 12.7% (249/1960). Twenty-three complications (9.2 %) were type I, 159 (63.8%) type II, 9 (3.6%) type IIIa, 42 (16.8%) type IIIb, 7 (2.8%) type IVa and 9 (3.6%) were grade V according to Dindo-Clavien classification (DCC). The most frequent complication was anemia that required blood transfusion (27%) followed by wound infection (15.6%) and urinary tract infection (6%). Discussion: The overall complication rate after orthopedic surgery in our department was 12.7%. The implementation of the DCC following orthopedic surgery was an important tool to measure the standard of care.

Short term outcome for colorectal cancer patients undergoing surgery in Tertiary care center in Eastern India

2021 ◽  
Vol 47 (2) ◽  
pp. e50-e51
Author(s):  
Abhitesh Singh ◽  
Anshul Jain ◽  
Dillip Muduly ◽  
Mahesh Sultania ◽  
Jyoti Ranjan Swain ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patients ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Eastern India ◽  
Short Term ◽  
Term Outcome ◽  
Short Term Outcome ◽  
Colorectal Cancer Patients

Hearing Outcomes Following Type 3 Tympanoplasty With Stapes Columella Grafting in Canal Wall Down Mastoidectomy

2019 ◽  
Vol 128 (8) ◽  
pp. 736-741
Author(s):  
C. Burton Wood ◽  
Brendan P. O’Connell ◽  
Anne C. Lowery ◽  
Marc L. Bennett ◽  
George B. Wanna
Keyword(s):  
Care Center ◽  
Cohort Analysis ◽  
Tertiary Care ◽  
Canal Wall ◽  
Short Term ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
Hearing Outcomes ◽  
Type 3

Objectives: To analyze hearing outcomes following Type 3 tympanoplasty with stapes columella grafting after canal wall down mastoidectomy and determine disease recurrence rates in patients undergoing this procedure. Methods: This retrospective cohort analysis examines patients undergoing Type 3 tympanoplasty with stapes columella grafting following canal wall down mastoidectomy for cholesteatoma at a tertiary care center from 2005 to 2015. Patient charts were reviewed for demographic data, diagnosis, and operative details. Patients were included in statistical analysis if they were found to have undergone the aforementioned procedure. Evaluation of hearing improvement was made by comparing preoperative air-bone gap (ABG) and ABG at follow-up at 6 months and 1 year postoperatively. Results: Nineteen patients met criteria for this study. Erosion of the otic capsule, posterior fossa plate, or tegmen was noted in 37% of cases, highlighting disease severity. Eighteen (95%) had undergone prior otologic surgery. Mean time to short-term follow-up was 6 ± 3 months. The average short-term ABG was 26 ± 11 dB HL; 26% achieved an ABG <20 dB, and 58% achieved an ABG <30 dB. Fifteen had follow-up at least 1 year postoperatively (mean = 33 ± 16 months). At longer-term follow-up, mean ABG was 25 ± 10 dB HL; 33% achieved an ABG <20 dB, while 66% achieved an ABG <30 dB. Hearing remained stable over time ( P = .52). At date of last clinical follow-up, only 1 (5%) patient had undergone revision for recurrent disease. Conclusion: In some patients undergoing canal wall down mastoidectomy for advanced or recurrent cholesteatoma, Type 3 tympanoplasty with stapes columella grafting yields marginal hearing benefit. This type of reconstruction is a viable option in this challenging patient cohort, particularly as it is associated with low rates of revision surgery.

P199 IS ROUTINE ICU ADMISSION NECESSARY AFTER TRANSTHORACIC ESOPHAGECTOMY FOR ESOPHAGEAL AND ESOPHAGOGASTRIC JUNCTION CANCER?

2019 ◽  
Vol 32 (Supplement_2) ◽  
Author(s):  
Andrea Pansa ◽  
Roit Anna Da ◽  
Silvia Basato ◽  
Damiano Gentile ◽  
Pietro Riva ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Complication Rate ◽  
Esophagogastric Junction ◽  
Length Of Hospital Stay ◽  
High Volume ◽  
Type I ◽  
Transthoracic Esophagectomy ◽  
Short Term ◽  
Icu Admission ◽  
Esophagogastric Junction Cancer

Abstract Aim We evaluated short-term outcomes of esophagectomy for esophageal and esophagogastric carcinoma without routine postoperative admission to Intensive Care Unit (ICU). Background & Methods esophagectomy is subject to high rates of complications and mortality even when performed in high-volume centers and conventional postoperative management often involves routine ICU admission according to recent guidelines and recommendations1 . From January 2018 to June 2019 a total of 112 esophagectomies were performed in the Upper GI Surgery division of Humanitas Research Hospital. We included the 83 patients that underwent transthoracic esophagectomy with a hybrid technique (laparoscopy + right thoracotomy) and high intrathoracic anastomosis for esophageal and esophagogastric junction cancer. Preoperative assessment included a prehabilitation program (nutritional evaluation, respiratory physiotherapy and adjustment of cardiologic therapy). Postoperatively, patients were managed by surgical team members. We retrospectively recorded data on necessity of ICU, operative times, complication rate (according to ECCG)2,3, length of hospital stay, in-hospital, 30-day and 90-day mortality. Results 68 patients were males and 15 females. Mean age was 65 years old (range 29-82). 67 patients underwent neoadjuvant therapy (49 chemo-radiotherapy, 18 chemotherapy alone). Postoperative ICU admission was necessary in 6 patients (9,5%), reasons for admission were necessity of ventilatory weaning in 2 patients, high lactate levels in one patient, glottic oedema following oro-tracheal intubation in one patient, while in the other cases ICU admission was planned for severe comorbidities. Mean duration of prehabilitation was 20.3 days (1-107). Mean surgery duration was 452.4 minutes (337-549). Overall complication rate was 33.8%, with the most common complications being atrial fibrillation (50% of all complications) and urinary retention (20%). There were two type I anastomotic leaks. Median length of hospital stay was 11 days (range 8-29). All patients were alive at 30 and 90 days after surgery. Conclusion routine ICU admission is not necessary after transthoracic esophagectomy for cancer in over 90% of patients. Careful patients’ evaluation, stratification of the surgical risk and systematic use of a prehabilitation program, along with adequate peri-operative management, can narrow the need for postoperative ICU admission in the setting of a high-volume centre without any impact on short-term outcomes.

scholarly journals Multivisceral resections for rectal cancers: short-term oncological and clinical outcomes from a tertiary-care center in India

2016 ◽  
Vol 7 (3) ◽  
pp. 345-353 ◽  
Author(s):  
Vishwas D. Pai ◽  
Sudhir Jatal ◽  
Vikas Ostwal ◽  
Reena Engineer ◽  
Supreeta Arya ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Short Term ◽  
Rectal Cancers

Prognostic factors for short-term and long-term outcomes of gastric cancer surgery for elderly patients: 10 years of experience at a single tertiary care center

2018 ◽  
Vol 70 (2) ◽  
pp. 265-271 ◽  
Author(s):  
Stefano de Pascale ◽  
Daniele Belotti ◽  
Andrea Celotti ◽  
Eleonora Maddalena Minerva ◽  
Vittorio Quagliuolo ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Prognostic Factors ◽  
Elderly Patients ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Long Term Outcomes ◽  
Short Term ◽  
Gastric Cancer Surgery

scholarly journals Outcomes of Canal Wall Down Mastoidectomy following Type III Tympanoplasty

2021 ◽  
Vol 27 (2) ◽  
pp. 145-151
Author(s):  
Shoukat Ali ◽  
SM Masudul Alam ◽  
KM Nurul Alam ◽  
KM Mamun Morshed ◽  
Sirajul Islam Mahfuz ◽  
...  
Keyword(s):  
Care Center ◽  
Demographic Data ◽  
Tertiary Care ◽  
Canal Wall ◽  
Short Term ◽  
Recurrence Rates ◽  
Type Iii ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy

Objectives: To see the hearing outcomes following Type III tympanoplasty with stapes columella grafting after canal wall down mastoidectomy and find out the recurrence rates in patients undergoing this procedure. Methods: This prospective observational study includes 120 cases undergoing Type III tympanoplasty with stapes columella grafting following canal wall down mastoidectomy for cholesteatoma at a tertiary care center from 2018 to 2020. Patient charts were reviewed for demographic data, diagnosis, and operative details. Patients were included in statistical analysis if they were found to have undergone the aforementioned procedure. Evaluation of hearing improvement was made by comparing preoperative air-bone gap (ABG) and ABG at follow-up at 6 months and 1 year postoperatively. Results: One hundred and twenty patients were included for this study. Erosion of the otic capsule, posterior fossa plate, or tegmen was noted in 20% of cases, highlighting disease severity. One hundred and two (85%) had undergone prior otologic surgery. Mean time to short-term follow-up was 6 ± 3 months. The average short-term ABG was 25 ± 12 dB HL; 36% achieved an ABG <20 dB and thirteen had follow-up at least 1 year postoperatively (mean = 33 ± 16 months). At longer-term follow-up, mean ABG was 24 ± 11 dB HL. Hearing remained stable over time (P = .26). Conclusion: In some patients undergoing canal wall down mastoidectomy for advanced or recurrent cholesteatoma, Type III tympanoplasty with stapes columella grafting yields marginal hearing benefit. Bangladesh J Otorhinolaryngol 2021; 27(2): 145-151

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