scholarly journals Laparoscopic Gastrostomy Placement in Children Has Few Major, but Many Minor Early Complications

2019 ◽  
Vol 30 (06) ◽  
pp. 548-553
Author(s):  
Morten Kvello ◽  
Charlotte Kristensen Knatten ◽  
Kristin Bjørnland
Keyword(s):  
Postoperative Complications ◽  
Operating Time ◽  
Outlet Obstruction ◽  
Neurological Impairment ◽  
High Rate ◽  
Safe Procedure ◽  
Feeding Difficulties ◽  
Early Postoperative Complications ◽  
Laparoscopic Gastrostomy ◽  
Gastrostomy Complications

Abstract Introduction Laparoscopic gastrostomy (LAPG) is an increasingly popular alternative to more traditional gastrostomy techniques. This study evaluates early postoperative complications following LAPG and investigates risk factors for gastrostomy complications. Materials and Methods Retrospective study of patients <16 years undergoing LAPG from 2005 to 2018. Early postoperative complications (<30 days) were grouped as gastrostomy-related or general and graded according to the Clavien-Dindo classification for surgical complications. Results A total of 104 patients, of which 54 (52%) had neurological impairment (NI), were included. Median age and weight were 1.2 years (1 day–15.2 years) and 8.9 kg (3.4–36), respectively. Operating time was median 37 minutes (19–86) and shorter in the second half of the patients (46 vs. 35 minutes, p = 0.04). A total of 40 (38%) patients experienced 53 gastrostomy-related complications. Of these, seven complications needed surgical treatment; severe leakage (2), too short gastrostomy button (1), feeding difficulties (1), gastric outlet obstruction (1), omentum trapped in umbilical port sutures (1), and suspected fascial defect (1). Stoma infection and granulation tissue were reported in 13 and 12%, respectively. Tube dislodgement occurred in six patients and was managed with bedside reinsertion in all. Gastrostomy-related complications were less frequent in NI patients (46 vs 22%, p = 0.01). Conclusion LAPG is a safe procedure with few major complications, but a high rate of minor complications. Operating time declined during the study period, and NI patients had fewer gastrostomy-related complications.

scholarly journals Comparison of Outcomes between Elective Tracheostomy versus Emergency Tracheostomy

2021 ◽  
Vol 15 (7) ◽  
pp. 1560-1562
Author(s):  
Tarique Khan ◽  
Abid Rashid ◽  
Muhammad Awais Samee ◽  
Ahmed Ali
Keyword(s):  
Postoperative Complications ◽  
Neck Surgery ◽  
High Rate ◽  
Early Postoperative Complications ◽  
Emergency Tracheostomy ◽  
Group A ◽  
Males And Females ◽  
Elective Tracheostomy ◽  
The Difference ◽  
Group B

Aim: To compare the frequency of early postoperative complications of elective tracheostomy and emergency tracheostomy. Study design: Comparative/observational study Place and duration of study: Department of ENT/Head & Neck Surgery, Mayo Hospital Lahore from 1st July 2012 to 31st December 2012. Methodology: One hundred patients of both genders undergoing tracheostomy were enrolled. All the patients were divided equally in two groups; Group A (elective) comprised 50 patients and group B (emergency) tracheostomies also comprised 50 patients. Early postoperative complications were examined and compare between both groups. Results: There were 28 (56%) and 22 (44%) males and females in group A with mean age 42.45±10.55 years while in group B 30 (60%) and 20 (40%) patients were male and females with mean age 43.06±9.84 years. Patients received emergency tracheostomy had high rate of postoperative complications as compared to elective tracheostomy (36% vs 16%). The difference was statistically significant(P<0.05). Conclusion: Early postoperative complications were high in patients underwent emergency tracheostomy as compared to elective tracheostomy. Keywords: Early complications, Elective tracheostomy, Emergency tracheostomy

scholarly journals The Assessment of Early Complications and Risk Factors Affecting Their Occurrence in Breast Reconstructive Procedures

2021 ◽  
Author(s):  
Justyna Jończyk ◽  
Jerzy Jankau
Keyword(s):  
Risk Factors ◽  
Postoperative Complications ◽  
Breast Reconstruction ◽  
Complication Rate ◽  
Clinical Factors ◽  
Early Complications ◽  
Reconstructive Procedures ◽  
Factors Affecting ◽  
Rehospitalization Rate ◽  
Early Postoperative Complications

AbstractThe presence of postoperative complications may have a significant impact on the outcome of the breast reconstruction. The aim of this study was to investigate early postoperative complications and the risk factors for their occurrence. A prospective analysis was carried out to evaluate surgical outcomes after breast reconstructive surgeries performed over a 2-year period. Procedures included expander/implant (TE/IMP), pedicle transverse rectus abdominis musculocutaneous (pTRAM), and latissimus dorsi (LD) techniques. All adverse events which occurred within 6 weeks of surgery were ranked according to severity based on the contracted Accordion grading system. Outcomes were assessed for their association with surgical, demographic, and clinical variables. Sixty-one consecutive breast reconstruction procedures were analyzed. The overall complication rate was 60.7% (n = 37), and 8 patients (13.1%) required reoperation. The lowest complication rate was observed in implant-based reconstructions (TE/IMP, 18.8%; pTRAM, 72.7%; LD, 78.3%; p = 0.008). Mild complications occurred significantly more often after LD reconstructions (LD, 60.9%; pTRAM, 22.7%; TE/IMP, 12.5%; p = 0.031), while severe complications were significantly more frequent after the pTRAM procedures (pTRAM, 27.3%; TE/IMP, 6.2%; LD, 8.7%; p = 0.047). Severe complications were associated with higher rehospitalization rate (p = 0.010) and longer hospital stay. Study revealed a significant impact of the operative method on the incidence and severity of early complications after breast reconstruction procedures with little effect from other demographic and clinical factors.

scholarly journals Insertion of central venous catheters in children undergoing bone marrow transplantation: is there a platelet level for a safe procedure?

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Ahmed Elgendy ◽  
Ahmed M. Ismail ◽  
Eslam Elhawary ◽  
Ahmed Badran ◽  
Mohammed Ramadan El-Shanshory
Keyword(s):  
Bone Marrow ◽  
Platelet Count ◽  
Bone Marrow Transplantation ◽  
Postoperative Complications ◽  
Marrow Transplantation ◽  
Central Venous Catheters ◽  
Bleeding Complications ◽  
Safe Procedure ◽  
Central Venous ◽  
Platelet Transfusions

Abstract Background Bone marrow transplantation (BMT) is a therapeutic procedure for the management of several hematological diseases and malignancies in pediatric population. Central venous catheters (CVCs) play a pivotal role during the process of BMT. The aim of this study was to compare the complications of CVCs placements in children undergoing BMT with platelet levels above and below 50,000/μL and also to detect if there is a platelet count for a safe insertion. This prospective study included all children who had placements of tunneled CVCs during BMT at our hospital between March 2017 and March 2020. Procedures were divided into two groups accordingly to preoperative platelet counts (above and below 50,000/μL). Data were compared between both groups regarding postoperative complications including bleeding or catheter-related blood stream infections (CRBSIs). Results Forty-six CVC insertions were performed in 40 patients. There were 20 procedures below 50,000/μL (median 27,500; range 5000–42,000) inserted with perioperative platelet transfusions, and their postoperative levels were median 59,500/μL, range 18,000–88,000. Allogeneic BMT was adopted in 39 patients (97.5%). Beta thalassemia major was the commonest indication (21/40, 52.5%), followed by acute lymphocytic leukemia in six patients (15%). There were nine postoperative complications (bleeding n = 2 and CRBSIs n = 7) encountered in all placements. Four of them occurred in insertions below 50,000/μL (two bleeding complications that managed conservatively, and two CRBSIs). Post-procedural morbidities regarding bleeding or CRBSIs did not differ significantly between both groups (p value = 0.099 and 0.695, respectively). Conclusions Postponement of CVC insertions in thrombocytopenic children due to the fear of potential complications seems unwarranted, as it has no significant impact on the morbidity. Placements of such catheters can be safe under cover of perioperative platelet transfusions irrespective of the preoperative platelet count.

scholarly journals Modified Devine Exclusion for Unresectable Distal Gastric Cancer in Symptomatic Patients

2017 ◽  
Vol 11 (1) ◽  
pp. 9-16 ◽  
Author(s):  
María Carmen Fernández-Moreno ◽  
Roberto Martí-Obiol ◽  
Fernando López ◽  
Joaquín Ortega
Keyword(s):  
Gastric Cancer ◽  
Oral Tolerance ◽  
Outlet Obstruction ◽  
Postoperative Mortality ◽  
Palliative Surgery ◽  
Alternative Methods ◽  
Blood Transfusions ◽  
Safe Procedure ◽  
Severe Anemia ◽  
Distal Gastric Cancer

Background: In patients with outlet obstruction syndrome and/or severe anemia secondary to unresectable gastric cancer (GC), partial stomach-partitioning gastrojejunostomy, or modified Devine exclusion, is a surgical alternative. Methods: A retrospective study was conducted on patients with unresectable distal GC treated with modified Devine exclusion as palliative surgery between February 2005 and December 2015. It consisted of a series of 10 patients with outlet obstruction syndrome and/or severe anemia. The outcomes of this technique were based on oral tolerance, blood transfusions, postoperative complications, and survival. Results: Early oral tolerance and a low rate of blood transfusions were observed postoperatively. There was no postoperative mortality and a very low complication rate without anastomotic leakage. Median survival was 9 months. Conclusions: Partial stomach-partitioning gastrojejunostomy is a safe procedure for unresectable GC which can improve the quality of life of these patients.

Uso de fios faciais de tração como um meio para o rejuvenescimento facial – relato de caso

2021 ◽  
Vol 2 (6) ◽  
pp. 8-20
Author(s):  
Sidmarcio Ziroldo ◽  
Ana Paula Freitas Farias ◽  
Morgana Martins Setubal ◽  
Pedro Ivo Polak Junior ◽  
Talge Monteiro Celuppi Gonçalves
Keyword(s):  
Postoperative Complications ◽  
Polylactic Acid ◽  
Operating Time ◽  
Facial Rejuvenation ◽  
Thread Lift ◽  
The Face ◽  
Collagen Stimulation

Among the procedures for facial rejuvenation, thread lift are currently widespread among professionals and highly sought after by patients. This demand can be justified because they are procedures, without incisions, shorter inactivy time, low operating time, and for the risk of postoperative complications when compared to rhytidoplasty. These are procedures capable of promoting collagen stimulation, elevating ptosis tissues, and adding volume to the application areas contributing to the restructuring of the face. Thread lift have evolved considerably over the years and can be now meet on absorbable devices based on polydioxanone and polylactic acid. In this article is proposed the use of Fiobloc® thread lift for the purpose of assessing their affectiveness in the replacement of ptosis tissues.

scholarly journals Early postoperative complications have long-term impact on quality of life after restorative proctocolectomy

Medicine ◽  
2016 ◽  
Vol 95 (27) ◽  
pp. e3966 ◽  
Author(s):  
Andrew McCombie ◽  
Yun Lee ◽  
Rutvik Vanamala ◽  
Richard Gearry ◽  
Frank Frizelle ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Postoperative Complications ◽  
Restorative Proctocolectomy ◽  
Early Postoperative Complications ◽  
Long Term Impact

scholarly journals Single plus one port robotic radical prostatectomy (SPORP); Initial experience

2017 ◽  
Vol 89 (3) ◽  
pp. 178 ◽  
Author(s):  
Volkan Tugcu ◽  
Abdulmuttalip Simsek ◽  
Ismail Evren ◽  
Kamil Gokhan Seker ◽  
Ramazan Kocakaya ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Postoperative Complications ◽  
Radical Prostatectomy ◽  
Serum Level ◽  
Blood Loss ◽  
Clinical Stage ◽  
Operating Time ◽  
Positive Surgical Margin ◽  
Robotic Radical Prostatectomy ◽  
Postoperative Continence

Objective: This article reports on patients with early stage prostate cancer treated with single plus one port robotic radical prostatectomy (SPORP). Materials and methods: Since January 2014, we performed SPORP in 8 patients with localized prostate cancer. Age of patients, clinical stage, operation time, intraoperative and postoperative complications, blood loss, histopathological evaluation, postoperative continence, serum level of PSA were evaluated. Results: Mean age of the 8 patients was 59.85 years. All operations were completed without conversion to standard robotic procedure or open surgery. No intra operative complications occurred. Mean operating time was 143 minutes; prostate excision 123 minutes and urethrovesical anastomosis 20 minutes. Mean blood loss was 45 ml. Preoperative Gleason scores were (3 + 4) in one patient and (3 + 3) in 7 patients. Postoperative Gleason scores were (3 + 4) in 2 patients, and (3 + 3) in 6 patients. All these 8 cases were in T1c clinical stage. Early postoperative complications were drain leakage (n = 1), atelectasis (n = 1), wound infection (n = 1) and fever (n = 1). There was no positive surgical margin. The serum level of PSA was less than 0.2 ng/ml and no other complications happened during the 4 to 12 months follow-up period. Postoperative continence and cosmetic results were excellent. Conclusions: It is relatively easy for urologists who are skilled in traditional laparoscopic and robotic surgeries to master SPORP. However long-term outcomes of this surgery need further investigations.

scholarly journals Cirurgia no Aspergiloma Pulmonar: Experiência Mono-Institucional

2014 ◽  
Vol 27 (4) ◽  
pp. 417
Author(s):  
Silvia Da Silva Correia ◽  
Carlos Pinto ◽  
João Bernardo
Keyword(s):  
Postoperative Complications ◽  
Surgical Resection ◽  
Surgical Procedure ◽  
Lung Resection ◽  
Previous History ◽  
Term Treatment ◽  
High Rate ◽  
Long Term Treatment ◽  
Immunosuppressed Patients ◽  
Pulmonary Aspergilloma

<strong>Introduction:</strong> Pulmonary aspergiloma or mycetoma is a saprophytic colonization of a preexisting cavity by aspergilloma. Surgical resection is the only effective long-term treatment, but remains controversial because of the high rate of complications in the perioperative and postoperative time.<br /><strong>Objectives:</strong> Analysis of the experience of a Cardiothoracic Surgery Center for the treatment of pulmonary aspergilloma and evaluation of the prognostic factors after surgery.<br /><strong>Material and Methods:</strong> Retrospective analysis including all the patients with a diagnosis of pulmonary aspergilloma submitted to surgery for a 10 years period, in a single institution (June 2001-June 2011).<br /><strong>Results:</strong> The study included 22 patients (18 men) with a mean age of 51.0 + 17.4 years. Of them, 46% were smokers, 41% were alcoholic and 50% had a previous history of tuberculosis. Most of the patients had a complex aspergilloma (73%) and 17% a simple aspergilloma. The most common presentation was hemoptysis (50%). The common surgical procedure performed was atypical lung resection in 55%, lobectomy in 27% and pneumectomy in 9%. Two patients were submitted to thoracoplasty. There was one operative death (5%). Postoperative complications occurred in 36% and the most frequent were pneumothorax (18%) and empyema (18%). The mean follow-up period was 52 months (3 - 116) and the 5 years mortality rate of 35%. Of them, 4 patients died because of non- related causes and 3 were immunosuppressed patients. The mortality was 40% in the group of complex aspergilloma and 33% in the group of complex aspergilloma.<br /><strong>Discussion:</strong> The most common surgical procedure performed was atypical lung resection. The postoperative complications rate was similar to previous studies.<br /><strong>Conclusion:</strong> Surgical resection of aspergilloma presents a low morbidity and mortality. Therefore, for patients with lung function preserved, it is the preferred treatment.<br /><strong>Keywords:</strong> Aspergillus; Pulmonary Aspergillosis/surgery.

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