scholarly journals 163 Morbidity of Presumed Temporary Loop De-Functioning Stomas in Patients with Colorectal Cancer

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
J Alfred ◽  
S Macdonald ◽  
R Kalaiselvan
Keyword(s):  
Colorectal Cancer ◽  
Hospital Admissions ◽  
Single Centre ◽  
Patient Demographics ◽  
Emergency Procedures ◽  
Stoma Complications ◽  
Life Threatening ◽  
Picture Archiving And Communication ◽  
High Output

Abstract Objectives The incidence of parastomal hernia (PSH) can be up to 80% of patients who have a stoma following abdominal surgery (1). Surgical intervention is required in 70% of patients due to pain, obstructive symptoms, or stoma appliance issues (2). This study aims to show the morbidity related to a presumed temporary loop stoma. Method This was a retrospective cohort study of all left-sided colorectal cancer resections undertaken in a single centre. Electronic healthcare records and Picture Archiving and Communication System (PACS) were used to gather data on patient demographics, operative details and details of de-functioning stoma fashioned. Morbidity related to de-functioning stoma was determined based on hospital admissions and length of inpatient stay related to stoma, complications in relation to the stoma, return to theatre, stoma reversal and fate of stoma site. Results 147 patients (87 M; 60 F, median age 69 (23-93)) underwent left sided colorectal cancer resections at a single centre. In total, 50 de-functioning loop stomas were fashioned (49 loop ileostomies and 1 loop colostomy.) At a median follow-up of 23 months (8-44), prior to reversal, 12 PSH were identified. 38 of the de-functioning stomas were reversed at a median time of 11 months (1-44), 5 of which were emergency procedures due to obstruction (n = 3) or high output (n = 2). There were 9 stoma related re-admissions identified in 7 patients. Conclusions Presumed temporary defunctioning loop ileostomies in Low anterior resections is associated with significant morbidity, but low risk in terms of life-threatening complication.

EP.FRI.50 Morbidity of presumed temporary loop de-functioning stomas in patients with colorectal cancer

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Joshua Alfred ◽  
Siobhan Macdonald ◽  
Ramaya Kalaiselvan ◽  
Susanna Schuster Bruce
Keyword(s):  
Colorectal Cancer ◽  
Hospital Admissions ◽  
Single Centre ◽  
Patient Demographics ◽  
Emergency Procedures ◽  
Stoma Complications ◽  
Life Threatening ◽  
Picture Archiving And Communication ◽  
High Output

Abstract Objectives The incidence of parastomal hernia (PSH) can be up to 80% of patients who have a stoma following abdominal surgery (1). Surgical intervention is required in 70% of patients due to pain, obstructive symptoms or stoma appliance issues (2). This study aims to show the morbidity related to a presumed temporary loop stoma.  Methods This was a retrospective cohort study of all left-sided colorectal cancer resections undertaken in a single centre. Electronic healthcare records and Picture Archiving and Communication System (PACS) were used to gather data on patient demographics, operative details and details of de-functioning stoma fashioned. Morbidity related to de-functioning stoma was determined based on hospital admissions and length of inpatient stay related to stoma, complications in relation to the stoma, return to theatre, stoma reversal and fate of stoma site.  Results 147 patients (87 M; 60 F, median age 69 (23-93)) underwent left sided colorectal cancer resections at a single centre. In total, 50 de-functioning loop stomas were fashioned (49 loop ileostomies and 1 loop colostomy.) At a median follow-up of 23 months (8-44), prior to reversal, 12 PSH were identified. 38 of the de-functioning stomas were reversed at a median time of 11 months (1-44), 5 of which were emergency procedures due to obstruction (n = 3) or high output (n = 2). There were 9 stoma related re-admissions identified in 7 patients.  Conclusion Presumed temporary defunctioning loop ileostomies in Low anterior resections is associated with significant morbidity, but low risk in terms of life-threatening complication.

scholarly journals Stoma Complications

Acta Medica ◽  
2019 ◽  
Vol 50 (2) ◽  
pp. 47-52
Author(s):  
Timuçin Erol
Keyword(s):  
Treatment Options ◽  
Early Postoperative Period ◽  
Stoma Creation ◽  
Quick Recovery ◽  
Stoma Complications ◽  
Post Operative Period ◽  
Life Threatening ◽  
The Ideal

An improper stoma creation can cause many complications, varying from minor to life-threatening ones. Conversely, a good functioning stoma, at the ideal site improves patient’s quality of life. Most of the stoma complications occur in the early postoperative period and all clinicians must be familiar to these complications. All measures before and during operation must be taken to avoid these complications. Careful follow up after post operative period can help early diagnosis, proper treatment quick recovery of the patient. This review focus on common complications and treatment options of stoma creation.  

scholarly journals Significant predictive factors of the severity and outcomes of the first attack of acute angioedema in children

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yuan-Jhen Syue ◽  
Chao-Jui Li ◽  
Wen-Liang Chen ◽  
Tsung-Han Lee ◽  
Cheng-Chieh Huang ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Respiratory Symptoms ◽  
Clinical Presentation ◽  
Preschool Age ◽  
Short Term ◽  
Patient Demographics ◽  
Life Threatening ◽  
History Of ◽  
Initial Episode

Abstract Background The initial episode of angioedema in children can be potential life-threatening due to the lack of prompt identification and treatment. We aimed to analyze the factors predicting the severity and outcomes of the first attack of acute angioedema in children. Methods This was a retrospective study with 406 children (< 18 years) who presented in the emergency department (ED) with an initial episode of acute angioedema and who had subsequent follow-up visits in the out-patient department from January 2008 to December 2014. The severity of the acute angioedema was categorized as severe (requiring hospital admission), moderate (requiring a stay in the short-term pediatric observation unit [POU]), or mild (discharged directly from the ED). The associations among the disease severity, patient demographics and clinical presentation were analyzed. Result In total, 109 (26.8%) children had severe angioedema, and the majority of those children were male (65.1%). Most of the children were of preschool age (56.4%), and only 6.4% were adolescents. The co-occurrence of pyrexia or urticaria, etiologies of the angioedema related to medications or infections, the presence of respiratory symptoms, and a history of allergies (asthma, allergic rhinitis) were predictors of severe angioedema (all p < 0.05). Finally, the duration of angioedema was significantly shorter in children who had received short-term POU treatment (2.1 ± 1.1 days) than in those who discharged from ED directly (2.3 ± 1.4 days) and admitted to the hospital (3.5 ± 2.0 days) (p < 0.001). Conclusion The co-occurrence of pyrexia or urticaria, etiologies related to medications or infections, the presence of respiratory symptoms, and a history of allergies were predictors of severe angioedema. More importantly, short-term POU observation and prompt treatment might be benefit for patients who did not require hospital admission.

scholarly journals TP7.2.19 Review of bascom cleft lift and flap-procedures versus excision for pilonidal disease in a single centre (2017-2019)

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Stephen Stonelake ◽  
Pratik Bhattacharya ◽  
Christopher Thompson
Keyword(s):  
Pilonidal Disease ◽  
Surgical Techniques ◽  
Recurrence Rates ◽  
Female Ratio ◽  
Patient Demographics ◽  
Emergency Procedures ◽  
Flap Procedure ◽  
Cleft Lift ◽  
Rhomboid Flap

Abstract Introduction Pilonidal disease continues to be managed with varying surgical techniques. We review results with Bascom cleft lift comparing to other practices at our institution. Methods All elective procedures for pilonidal disease reviewed from December 2017 to December 2019. Patient demographics, previous emergency and elective procedures for pilonidal disease, follow-up, dehiscence and recurrence rates, and all-cause morbidity were examined retrospectively. Results In the study period there were 106 procedures. Average age was 27 years (range 15-64). Male to female ratio was 83:23. Procedures were excision and primary closure (48), excision and packing (19), rhomboid flap (2), Bascom cleft lift flap (31), other rotational/perforator or V to Y flaps (6). Rates of previous elective procedures in the flap procedures versus excision group were 31% and 10% respectively (P = 0.01). Rates of previous emergency procedures in the flap-procedures versus excision group were 41% and 31% respectively (P = 0.40). In 50 procedures there was a documented follow up encounter at a mean time of 55 days (median 34 days, range 2-239). Dehiscence (partial and full) in flap procedures versus excision and closure was 33% and 27% respectively (P = 0.64). Recurrence rates in flap procedures versus excision +/- closure or packing were 0% and 8% respectively (P = 0.16). Conclusion Flap procedures have a lower rate of recurrence and comparable dehiscence rates despite being performed in patients with higher rates of prior procedures for pilonidal disease. Bascom cleft lift was the simplest flap procedure most commonly performed and matches the results of more complex flaps.

scholarly journals Palmoplantar Pustulosis: A Case Report

2020 ◽  
Vol 4 (4) ◽  
pp. 664-667
Author(s):  
Anne Dulski ◽  
Vince Varamo
Keyword(s):  
Case Report ◽  
Hospital Admissions ◽  
Tertiary Care ◽  
Skin Condition ◽  
Care Hospital ◽  
Palmoplantar Pustulosis ◽  
Life Threatening ◽  
Physician Awareness ◽  
Ed Visits

Introduction: Dermatology complaints account for 3.3% of emergency department (ED) visits per year. Most rashes are benign, but there are a select few that emergency physicians must be familiar with as delay in treatment could be life threatening. Case Report: A well-appearing, 76-year-old male presented to the ED with multiple coalescing pustules to his palms and soles and was transferred to the nearest tertiary care hospital for dermatology consult. He was diagnosed with palmoplantar pustulosis and discharged home with a five-day course of clobetasol propionate 0.05% cream twice daily and outpatient dermatology follow-up. Conclusion: Palmoplantar pustulosis is an uncommon skin condition characterized by recurrent eruptions of sterile pustules localized to the palms and soles. Emergency physician awareness of this rare diagnosis may help prevent hospital admissions and lead to earlier initiation of treatment with outpatient dermatology follow-up.

scholarly journals 209 Breast Lymphoma Treatment Outcomes in a Pakistani Population: 20 Years of Experience at a Single Centre

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
M Abid ◽  
R Bano ◽  
A I Khan ◽  
S A Fiaz ◽  
M Z Chaudry ◽  
...  
Keyword(s):  
Progressive Disease ◽  
Complete Response ◽  
Treatment Modalities ◽  
Single Centre ◽  
Pakistani Population ◽  
Patient Demographics ◽  
Breast Lymphoma ◽  
Lymphoma Treatment ◽  
The Mean

Abstract Background Breast lymphomas constitute a rare disease entity. To date, limited relevant data have been reported. We therefore here present a review of breast lymphoma patients treated at a single centre over 20-year period, focusing on histological types, treatment modalities and outcomes. Method We identified patients who were diagnosed and treated for breast lymphoma at a single centre from January 1995 to January 2014 and extracted data regarding patient demographics and clinical data. Results Twenty-seven patients with breast lymphoma were identified, of which 3 were males. Median age at diagnosis was 37 years (range:22-76 years). Chemotherapy was main stay of treatment and 55.6% patients also received radiation to affected breast. At our institute, only 3 patients, all with progressive disease, had surgery performed to achieve local palliation. Complete response after chemotherapy was seen in 63% patients and partial response in 7.4%, while 26% patients demonstrated disease progression. The mean follow up was 46.8 months. Seven patients (33.3%) who were alive at last follow up, as well as 1 patient who died, survived more than 5 years after diagnosis. Conclusions Patients with breast lymphoma should receive aggressive treatment, with combination of chemotherapy and radiation therapy. Surgery should be limited for diagnosis and palliation of local symptoms in cases of progressive disease.

Periprocedural risk and long-term outcome of intracranial angioplasty based on a single-centre experience

VASA ◽  
2013 ◽  
Vol 42 (4) ◽  
pp. 264-274
Author(s):  
Dagmar Krajíčková ◽  
Antonín Krajina ◽  
Miroslav Lojík ◽  
Martina Mulačová ◽  
Martin Vališ
Keyword(s):  
Death Rate ◽  
Long Term Outcomes ◽  
Single Centre ◽  
Intracranial Atherosclerotic Stenosis ◽  
Atherosclerotic Stenosis ◽  
Angioplasty And Stenting ◽  
Aggressive Medical Management ◽  
Stroke Death

Background: Intracranial atherosclerotic stenosis is a major cause of stroke and yet there are currently no proven effective treatments for it. The SAMMPRIS trial, comparing aggressive medical management alone with aggressive medical management combined with intracranial angioplasty and stenting, was prematurely halted when an unexpectedly high rate of periprocedural events was found in the endovascular arm. The goal of our study is to report the immediate and long-term outcomes of patients with ≥ 70 % symptomatic intracranial atherosclerotic stenosis treated with balloon angioplasty and stent placement in a single centre. Patients and methods: This is a retrospective review of 37 consecutive patients with 42 procedures of ballon angioplasty and stenting for intracranial atherosclerotic stenosis (≥ 70 % stenosis) treated between 1999 and 2012. Technical success (residual stenosis ≤ 50 %), periprocedural success (no vascular complications within 72 hours), and long-term outcomes are reported. Results: Technical and periprocedural success was achieved in 90.5 % of patients. The within 72 hours periprocedural stroke/death rate was 7.1 % (4.8 % intracranial haemorrhage), and the 30-day stroke/death rate was 9.5 %. Thirty patients (81 %) had clinical follow-up at ≥ 6 months. During follow-up, 5 patients developed 6 ischemic events; 5 of them (17 %) were ipsilateral. The restenosis rate was 27 %, and the retreatment rate was 12 %. Conclusions: Our outcomes of the balloon angioplasty/stent placement for intracranial atherosclerotic stenosis are better than those in the SAMMPRIS study and compare favourably with those in large registries and observational studies.

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