Endoscopic Path Planning in Robot-Assisted Endoscopic Nasal Surgery

Objectives: Postoperative urinary retention (POUR) is influenced by many factors, and its reported incidence rate varies widely. This study aimed to investigate the occurrence and risk factors for urinary retention following general anesthesia for endoscopic nasal surgery in male patients aged >60 years. Methods: A retrospective review of medical records between January 2015 and December 2019 identified 253 patients for inclusion in our study. Age, body mass index (BMI), a history of diabetes/hypertension, American Society of Anesthesiologists (ASA) classification, and urologic history were included as patient-related factors. Urologic history was subdivided into 3 groups according to history of benign prostate hyperplasia (BPH)/lower urinary tract symptoms (LUTS) and current medication. The following was analyzed as perioperative variables for POUR development: duration of anesthesia and surgery; amount of fluid administered; rate of fluid administration; intraoperative requirement for fentanyl, ephedrine, and dexamethasone; postoperative pain; and analgesic use. Preoperatively measured prostate size and uroflowmetry parameters of patients on medication for symptoms were compared according to the incidence of urinary retention. Results: Thirty-seven (15.7%) patients developed POUR. Age (71.4 vs 69.6 years), BMI (23.9 vs 24.9 kg/m2), a history of diabetes/hypertension, ASA classification, and perioperative variables were not significantly different between patients with and without POUR. Only urologic history was identified as a factor affecting the occurrence of POUR ( P = .03). The incidence rate among patients without urologic issues was 5.9%, whereas that among patients with BPH/LUTS history was 19.8%. Among patients taking medication for symptoms, the maximal and average velocity of urine flow were significantly lower in patients with POUR. Conclusions: General anesthesia for endoscopic nasal surgery may be a potent trigger for urinary retention in male patients aged >60 years. The patient’s urological history and urinary conditions appear to affect the occurrence of POUR.

Download Full-text

Comparison of Parecoxib and Proparacetamol in Endoscopic Nasal Surgery Patients

Yonsei Medical Journal ◽

10.3349/ymj.2008.49.3.383 ◽

2008 ◽

Vol 49 (3) ◽

pp. 383 ◽

Cited By ~ 14

Author(s):

Yigal Leykin ◽

Andrea Casati ◽

Alessandro Rapotec ◽

Massimiliano Dalsasso ◽

Luigi Barzan ◽

...

Keyword(s):

Nasal Surgery ◽

Endoscopic Nasal Surgery

Download Full-text

Objective and Subjective Evaluation of Endoscopic Nasal Surgery Outcomes

American Journal of Rhinology ◽

10.1177/194589240301700603 ◽

2003 ◽

Vol 17 (6) ◽

pp. 327-333 ◽

Cited By ~ 11

Author(s):

Roland Giger ◽

Basile Nicolas Landis ◽

Chunquan Zheng ◽

Didier-David Malis ◽

Alma Ricchetti ◽

...

Keyword(s):

Subjective Evaluation ◽

Nasal Surgery ◽

Surgery Outcomes ◽

Endoscopic Nasal Surgery ◽

Objective And Subjective Evaluation

Download Full-text

Urinary Retention Following General Anesthesia for Endoscopic Nasal Surgery in Men Aged Over 60 Years: A Retrospective Study

10.21203/rs.3.rs-43524/v1 ◽

2020 ◽

Author(s):

Yong Won Lee ◽

Bum Sik Kim ◽

Jihyun Chung

Keyword(s):

General Anesthesia ◽

Incidence Rate ◽

Urinary Retention ◽

Nasal Surgery ◽

Related Factors ◽

Predisposing Factor ◽

Prostate Hyperplasia ◽

History Of ◽

Male Patients ◽

Endoscopic Nasal Surgery

Abstract Background: Postoperative urinary retention (POUR) after anesthesia and surgery is influenced by many factors, and its reported incidence rate varies widely. The aim of this study was to investigate the occurrence and risk factors for urinary retention following general anesthesia for endoscopic nasal surgery in male patients aged over 60 years. Methods: Retrospective review of medical records between January 2015 and December 2019 identified 253 subjects for inclusion in our study. Age, body mass index, history of diabetes/hypertension, American Society of Anesthesiologists classification, and urologic history were included as patient-related factors. Urologic history was subdivided into three groups according to history of benign prostate hyperplasia (BPH)/lower urinary tract symptoms (LUTS) and current medication. The following were analyzed as perioperative variables for the development of POUR: duration of anesthesia and surgery; amount of fluid administered; rate of fluid administration; intraoperative requirement for fentanyl, ephedrine, and dexamethasone; postoperative pain; and analgesic use. Preoperatively measured prostate size and uroflowmetry parameters of patients on medication for symptoms were compared according to the incidence of urinary retention.Results: Thirty-seven patients (15.7%) had urinary retention requiring catheterization. Among analyzed variables, only urologic history was identified as a predisposing factor. The incidence rate among patients without urologic issues was 5.9%. This compared to 19.8% among patients with a history of BPH/LUTS, which was not reduced by taking medical treatment. Among patients taking medication for symptoms, the maximal and average velocity of urine flow were significantly lower in subjects with POUR. Conclusions: General anesthesia for endoscopic nasal surgery is a potent trigger of urinary retention in male patients aged over 60 years. The urological history of the patient was the most important risk factor, and the occurrence of POUR appears to be affected by urinary conditions. The present study is helpful in understanding the occurrence of POUR following general anesthesia in elderly male patients.

Download Full-text

Endonasal surgery in the coronavirus era – Birmingham experience

The Journal of Laryngology & Otology ◽

10.1017/s0022215120002364 ◽

2020 ◽

pp. 1-4

Author(s):

P P Naik ◽

G Tsermoulas ◽

A Paluzzi ◽

L McClelland ◽

S K Ahmed

Keyword(s):

Skull Base Surgery ◽

High Viral Load ◽

Anterior Skull Base ◽

World Health ◽

Nasal Surgery ◽

University Hospitals ◽

Endonasal Surgery ◽

Health Organization ◽

The Uk ◽

Endoscopic Nasal Surgery

Abstract Background The World Health Organization declared coronavirus disease 2019 a pandemic on 11th March 2020. There is concern regarding performing endonasal surgical procedures because of a high viral load in the nasopharynx. This paper describes our experience in conducting emergency and urgent endonasal operations during the peak of the coronavirus disease 2019 pandemic in the UK. Objectives To show the outcome of endonasal surgery during the peak of the coronavirus disease 2019 pandemic and to assess the post-operative rate of nosocomial coronavirus disease 2019 infection. Methods A retrospective cohort study was conducted of all patients who underwent high priority endoscopic nasal surgery or anterior skull base surgery between 23rd March and 15th June 2020 at University Hospitals Birmingham NHS Trust. Results Twenty-four patients underwent endonasal surgery during the study period, 12 were males and 12 were females. There was no coronavirus-related morbidity in any patient. Conclusion This observational study found that it is possible to safely undertake urgent endonasal surgery; the nosocomial risk of coronavirus disease 2019 can be mitigated with appropriate peri-operative precautions.

Download Full-text