Comparison of 5 Surgical Techniques for Partial Liver Lobectomy in the Dog for Intraoperative Blood Loss and Surgical Time

Objective To retrospectively analyze the clinical outcomes of two intramedullary fixation devices, the INTERTAN nail and Gamma3 nail, for treatment of AO/OTA 31-A2 trochanteric fractures in elderly patients. Methods In total, 165 elderly patients underwent treatment for AO/OTA 31-A2 trochanteric fractures in our hospital from June 2017 to June 2018 (INTERTAN group, n = 79; Gamma3 group, n = 86). All patients underwent radiological and clinical investigations and were followed up for an average of 12 months. Age, sex, fracture type, surgical time, intraoperative blood loss, fracture healing time, and complications were compared between the two groups. Results The surgical time was significantly shorter and the intraoperative blood loss volume was significantly lower in the Gamma3 than INTERTAN group (58.2 ± 2.5 vs. 81.7 ± 14.2 minutes and 170 ± 29 vs. 220 ± 16 mL, respectively). However, there were no significant differences in the reduction quality, hospital stay, fracture healing time, Harris hip score, postoperative complications, or 1-year postoperative mortality. Conclusion Both INTERTAN and Gamma3 nails may be effective for surgical treatment of AO/OTA 31-A2 trochanteric fractures in elderly patients. However, the Gamma3 nail was superior to the INTERTAN nail in terms of surgical time and intraoperative blood loss.

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Percutaneous vertebroplasty versus kyphoplasty for the treatment of neurologically intact osteoporotic Kümmell’s disease

BMC Surgery ◽

10.1186/s12893-021-01057-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Shou-qian Dai ◽

Rong-qing Qin ◽

Xiu Shi ◽

Hui-lin Yang

Keyword(s):

Blood Loss ◽

Bone Cement ◽

Percutaneous Vertebroplasty ◽

Cement Leakage ◽

Intraoperative Blood Loss ◽

Surgical Time ◽

Significant Difference ◽

Neurologically Intact ◽

Operation Cost

Abstract Background Percutaneous vertebroplasty (PVP) and kyphoplasty (PKP) have been widely used to treat neurologically intact osteoporotic Kümmell’s disease (KD), but it is still unclear which treatment is more advantageous. Our study aimed to compare and investigate the safety and clinical efficacy of PVP and PKP in the treatment of KD. Methods The relevant data that 64 patients of neurologically intact osteoporotic KD receiving PVP (30 patients) or PKP (34 patients) were analyzed. Surgical time, operation costs, intraoperative blood loss, volume of bone cement injection, and fluoroscopy times were compared. Occurrence of cement leakage, transient fever and re-fracture were recorded. Universal indicators of visual analogue scale (VAS) and Oswestry disability index (ODI) were evaluated separately before surgery and at 1 day, 6 months, 1 year, 2 years and the final follow-up after operation. The height of anterior edge of the affected vertebra and the Cobb’s angle were assessed by imaging. Results All patients were followed up for at least 24 months. The volume of bone cement injection, intraoperative blood loss, occurrence of bone cement leakage, transient fever and re-fracture between two groups showed no significant difference. The surgical time, the operation cost and fluoroscopy times of the PKP group was significantly higher than that of the PVP group. The post-operative VAS, ODI scores, the height of the anterior edge of the injured vertebrae and kyphosis deformity were significantly improved in both groups compared with the pre-operation. The improvement of vertebral height and kyphosis deformity in PKP group was significantly better than that in the PVP group at every same time point during the follow-up periods, but the VAS and ODI scores between the two groups showed no significant difference. Conclusion PVP and PKP can both significantly alleviate the pain of patients with KD and obtain good clinical efficacy and safety. By contrast, PKP can achieve better imaging height and kyphosis correction, while PVP has the advantages of shorter operation time, less radiation volume and operation cost.

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Clinical benefit of liver hanging maneuver for right-side major hepatectomy

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.15171 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 15171-15171

Author(s):

H. Hayashi ◽

T. Beppu ◽

J. Nasu ◽

T. Masuda ◽

T. Mizumoto ◽

...

Keyword(s):

Blood Loss ◽

Liver Tumor ◽

Tumor Size ◽

Anterior Approach ◽

Major Hepatectomy ◽

Red Blood Cell Transfusion ◽

Intraoperative Blood Loss ◽

Liver Hanging Maneuver ◽

Surgical Time ◽

Hanging Maneuver

15171 Background: Liver hanging maneuver is a new technique in anterior approach of major hepatectomy. However, the impact of the maneuver has never been fully investigated in patients with liver tumors. To evaluate the surgical benefits of liver hanging maneuver, we set up a comparative study in right-side major hepatectomy. Methods: From 2000 to 2006, 326 hepatectomy were performed in our institution. Fifty-eight patients with liver tumor (hepatocellularcarcinoma in 36, metastatic liver tumor in 13, and the others in 9) considered for right-side major hepatectomy were prospectively analyzed. Right-side hepatectomy included 26 right hepatectomy, 24 extended right hepatectomy, and 8 tri-segmentectomy. The patients were devided into a group with conventional approach (n = 21), a group with anterior approach without hanging maneuver (n = 19), and a group with approach with liver hanging maneuver (n = 18). In the three groups, age, body mass index, child-pugh classification, type of liver tumor, staging in hepatocellularcarcinoma, tumor size, resected liver weights, intraoperative blood loss, frequency of transfusion and surgical time were analyzed. Results: In conventional approach, anterior approach without hanging maneuver, and approach with liver hanging maneuver, mean age was 55, 59, and 65 years, and mean tumor size was 65, 75, and 108mm, respectively. Patients with liver hanging maneuver were significantly elder (p<0.05) and have larger tumor size (p<0.01). There were no significant differences in body mass index, child-pugh classification, type of liver tumor, staging in hepatocellularcarcinoma, and resected liver weights. Mean intraoperative blood loss was 1771, 805, and 704g, and mean surgical time was 562, 483, and 435minutes, and the frequency of red blood cell transfusion was 33, 21, and 17%, respectively. Patients with liver hanging maneuver had significantly less intraoperative blood loss (P=0.0001) and surgical time (P=0.002). The frequency of red blood cell transfusion in the liver hanging maneuver group was significantly lower than that of the conventional group (p<0.05). Postoperative morbidity rate were 33.3, 15.8, and 16.7%, respectively. Conclusions: Liver hanging maneuver is less invasive and a quite useful method for right-side major hepatectomy. No significant financial relationships to disclose.

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A novel electrosurgical divider: performance in a self-controlled tonsillectomy study

European Archives of Oto-Rhino-Laryngology ◽

10.1007/s00405-021-07008-9 ◽

2021 ◽

Author(s):

Gerold Besser ◽

Stefan Grasl ◽

Elias L. Meyer ◽

Julia Schnoell ◽

Tina J. Bartosik ◽

...

Keyword(s):

Postoperative Pain ◽

Blood Loss ◽

Postoperative Bleeding ◽

Neck Surgery ◽

Controlled Clinical Trial ◽

Intraoperative Blood Loss ◽

Bleeding Events ◽

Surgical Time ◽

Secondary Bleeding ◽

Temperature Controlled

Abstract Purpose Tonsillectomies are among the most common surgeries in otorhinolaryngology. A novel electrosurgical temperature-controlled instrument (device) promises rapid tonsillectomies and might reduce postoperative pain, but comparative studies to assess performance are warranted. Methods This randomized self-controlled clinical trial was conducted from October 2019 to October 2020 at the Department of Otorhinolaryngology, Head and Neck Surgery of the Medical University of Vienna. Forty-eight patients underwent a tonsillectomy with the device on one side and using cold-steel with localized bipolar cauterization on the other side (control). Main outcomes were the time for tonsil removal (per side) and the time to stop bleeding (per side). Secondary measurements were postoperative pain, assessed once on day 0 and five times on days 1, 3, 5, 7, and 10. Postoperative bleeding episodes and consequences were recorded. Results Device tonsillectomies were performed significantly faster than controls; the mean surgical time difference was 209 s (p < 0.001, 95% CI 129; 288). Intraoperative blood loss was significantly lower on the device side (all p < 0.05). Postoperative measurements of pain and bleeding were similar for both sides. Two return-to-theatre secondary bleeding events were recorded for the control side. Conclusion The novel electrosurgical temperature-controlled divider reduced the tonsillectomy surgical time and intraoperative blood loss, with no apparent negative effects on postoperative pain or bleeding, compared to a cold-steel tonsillectomy with localized bipolar cauterization. In time-restricted settings, the device could be beneficial, particularly after familiarization with device handling. Trial registration ClinicalTrials.gov Identifier: < Blinded for review >

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Comparison between the results of proximal femur nail anti-rotation and cemented bipolar hemiarthroplasty in treatment of intertrochanteric fractures in Sanglah Hospital in 2016

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20193931 ◽

2019 ◽

Vol 7 (9) ◽

pp. 3475

Author(s):

Wayan Suryanto Dusak ◽

Herryanto Agustriadi Simanjuntak ◽

I Gusti Ngurah Paramartha Wijaya Putra

Keyword(s):

Blood Loss ◽

Postoperative Complication ◽

Harris Hip Score ◽

Secondary Outcome ◽

Surgical Trauma ◽

Transfusion Rate ◽

Bipolar Hemiarthroplasty ◽

Intertrochanteric Fractures ◽

Intraoperative Blood Loss ◽

Surgical Time

Background: Hemiarthroplasty is now being considered as a primary treatment for comminuted unstable type of IT fracture in elderly on the grounds that it allows early mobilization and full weight bearing. Recently popular modality is fourth generation of intramedullary nails like the Proximal Femoral Nails. The goal of treatment is restoring mobility safely and efficiently, while minimizing the risk of medical complications and technical failure.Methods: A Forty patients, having Intertrochanteric fractures treated with PFNA or cemented BH at our institution between April 2016 and April 2017. The primary outcomes measures were postoperative complication and hip function. The secondary outcome measures were intraoperative blood loss, transfusion rate, surgical time, postoperative haemoglobin and hospital stay.Results: Seventeen patients in PFNA group and 23 patients in BH group were included for analysis. There were no significant differences between the two group regarding to the Harris Hip Score at 6 months follow up. Significant differences were found between PFNA and BH group in comparison of intraoperative blood loss (p < 0.001), length of stay (p = 0.006), surgical time (p < 0.001), postoperative transfusion (p < 0.001), and decrease of hemoglobin (p=0.001).Conclusions: These findings indicate that PFNA has obvious advantages over the BH in treatment of intertrochanteric fractures in case of surgical trauma and postoperative complication.

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Total Shoulder Arthroplasty After Previous Arthroscopic Surgery for Glenohumeral Osteoarthritis: A Case-Control Matched Cohort Study

The American Journal of Sports Medicine ◽

10.1177/03635465211006479 ◽

2021 ◽

pp. 036354652110064

Author(s):

Philip-C. Nolte ◽

Bryant P. Elrick ◽

Justin W. Arner ◽

T.J. Ridley ◽

Thomas E. Woolson ◽

...

Keyword(s):

Cohort Study ◽

Patient Satisfaction ◽

Blood Loss ◽

Shoulder Arthroplasty ◽

Total Shoulder Arthroplasty ◽

Revision Arthroplasty ◽

Intraoperative Blood Loss ◽

Surgical Time ◽

Glenohumeral Osteoarthritis

Background: When comprehensive arthroscopic management (CAM) for glenohumeral osteoarthritis fails, total shoulder arthroplasty (TSA) may be needed, and it remains unknown whether previous CAM adversely affects outcomes after subsequent TSA. Purpose: To compare the outcomes of patients with glenohumeral osteoarthritis who underwent TSA as a primary procedure with those who underwent TSA after CAM (CAM-TSA). Study Design: Cohort study; Level of evidence, 3. Methods: Patients younger than 70 years who underwent primary TSA or CAM-TSA and were at least 2 years postoperative were included. A total of 21 patients who underwent CAM-TSA were matched to 42 patients who underwent primary TSA by age, sex, and grade of osteoarthritis. Intraoperative blood loss and surgical time were assessed. Patient-reported outcome (PRO) scores were collected preoperatively and at final follow-up including the American Shoulder and Elbow Surgeons (ASES) score, Single Assessment Numeric Evaluation (SANE), shortened version of Disabilities of the Arm, Shoulder and Hand (QuickDASH), 12-Item Short Form Health Survey Physical Component Summary (SF-12 PCS), visual analog scale, and patient satisfaction. Revision arthroplasty was defined as failure. Results: Of 63 patients, 56 of them (19 CAM-TSA and 37 primary TSA; 88.9%) were available for follow-up. There were 16 female (28.6%) and 40 male (71.4%) patients with a mean age of 57.8 years (range, 38.8-66.7 years). There were no significant differences in intraoperative blood loss ( P > .999) or surgical time ( P = .127) between the groups. There were 4 patients (7.1%) who had failure, and failure rates did not differ significantly between the CAM-TSA (5.3%; n = 1) and primary TSA (8.1%; n = 3) groups ( P > .999). Additionally, 2 patients underwent revision arthroplasty because of trauma. A total of 50 patients who did not experience failure (17 CAM-TSA and 33 primary TSA) completed PRO measures at a mean follow-up of 4.8 years (range, 2.0-11.5 years), with no significant difference between the CAM-TSA (4.4 years [range, 2.1-10.5 years]) and primary TSA (5.0 years [range, 2.0-11.5 years]) groups ( P = .164). Both groups improved significantly from preoperatively to postoperatively in all PRO scores ( P < .05). No significant differences in any median PRO scores between the CAM-TSA and primary TSA groups, respectively, were seen at final follow-up: ASES: 89.9 (interquartile range [IQR], 74.9-96.6) versus 94.1 (IQR, 74.9-98.3) ( P = .545); SANE: 84.0 (IQR, 74.0-94.0) versus 91.5 (IQR, 75.3-99.0) ( P = .246); QuickDASH: 9.0 (IQR, 3.4-27.3) versus 9.0 (IQR, 5.1-18.1) ( P = .921); SF-12 PCS: 53.8 (IQR, 50.1-57.1) versus 49.3 (IQR, 41.2-56.5) ( P = .065); and patient satisfaction: 9.5 (IQR, 7.3-10.0) versus 9.0 (IQR, 5.3-10.0) ( P = .308). Conclusion: Patients with severe glenohumeral osteoarthritis who failed previous CAM benefited similarly from TSA compared with patients who opted directly for TSA.

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Natural Orifice Non-Descent Hysterectomy - Revisiting Fading Surgical Art

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2021/764 ◽

2021 ◽

Vol 10 (44) ◽

pp. 3781-3784

Author(s):

Shashi Prateek

Keyword(s):

Blood Loss ◽

Tertiary Care ◽

Surgical Techniques ◽

Natural Orifice ◽

Indication For Surgery ◽

Tertiary Care Centre ◽

Surgical Time ◽

Surgical Expertise ◽

Abdominal Route ◽

Operative Recovery

BACKGROUND We wanted to assess the feasibility of natural orifice non-descent hysterectomy (NONH) for various benign gynaecological indications. METHODS This retrospective study was conducted at a tertiary care centre including patients requiring hysterectomy for various gynaecological indications over 12 months. Outcomes including time of surgery, blood loss, intraoperative surgical technique, complications, and conversion to the abdominal route were noted. RESULTS A total of 68 cases of natural orifice non-descent hysterectomy were performed. The uterine fibroid was the most common (50 %) indication for surgery followed by adenomyosis. Uteri with previous multiple surgeries were also successfully operated vaginally. The average surgical time was 60 min, with minimal blood loss. Post-operative recovery was good and patients were discharged after 48 hours. CONCLUSIONS This article concludes that natural orifice is a safe route of non-descent hysterectomy even for larger and scarred uteri using various debulking and surgical techniques but requiring good anatomical knowledge, surgical expertise and teamwork. KEY WORDS Natural Orifice Non-Descent Hysterectomy (NONH); Surgical Variations; Debulking Technique; Post-Operative Recovery

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Coblation vs. dissection tonsillectomy: a prospective randomized study comparing surgical and clinical outcomes

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20190492 ◽

2019 ◽

Vol 5 (2) ◽

pp. 306

Author(s):

Shifa Vyas ◽

Pritosh Sharma ◽

Nitin Sharma ◽

Abhijit Makwana ◽

V. P. Goyal

Keyword(s):

Postoperative Pain ◽

Blood Loss ◽

Randomized Study ◽

Postoperative Bleeding ◽

Intraoperative Blood Loss ◽

Surgical Time ◽

Intraoperative Bleeding ◽

Time Required ◽

Pain Patients ◽

Better Than

Background: The objective of this study is to compare operative time, intraoperative bleeding, postoperative pain between coblation and dissection tonsillectomy.Methods: A total of 62 patients who met the inclusion criteria were divided into two groups according to the surgical procedure they went through. Surgical time intraoperative blood loss, postoperative pain, postoperative regaining of activity and any episode of postoperative bleeding were noted in both the groups and compared. Results: Coblation tonsillectomy fared better than dissection tonsillectomy in terms of having less intraoperative blood loss, less postoperative pain. Patients who underwent coblation assisted tonsillectomy also had earlier return to normal activities. Though the time required for coblation tonsillectomy was more than dissection tonsillectomy there were no episodes of postoperative bleeding in subjects who underwent coblation tonsillectomy.Conclusions: Coblation assisted tonsillectomy is a promising new technique for tonsillectomy as patients had less postoperative morbidity mainly pain. The surgical time required could be reduced further with experience.

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Percutaneous vertebroplasty versus kyphoplasty for the treatment of neurologically intact osteoporotic Kümmell’s disease

10.21203/rs.3.rs-97667/v1 ◽

2020 ◽

Author(s):

Shouqian Dai ◽

Rongqing qin ◽

xiu shi ◽

Hui-lin Yang

Keyword(s):

Blood Loss ◽

Bone Cement ◽

Clinical Efficacy ◽

Percutaneous Vertebroplasty ◽

Cement Leakage ◽

Intraoperative Blood Loss ◽

Surgical Time ◽

Significant Difference ◽

Neurologically Intact

Abstract Background: Percutaneous vertebroplasty (PVP) and kyphoplasty (PKP) have been widely used to treat neurologically intact osteoporotic Kümmell’s disease (KD), but it is still unclear which treatment is more advantageous. Our study aimed to compare and investigate the safety and clinical efficacy of PVP and PKP in the treatment of KD.Methods: The relevant data that 64 patients of neurologically intact osteoporotic KD receiving PVP (30 patients) or PKP (34 patients) were analyzed. Surgical time, operation costs, intraoperative blood loss, volume of bone cement injection, and fluoroscopy times were compared. Occurrence of cement leakage, transient fever and re-fracture were recorded. Universal indicators of visual analogue scale (VAS) and Oswestry disability index (ODI) were evaluated separately before surgery and at 1 day, 6 months, 1 year, 2 years and the final follow-up after operation. The height of anterior edge of the affected vertebra and the Cobb’s angle were assessed by imaging. Results: All patients were followed up for at least 24 months. The volume of bone cement injection, intraoperative blood loss, occurrence of bone cement leakage, transient fever and re-fracture between two groups showed no significant difference. The surgical time, the operation cost and fluoroscopy times of the PKP group was significantly higher than that of the PVP group. The post-operative VAS, ODI scores, the height of the anterior edge of the injured vertebrae and kyphosis deformity were significantly improved in both groups compared with the pre-operation. The improvement of vertebral height and kyphosis deformity in PKP group was significantly better than that in the PVP group at every same time point during the follow-up periods, but the VAS and ODI scores between the two groups showed no significant difference.Conclusion: PVP and PKP can both significantly alleviate the pain of patients with KD and obtain good clinical efficacy and safety. By contrast, PKP can achieve better imaging height and kyphosis correction, and can be recommended as a preferred treatment options for KD.

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Intraoperative blood loss and surgical time according to the direction of maxillary movement

Archives of Plastic Surgery ◽

10.5999/aps.2020.00878 ◽

2020 ◽

Vol 47 (5) ◽

pp. 411-418

Author(s):

Hyo Seong Kim ◽

Ji Hwan Son ◽

Jee Hyeok Chung ◽

Kyung Sik Kim ◽

Joon Choi ◽

...

Keyword(s):

Retrospective Study ◽

Blood Loss ◽

Postoperative Care ◽

Orthognathic Surgery ◽

Regression Analyses ◽

Intraoperative Blood Loss ◽

Surgical Time ◽

Excessive Bleeding ◽

P Values ◽

Significant Difference

Background Excessive bleeding is one of the most severe complications of orthognathic surgery (OGS). This study investigated the associations of intraoperative blood loss and surgical time with the direction of maxillary movement.Methods This retrospective study involved patients who underwent OGS from October 2017 to February 2020. They were classified based on whether maxillary setback was performed into groups A1 and B1, respectively. Relative blood loss (RBL, %) was used as an indicator to compare intraoperative blood loss between the two groups. The surgical time of the two groups was also measured. Subsequently, the patients were reclassified based on whether posterior impaction of the maxilla was performed into groups A2 and B2, respectively. RBL and surgical time were measured in the two groups. Simple linear and multiple regression analyses were performed. P-values <0.05 were considered to indicate statistical significance.Results Eighteen patients were included. The RBL and surgical time for the groups were: A1, 13.15%±5.99% and 194.37±42.04 minutes; B1, 12.41%±1.89% and 196.50±46.07 minutes; A2, 13.94%±3.82% and 201.00±39.70 minutes; and B2, 9.61%±3.27% and 188.84±38.63 minutes, respectively. Only RBL showed a statistically significant difference between the two groups (A2 and B2, P=0.04).Conclusions Unlike maxillary setback, posterior impaction of the maxilla showed a significant association with RBL during surgery. When performing posterior impaction of the maxilla, clinicians need to pay particular attention to surgery and postoperative care.

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