scholarly journals Transvaginal Appendectomy: A Systematic Review

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Mehmet Ali Yagci ◽  
Cuneyt Kayaalp
Keyword(s):  
Comparative Studies ◽  
Operating Time ◽  
Surgical Techniques ◽  
Length Of Hospital Stay ◽  
Minimal Invasive ◽  
Morbidly Obese ◽  
Complication Rates ◽  
Study Selection ◽  
History Of ◽  
Patient Selection Criteria

Background. Natural orifice transluminal endoscopic surgery (NOTES) is a new approach that allows minimal invasive surgery through the mouth, anus, or vagina.Objective. To summarize the recent clinical appraisal, feasibility, complications, and limitations of transvaginal appendectomy for humans and outline the techniques.Data Sources. PubMed/MEDLINE, Cochrane, Google-Scholar, EBSCO, clinicaltrials.gov and congress abstracts, were searched.Study Selection. All related reports were included, irrespective of age, region, race, obesity, comorbidities or history of previous surgery. No restrictions were made in terms of language, country or journal.Main Outcome Measures. Patient selection criteria, surgical techniques, and results.Results. There were total 112 transvaginal appendectomies. All the selected patients had uncomplicated appendicitis and there were no morbidly obese patients. There was no standard surgical technique for transvaginal appendectomy. Mean operating time was 53.3 minutes (25–130 minutes). Conversion and complication rates were 3.6% and 8.2%, respectively. Mean length of hospital stay was 1.9 days.Limitations.There are a limited number of comparative studies and an absence of randomized studies.Conclusions. For now, nonmorbidly obese females with noncomplicated appendicitis can be a candidate for transvaginal appendectomy. It may decrease postoperative pain and enable the return to normal life and work off time. More comparative studies including subgroups are necessary.

scholarly journals Staged Bilateral Hip or Knee Arthroplasties

2007 ◽  
Vol 15 (2) ◽  
pp. 159-162 ◽  
Author(s):  
FR Hashmi ◽  
K Barlas ◽  
CF Mann ◽  
FR Howell
Keyword(s):  
Hospital Admission ◽  
Hospital Stay ◽  
Operating Time ◽  
Length Of Hospital Stay ◽  
Mean Difference ◽  
Complication Rates ◽  
Early Complication ◽  
Early Complications ◽  
Hospital Stays ◽  
The Mean

Purpose. To compare the operating time, amount of blood transfused, length of hospital stay, and early complications (within 6 months) between 2-week staged bilateral arthroplasties and matched randomised controls undergoing unilateral arthroplasties. Methods. From October 1992 to October 2000, 90 patients who underwent bilateral hip or knee arthroplasties with a 2-week interval were compared with matched randomised controls undergoing unilateral arthroplasties. A single surgeon performed all procedures. Results. After the match-up process, 30 pairs of patients were included in the analysis. There were no significant differences in the operating times, amount of blood transfused, and early complication rates. The mean difference in length of hospital stay was significant ( t= −3.552, df=29, p<0.001). Conclusion. Compared to staged procedures with an interval months apart, staged sequential arthroplasty with a 7- to 10-day interval during one hospital admission is more efficient, as it facilitates earlier rehabilitation without higher complication rates, and entails shorter hospital stays.

scholarly journals Impact of an acute Care Surgery Model on the Management of acute Appendicitis in South Korea: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Gun-Hee Yi ◽  
Hak-Jae Lee ◽  
Seul Lee ◽  
Jong-Hee Yoon ◽  
Suk-Kyung Hong
Keyword(s):  
Acute Appendicitis ◽  
South Korea ◽  
Hospital Stay ◽  
Acute Care ◽  
Surgical Techniques ◽  
Length Of Hospital Stay ◽  
Acute Care Surgery ◽  
Medical Procedure ◽  
Complication Rates ◽  
Care Surgery

Abstract Background The acute care surgery (ACS) system is a new model for the prompt management of diseases that require rapid treatment in patients with acute abdomen. This study compared the outcomes and characteristics of the ACS system and traditional on-call system (TROS) for acute appendicitis in South Korea. Methods This single-center, retrospective study included all patients (aged ≥18 years) who underwent surgery for acute appendicitis in 2016 and 2018. The TROS and ACS system were used for the 2016 and 2018 groups, respectively. We retrospectively obtained data on each patient from the electrical medical records. The independent samples t-test and Mann-Whitney U-test were used for continuous and non-normally distributed data, respectively.Results In total, 126 patients were included. The time taken to get from the emergency room admission to the operating room, operation times, and postoperative complication rates were similar between both groups. However, the length of the hospital stay was shorter in the ACS group than in the TROS group (4.3±3.2 days vs. 7.2±9.6 days, p=0.039).Conclusions Since the introduction of the ACS system, the length of hospital stay for surgical patients has decreased. This may be due to the application of an integrated medical procedure, such as a new clinical pathway, rather than differences in the surgical techniques.Trial registration: Retrospectively registered.

scholarly journals Surgical approaches for treatment of ureteropelvic junction obstruction – a systematic review and network meta-analysis

BMC Urology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Annemarie Uhlig ◽  
Johannes Uhlig ◽  
Lutz Trojan ◽  
Marc Hinterthaner ◽  
Alexander von Hammerstein-Equord ◽  
...  
Keyword(s):  
Ureteropelvic Junction Obstruction ◽  
Treatment Options ◽  
Operating Time ◽  
Surgical Techniques ◽  
Ureteropelvic Junction ◽  
Surgical Approaches ◽  
Transfusion Rate ◽  
Complication Rates ◽  
Success Rates ◽  
Urinary Leakage

Abstract Background Multiple surgical treatment options are available for the treatment of ureteropelvic junction obstruction (UPJO). The aim of this study is to compare the most frequently used technics in a comprehensive network approach. Methods A systematic literature search of the EMBASE, MEDLINE and COCHRANE libraries was conducted in January 2018. Publications were included that evaluated at least two of the following surgical techniques: open pyeloplasty (OP), endopyelotomy (EP), laparoscopic (LP) and robot assisted pyeloplasty (RP). Main outcomes were operative success, complications, urinary leakage, re-operation, transfusion rate, operating time, and length of stay. Network meta-analyses with random effects models simultaneously assessed effectiveness of all surgical techniques. Results A total of 26 studies including 3143 patients were analyzed. Compared with RP, EP and LP showed lower operative success rates (EP: OR = 0.09, 95%CI:0.05–0.19; p < 0.001; LP: OR = 0.51, 95%CI:0.31–0.84; p = 0.008). Compared with OP, LP and RP had lower risk for complications (LP: OR = 0.62; 95%CI:0.41–0.95; p = 0.027; RP: OR = 0.41; 95%CI:0.22–0.79; p = 0.007). Compared with RP, no significant differences were detected for urinary leakage or re-operation, transfusion rates. Compared with EP, RP yielded longer operating time (mean = 102.87 min, 95%CI:41.79 min–163.95 min, p = < 0.001). Further significant differences in operating times were detected when comparing LP to EP (mean = 115.13 min, 95%CI:65.63 min–164.63 min, p = < 0.001) and OP to EP (mean = 91.96 min, 95%CI:32.33 min–151.58 min, p = 0.003). Conclusions Multiple surgical techniques are available for treatment of UPJO. RP has the highest rates of operative success and as well as LP lower complication rates than OP. Although surgical outcomes are worse for EP, its operating time is shorter than OP, RP, and LP. Surgeons should consider these findings when selecting the optimal treatment method for individual patients.

Data validation in an economic evaluation of surgery for colon cancer

2005 ◽  
Vol 21 (2) ◽  
pp. 246-252 ◽  
Author(s):  
Martin Janson ◽  
Per Carlsson ◽  
Eva Haglind ◽  
Bo Anderberg
Keyword(s):  
Colon Cancer ◽  
Economic Evaluation ◽  
Surgical Techniques ◽  
Length Of Hospital Stay ◽  
Multicenter Trial ◽  
Complication Rates ◽  
Accurate Data ◽  
Case Record ◽  
Telephone Surveys ◽  
Open Versus

Objectives:This study aimed to validate the accuracy of data retrieved in a prospective multicenter trial, the purpose of which was an economic evaluation of two techniques of surgery for colon cancer.Methods:Within the Swedish contribution of the COLOR trial (Colon Cancer Open or Laparoscopic Resection), an economic evaluation of open versus laparoscopic surgical techniques was conducted. Data were collected by case record forms (CRF), patient diaries, and telephone surveys every 2 weeks. The study period was 12 weeks, and the perspective was societal. Data from the first consecutive forty patients to complete the health economic study protocol were validated. Retrieved data were compared with data from medical records and data from local social security offices for agreement.Results:Statistically significant differences were found for duration of anesthesia, length of surgery, number of outpatient consultations by doctors and district nurses, complication rate, and the use of central venous lines. No significant differences were observed concerning length of hospital stay, disposable instruments cost, and time off work, all of which heavily influence total costs.Conclusions:The present method of data collection regarding resources used in this setting seems to produce accurate data for economic evaluation; however, relative to complication rates, the method did not retrieve accurate data.

scholarly journals Non-descent vaginal hysterectomy in women with previous caesarean section scar: our experience

2018 ◽  
Vol 7 (6) ◽  
pp. 2404
Author(s):  
G. D. Maiti ◽  
Ashok Pillai ◽  
Tony Jose ◽  
P. R. Lele
Keyword(s):  
Caesarean Section ◽  
Vaginal Hysterectomy ◽  
Operating Time ◽  
Surgical Techniques ◽  
Length Of Hospital Stay ◽  
Cost Effective ◽  
Bladder Injury ◽  
Previous Caesarean Section ◽  
Technological Advancement ◽  
Scarred Uterus

Background: Hysterectomy is one of the common gynaecological major surgeries performed worldwide. In spite of technological advancement with laparoscopic and robotic hysterectomy conventional hysterectomy through vaginal route of nonprolapse uterus popularly known as, Non-Descent Vaginal Hysterectomy (NDVH) remains a justifiable cost effective, cosmetically appealing option especially in resource-crunched developing country. NDVH in post caesarean scarred uterus too a technically challenged procedure requiring skills and expertise.Assessment of technical feasibility and safety of non-descent vaginal hysterectomy in women with previous caesarean section scar were studied.Methods: The study was a prospective observational study of 72 patients with LSCS scar requiring hysterectomy for benign conditions were selected based on the inclusion and exclusion criteria carried out from June 2012 to May 2017. Operating time, blood loss, surgical techniques, intra/postoperative challenges, conversion to laparotomy or laparoscopic assistance and length of hospital stay were recorded for each case. Patients were followed up till 03 months of surgery.Results: Vaginal hysterectomy was successful in all cases. Morcellation, bisection or myomectomy, were done in 86% cases. Two patients had bladder injury, which was repaired vaginally, two cases required support of laparoscopy.  No patients needed blood transfusion. None of the patients were converted to laparotomy.Conclusions: Vaginal hysterectomy is a safe and effective procedure for benign non-prolapsed uteri in women with previous caesarean section scar when uterine size is less than 14 weeks. Standby operating laparoscopy provides added advantages to surgeon in doubtful or difficult cases to avoid conversion laparotomy.

Standard Bipolar Diathermy Vessel Ligation for Thyroidectomy

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P45-P46
Author(s):  
James Russell Tysome ◽  
Rudaina Hassan ◽  
Jeremy Davis
Keyword(s):  
Thyroid Surgery ◽  
Operating Time ◽  
Length Of Hospital Stay ◽  
Patient Discharge ◽  
Complication Rates ◽  
Bipolar Diathermy ◽  
Retrospective Case ◽  
Vessel Sealing ◽  
Chi Squared ◽  
Vessel Ligation

Objective Assess the safety and possible advantages of using bipolar diathermy with standard forceps, compared to clamp-and-tie for vessel ligation in thyroidectomy. Methods Retrospective case-control study of 153 patients undergoing thyroid surgery at our unit using the clamp-and-tie technique (January 2000-December 2002), compared to bipolar diathermy with standard bipolar forceps (January 2003-January 2006) for vessel ligation. Patient demographics, operating time, length of hospital stay, need for drain insertion, and complications (recurrent laryngeal nerve palsies, reactionary haemorrhage requiring re-exploration or late (>24h post-op) haematomas, hypocalcaemia) were compared between the two groups. Outcomes were compared using Prism (GraphPad Software, CA, USA). Data sets were initially tested for normal distribution using the D'Agostino and Pearson test of normality before comparison using two-tailed, unpaired t-tests, Mann-Whitney U test, Chi-squared or Fisher exact tests as appropriate, with p<0.05 considered significant. Results Significantly fewer drains were inserted and patients were discharged significantly earlier when standard bipolar diathermy was used for vessel ligation in hemithyroidectomies (p<0.001). The complication rates were similar for thyroidectomy using either technique, comparable to rates in large published series. Conclusions The use of bipolar diathermy with standard forceps for vessel ligation in thyroid surgery has been shown to be as safe and effective as the clamp-and-tie technique, while providing the advantage of the use of fewer drains, resulting in earlier patient discharge. This is a cost-efficient technique as it gives the advantage of reduced inpatient stay seen by others using bipolar vessel sealing devices or the harmonic scalpel, but without the expense.

scholarly journals Posthysterectomy vault prolapse of vaginal walls: Choice of operating procedure

2012 ◽  
Vol 140 (9-10) ◽  
pp. 666-672 ◽  
Author(s):  
Rajka Argirovic
Keyword(s):  
Pelvic Floor ◽  
Negative Impact ◽  
Surgical Techniques ◽  
Length Of Hospital Stay ◽  
Vaginal Vault ◽  
Clear Understanding ◽  
Complication Rates ◽  
Vault Prolapse ◽  
Ureteric Injury ◽  
Abdominal Sacrocolpopexy

Post-hysterectomy vaginal vault prolapse is a common complication following different types of hysterectomy with a negative impact on the woman?s quality of life due to associated urinary, anorectal and sexual dysfunction. A clear understanding of the supporting mechanisms for the uterus and vagina is important in order to make the right choice of the corrective procedure and also to minimize the risk of posthysterectomy occurrence of vault prolapse. Preexisting pelvic floor defect prior to hysterectomy is the single most important risk factor for vault prolapse. Various surgical techniques have been advanced in hysterectomy to prevent vault prolapse. Vaginal vault repair can be carried out abdominally or vaginally. Sacrospinous fixation and abdominal sacrocolpopexy are the commonly performed procedures. The vaginal approach for vault prolapse is superior to the abdominal approach in terms of complication rates, blood loss, postoperative discomfort, length of hospital stay and costeffectiveness. Moreover, it allows the simultaneous repair of all coexistent pelvic floor defects, such as cystocele, enterocele and rectocele. Abdominal sacrocolpopexy is associated with a lower rate of recurrent vault prolapse and dyspareunia than the vaginal sacrospinous colpopexy. Other less commonly performed procedures include uterosacral ligament suspension and illeococcygeal fixation with a high risk of ureteric injury. Surgical mesh of non-absorbent material is gaining in popularity and preliminary data from vaginal mesh procedures is encouraging.

scholarly journals Impact of an Acute Care Surgery Model on the Management of Acute Appendicitis in South Korea: A Retrospective Cohort Study

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Gun-Hee Yi ◽  
Hak-Jae Lee ◽  
Seul Lee ◽  
Jong-Hee Yoon ◽  
Suk-Kyung Hong
Keyword(s):  
Acute Appendicitis ◽  
South Korea ◽  
Hospital Stay ◽  
Acute Care ◽  
Surgical Techniques ◽  
Length Of Hospital Stay ◽  
Acute Care Surgery ◽  
Medical Procedure ◽  
Complication Rates ◽  
Care Surgery

Background. The acute care surgery (ACS) system is a new model for the prompt management of diseases that require rapid treatment in patients with acute abdomen. This study compared the outcomes and characteristics of the ACS system and traditional on-call system (TROS) for acute appendicitis in South Korea. Methods. This single-center, retrospective study included all patients (aged ≥18 years) who underwent surgery for acute appendicitis in 2016 and 2018. The TROS and ACS system were used for the 2016 and 2018 groups, respectively. We retrospectively obtained data on each patient from the electrical medical records. The independent samples t-test and Mann–Whitney U-test were used for continuous and nonnormally distributed data, respectively. Results. In total, 126 patients were included. The time taken to get from the emergency room admission to the operating room, operation times, and postoperative complication rates were similar between both groups. However, the length of the hospital stay was shorter in the ACS group than in the TROS group (4.3 ± 3.2 days vs. 7.2 ± 9.6 days, p = 0.039 ). Conclusions. Since the introduction of the ACS system, the length of hospital stay for surgical patients has decreased. This may be due to the application of an integrated medical procedure, such as a new clinical pathway, rather than differences in the surgical techniques.

Three-Port, Two Located on the Pfannenstiel Line, Laparoscopic Cholecystectomy Comparison with Traditional Laparoscopic Cholecystectomy

2017 ◽  
Vol 83 (3) ◽  
pp. 260-264
Author(s):  
Musa Akoglu ◽  
Erdal Birol Bostanci ◽  
Muhammet Kadri Colakoglu ◽  
Erol Aksoy
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Operating Time ◽  
Length Of Hospital Stay ◽  
Postoperative Results ◽  
Conversion To Open Surgery ◽  
Included Patient ◽  
History Of ◽  
Abdominal Operations ◽  
American Society ◽  
American Society Of Anesthesiologists

Laparoscopic cholecystectomy (LC) is seen as a gateway to minimally invasive surgery. We defined a new three-port technique with different port sites and compared the postoperative results with traditional four-port LC procedure in a case-match study. Between June 2012 and May 2013, 104 consecutive patients underwent three-port LC by same experienced surgeon. In the same center, 2963 consecutive patients underwent four-port LC, and of these 2963 patients, a matched group of 104 patients was selected. Data included patient age, gender, body mass index, American Society of Anesthesiologists score, history of abdominal operations, intraoperative data about operating time and conversion to open surgery, and postoperative data about length of hospital stay and postoperative complications were recorded prospectively. We concluded that our new three-port technique with different port sites is as feasible and safe as traditional four-port technique.

scholarly journals Comparison of Percutaneous and Open Surgical Techniques for First-Time Peritoneal Dialysis Catheter Placement in the Unbreached Peritoneum

2015 ◽  
Vol 35 (5) ◽  
pp. 576-585 ◽  
Author(s):  
Samar Medani ◽  
Wael Hussein ◽  
Mohamed Shantier ◽  
Robert Flynn ◽  
Catherine Wall ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Abdominal Surgery ◽  
Surgical Techniques ◽  
Complication Rates ◽  
Peritoneal Dialysis Catheter ◽  
Dialysis Catheter ◽  
Catheter Survival ◽  
Significant Difference ◽  
History Of ◽  
First Time

BackgroundThe percutaneous Seldinger method of peritoneal dialysis catheter (PDC) insertion has gained favor over recent years whereas traditionally it was reserved for patients considered not fit for general anesthesia. This blind technique is believed to be less safe, and is hence avoided in patients with previous laparotomy incisions. Reports on the success of this method may therefore be criticized for selection bias. In those with no prior abdominal surgery the optimal method of insertion has not been established.MethodsWe retrospectively reviewed the outcomes of first-time PDC placements comparing the percutaneous (group P) and surgical (group S) insertion techniques in patients without a history of previous abdominal surgery in a single center between January 2003 and June 2010. We assessed catheter survival at 3 and 12 months post-insertion and compared complication rates between the two groups.ResultsA total of 63 percutaneous and 64 surgical catheter insertions were analyzed. No significant difference was noted in catheter survival rates between group P and group S (86.2% vs 80% at 3 months, p = 0.37; and 78.3% vs 71.2% at 12 months, p = 0.42 respectively). Early and overall peritonitis rates were similar (5% vs 5.3%; p = 1, and 3.5 vs 4.9 episodes per 100 patient-months; p = 0.13 for group P and group S respectively). There were also no significant differences between the two groups in exit site leaks (15.9% in group P vs 6.3% in group S; p = 0.15), poor initial drainage (9.5% in group P vs 10.9% in group S, p = 0.34) or secondary drainage failure (7.9% in group P vs 18.8% in group S, p = 0.09).ConclusionThis study illustrates the success and safety of percutaneous PDC insertion compared with the open surgical technique in PD naive patients without a history of prior abdominal surgery. Catheter survival was favorable with percutaneous insertion in this low-risk patient population but larger prospective studies may help to determine whether either method is superior. The percutaneous technique can be recommended as a minimally invasive, cost-effective procedure that facilitates implementing an integrated care model in nephrology practice.

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