Postoperative Complication Assessments of Different Reconstruction Procedures after Total Pharyngolaryngoesophagectomy: Tubular Gastric Pull-Up versus Whole Gastric Pull-Up

2018 ◽  
Vol 84 (12) ◽  
pp. 1927-1931
Author(s):  
Zhenbo Dai ◽  
Qinghua He ◽  
Boyu Pan ◽  
Liren Liu ◽  
Dejun Zhou
Keyword(s):  
Postoperative Complications ◽  
Hypopharyngeal Cancer ◽  
Reconstruction Method ◽  
Observation Study ◽  
Reconstruction Procedure ◽  
Intrathoracic Stomach ◽  
Group A ◽  
Group B ◽  
Medical University ◽  
Gastric Pull Up

Hypopharynx carcinoma tends to be diagnosed at advanced stage and usually has a poor prognosis because of the high incidence of submucosal spreading and lymphatic metastasis. Total pharyngolaryngoesophagectomy (PLE) is mostly used as a curative intervention for this deadly disease, and a commonly used reconstruction method after PLE is gastric pull-up, which could be further divided into tubular gastric pull-up and whole gastric pull-up procedures. Aiming to achieve a precise guidance on optimal reconstruction method after PLE, the present study evaluated the postoperative complications involving in different gastric pull-up procedures in patients with hypopharynx cancer. A total of 52 consecutive patients with hypopharyngeal cancer who underwent total PLE with gastric pull-up reconstruction in Tianjin Medical University Cancer Institute and Hospital between 1996 and 2014 were analyzed in this study. Of these patients, 28 underwent tubular gastric pull-up reconstruction procedure (Group A), whereas 24 underwent whole gastric pull-up reconstruction procedure (Group B). We compared the postoperative complications between these two groups retrospectively. Postoperative anastomotic fistulas occurred in three patients in Group A (3/28) versus eight patients in Group B (8/24), leading to an incidence rate of 10.71 and 33.33 per cent, respectively. The incidence of intrathoracic stomach syndrome was 21.43 per cent in Group A (6/28) versus 58.33 per cent in Group B (14/24), and the incidence of reflux was 35.71 per cent in Group A (10/28) versus 66.67 per cent in Group B (16/24). All of the above postoperative complications exhibited statistical differences between two groups ( P ≤ 0.05). This retrospective observation study suggests that compared with whole gastric pull-up, tubular gastric pull-up is a better reconstruction procedure of choice after PLE, evidenced by reduced incidences of postoperative anastomotic fistula, intrathoracic stomach syndrome, and reflux.

Comprehensive Nursing can Relieve the Negative Emotions of Patients undergoing Breast Cancer Resection and Reduce Postoperative

2021 ◽  
Vol 7 (5) ◽  
pp. 4234-4243
Author(s):  
Xiaoxia Lv ◽  
Lihua Wang ◽  
Yan Zhai
Keyword(s):  
Breast Cancer ◽  
Postoperative Complications ◽  
Quality Score ◽  
Cancer Resection ◽  
Upper Limb Function ◽  
Sf 36 ◽  
Group A ◽  
Group B ◽  
Nursing Quality

To explore the effect of comprehensive nursing on adverse emotions and postoperative complications of breast cancer patients undergoing mastectomy. Altogether 180 patients who received treatment in our hospital from May 2017 to May 2019 were selected as the research participants and divided into group A and group B. Among them, 100 cases in group A received comprehensive nursing, 80 cases in group B received routine nursing. The surgical indications, upper limb function, serum NGF, TK1 and CA15-3 expression level, VAS score, SAS, SDS score, quality of life SF-36 score were detected, and the incidence rate of postoperative complications and nursing quality score were compared. Compared with group B, group A had less postoperative bed time, intraoperative blood loss, length of hospital stay, better recovery of upper limb function, lower expression levels of serum NGF, TK1 and CA15-3, lower VAS score, SAS and SDS score, higher quality of life SF-36 score, lower incidence of postoperative complications and higher nursing quality score. Comprehensive nursing can relieve the negative emotions of patients undergoing breast cancer resection and reduce the incidence of postoperative complications.

scholarly journals Adverse outcome of methotrexate and mini pulse betamethasone in the treatment of lichen planus

2013 ◽  
Vol 39 (1) ◽  
pp. 22-27 ◽  
Author(s):  
SC Hazra ◽  
AM Choudhury ◽  
ATM Asaduzzaman ◽  
HK Paul
Keyword(s):  
Adverse Effects ◽  
Lichen Planus ◽  
Adverse Outcome ◽  
Adverse Outcomes ◽  
Haematological Parameter ◽  
Morning Dose ◽  
Group A ◽  
Laboratory Investigations ◽  
Group B ◽  
Medical University

The objectives of this study were to compare the adverse outcome of methotrexate and mini pulse betamethasone therapy in the treatment of lichen planus. It was a clinical trial conducted in the department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University, Dhaka, from January 2009 to December 2010. Forty four patients of lichen planus were included in the study. Patients in Group-A, (n=23) were treated with methotrexate (10 mg) single morning dose and group-B (n=21) were treated with mini pulse betamethasone (5mg) single morning dose on 2 consecutive days during the period of 12 weeks. Adverse outcomes were measured by clinical examination and laboratory investigations during follow up visits. Anemia 3(14.2%) and edema 12(57.1%) developed in group-B but none in group-A. In group-B, dyspepsia 15(71.4%), acne 10(47.6%), mooning face 8(38.1%), striae 8(38.1%) and hypertrichosis 4(19.0%) developed but none in group-A. Intermittent diarrhoea, headache, nausea and fatigue complained in both groups of patients but the percentage of complaints was higher amog group-B compared to group-A. Menstrual abnormality developed in group-B 5(71.4%) but none in group-A. Laboratory investigations showed abnormality in platelet count and SGPT in group-A but none in group-B. The adverse effects of methotrexate on haematological parameter and liver functions were mild and could be prevented by reducing the dose but the adverse effects of betamethasone were unavoidable. The overall adverse effects were less in group-A than group-B. Therefore, methotrexate can be used as an alternative safer option for the treatment of lichen planus. DOI: http://dx.doi.org/10.3329/bmrcb.v39i1.15806 Bangladesh Med Res Counc Bull 2013; 39: 22-27

scholarly journals Ablating Aspiration Needle Tract Prior to Microwave Ablation Can Improve Therapeutic Outcomes for Predominantly Cystic Thyroid Nodules

2021 ◽  
Vol 12 ◽  
Author(s):  
Haizhen Yang ◽  
Yanwei Chen ◽  
Baoding Chen ◽  
Shuangshuang Zhao ◽  
Zheng Zhang ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Microwave Ablation ◽  
Thyroid Nodules ◽  
Cyst Fluid ◽  
Cystic Fluid ◽  
Needle Tract ◽  
Intracystic Hemorrhage ◽  
Group A ◽  
Hospital Stays ◽  
Group B

PurposeTo investigate whether ablating the aspiration needle tract could improve the safety and efficacy of ultrasound-guided microwave ablation (MWA) for predominantly cystic thyroid nodules.Materials and MethodsThis retrospective study evaluated 41 predominantly cystic thyroid nodules that underwent MWA between June 2017 and August 2019. The nodules were stratified by different procedures into two groups: the aspiration needle tract was ablated before cyst fluid aspiration and MWA when treating 26 nodules in Group A, while the other 15 nodules in Group B underwent MWA directly after cyst fluid aspiration. Baseline characteristics, intervention time, hospital stays, nodules with intraoperative intracystic hemorrhage, and postoperative complications were compared between the two groups. Volume, volume reduction rate (VRR), compressive score (CS), and aesthetic score (AS) were evaluated during follow-up.ResultsBoth groups achieved decreases in volume, CS, and AS, as well as an increase in VRR. The volumes and VRRs in Group A at 1, 3, 6, and 12 months were significantly smaller and greater than those in Group B (p < 0.001). The incidence of intraoperative intracystic hemorrhage in Group A was significantly lower than that in Group B (p=0.035). Compared to Group B, hospital stays were much shorter in Group A (p=0.040). There were no significant differences in intervention time, cystic fluid volume or postoperative complications.ConclusionAspiration needle tract ablation dramatically reduces the incidence of intraoperative intracystic hemorrhage and markedly improves the efficacy of MWA for predominantly cystic thyroid nodules.

scholarly journals Dyslipidemia in End Stage Renal Disease: A Study on Dialysis Patients in Bangabandhu Sheikh Mujib Medical University Bangladesh

KYAMC Journal ◽  
2020 ◽  
Vol 11 (3) ◽  
pp. 113-117
Author(s):  
Salahuddin Feroz ◽  
Shah Md Zakir Hossain ◽  
Rafi Nazrul Islam ◽  
Amir Mohammad Kaiser ◽  
Miliva Mozaffor ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Hdl Cholesterol ◽  
Dialysis Patients ◽  
Ckd Stage ◽  
Group A ◽  
Group B ◽  
Stage Renal Disease ◽  
End Stage ◽  
Medical University

Background: Dyslipidemia contributes to the high cardiovascular risk in end stage renal disease (ESRD) or in dialysis patients; however, it remains an underestimated problem. Objective: To see the extent of dyslipidemia in patients of end stage renal disease i.e. chronic kidney disease (CKD) stage 5 who underwent hemodialysis or peritoneal dialysis procedure. Materials and Methods: This cross-sectional study was conducted from September 2016 to March 2018 Bangabandhu Sheikh Mujib Medical University (BSMMU) on 55 CKD (stage 5) patients where 31 in hemodialysis (HD) (group A) and 24 in continuous ambulatory peritoneal dialysis (CAPD) (group B). Serum lipid profile was estimated in both groups by using the standard laboratory technique. Results: Dialysis adequacy (Kt/V) was found 1.46 for HD patients (group A) and 1.81 for CAPD patients (group B).All serum lipids were higher in amount in CAPD patients than HD patients-total cholesterol (222.3±24.2 mg/dl vs. 198.9±28.4 mg/dl; p<0.05), triglycerides (179.6±24.7 mg/dl vs. 176.6±24.4 mg/dl; p<0.05), HDL cholesterol (40.8±3.90 mg/dl vs. 38.5±4.95 mg/dl; p>0.05) and LDL cholesterol (145.5±22.1 mg/dl vs. 123.2±26.5 mg/dl; p<0.05). Besides, dyslipidemia was more evident in CAPD patients than HD patients, as per raised serum total cholesterol (83.33% vs. 70.97%), raised triglycerides (95.83% vs. 83.87%), raised LDL (100% vs. 77.42%) and lowering of HDL cholesterol (87.5% vs. 80.65%) were found more in group B in comparison to group A. Conclusion: Dyslipidemic risk factors are highly evident in dialysis patients and the extent of dyslipidemia is observed more in CAPD than HD patients. KYAMC Journal Vol. 11, No.-3, October 2020, Page 113-117

scholarly journals Low Iron Level is related to Telogen Effluvium in Women

2013 ◽  
Vol 21 (2) ◽  
pp. 84-89 ◽  
Author(s):  
Md Manjurul Karim ◽  
Md Abdul Wahab ◽  
Lubna Khondoker ◽  
Md Shirajul Islam Khan
Keyword(s):  
Hair Loss ◽  
Control Group ◽  
Case Group ◽  
Iron Level ◽  
History Of ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Medical University ◽  
Control Study

A case-control study conducted in the Department of Dermatology and Venereology of Bangabandhu Sheikh Mujib Medical University, Dhaka from July 2008- December 2010. A total 60 female patients of telogen effluvium attending in outpatient department (OPD) were enrolled in the study with 30 having hair loss considered as case (Group-A) and another 30 females had no history of hair loss were considered as control (Group-B). The study included 60 patients and the mean age were 25.4±7 years ranging from 18 to 42 years in group A and 24.8±5.6 years ranging from 17 to 36 years in group B. Maximum number was found in the age group of 21- 30 years in both groups and nearly three fourth (73.4%) patients were unmarried in group A and 18(60.0%) in group B. Most of the patients were student in both groups, which were 21(70.0%) and 17(56.7%) in group A and group B respectively and majority of the the patients were HSC level in both groups, 15(50.0%) and 14(46.7%) in Group A and Group B respectively. Most of the patients came from middle class, which were 20(66.7%) and 16(53.3%) in group A and group B respectively. The mean serum ferritin were 18.8±8.1 g/L ranging from 4.5 to 36.54 g/L and 36.6±9.9 mg/L ranging from 18.46 to 56.3 mg/ L in group A and group B respectively. The mean Hb level was 11.5±1.4 gm/dl ranging from 8.5 to 14.0 gm/dl in group A and 12.8±1.1 gm/dl ranging from 10.5 to 14.5 gm/dl in group B. The mean difference of Hb level was statistically significant (p<0.05) between two groups in unpaired t-test. It can be concluded that low iron level is associated with telogen effluvium in women. DOI: http://dx.doi.org/10.3329/bjmed.v21i2.13617 Bangladesh J Medicine 2010; 21: 84-89

Hematological and Biochemical Parameter Changes Related to Methotrexate Therapy

2014 ◽  
Vol 40 (3) ◽  
pp. 40-43
Author(s):  
Samaresh Chandra Hazra ◽  
Agha Masood Choudhury ◽  
Lubana Khondker ◽  
Md Shirajul Islam Khan ◽  
Nafiza Ahmed
Keyword(s):  
Lichen Planus ◽  
Biochemical Parameter ◽  
Pulse Therapy ◽  
Control Group ◽  
Case Group ◽  
Increasing Trend ◽  
Function Test ◽  
Group A ◽  
Group B ◽  
Medical University

A clinical trial was conducted to evaluate the hematological and biochemical changes related to methotrexate in the treatment of lichen planus. A total of forty four patients with lichen planus, attendign at the department of Dermatology and Venereology, Bangabandhu Seikha Mujib Medical University (BSMMU), Dhaka, Bangladesh durign the period of january 2009 to December 2010 were enrolled in this study purposively. Of them, 23 patients in group-A (case group) and 21 patients in group-B (control group) were selected randomly. The case group was treated with oral methotrexate and the control group was trated with betamethasone oral mini- pulse therapy. A decreasing trend of hemoglobin level and platet count was observed between two groups. An increasing trend of SGPT was observed among the case adn control up to 6th week of observation and then it decreased. This study also revealed abnormlity in platelet count and liver function test in both the groups. But the overall effects were less in cases than control. So it cand be concluded from this study that methtrexate can be used as an alternative saf drug therapy for the treatmetn of lichen planus. DOI: http://dx.doi.org/10.3329/bmj.v40i3.18674 Bangladesh Medical Journal 2011 Vol.40(3):40-43

scholarly journals Will women’s choice of position in first stage of labor affect labor process?

2020 ◽  
Vol 9 (4) ◽  
pp. 1515
Author(s):  
Shubha Rao ◽  
Shylabhirami Sridharan ◽  
Akhila Vasudeva ◽  
Roopa P. S.
Keyword(s):  
Pregnant Women ◽  
Neonatal Outcome ◽  
Total Duration ◽  
Labor Process ◽  
Recumbent Position ◽  
Observation Study ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Type Of Delivery

Background: Controlling the process of childbirth has disabled the parturient to embrace the most spontaneous position of delivery but constricting her to assume a recumbent position. Objective of this study was to study if alternating comfortable maternal positioning i.e., recumbent and alternative position have any influence in the process of labor, type of delivery, neonatal well-being.Methods: Study conducted an observation study on term pregnant women. Study inclusion criteria included all term pregnant women. Exclusion criteria included multiple pregnancies, preterm patient, severe pre-eclampsia, and eclampsia, preterm premature rupture of membranes, sever intrauterine growth restricted fetus. The measured date were maternal general characteristics, duration of labor process, type of delivery and neonatal outcome. Patients were divided into two groups. Group A - if they spent more than 50% in a recumbent position and Group B - any other alternating position.Results: A total 250 women were equally included in this study. The demographic characteristics were matched in both groups and found no significant difference. In the process of labor, Group B had a difference of 1 hours as compared to Group A and the rate of cervical dilation was also faster in Group B. Both of these variables were found to be statistically significant. However, there were no significant difference in the terms of type of delivery and neonatal outcome.Conclusions: The ancient practice of recumbent position during labor is to be discarded as alternating maternal position during the process of labor may a positive influence on the total duration labor. However even though it may or may not have an influence on the other outcome such as route of delivery and neonatal outcome, it is best to encourage women to move and deliver in the most comfortable position.

Outcomes of Esophageal Replacement: Gastric Pull-Up and Colonic Interposition Procedures

2017 ◽  
Vol 28 (01) ◽  
pp. 022-029 ◽  
Author(s):  
Keren Sloan ◽  
Anna Morandi ◽  
Bhanumathi Lakshminarayanan ◽  
Sharon Cox ◽  
Alastair Millar ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Oral Feeding ◽  
Esophageal Replacement ◽  
Caustic Ingestion ◽  
Colonic Interposition ◽  
Septic Complications ◽  
Anastomotic Strictures ◽  
Group A ◽  
Group B ◽  
Gastric Pull Up

Aim No consensus exists about the optimal surgical technique for esophageal replacement. This study reports the surgical outcomes for the gastric pull-up and the colonic interposition procedures. Materials and Methods A retrospective review of children undergoing esophageal replacement surgery between January 2001 and June 2015 across four different pediatric surgery centers was conducted. Data collected included indications, epidemiology, surgical technique, complications, and outcomes. Patients were divided into group A, those that had a gastric pull-up procedure and group B, those that had a colonic interposition procedure. Results In total, 50 patients were included; 29 in group A and 21 in group B. Indications included esophageal atresia, caustic ingestion, and infective esophageal stricture. The median age at the time of surgery was 13 months. The mean length of follow-up was 5.2 years. Three patients died giving a mortality rate of 6%; 2 in group A and 1 in group B.In both groups, early postoperative complications included infective complications, such as wound infections, sepsis, and pneumonia (11), anastomotic leak (7), and respiratory complications (7). Late complications included adhesive bowel obstruction (2), anastomotic strictures (4), redundancy (1), and jejunostomy problems (1). Septic complications and anastomotic strictures occurred more frequently in group B. Further surgery was needed in eight patients; this was significantly higher in group B. Full oral feeding was achieved within 6 months in 91.5%. Conclusion The gastric pull-up and colonic interposition have comparable mortality and outcomes. The colonic interposition was associated with a higher rate of early septic complications, anastomotic strictures, and need for further surgery.

Surgical management of synchronous colorectal liver metastases: Simultaneous versus staged resections.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 616-616
Author(s):  
Igor Shchepotin ◽  
Andrii Lukashenko ◽  
Olena Kolesnik ◽  
Anton Burlaka
Keyword(s):  
Colorectal Cancer ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Liver Metastases ◽  
Metastatic Cancer ◽  
Economic Effect ◽  
Hepatic Metastases ◽  
Group A ◽  
Bed Days ◽  
Group B

616 Background: Surgical treatment of metastatic colorectal cancer remains the only method that improves overall 5-year survival. This study aimed to compare the surgical outcome and survival benefit between synchronous and staged resection of liver metastases from colorectal cancer. Methods: Clinicopathologic data, treatments, and postoperative outcomes from 110 patients who underwent simultaneous (48 patients, group A) or staged (62 patients, group B) colorectal and hepatic resections at clinic of National cancer institute in period of 2008-2013 were reviewed. Results: Postoperative complications in patients with simultaneous resections (group A) were observed in 13 cases (27.1%), including 5, 1, 4, 2, 0, and 1 of grades I, II, IIIa, IIIb, IV, and V, respectively. Similar results have been reported in group B after staged resections, where overall postoperative complications registered in 16 patients (25.8 %), including 4, 3, 6, 3, 0 of grades I, II, IIIa, IIIb, and IV respectively. Overall level of post-operative complications in the groups A and B after surgical stages finishing did not differ statistically (p=0.96). Shorter operative intervention duration was registered in the group A – (311±10.1) min, whereas in the group B it was (496.6±16.2) min (р<0.001). Patients after staged resection stayed in clinic for a longer time – 23.9±0.8 bed-days, when simultaneous resections provided with shorter recovery terms in post-operative period – 9.8±0.5 bed-days (p<0.001). Overall 3-year survival in the group of patients with simultaneous resections (group А) was 42 % and in the group B 55 % (р=0.22). Conclusions: Analysis of our research indicated necessity of the development of differentiated approach in management of synchronous colorectal liver metastatic cancer. Simultaneous resections of colorectal cancer primary lesions and hepatic metastases were safe and could serve as a primary option for selected patients. Subsequent research should be directed towards study of prognosis factors and criteria for patients’ selection for surgical treatment groups, assessment of economic effect, and patients life quality.

Use of Perioperative Steroids with Microvascular Decompression Operations

Neurosurgery ◽  
1988 ◽  
Vol 22 (2) ◽  
pp. 353-357 ◽  
Author(s):  
Donald W. Marion ◽  
Peter J. Jannetta
Keyword(s):  
Postoperative Complications ◽  
Microvascular Decompression ◽  
Cranial Nerves ◽  
Wound Infections ◽  
Related Complication ◽  
Deep Wound ◽  
Life Threatening ◽  
Group A ◽  
Group B ◽  
Single Blind

Abstract Complications associated with the use of perioperative steroids in elective craniotomies were evaluated in a single-blind prospective study of 222 consecutive microvascular decompression operations. Patients were randomized into one of three groups: Group A received steroids preoperatively and for 4 days postoperatively, Group B received steroids preand postoperatively for 1 day, and Group C received no steroids. There were 17 complications in Group A; 12 of these were wound-related. There were significantly fewer complications in Groups B and C (P &lt; 0.01). Group B had 3 complications, Group C had 4, and there was only 1 wound-related complication in Group C. There were no deaths, deep wound infections, or life-threatening complications. Severe postoperative headaches, a symptom that steroids were intended to minimize, occurred in 38% of patients in Group A, 42% of patients in Group B, and 25% of patients in Group C. The use of perioperative steroids did not reduce the length of postoperative hospitalization. Duration of the operation had no significant effect on the incidence of postoperative complications or the length of postoperative hospitalization. We conclude that there is no indication for the routine perioperative use of steroids with microvascular decompression operations of the posterior fossa cranial nerves and that such use leads to a higher incidence of postoperative complications. (Neurosurgery 22:353-357, 1988)

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