Novel Approach for 2-Port Laparoscopic Hysterectomy

2019 ◽  
Vol 26 (4) ◽  
pp. 442-448
Author(s):  
Paul Tyan ◽  
James Robinson ◽  
Monica Dandapani ◽  
Jessica Li ◽  
Alex Gu ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Case Series ◽  
Laparoscopic Hysterectomy ◽  
University Hospital ◽  
Surgical Interventions ◽  
Novel Approach ◽  
Estimated Blood Loss ◽  
Surgical History ◽  
Retrospective Comparative Study

Background and Objectives. To describe a novel technique for a port-reducing laparoscopic hysterectomy. The 2-port laparoscopic hysterectomy (TPH) is performed through two 5-mm ports without the use of any multiport channels. We demonstrate outcomes via a large case series. We also describe and provide a video showing the TPH technique. Methods. Retrospective comparative study between the newly developed TPH and the conventional 4-port hysterectomy techniques. Variables of patients who underwent a TPH with fellowship-trained gynecologic surgeons at a single academic university hospital were collected through electronic medical records chart review. Results. Forty-five patients underwent a TPH. Mean age was 39.4, body mass index was 28.5 kg/m2, and uterine weight was 170.0 g. Our outcomes of interest were operative time (98.4 minutes, mean), estimated blood loss (65.6 mL, mean), conversion to 3-port (1/45), and intraoperative (0/45) and postoperative (5/45) complications. By comparing the TPH to the conventional 4-port laparoscopic hysterectomy within a similar setting, we provide insight into variables that prompt the minimally invasive gynecologic surgeon to perform a port-reducing procedure. Patients were more likely to be allocated for a TPH if they were younger (37.8 vs 44.7, P = .005), had a lower body mass index (29.0 vs 32.5, P = .07), smaller uterus (143.1 vs 672.3 g, P < .001), and were white (56.8% and 22.4%, P < .001). Conclusions. The TPH is a novel port-reducing hysterectomy that is safe in a subset of patients with small uteri and limited surgical history who require no other surgical interventions at the time of hysterectomy.

Abdominal Wall Hernias in End-Stage Renal Disease Patients on Peritoneal Dialysis

2008 ◽  
Vol 28 (4) ◽  
pp. 391-396 ◽  
Author(s):  
Gustavo Martínez-Mier ◽  
Eduardo Garcia-Almazan ◽  
Hugo E. Reyes-Devesa ◽  
Victor Garcia-Garcia ◽  
Sergio Cano-Gutierrez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Peritoneal Dialysis ◽  
Body Mass ◽  
Small Body ◽  
Retrospective Chart Review ◽  
University Hospital ◽  
Dialysis Patients ◽  
Dialysis Unit ◽  
Mesh Hernioplasty

Objective To describe our experience with hernioplasty in peritoneal dialysis patients and to identify possible risk factors for surgical complications. Design A 4-year retrospective chart review of data. Setting Peritoneal dialysis unit of a university hospital. Patients and Methods 58 hernias in 50 patients were included. Detailed surgical technique and complications were recorded. Possible risk factors included age, gender, weight, height, body mass index, previous surgery, diabetes, time on dialysis, emergency surgery, hospital stay, type of hernia, mesh use, blood hemoglobin, and serum urea, creatinine, and potassium. Results Complications occurred in 12 hernioplasties (4 wound infections, 2 peritonitis, 4 catheter dysfunction, and 5 re-operations). Recurrence rate was 12% without mesh use and 0% with mesh hernioplasty. Dialysis was re-instituted in 96% of cases within 3 days postoperatively. Identified risk factors for complications were diabetes, low weight, low height, small body mass index, and low serum creatinine. Conclusions Mesh hernioplasty in peritoneal dialysis patients is advisable. Postoperative dialysis with low volume is feasible after surgery. Prospective studies will corroborate our risk factors for morbidity.

scholarly journals Relationship between Body Mass Index and T-Scores of Bone Mineral Density in the Hip and Spine Regions among Older Adults with Diabetes: A Retrospective Review

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Abdulaziz F. Hariri ◽  
Mohammad N. Almatrafi ◽  
Aws B. Zamka ◽  
Abdullah S. Babaker ◽  
Tariq M. Fallatah ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Body Mass Index ◽  
Femoral Neck ◽  
Body Mass ◽  
Bone Mineral ◽  
University Hospital ◽  
Lumbar Region ◽  
Mineral Density ◽  
Patients With Diabetes ◽  
Low Bmi

Diabetes mellitus (DM) cases are increasing worldwide, especially in Saudi Arabia. Previous studies suggested a positive relationship between body mass index (BMI) and bone mineral density (BMD) levels. Generally, patients with low BMI (<18.5 kg/m2) have reduced BMD levels and, thus, low T-scores; hence, they are categorized as osteopenic or osteoporotic. In this study, we aimed to determine whether a relationship between BMI and BMD T-scores in the hip and spine regions of patients with diabetes exists. This retrospective record review investigated older adult patients with diabetes in King Abdulaziz University Hospital (n=198; age 50–90 years) who underwent BMD scan between January 1, 2016, and June 25, 2018, regardless of their sex but limited to type 2 DM. The height and weight of all subjects were recorded, and BMI was calculated and categorized. We used SPSS version 21 for data analysis; measures of central tendencies, Pearson’s correlations, chi-square tests, and independent t-tests were employed. We found positive relationships between BMI and BMD T-scores in the hip and spine regions (right femoral neck: R=+0.214, P≤0.002; total right hip: R=+0.912, P≤0.001; left femoral neck: R=+0.939, P≤0.001; total left hip: R=+0.885, P≤0.001; and total lumbar region: R=+0.607, P≤0.001). Low BMI (<18.5 kg/m2) could be a risk factor for osteoporosis, whereas normal/high BMI could be protective against osteoporosis among adults with diabetes.

scholarly journals Primarily treated patients versus referred patients in the treatment of native septic arthritis of digits: a retrospective comparative study

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Sang Ho Kwak ◽  
Jung Yun Bae ◽  
Youngkwang Oh ◽  
Hyo Seok Jang ◽  
Tae Young Ahn ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Septic Arthritis ◽  
Hospital Stay ◽  
Surgical Intervention ◽  
Treatment Plan ◽  
Case Series ◽  
Flap Surgery ◽  
Surgical History ◽  
History Of ◽  
Retrospective Comparative Study

Abstract Background Septic arthritis of digits needs urgent treatment. When treatments delayed or insufficient, patients may be referred to the upper-level hospital due to uncontrolled infection. We reviewed the treatment history of referred patients and compared the microorganisms and the clinical course of both primary and referred patients as relevant studies are rare. Methods In this retrospective review of consecutive case series, 45 patients (primary, n = 11; referred, n = 34) were treated with multiple irrigation and debridement. Cefazolin was used as empiric antibiotics, then changed according to microbiologic study. Previously used antibiotics, treatment delay, surgical history of the referred patients were reviewed. Identified microorganisms, required surgical intervention, hospital stay, radiologic outcome, functional outcomes were compared between both groups. Results In the referred patients, methicillin-resistant Staphylococcus aureus (MRSA) was commonly found and cefazolin was susceptible in only 15% of the cases. Longer hospital stay, prolonged antibiotic therapy, more surgical intervention including flap surgery was required to treat the referred patients. Postoperative pain was not severe in daily activities, but the final range of motion was significantly less in the referred patients compared to the primary patients. Conclusions This study suggests that in the treatment of uncontrolled septic arthritis of the digits, antibiotic agents covering MRSA may shorten the duration of antibiotic therapy in areas of high MRSA incidence. Besides, more number of I & D including flap surgery may be required for the referred patients compared with the primary patients. These findings can help the surgeon in setting up a treatment plan or in counseling of referred patients with uncontrolled septic arthritis of the digits.

Association of serum 25-hydroxy vitamin D and body mass index in cancer

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 6625-6625
Author(s):  
D. Gupta ◽  
K. Trukova ◽  
P. G. Vashi ◽  
A. Adams ◽  
G. M. Lambert ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Vitamin D ◽  
Cancer Patients ◽  
Body Mass ◽  
Case Series ◽  
Spearman Correlation ◽  
Dietary Recommendations ◽  
25 Hydroxy Vitamin D ◽  
The Mean ◽  
The Relationship

6625 Background: The association between vitamin D and obesity remains unsettled with studies reporting conflicting findings on the relationship between the two. This association assumes even greater importance in cancer because of the alleged role of vitamin D in cancer risk and survival. Currently, the dietary recommendations for Vitamin D do not take into account a person's body mass index (BMI). We investigated the relationship between serum 25-hydroxy-vitamin D [25(OH)D] and BMI in a large sample of cancer patients. Methods: A consecutive case series of 740 cancer patients seen at Cancer Treatment Centers of America from Jan 08 to June 08. Serum 25(OH)D was measured at presentation to the hospital. The cohort was divided in 4 BMI groups (<18.5, 18.5–24.9, 25–29.9, and >30.0 kg/m2). Correlation between 25(OH)D and BMI was evaluated using Spearman correlation coefficient. Mean 25(OH)D was compared across the 4 BMI groups using ANOVA. Linear regression was used to quantify the relationship between BMI and 25(OH)D. Results: Of 740 patients, 303 were males and 437 females. The mean age at presentation was 55.7 years (SD = 10.2). The mean BMI was 27.9 kg/m2 (SD = 6.7). Most common cancers were lung (134, 18.1%), breast (131, 17.7%), colorectal (97, 13.1%), pancreas (86, 11.6%), prostate (45, 6.1%) and ovarian (39, 5.3%). The mean serum 25(OH)D was 21.9 ng/ml (SD = 13.5). Analysis revealed that as BMI groups increased from normal to overweight or obese classifications, there was a significant decrease in 25(OH)D (Table). The Spearman correlation between 25(OH)D and BMI was -0.20 (p = 0.001). Every 1 kg/m2 increase in BMI was significantly associated with a 0.43 ng/ml decline in serum 25(OH)D (p = 0.001). Conclusions: We found that obese cancer patients (BMI >=30 kg/m2) had significantly lower levels of serum 25(OH)D as compared to nonobese patients (BMI <30 kg/m2). BMI should be taken into account when assessing a patient's vitamin D status and more aggressive vitamin D supplementation should be considered in obese cancer patients. [Table: see text] No significant financial relationships to disclose.

Underweight and breast cancer recurrence and death

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e22054-e22054
Author(s):  
H. Moon ◽  
W. Han ◽  
J. Lee ◽  
E. Ko ◽  
E. Kim ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Body Mass Index ◽  
Body Mass ◽  
Cancer Registry ◽  
Cancer Recurrence ◽  
Breast Cancer Recurrence ◽  
University Hospital ◽  
National University ◽  
Seoul National University ◽  
Breast Cancer Registry

e22054 Background: The association of body mass index or body weight and breast cancer outcome is controversial. Furthermore, the impact of underweight on breast cancer recurrence and death has not been adequately addressed. Methods: We investigated this issue in a large nation-wide database of 14,039 Korean breast cancer patients (Korean Breast Cancer Registry). Furthermore, to test whether the association was due to more frequent non-cancer death in underweight women, we used breast cancer recurrence data of 4,345 women from single institution (Seoul National University Hospital). Results: The results from Korean Breast Cancer Registry data showed significantly lower overall survival in underweight patients compared to normal weight after adjusting known prognostic factors [hazard ratio=1.36 (95% CI 1.08–1.72)], which was not observed in obese patients. The association between body mass index and breast cancer recurrence was further investigated in Seoul National University Hospital data. Underweight women had significantly higher risk of distant metastasis and local recurrence of breast cancer [hazard ratio=1.86 (95% CI 1.25–2.76) and 2.62 (95% CI 1.55–4.41), respectively]. Conclusions: These findings suggest that underweight could be considered as high risk factor of death and recurrence after breast cancer surgery. No significant financial relationships to disclose.

Total laparoscopic hysterectomy for benign, malignant and pre-malignant gynaecological pathology: relation between surgical outcome and body mass index

2016 ◽  
Vol 13 (4) ◽  
pp. 493-497
Author(s):  
Vasileios Minas ◽  
Claudia Ventii ◽  
Nicola Murray ◽  
Thomas Aust ◽  
David Rowlands ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Surgical Outcome ◽  
Laparoscopic Hysterectomy ◽  
Total Laparoscopic Hysterectomy

Effect of Body Mass Index on Robotic-Assisted Total Laparoscopic Hysterectomy

2011 ◽  
Vol 18 (3) ◽  
pp. 328-332 ◽  
Author(s):  
A. Karim Nawfal ◽  
Mona Orady ◽  
David Eisenstein ◽  
Ganesa Wegienka
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Laparoscopic Hysterectomy ◽  
Total Laparoscopic Hysterectomy ◽  
Robotic Assisted

scholarly journals Work Fatigue Determination of Nurses in Hospital of Hasanuddin University

2020 ◽  
Vol 1 (2) ◽  
pp. 33-41
Author(s):  
Asna Ampang Allo ◽  
Masyitha Muis ◽  
Ansariadi Ansariadi ◽  
Atjo Wahyu ◽  
Syamsiar S. Russeng ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Mental Workload ◽  
Simple Random Sampling ◽  
The Body ◽  
University Hospital ◽  
Physical Workload ◽  
Sleep Patterns ◽  
Cross Sectional ◽  
Before And After

This study aims to determine the effect of body mass index (BMI), sleep patterns, working years, physical workload, mental workload, and work time on work fatigue on nurses at Hasanuddin University Hospital Makassar. This research is a quantitative study with a cross-sectional design with a sample size of 56 people. Sampling using a simple random sampling method. Data collection was carried out by means of a questionnaire. Bodyweight is measured by weight scales, body temperature is measured by microtoice, and physical workload is measured by a pulse oximeter, which is by looking at the pulse of the nurse before and after work. Data analysis in this study used the SPSS program. The results of this study indicate that there is an influence between Body Mass Index (BMI) on work fatigue (p = 0.001), there is an effect of sleep patterns on work fatigue (p = 0.019), there is an effect of tenure on work fatigue (p = 0.017), the relationship between physical workload and work fatigue (p = 0.000), there is an effect of mental workload on work fatigue (p = 0.000) and there is an effect of length of work on work fatigue (p = 0.017). The physical workload is the variable with the greatest influence on work fatigue on nurses at Hasanuddin University Hospital Makassar with Exp. (B) = 14,526. The results of this study concluded that there was a significant influence between the Body Mass Index (BMI), sleep patterns, years of work, physical workload, mental workload, and length of work for nurses at Hasanuddin University Hospital Makassar.

scholarly journals Primarily Treated Patients versus Referred Patients in the Treatment of Native Septic Arthritis of Digits: A Retrospective Comparative Study

2020 ◽  
Author(s):  
Sang Ho Kwak ◽  
Jung Yun Bae ◽  
Youngkwang Oh ◽  
Hyo Seok Jang ◽  
Tae Young Ahn ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Septic Arthritis ◽  
Hospital Stay ◽  
Surgical Intervention ◽  
Treatment Plan ◽  
Case Series ◽  
Flap Surgery ◽  
Surgical History ◽  
History Of ◽  
Retrospective Comparative Study

Abstract BackgroundSeptic arthritis of digits needs urgent treatment. When treatments delayed or insufficient, patients may be referred to the upper-level hospital due to uncontrolled infection. We reviewed the treatment history of referred patients and compared the microorganisms and the clinical course of both primary and referred patients as relevant studies are rare.MethodsIn this retrospective review of consecutive case series, 45 patients (primary, n=11; referred, n=34) were treated with multiple irrigation and debridement. Cefazolin was used as empiric antibiotics, then changed according to microbiologic study. Previously used antibiotics, treatment delay, surgical history of the referred patients were reviewed. Identified microorganisms, required surgical intervention, hospital stay, radiologic outcome, functional outcomes were compared between both groups. ResultsIn the referred patients, methicillin-resistant Staphylococcus aureus (MRSA) was commonly found and cefazolin was susceptible in only 15% of the cases. Longer hospital stay, prolonged antibiotic therapy, more surgical intervention including flap surgery was required to treat the referred patients. Postoperative pain was not severe in daily activities, but the final range of motion was significantly less in the referred patients compared to the primary patients.ConclusionsThis study suggests that in the treatment of uncontrolled septic arthritis of the digits, antibiotic agents covering MRSA may shorten the duration of antibiotic therapy in areas of high MRSA incidence. Besides, more number of I & D including flap surgery may be required for the referred patients compared with the primary patients. These findings can help the surgeon in setting up a treatment plan or in counseling of referred patients with uncontrolled septic arthritis of the digits.

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