scholarly journals Which Criterion for Wound Drain Removal is Better Following Posterior 1-Level or 2-Level Lumbar Fusion With Instrumentation: Time Driven or Output Driven?

2021 ◽  
pp. 219256822110137
Author(s):  
Hang Shi ◽  
Zhi-Hao Huang ◽  
Yong Huang ◽  
Lei Zhu ◽  
Zan-Li Jiang ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Lumbar Fusion ◽  
Demographic Characteristics ◽  
Total Blood ◽  
Duration Of Hospital Stay ◽  
Drain Removal ◽  
Group I ◽  
Wound Drain ◽  
Group Ii

Study Design: Case-control study. Objectives: To compare the outcomes of 2 different criteria (time driven and output driven) for wound drain removal and identify which one is better. Methods: 743 patients who underwent posterior lumbar fusion with instrumentation involving 1 or 2 motion segments were enrolled in this study. Based on the different criteria for drain removal, the patients were divided into 2 groups. The drains were discontinued by time driven (postoperative day 2) in group I and output driven (<50 ml per day) in group II. Demographic characteristics, perioperative parameters and clinical outcomes were compared between the 2 groups. Results: The demographic characteristics in both groups were comparable. The postoperative drain output, total blood loss, postoperative timing of ambulation, and postoperative duration of hospital stay in group I were lower than those in group II ( P < 0.001). There was a higher proportion of patients requiring postoperative blood transfusion in group II, but not to a level of statistical significance ( P = 0.054). There was no statistical significant difference in the incidence of surgical site infection (SSI) or symptomatic spinal epidural hematoma (SEH) between the 2 groups ( P > 0.05). Conclusions: This study reveals that there are more benefits of wound drain removal by time driven than that by output driven for patients undergoing posterior 1-level or 2-level lumbar fusion with instrumentation, including less postoperative drain output, less total blood loss, earlier postoperative timing of ambulation and less postoperative duration of hospital stay without increasing the incidence of postoperative SSI or symptomatic SEH.

scholarly journals Percutaneous endoscopic treatment of benign and malignant renal pelvis carcinoma: A single-center experience

2020 ◽  
Author(s):  
Xin Zhang ◽  
Wu Xiu Han ◽  
Sheng Yan Li ◽  
Hao Yuan Chen ◽  
Zhe Yu Tang ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Renal Pelvis ◽  
Operation Time ◽  
Laser Evaporation ◽  
Pathological Grade ◽  
Group I ◽  
Grade Ii ◽  
The Mean ◽  
Group Ii

Abstract Background Percutaneous nephrolithotomy (PCNL) is a safe and efficient treatment for intro-renal diseases, most of which are calculus disease. In this study, we carried out percutaneous endoscopic nephron-sparing ablation for renal carcinoma in carefully selected patients. Our aim was to evaluate whether percutaneous endoscopic nephron-sparing operation was feasible for patients with renal cell carcinoma.Methods A total of 15 patients with renal pelvis carcinoma were treated with laser evaporation under percutaneous endoscopy between January 2015 and September 2019 ( group I ). Another 13 patients who received standard radical nephroureterectomy were recruited as the control group (group II). We recorded demographic data of the patients, the indication for surgery, tumor pathological grade, size and side of tumor, and the intraoperative and postoperative outcome, including the duration of surgery, length of hospital stay, and complication rate, as well as progression-free survival (PFS).Results In both groups, all of the patients received flexible ureteroscopy. In group I, 14 patients had transitional renal cell carcinoma (UCC), four had pathological grade I, nine had grade II, and one had hemangiopericytoma. In group II, all patients had UCC, five had pathological grade I, and eight had grade II. In group I, the mean operation time was 118 min (65–236 min), the mean blood loss was 110 ml (55–220 ml), and the mean hospital stay was 9 days (7–12 days). During follow-up, two patients died and two had recurrence; among them, one had systematic bone metastasis. The PFS rate was 66.7% (10/15). In group II, the mean operation time was 265 min (185–436 min), the mean blood loss was 133 ml (85–240 ml), and the mean hospital stay was 13 days (9–16 days). During the follow-up, two patients died and there was no local or systematic metastasis. The PFS rate was 84.6% (11/13). There was no significant difference in blood loss between the groups. However, the operation time and mean hospital stay were significantly shorter in group I compared with that in group II ( P < 0.05). But the PFS rate was significantly higher in group II than in group I (P < 0.05).Conclusions This study shows that laser evaporation under percutaneous endoscopy for renal pelvis carcinoma is a safe, effective, and technically feasible procedure for treating benign and malignant renal pelvis carcinoma.

scholarly journals Short-Time Intermittent Preexposure of Living Human Donors to Hyperoxia Improves Renal Function in Early Posttransplant Period: A Double-Blind Randomized Clinical Trial

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Kamran Montazeri ◽  
Mohammadali Vakily ◽  
Azim Honarmand ◽  
Parviz Kashefi ◽  
Mohammadreza Safavi ◽  
...  
Keyword(s):  
Renal Function ◽  
Kidney Transplantation ◽  
Hospital Stay ◽  
Urine Output ◽  
Human Study ◽  
Kidney Donor ◽  
Living Kidney Donor ◽  
Duration Of Hospital Stay ◽  
Group I ◽  
Group Ii

The purpose of this human study was to investigate the effect of oxygen pretreatment in living kidney donors on early renal function of transplanted kidney. Sixty living kidney donor individuals were assigned to receive either 8–10 L/min oxygen (Group I) by a non-rebreather mask with reservoir bag intermittently for one hour at four times (20, 16, 12, and 1 hours before transplantation) or air (Group II). After kidney transplantation, urine output, blood urea nitrogen (BUN), serum creatinine, need to additional diuretics (NTADs) in the first 24 hours after transplantation, delayed graft function (DGF), the creatinine clearance (CrCL) on 10th day, and duration of hospital stay from the first posttransplant day till normalization of renal function was recorded and compared in two groups. Mean CrCL in posttransplant day 10, NTAD after 24 hours of transplantation, and urine output during 6 hours after operation were significantly better in Group I compared with Group II (). Also, DGF during the first week after operation and duration of hospital stay was less in Group I compared with Group II. Intermittent exposure of human living kidney donor to hyperoxic environment may improve renal function following kidney transplantation.

Preoperative Angiography and Transarterial Embolization in the Management of Carotid Body Tumor: A Single-Center, 10-Year Experience

Neurosurgery ◽  
2010 ◽  
Vol 67 (4) ◽  
pp. 941-948 ◽  
Author(s):  
Jiaping Li ◽  
Shenming Wang ◽  
Chishing Zee ◽  
Jianyong Yang ◽  
Wei Chen ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Carotid Body ◽  
Operation Time ◽  
Class Ii ◽  
Preoperative Embolization ◽  
Intraoperative Blood Loss ◽  
Class Iii ◽  
Group I ◽  
Group Ii

Abstract BACKGROUND: Sixty percent of paragangliomas are located unilaterally at the carotid bifurcation. These are referred to as carotid body tumors (CBTs). OBJECTIVE: To present our 10-year experience in the management of patients with CBTs, and to evaluate the efficacy of angiography and preoperative embolization technique in this retrospective study. METHODS: Sixty-two patients with surgically removed CBTs (Shamblin class II and III), were divided into two groups. Group I, the preoperative embolization group, included 33 patients with 11 class II lesions and 25 class III lesions. Group II, the group that had surgery only, without preoperative embolization, included 29 patients with 9 class II lesions and 21 class III lesions. Comparisons were made between the groups in terms of mean intraoperative blood loss, mean operation time, mean postoperative hospital stay, and clinical complications. RESULTS: In group I, post-embolization angiography demonstrated complete tumor devascularization in 25 (76%) lesions and partial devascularization in 11 (24%) lesions. All but 1 (2%) lesion were completely excised. Mean intraoperative blood loss, mean operation time, and mean hospital stay were 354.8 ± 334.4 mL, 170.3 ± 75.4 min, 8.0 ± 2.1days in group I and 656.4 ± 497.4 mL, 224.6 ± 114.0 min, 9.5 ± 3.5days in group II, respectively. In group II, 27 lesions (91%) were completely removed. The transient ischemic attack (TIA) and cranial nerve injury incidence rates were 10.3% and 13.8% in group II and only 3% for TIA in group I. CONCLUSION: These results suggest angiography is highly valuable for the diagnosis of CBT. Preoperative selective embolization of CBT is an effective and safe adjunct for surgical resection, especially for Shamblin class II and III tumors.

scholarly journals Laparoscopy versus laparotomy in the treatment of benign ovarian cyst

2016 ◽  
Vol 11 (4) ◽  
Author(s):  
Humaira Akram ◽  
Sohail Khurshid Lodhi ◽  
Tabinda Rana
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Ovarian Cyst ◽  
Preoperative Evaluation ◽  
Normal Activity ◽  
Group I ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Laparoscopic Fenestration ◽  
Group Ii

Objective: To compare laparoscopy with laparotomy in the treatment of benign ovarian cyst in women under 40 years of age. Design: Experimental. Place and duration of study: The study was conducted over a period of one and half year from June 2003 to Nov 2004 in Obstetrics & Gynaecology Department, Unit-III, Lady Willingdon Hospital, Lahore. Subjects & Methods: The sixty consecutive patients of benign ovarian cysts who required surgical treatment underwent either Laparoscopy(group I). or laparotomy (group II). The laparoscopic fenestration, aspiration and cystectomies were performed in group I (30 patients). However, ovarian cystectomies, salpingo-oophorectomy and oophorectomy were performed by laparotomy in group II (30 patients). Results: The comparison was done with respect to duration of surgery intra-operative blood loss, time of mobilization, duration of hospital stay and amount of analgesia used, time to return to normal activity. The amount of analgesics used, time of mobilization, duration of hosp ital stay and time to return to normal activity was less (P<0.05) in Laparoscopy as compared to Laparotomy. There was statistically no significant difference in the duration of surgery, blood loss and post operative morbidity (P>0.05). Conclusion: With appropriate preoperative evaluation, laparoscopic surgery is safe and effective in treating benign ovarian cyst in women under 40 years of age where the risk of malignancy is low. It is associated with early mobilization, less use of analgesia, shorter hospital stay.

Pediatric Referrals to Psychiatry: I. Comparison of Referrals and Nonreferrals

1977 ◽  
Vol 7 (3) ◽  
pp. 241-247 ◽  
Author(s):  
Arthur P. Froese
Keyword(s):  
Hospital Stay ◽  
Psychiatric Diagnosis ◽  
Psychiatric Evaluation ◽  
Discharge Diagnosis ◽  
Sex Distribution ◽  
Duration Of Hospital Stay ◽  
Group I ◽  
Group Ii

Age, sex and duration of hospital stay of 220 patients consecutively referred to psychiatry (Group I) and of their fellow 2065 nonreferred patients (Group II) were compared. Overall, Group I was significantly older, remained in hospital longer, and included more girls than boys, whereas Group II included slightly more boys than girls. Separation of Group II into those whose primary discharge diagnosis was psychiatric or nonpsychiatric revealed that mean age and duration of hospital stay of the former were almost identical, and the sex distribution was similar, to those of Group I. These findings suggest that children referred for psychiatric evaluation differ from their nonreferred fellows discharged with a nonpsychiatric diagnosis but not from nonreferred fellows discharged with a psychiatric diagnosis.

scholarly journals Comparison between Outcome of Wedge Excision of Perforation Site and Trimming of Perforation Margin Followed by Primary Repair in the Management of Ileal Perforation

2017 ◽  
Vol 29 (2) ◽  
pp. 17-20
Author(s):  
Md Aziz Ullah ◽  
Soma Rahman
Keyword(s):  
Hospital Stay ◽  
Anastomotic Leakage ◽  
Primary Repair ◽  
Ileal Perforation ◽  
Duration Of Hospital Stay ◽  
Perforation Site ◽  
Group I ◽  
Nonspecific Ulcer ◽  
The Mean ◽  
Group Ii

The aim of this study is to compare between the outcome of wedge excision of perforation site and trimming of perforation margin followed by primary repair in the management of ileal perforation in selected patients. This is an observational study with data from department of Surgery, Sir Salimullah Medical College and Mitford Hospital during February, 2007 to July, 2010. The study included 108 patients of ileal perforation of 15-67 years of age. All patients were treated by primary repair after either wedge excision of perforation site (Group I) or trimming of perforation margin (Group II). Perforation due to typhoid is common in both groups. Abdominal pain, fever, abdominal distention, constipation and vomiting were more frequent in both groups of patients. Signs of peritonitis were observed almost all the patients. Pneumoperitoneum was found 77.8% in group I and 66.7% in group II in X-ray. In ultrasonography ascitis and distended bowel loop was found 44.4% in group I and 66.7% in group II. Typhoid, tuberculosis, nonspecific ulcer and chronic nonspecific ulcer were found in histopathology. Post-operative complications were more in group II. Anastomotic leakage was found 18.5% in group I and 38.9% in group II. Prolonged ileus was observed 16.7% in group I and 33.3% in group II. Anastomotic leakage and Prolonged ileus difference were statistically significant (p<0.05). The mean duration of hospital stay was significantly (p<0.05) higher in group II, where the mean(±SD) duration of hospital stay was 14.2±7.2 days in group I and 18.1±8.9 days in group II. Mortality was observed 9.3% only in group II. So Wedge excision followed by primary repair is better in terms of post operative mortality and morbidity in the management of ileal perforation in selected patients.Medicine Today 2017 Vol.29(2): 17-20

scholarly journals Excision with primary midline closure compared with Limberg flap in the treatment of sacrococcygeal pilonidal disease: a randomised clinical trial

2019 ◽  
Vol 101 (1) ◽  
pp. 21-29 ◽  
Author(s):  
M Arnous ◽  
H Elgendy ◽  
W Thabet ◽  
SH Emile ◽  
SA Elbaz ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Hospital Stay ◽  
Recurrence Rate ◽  
Primary Closure ◽  
Randomised Clinical Trial ◽  
Limberg Flap ◽  
Complication Rates ◽  
Cosmetic Results ◽  
Group I ◽  
Group Ii

BackgroundAlthough several surgical techniques for treatment of sacrococcygeal pilonidal sinus (SPND) have been described, there is no consensus on the optimal surgical procedure. In this study we compared excision with primary closure and Limberg flap in the treatment of SPND.MethodsThis was a prospective randomised clinical trial in patients with SPND who were randomly allocated to one of two groups: group I (excision and primary closure) and group II (Limberg flap technique). The primary outcome of the trial was recurrence of SPND whereas postoperative complications, return to work and cosmetic results were the secondary outcomes.ResultsSixty patients were included, with a mean age of 24.1 years and mean body mass index (BMI) of 26.8 kg/m2. Group 1 had significantly shorter operation time than group II. Both groups had similar hospital stay and comparable complication rates (43.3% vs 30%; P = 0.4). Group I had significantly higher recurrence rate (20% vs 0; P < 0.02) and significantly better cosmetic satisfaction score than group II. Being hairy (P = 0.04), positive family history (P = 0.03), diabetes mellitus (P = 0.005) and history of previous surgery for SPND (P = 0.01) were the significant predictors for recurrence.ConclusionsThe Limberg flap is an effective technique for the treatment of SPND with very low recurrence rate and comparable complication rate and hospital stay to excision and primary closure. Excision and primary closure offered the advantages of quicker healing time, earlier resumption of daily activities, better cosmetic results, which may render it more suitable for patients with low risk for recurrence.

scholarly journals Short term versus conventional Catheterisation after Genital Prolapse Surgery

2013 ◽  
Vol 26 (2) ◽  
pp. 68-71 ◽  
Author(s):  
Khurshida Tahmin ◽  
Shamsun Nahar Begum
Keyword(s):  
Hospital Stay ◽  
Urine Volume ◽  
Genital Prolapse ◽  
Prolapse Surgery ◽  
Controlled Clinical Trial ◽  
Group I ◽  
Short Period ◽  
Group Ii ◽  
Catheter Urine ◽  
Randomised Controlled

This Randomised controlled clinical trial was undertaken to determine the suitable time of catheter removal after urogenital prolapse surgery in order to reduce the catheter related UTI and its long term sequel. Method: Total 80 patients undergoing vaginal hysterectomy with pelvic floor repair were enrolled and randomised into two equal groups by lottery method. Trans-urethral catheter was removed on 2nd & 5th post operative day in group I (n=40) and in group II (n=40) respectively. Post   voidal residual urine volume before operation and after removal of catheter was measured in   all patients by ultrasound scanning. Re-catheterisation was done for three more days if residual volume > 200ml after removal of catheter. Urine samples were taken before removal of catheter and send for routine microscopic examination and culture & sensitivity test to detect UTI.Results: Removal of catheter on 2nd post-operative day lead to significant reduction of rate of UTI. The rate of UTI following removal of catheter was 7.5% versus 42.5% in group I and in group II (p<0.001). But need for recatheterisation was significantly higher in group I (15%) than in group II (2.5%). The mean duration of catheterisation was 47.63 (±0.628) and 119.35 (±0.864) hours in group I and group II respectively. Majority of the patients in group I did not  require prolongation of catheterisation. Mean duration of hospital stay after operation was 5 days in group I and 7.95 days in group II (p<0.001). Conclusion: Short period catheterisation is associated with lower rate of UTI and shorter hospital stay. Disadvantages of prolonged catheterisation outweigh the advantages. Therefore removal of the catheter on the 2nd post-operative day after genital prolapse surgery is preferable than 5 days catheterization DOI: http://dx.doi.org/10.3329/bjog.v26i2.13782 Bangladesh J Obstet Gynaecol, 2011; Vol. 26(2) : 68-71

scholarly journals Results of observation of the postoperative period in patients with surgical aortic pathology after surgical intervention using cardiopulmonary bypass

2019 ◽  
Vol 23 (2) ◽  
pp. 267-276
Author(s):  
K. A. Khyzhniak ◽  
Y. V. Volkova ◽  
K. Y. Sharlai ◽  
M. V. Khartanovych
Keyword(s):  
Cardiopulmonary Bypass ◽  
Hospital Stay ◽  
Postoperative Period ◽  
Surgical Intervention ◽  
Infusion Therapy ◽  
The Third ◽  
Group I ◽  
Aortic Pathology ◽  
Number Of Patients ◽  
Group Ii

The aim of the work was to analyze the results of the observation of the postoperative period in patients with surgical aortic pathology after surgical intervention using cardiopulmonary bypass. 118 patients with surgical aortic pathology (SAP) were examined. Patients were divided into 2 groups. Group I included 46 patients who were additionally prescribed a solution of meglumin sodium succinate (reamberin), group II included 46 patients who were additionally assigned a solution of D-fructose-1,6-diphosphate sodium hydrate salt (esophosphine). The control group (K) consisted of 26 patients who had surgical pathology of the aorta, all the criteria coincided with patients of groups I and II, but did not have additional substances as part of intensive care (IT) in order to prevent postoperative cognitive dysfunction (PСD). Analyzed the patient's condition on a scale of postoperative mortality prediction EuroSCORE II, the depth of anesthesia with a BIS monitor, the qualitative composition of the leukocyte formula, nasal and rectal temperature, blood gas composition, electrolyte level, glucose, lactate, coagulogram indices, hemolysis and phosphates; levels of autoantibodies to brain antigens (MBP, calcium binding protein S-100, NSE and GBA) were determined in the serum by ELISA a day before the operation and on the first, third, seventh and fourteenth day after surgery. The morphometric and functional properties of erythrocytes were investigated the day before the operation (starting level), 12:00 after the operation, and on the third day of hospital stay. The initial assessment of the cognitive abilities of the patients was made the day before the operation, on the third, seventh and fourteenth day of hospital stay. Used to determine the magnitude of the coefficient of linear Pearson correlation. In the analysis, no significant differences were found between the preliminary data on the phosphorus content in the patients' blood, however, the recovery dynamics of its numbers differed in the K, I and II patients. So, in group K and in group I, after 12:00 after surgery, the level of phosphatemia was 0.86 ± 0.21 mmol/l and 0.85 ± 0.18 mmol / l, on the 3rd day of hospital stay — 0,94 ± 0.08 mmol/l and 0.97 ± 0.04 mmol/l, on the 7th day — 1.04 ± 0.16 mmol/l and 1.07 ± 0.21 mmol/l and on The 14th day — 1.08 ± 0.12 mmol/l and 1.1 ± 0.14 mmol/l. It can be noted that the dynamics of blood phosphatemia in patients of groups K and I was identical, its figures almost coincided in terms of the level of phosphorus in the blood and the corresponding number of patients in the variation rows of patients in both groups. It may be noted that there is an unconditional positive effect on the course of the perioperative period of the option of infusion therapy in the IT complex in patients of group II.  

scholarly journals Surgical treatment of patients with sagittal imbalance of degenerative etiology: a comparison of two methods

2020 ◽  
Vol 27 (3) ◽  
pp. 16-26
Author(s):  
Evgenii S. Baykov ◽  
Alexey V. Peleganchuk ◽  
Abdugafur J. Sanginov ◽  
Olga N. Leonova ◽  
Aleksandr V. Krutko
Keyword(s):  
Surgical Treatment ◽  
Blood Loss ◽  
Perioperative Complications ◽  
Sagittal Imbalance ◽  
Radiological Parameters ◽  
Results Of Treatment ◽  
Group I ◽  
Surgical Methods ◽  
Group Ii ◽  
Clinical And Radiological Results

Purpose. Compare the clinical and radiological results of treatment of patients with spinal deformities operated on using the PSO method and corrective fusion in the lumbar spine. Materials and methods. Retrospective monocenter cohort study. The data of 42 patients were analyzed. PSO (group I) was performed in 12 patients; 30 patients had a combination of surgical methods (group II) with mandatory ventral corrective spinal fusion at levels L4-L5, L5-S1. Clinical and radiological parameters were evaluated during hospitalization and at least 1 year later. Results. Postoperative hospitalization in group I 32.5 7.4 days, 27.1 7.4 in group II (p = 0.558758). The duration of the operation in group I was 402.5 55.6 minutes, in group II 526.0 116.2 minutes (p = 0.001124); blood loss 1862.5 454.3 ml versus 1096.0 543.3 ml (p = 0.000171). In both groups, significantly improved clinical and radiological parameters after surgery and after 1 year (p 0.05). In group II, as compared with group I after surgery and more than 1 year: lower back pain according to VAS (p = 0.015424 and p = 0.015424); below ODI after 1 year was (p = 0.000001). In group I, compared with group II after surgery and after 1 year, SVA is less (p = 0.029879 and p = 0.000014), lumbar lordosis is higher (p = 0.045002 and p = 0.024120), LDI is restored more optimally (p = 0.000001 and p = 0.000002), the GAP is lower (p = 0.005845 and p = 0.002639). The ideal Russoly type is restored more often in patients of group II (p = 0,00032). Complications in group I were noted in 12 (100%) patients, in group II in 13 (43.3%) patients (p = 0.001). Conclusions. In multistep surgical treatment compared with PSO, the anterior corrective interbody fusion L4-L5, L5-S1 reliably better and more harmoniously restores the sagittal balance parameters, has significantly lower volume of intraoperative blood loss, fewer perioperative complications and significantly improves the quality of life of patients.

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