Comparison of conventional fenestration discectomy with Transforaminal endoscopic lumbar discectomy for treating lumbar disc herniation:minimum 2-year long-term follow-up in 1100 patients

Abstract Purpose To compare the efficacy of conventional interlaminar fenestration discectomy (IFD) with transforaminal endoscopic lumbar discectomy (TELD) for treating lumbar disc herniation (LDH). Methods The clinical data of 1100 patients who had been diagnosed with LDH between January 2012 and December 2017 were retrospectively analysed. IFD was performed on 605 patients in Group A, whereas TELD was performed on 505 patients in Group B. The Oswestry Disability Index, Visual Analogue Scale for pain and modified MacNab criteria were used to evaluate the outcomes. The surgery duration, intraoperative blood loss, postoperative off-bed activity and postoperative length of hospital stay were recorded. Results The follow-up period ranged from 24 to 60 months, with an average of 43 months. The excellent and good outcome rates were 93.5% in Group A and 92.6% in Group B. There was no significant difference in efficacy between the groups (P > 0.05). However, Group B had significantly less intraoperative blood loss and shorter bed rest duration and postoperative length of hospital stay than Group A (P < 0.05). There were two cases of postoperative recurrence in Group A and three in Group B. Conclusions Although conventional IFD and TELD had similar levels of efficacy in treating LDH, TELD had several advantages. There was less intraoperative bleeding, shorter length of hospital stay and shorter bed rest duration. It can be considered a safe and effective surgical option for treating LDH.

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Comparison of Conventional Fenestration Discectomy with Transforaminal Endoscopic Lumbar Discectomy for Treating Lumbar Disc Herniation：Minimum 2-year Long-term Follow-up in 1,100 patients

10.21203/rs.3.rs-20662/v3 ◽

2020 ◽

Author(s):

Quanyi Li ◽

yongchun zhou

Keyword(s):

Hospital Stay ◽

Lumbar Disc ◽

Length Of Hospital Stay ◽

Bed Rest ◽

Intraoperative Blood Loss ◽

Postoperative Length ◽

Group A ◽

Group B ◽

Endoscopic Lumbar Discectomy

Abstract Purpose: To compare the efficacy of conventional interlaminar fenestration discectomy (IFD) with transforaminal endoscopic lumbar discectomy (TELD) for treating lumbar disc herniation (LDH). Methods: The clinical data of 1,100 patients who had been diagnosed with LDH between January 2012 and December 2017 were retrospectively analysed. IFD was performed on 605 patients in Group A, whereas TELD was performed on 505 patients in Group B. The Oswestry Disability Index, Visual Analogue Scale for pain and modified MacNab criteria were used to evaluate the outcomes. The surgery duration, intraoperative blood loss, postoperative off-bed activity and postoperative length of hospital stay were recorded. Results: The follow-up period ranged from 24 to 60 months, with an average of 43 months. The excellent and good outcome rates were 93.5% in Group A and 92.6% in Group B. There was no significant difference in efficacy between the groups (P > 0.05). However, Group B had significantly less intraoperative blood loss and shorter bed rest duration and postoperative length of hospital stay than Group A (P < 0.05). There were two cases of postoperative recurrence in Group A and three in Group B. Conclusions: Although conventional IFD and TELD had similar levels of efficacy in treating LDH, TELD had several advantages. There was less intraoperative bleeding, shorter length of hospital stay and shorter bed rest duration. It can be considered a safe and effective surgical option for treating LDH.

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Comparison of Conventional Fenestration Discectomy with Percutaneous Transforaminal Endoscopic Discectomy for Treating Lumbar Disc Herniation:Maximum 5 year follow-up in 1,100 patients

10.21203/rs.3.rs-20662/v2 ◽

2020 ◽

Author(s):

Quanyi Li ◽

yongchun zhou

Keyword(s):

Hospital Stay ◽

Lumbar Disc ◽

Length Of Hospital Stay ◽

Bed Rest ◽

Endoscopic Discectomy ◽

Percutaneous Transforaminal Endoscopic Discectomy ◽

Postoperative Length ◽

Group A ◽

Group B

Abstract Purpose: To compare the efficacy of conventional interlaminar fenestration discectomy (IFD) with percutaneous transforaminal endoscopic discectomy (PTED) for treating lumbar disc herniation (LDH). Methods: The clinical data of 1,100 patients who had been diagnosed with LDH between January 2012 and December 2017 were retrospectively analysed. IFD was performed on 605 patients in Group A, whereas PTED was performed on 505 patients in Group B. The Oswestry Disability Index, Visual Analogue Scale for pain and modified MacNab criteria were used to evaluate the outcomes. The surgery duration, intraoperative blood loss, postoperative off-bed activity and postoperative length of hospital stay were recorded. Results: The follow-up period ranged from 24 to 60 months, with an average of 43 months. The excellent and good outcome rates were 93.5% in Group A and 92.6% in Group B. There was no significant difference in efficacy between the groups (P > 0.05). However, Group B had significantly less intraoperative blood loss and shorter bed rest duration and postoperative length of hospital stay than Group A (P < 0.05). There were two cases of postoperative recurrence in Group A and three in Group B. Conclusions: Although conventional IFD and PTED had similar levels of efficacy in treating LDH, PTED had several advantages. There was less intraoperative bleeding, shorter length of hospital stay and shorter bed rest duration. It can be considered a safe and effective surgical option for treating LDH.

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Comparison of Conventional Fenestration Discectomy Versus Percutaneous Transforaminal Endoscopic Discectomy for Treating Lumbar Disc Herniation

10.21203/rs.3.rs-20662/v1 ◽

2020 ◽

Author(s):

Quanyi Li ◽

yongchun zhou

Keyword(s):

Blood Loss ◽

Hospital Stay ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Intraoperative Blood Loss ◽

Endoscopic Discectomy ◽

Percutaneous Transforaminal Endoscopic Discectomy ◽

Group A ◽

Group B

Abstract Purpose: To compare the efficacy of conventional interlaminar fenestration discectomy (IFD) versus percutaneous transforaminal endoscopic discectomy (PTED) for treating lumbar disc herniation (LDH). Methods: The clinical data of 1,100 patients who had been diagnosed with LDH from January 2012 to December 2017 were retrospectively analysed. IFD was performed on the 605 patients in Group A, while PTED was performed on the 505 patients in Group B. The Oswestry Disability Index (ODI), Visual Analogue Scale (VAS) for pain, and modified Macnab criteria were adopted to evaluate the outcomes. Moreover, the surgery durations, intraoperative blood loss, postoperative off-bed activities, and postoperative lengths of hospital stay for the two groups were observed. Results: The follow-up period ranged from 24 months to 60 months, with an average duration of 43 months. As the excellent and good outcome rate was 93.5% in Group A and 92.6% in Group B, there were no significant differences in efficacy between the two groups (P > 0.05). However, Group B had significantly less intraoperative blood loss and shorter bed rest durations and postoperative lengths of hospital stay than did Group A (P < 0.05). There were two cases of postoperative recurrence in Group A and three in Group B. Conclusions: Although conventional IFD and PTED had similar levels of efficacy in treating LDH, transforaminal endoscopic discectomy exhibited several advantages, such as less trauma, less bleeding, and a shorter length of hospital stay, and it can be considered an ideal surgical option for treating LDH.Save and Continue

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Comparative evaluation of nebulised 3% saline versus nebulised 0.9% saline in the treatment of acute bronchiolitis

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20192008 ◽

2019 ◽

Vol 6 (3) ◽

pp. 1182

Author(s):

Pragalatha Kumar A. ◽

Indhuja Rajarathinam ◽

Aruna Gowdra

Keyword(s):

Hospital Stay ◽

Severity Score ◽

Length Of Hospital Stay ◽

Signs And Symptoms ◽

Clinical Severity ◽

Controlled Study ◽

Acute Bronchiolitis ◽

Clinical Severity Score ◽

Group A ◽

Group B

Background: Acute bronchiolitis is the most common respiratory tract infection in young children. Despite the high prevalence of acute bronchiolitis, no consensus exists on the management. Studies have shown that except oxygen therapy, no other treatment found to be effective. Hence, the present study was conducted to find out the efficacy of nebulised 3% saline versus is 0.9% saline for the treatment of acute bronchiolitis.Methods: A prospective randomized controlled study of 150 children between the age group of 2 months to 24 months with signs and symptoms of Acute Bronchiolitis admitted to Indira Gandhi Institute of Child Health, Bangalore from January 2016 to December 2016 formed the study group, they were randomized into 2 groups, one received 3% saline nebulization and the other received 0.9% saline.Results: A total of 150 children were enrolled in the study, 75 children (group A) received 0.9% saline and 75 children (group B) received 3% saline. At 24 hours, the mean clinical severity score for group A was 2.49±1.03 and group B was 2.16±0.49 (P=0.013). The duration of hospital stay was shorter (1-3 days) in 3% saline with a mean of 2.35 days and was longer (3-5 days) in 0.9% saline with mean value of 4.04 days which was statistically significant (p <0.001).Conclusions: 3% saline nebulization can be used as an effective treatment for acute bronchiolitis. It significantly reduced the clinical severity score and length of hospital stay compared to 0.9% normal saline.

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Adrenaline and Dexamethasone, vs Adrenaline and Fluticasone, vs Adrenaline alone in Bronchiolitis: A Randomized Controlled Trial

Asian Journal of Pediatric Research ◽

10.9734/ajpr/2020/v3i130120 ◽

2020 ◽

pp. 20-28

Author(s):

Jayendra R. Gohil ◽

Atul M. Sheladiya ◽

N. B. Adithya ◽

Ratna D. Bhojak

Keyword(s):

Hospital Stay ◽

Clinical Symptoms ◽

Controlled Trial ◽

Length Of Hospital Stay ◽

Primary Objective ◽

Assessment Instrument ◽

Clinical Severity ◽

Group A ◽

The Difference ◽

Group B

Background and Objectives: There is no consensus over which drug best reduces symptoms in Bronchiolitis syndrome. The primary objective of our study is to establish comparative effect of adrenaline nebulisation alone and combination of adrenaline nebulisation plus injectable dexamethasone and adrenaline nebulisation plus fluticasone nebulisation in the treatment of clinical cases of bronchiolitis. Methods: 100 patients diagnosed clinically as bronchiolitis were enrolled in study from 1 month to 24 months of age. Patients were enrolled by purposive sampling. Patients with respiratory distress assessment instrument score [RDAI] of 4 to 15 were chosen, randomized into three groups and treatment given till patient fullfilled discharge criteria. Group A (n=33) were given nebulised adrenaline alone, Group B (n=34) were given nebulised adrenaline plus injectable dexamethasone and Group C (n=33) were given nebulised adrenaline plus nebulised fluticasone. Results: The mean reduction in clinical severity-RDAI score was 1.75 ±0.86 in Group A, 2.30 ± 0.68 in Group B and 1.42 ± 0.9 in Group C when measured in terms of difference in clinical scores between day 1 and 2 (p=0.0003). Mean duration of hospital stay in the group A was (4.93±1.95 days), Group C (4.78±1.83) and Group B (3.91 ±1.37 days). The difference of stay between the Groups A and B was 1.02±0.58 days vs 0.87± 0.46 days in groups B and C (p-0.0048). Reduction in the length of hospital stay in group B was 22% compared to Group A & 19% compared to Group C (p-0.0048). Side effects were tachycardia in six patients. Conclusion: Combination of adrenaline nebulization and injectable dexamethasone was found significantly better as compared to nebulised adrenaline plus nebulised fluticasone and nebulised adrenaline alone in patients of clinical bronchiolitis in reducing severity of clinical symptoms and duration of hospitalization.

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Evaluation of percutaneous endoscopic lumbar discectomy in treatment of obese adolescents with lumbar disc herniation：A retrospective study

10.21203/rs.3.rs-389600/v1 ◽

2021 ◽

Author(s):

Haijiang Yu ◽

Bin Zhu ◽

Xiaoguang Liu

Keyword(s):

Propensity Score ◽

Blood Loss ◽

Operative Time ◽

Lumbar Disc ◽

Lumbar Discectomy ◽

Obese Patients ◽

Intraoperative Blood Loss ◽

Endoscopic Lumbar Discectomy ◽

Time Point

Abstract Background: Obese patients are at risk of complications such as poor wound healing and increased infection rates after spinal surgery. Percutaneous endoscopic lumbar discectomy (PELD) has advantages over conventional open surgery in the treatment of obese adult patients with lumbar disc herniation (LDH) because it can decrease perioperative complications and enhance satisfaction degrees of patients. However, no clinical studies have evaluated the efficacy of PELD in obese adolescents with LDH. This study aimed to evaluate the efficacy of PELD in the treatment of obese ALDH.Methods: We retrospectively collected clinical data from 208 patients with single-segment ALDH who underwent PELD treatment in our hospital between January 2015 and December 2019. According to the body mass index classification standard of obesity for adolescents in our country, the patients were divided into obese and non-obese groups (control group). Based on the preoperative baseline data of the two groups, propensity score matching was performed to select patients from the two groups for the comparative study. Perioperative data included operative time, intraoperative blood loss and length of postoperative hospitalization. The visual analog scale (VAS), Oswestry disability index (ODI) and modified MacNab criteria were recorded as the main indicators of the surgical outcome, and the recurrence rate and incidence of complications were recorded as the minor indicators. Results: The obese and control groups included 45 patients each after 1:1 propensity score matching. Both groups showed improvements in VAS and ODI scores after surgery and at each follow-up time point (p < 0.05). However, there was no significant statistical difference in VAS and ODI scores between the two groups at each follow-up time point (p >0.05). In addition, the differences in operative time, intraoperative blood loss, length of postoperative hospitalization, incidence of complications, and recurrence rate were not statistically significant between the two groups (p >0.05). At the final follow-up, there was no significant difference in the excellent and good rate of MacNab classification between the two groups (p >0.05). Conclusion: PELD is a safe and effective minimally invasive technique for the treatment of obese patients with ALDH. The efficacy of PELD in obese and non-obese patients with ALDH was comparable.

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Transcatheter and intraoperative device closure of atrial septal defect in infants under three years of age

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-020-1063-z ◽

2020 ◽

Vol 15 (1) ◽

Cited By ~ 1

Author(s):

Yangyang Han ◽

Xiquan Zhang ◽

Fengwei Zhang

Keyword(s):

Atrial Septal Defect ◽

Hospital Stay ◽

Clinical Data ◽

Septal Defect ◽

Postoperative Hospital Stay ◽

Device Closure ◽

Young Infants ◽

Group A ◽

Group B

Abstract Background Transcatheter and intraoperative device closures have been widely used in the treatment of secundum atrial septal defect (ASD). However, for young infants with ASD, device closure remains controversial, and such treatment features limited data. We compared the clinical data and follow-up results of percutaneous and intraoperative device closure for ASD to evaluate the feasibility, safety, and efficacy of both treatments in infants under 3 years of age. Methods From September 2010 to September 2018, 186 children under 3 years of age with significant secundum ASD were included in this study. A total of 88 and 98 patients were divided into groups A (transcatheter device closure) and B (intraoperative device closure), respectively. The clinical data and follow-up results of the two groups were analyzed retrospectively. Result The mean age and weight of patients in group A were significantly higher than those in group B. The proportion of complex ASDs (multiples or rims deficiency) and the device/weight ratio in group B were significantly higher than those in group A. Successful closure was obtained in 86 (97.7%) and 96 (98.0%) infants in groups A and B, respectively, with two failed cases in each group (2.3% vs 2%). The rate of periprocedural complications reached 13.6 and 26.5% for groups A and B (P = 0.058), respectively. The durations of the procedure and postoperative hospital stay in group A were significantly shorter than those in group B (P < 0.05). Excellent follow-up results were observed in both groups. At present, no death nor major complications have occurred. Symptoms either resolved completely or improved significantly for all symptomatic infants. No residual shunts at the 6th month of follow-up evaluation were observed. Patients with failure to thrive gained weight appropriately for age, and the structure and hemodynamic parameters significantly improved during follow-up. Conclusion Transcatheter and intraoperative device closure are feasible, effective, and safe methods for the treatment of ASDs in infants under 3 years of age. Considering improved cosmetic effect and the short duration of the procedure and postoperative hospital stay, transcatheter is preferred for patients with appropriate conditions. Intraoperative device closure can be performed as an alternative to percutaneous closure, particularly for infants with large, complex ASDs, young age, or low-body weight.

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Alvimopan as an essential component of ERAS protocol to decrease length of hospital stay.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.6_suppl.517 ◽

2020 ◽

Vol 38 (6_suppl) ◽

pp. 517-517

Author(s):

Peter Hanna ◽

Arveen Kalapara ◽

Subodh Regmi ◽

Kalyana Srujana ◽

Joseph Zabell ◽

...

Keyword(s):

Bladder Cancer ◽

Hospital Stay ◽

Radical Cystectomy ◽

Smoking Status ◽

Length Of Hospital Stay ◽

Significant Difference ◽

Bowel Movements ◽

Group A ◽

Group B ◽

Eras Protocol

517 Background: Radical cystectomy for muscle invasive bladder cancer is the gold standard. However, it is frequently associated with a prolonged length of hospital stay (LOS). We study the effect of ERAS protocol implementations and Alvimopan use in patients undergoing radical cystectomy and its impact on length of hospital stay (LOS). Methods: Retrospective cohort study involving consecutive patients undergoing radical cystectomy for bladder cancer at our institution from 2010 through 2018. We evaluated Alvimopan use plus an ERAS protocol post radical cystectomy versus patients who underwent ERAS protocol alone versus those who were managed prior to ERAS protocol implementation. Primary outcome of interest was LOS, controlling for age, sex, smoking status and Charleson comorbidities index. Results: 146 patients (49.32 %) received standard care (non-ERAS) (group A), 102 patients (34.45 %) underwent ERAS protocol alone (group B) and 47 patients (15.87 %) underwent ERAS protocol plus Alvimopan (group C). There was no significant difference in length of stay between group A and group B (p=0.856). However, group C experienced a shorter LOS (16.6%) compared to group A (p=0.015). Similarly, group B was not significantly associated with the days to bowel movements compared to group A (p=0.112), however, group C demonstrated a significantly shorter time (16.3%) to bowel movements compared to group A (p=0.015). On other hand, group c wasn’t significantly associated with time tolerance to regular diet (p=0.068). Limitations include retrospective nature of some of the data, non-randomized approach and confounders such as a mix of robot and open approaches to cystectomy. Conclusions: Of all ERAS protocol components, Alvimopan appeared to be the most significant contributor in accelerating GI recovery and decrease LOS in our cohort.

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“PROSPECTIVE RANDOMISED COMPARATIVE STUDY OF USE OF FIBRIN GLUE VS. TACKERS AS METHOD OF MESH FIXATION IN LAPAROSCOPIC TRANSABDOMINAL PRE-PERITONEAL (TAPP) HERNIA REPAIR”

10.36106/ijsr/8602659 ◽

2021 ◽

pp. 73-75

Author(s):

Ashish Andhare ◽

Hari S. Mahobia ◽

Abhishek Bansal

Keyword(s):

Postoperative Pain ◽

Hernia Repair ◽

Comparative Study ◽

Hospital Stay ◽

Length Of Hospital Stay ◽

Hernia Recurrence ◽

Seroma Formation ◽

Group B ◽

Time Required

BACKGROUND: Fixation of mesh in pre-peritoneal space is an important step in laparoscopic TAPP hernia repair. Mesh dislocation is one of the most frequent causes responsible for recurrence. Of the many factors inuencing postoperative pain, the technique of xation has been reported to be one of the most signicant determinants. So mesh xation with adhesives instead of mechanical devices has been proposed as a mean to reduce the incidence of postoperative pain. AIM: To compare clinical outcome and morbidity of xation of mesh using brin glue and tackers in trans-abdominal pre-peritoneal inguinal hernia repair METHODOLOGY: We did a prospective randomized comparative study in which we enrolled 50 patients undergoing laparoscopic hernia repair (TAPP). Those who met our inclusion criteria were randomized for study purpose after obtaining informed consent, in 25 patients mesh xed with tackers (group A) and in other 25 patients mesh xed with brin glue (group B). Patients were compared for intraoperative time required for mesh xation, early and late postoperative pain, time required to resume normal daily physical activity, length of hospital stay, hernia recurrence and seroma formation. Postoperative follow up was done up to six months. RESULTS: Two groups were comparable in terms of demographic variables. We observed that postoperative pain, time required resuming normal daily activity and incidence of seroma formation was less in group B (Mesh xed with glue). There was no signicant difference in length of hospital stay in both groups and no evidence of hernia recurrence in both groups during follow up period. CONCLUSION: It can be concluded that xation of mesh with brin glue when compared with tackers, seems to reduce postoperative pain, time to resume daily activities and incidence of seroma formation with no difference in length of hospital stay, early hernia recurrence with longer operative time.

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The Improvement Effect of Different Doses of Gamma Globulin on the Disease Condition of Infants with Hemolytic Disease of Newborn and Their Effects on Immune Factors in Serum

Iranian Journal of Public Health ◽

10.18502/ijph.v49i5.3209 ◽

2020 ◽

Author(s):

Shuwen HUANG ◽

Lin LIU ◽

Guanglei QIAN ◽

Wenxue LIU ◽

Jialiang WANG ◽

...

Keyword(s):

Hospital Stay ◽

Gamma Globulin ◽

Length Of Hospital Stay ◽

High Dose ◽

Serum Total Bilirubin ◽

Hemolytic Disease ◽

Group A ◽

Immune Factors ◽

Group B ◽

Different Doses

Background: To explore the effect of different doses of Gamma Globulin (GG) on the condition of children with Hemolytic Disease of Newborn (HDN) and the influence of immune factors in serum. Methods: Overall, 180 infants with hemolytic disease of newborn in the People’s Hospital of Zhangqiu Area, Jinan, China from April 2016 to August 2018 were divided into group A (88 cases) and group B (92 cases). Group A was given intravenous low-dose GG on the basis of phototherapy, and group B was given intravenous high-dose GG on the basis of phototherapy. The level of serum total bilirubin of the infants, the levels of CD3+, CD4+, CD8+, IgA, IgG and IgM of the infants, the time of jaundice disappearance and the length of hospital stay, hemoglobin and reticulocyte levels were recorded before treatment and after treatment. The number and condition of adverse reactions were recorded. Results: After treatment, the levels of TBiL, hemoglobin and reticulocyte, the time of jaundice disappearance and hospital stay in group B were significantly lower than those in group A. The level of immune cells in group B was significantly higher than that in group A after 7 days of treatment, and the levels of IgA / IgG / IgM in group B were significantly higher than those in group A after 28 days of treatment. Conclusion: Intravenous high-dose GG has a better effect on the condition of neonatal hemolytic disease patients, and more effectively improve the immune function of children.

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