Use of human fibrin glue (Tisseel) versus suture during transvaginal natural orifice ovarian cystectomy of benign and non-endometriotic ovarian tumor: a retrospective comparative study

Abstract Background To evaluate the use of a human fibrin glue (Tisseel) for minor bleeding control and approximation of ovarian defect during transvaginal natural orifice ovarian cystectomy (TNOOC) of benign and non-endometriotic ovarian tumors. Methods A total of 125 women with benign and non-endometriotic ovarian tumors who underwent TNOOC between May 2011 and January 2020: 54 with the aid of Tisseel and 71 with traditional suture for hemostasis and approximation of ovarian defect. Surgical outcomes such as length of surgery, operative blood loss, postoperative pain score, and postoperative hospital stay were recorded. Before and immediately (10 days) and at 6 months after the procedure, serum anti-Müllerian hormone (AMH) levels were also determined. Results Complete hemostasis and approximation of ovarian defect were achieved in all cases. No significant difference was noted in the operating time, operative blood loss, postoperative pain scores after 12, 24 and 48 h, length of postoperative stay, and baseline AMH levels between the two groups. The operation did not have a negative effect on the immediate and 6-month postoperative AMH levels in the suture group. However, the decline in the AMH levels was significant immediately after surgery in the Tisseel group, nevertheless, no significant difference was noted in the AMH levels at 6 months (3.3 vs. 1.7 mg/mL; p = 0.042, adjusted p = 0.210). Conclusion The use of Tisseel in TNOOC of benign and non-endometriotic ovarian tumors without suturing the ovarian tissue is clinically safe and feasible.

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Bipolar Radiofrequency Dissection Tonsillectomy: A Prospective Randomized Trial

Otolaryngology ◽

10.1016/j.otohns.2005.07.037 ◽

2005 ◽

Vol 133 (6) ◽

pp. 961-965 ◽

Cited By ~ 17

Author(s):

Sameh M. Ragab

Keyword(s):

Postoperative Pain ◽

Postoperative Complications ◽

Blood Loss ◽

Operative Time ◽

Operating Time ◽

Controlled Study ◽

Operative Blood Loss ◽

Bipolar Radiofrequency ◽

Significant Difference ◽

Cold Dissection

OBJECTIVES: To conduct a prospective randomized controlled study presenting and comparing bipolar radiofrequency dissection tonsillectomy (BRDT) to cold dissection tonsillectomy (CDT) regarding intra-operative blood loss, operative time, postoperative pain, and postoperative complications including hemorrhage. MATERIALS AND METHODS: From January 2004 to March 2005, 200 children planned to undergo tonsillectomy were included in this study. Children were prospectively randomized into two equal groups: bipolar radiofrequency dissection tonsillectomy and cold dissection tonsillectomy. The operative time and intraoperative blood loss were recorded. Children were asked to record their pain on a standardized visual analog scale on days 1, 4, 7, and 14. All children were reviewed on the 4th, 7th, and 14th day after surgery. Postoperative complications were recorded and dealt with. RESULTS: There was a shorter operative time (mean 8.5 minutes, P < 0.001) in the radiofrequency group. BRDT showed a decrease of 7 minutes in the mean when compared to the CDT group. The amount of blood lost during BRDT was minimal (mean 13 cc), with a mean difference of 69 cc when compared to CDT ( P < 0.001). There was no statistical significant difference in pain score between the two groups except in the first postoperative day where the BRDT demonstrated a statistically significant lower parameters ( P < 0.05). No evidence for statistically significant difference between the two groups regarding postoperative complications. CONCLUSION: BRDT is a new, easy, and safe technique that offers a complete eradication of the tonsillar disease, short operating time, minimal intra-operative blood loss, and a suitable cost with no additional increase in postoperative pain and hemorrhage when compared to the conventional CDT. Our experience promotes BRDT as the preferred method of tonsillectomy. EBM RATING: A

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Comparison between scalpel incision and electrocautery incision in midline abdominal surgery: a comparative study

International Surgery Journal ◽

10.18203/2349-2902.isj20211817 ◽

2021 ◽

Vol 8 (5) ◽

pp. 1507

Author(s):

Amit Yadav ◽

Lakshman Agarwal ◽

Sumit A. Jain ◽

Sanjay Kumawat ◽

Sandeep Sharma

Keyword(s):

Postoperative Pain ◽

Blood Loss ◽

Abdominal Surgery ◽

Wound Infection ◽

Skin Incision ◽

P Value ◽

Wound Area ◽

Significant Difference ◽

Group A ◽

Group B

Background: Fear of poor wound healing have curtailed the use of diathermy for making skin incision. Scalpel produces little damage to surrounding tissue but causing more blood loss. Our aim of study was to compare electrocautery incision with scalpel incision in terms of incision time, blood loss, postoperative pain and wound infection.Methods: Total of 104 patients were included in the study undergoing midline abdominal surgery. Patients were randomized into electrocautery (group A) and scalpel (group B). The incision dimension, incision time and blood loss were noted intraoperatively. Postoperative pain was noted on postoperative day 2 using visual analog scale. Wound complications were recorded on every postoperative day till the patient was discharged.Results: 52 patients in each of the two groups were analyzed. There was significant difference found between group A and group B in terms of mean incision time per unit wound area, 8.16±1.59 s\cm2 and 11.02±1.72 s\cm2 respectively (p value=0.0001). The mean blood loss per unit wound area was found to be significantly lower in group A (0.31±0.04 ml\cm2) as compared to group B (1.21±0.21), p value=0.0001. There was no significant difference noted in terms of postoperative pain and wound infection between both groups.Conclusions: Electrocautery can be considered safe in making skin incision in midline laparotomy compared to scalpel incision with comparable postoperative pain and wound infection with less intraoperative blood loss and less time consuming.

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Transverse Versus Longitudinal Uterine Incision in Abdominal Myomectomy: A Randomized Controlled trial

QJM ◽

10.1093/qjmed/hcaa056.025 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

A Elguindy ◽

H Hemeda ◽

M Esmat ◽

M Nawara ◽

A M F Metwally

Keyword(s):

Blood Loss ◽

Operative Time ◽

Controlled Trial ◽

Demographic Data ◽

Operative Blood Loss ◽

Postoperative Fever ◽

Abdominal Myomectomy ◽

Randomized Controlled ◽

Uterine Incision ◽

Significant Difference

Abstract Objective The Aim of the study is to compare between transverse and longitudinal uterine incision in abdominal myomectomy regarding intraoperative blood loss Design: A randomized Controlled interventional study. Setting Ain Shams Maternity teaching hospital. Patients and methods 52 patients undergoing abdominal myomectomy for single myoma were involved The patients were randomized into two groups that showed no significant difference in demographic data, characters of myoma or indication of surgery Results Our results proved that there was no significant difference between both incisions regarding intra-operative blood loss, need for blood transfusion, post-operative Hgb drop, operative time or incidence of postoperative fever. Conclusion Transverse uterine incision for myomectomy does not cause more blood loss than longitudinal incision. There is no difference between both incisions in operative time or postoperative complications Trial identifier: NCT03009812, MY-789

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Short-term and long-term outcomes of minimally invasive and open transforaminal lumbar interbody fusions: is there a difference?

Neurosurgical FOCUS ◽

10.3171/2013.5.focus1377 ◽

2013 ◽

Vol 35 (2) ◽

pp. E6 ◽

Cited By ~ 29

Author(s):

Jason S. Cheng ◽

Priscilla Park ◽

Hai Le ◽

Lori Reisner ◽

Dean Chou ◽

...

Keyword(s):

Postoperative Pain ◽

Blood Loss ◽

Minimally Invasive ◽

San Francisco ◽

Pain Medication ◽

Functional Mobility ◽

Ambulatory Ability ◽

Significant Difference ◽

Morphine Equivalent

Object Previous studies comparing minimally invasive transforaminal lumbar interbody fusion (MITLIF) with open TLIF have demonstrated that MITLIF reduces blood loss and decreases postoperative pain while preserving fusion rates and reducing complications. In this study, the authors wanted to compare outcomes of MITLIF with those of open TLIF to determine whether MITLIF also improves postoperative functional mobility and decreases the usage of pain medication. Methods In total, 75 consecutive patients who underwent either single-level open TLIF or MITLIF at the University of California, San Francisco, between 2006 and 2011 were included, and patients were followed up for an average of 5.05 years. Fifty patients underwent MITLIF and 25 underwent open TLIF. Primary outcomes included administration of morphine-equivalent narcotics and functional status on postoperative Day 1. Secondary outcomes included operative characteristics, complications, long-term fusion rates, and visual analog scale (VAS) scores. Results No statistically significant differences in age, sex, body mass index (BMI), level of disease, or surgical indication were detected between the open TLIF and MITLIF groups. Similarly, preoperative medication usage did not significantly differ between these groups. Intraoperatively, compared with TLIF, MITLIF resulted in decreased lengths of operation, lower blood loss, and fewer complications (p < 0.05). Total administration of morphine-equivalent pain medication in the hospital also tended to be lower in the MITLIF than in the TLIF group. Functional assessment by physical therapy on postoperative Day 1 demonstrated higher function in the MITLIF patients for transfer-related tasks, ambulatory ability, and distance walked than in the TLIF patients (p < 0.05). This translated to shorter inpatient hospitalizations (6.05 vs 4.8 days for open TLIF vs MITLIF patients, respectively, p = 0.006) and an average cost reduction of $3885 per MITLIF patient. Long-term fusion rates were 92% in the MITLIF group and 100% in the open TLIF group (p = 0.09). Preoperative VAS pain scores were 7.1 for the MITLIF patients and 7.6 for the TLIF patients (p = 0.26). At the last follow-up, the reported VAS pain score was 2.9 in the MITLIF patients and 3.5 in the open TLIF patients, but this difference was not statistically significant (p = 0.25). There was also no statistically significant difference in the degree change in this score (p = 0.44). Conclusions The MITLIF approach achieves improved functional mobility, decreases the usage of postoperative pain medication, and significantly reduces cost compared with open TLIF while preserving long-term fusion rates. To the authors' knowledge, this is the first study comparing the postoperative usage of pain medication between treatments in the postoperative period before discharge.

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CO2 laser tonsillectomy: A comparison with conventional technique

Bangladesh Journal of Otorhinolaryngology ◽

10.3329/bjo.v15i1.4304 ◽

1970 ◽

Vol 15 (1) ◽

pp. 6-9

Author(s):

ABM Tofazzal Hossain ◽

Md Arif Hossain Bhuyan ◽

Shahnaz Afroza ◽

Shaila Kabir ◽

AHM Zahurul Huq

Keyword(s):

Postoperative Pain ◽

Blood Loss ◽

Conventional Method ◽

Co2 Laser ◽

Operation Time ◽

Conventional Technique ◽

Laser Technique ◽

Operative Blood Loss ◽

Advantages And Disadvantages ◽

Secondary Haemorrhage

Objective: To define the advantages and disadvantages of CO2 laser tonsillectomy compared with conventional method. Study design: Retrospective review. Setting: Department of Otolaryngology & Head and Neck Surgery, Apollo Hospitals Dhaka. Materials and Methods: This study included fifty two patients with tonsillectomies from October 2007 to May 2008. The patients were diagnosed with history and clinical examination. Preoperative investigations have been done for general anaesthesia. Patients were intubated with laser reinforced endotracheal tube and fire precautions were taken. Laser tonsillectomy has been avoided below 10 years in our centre. 52 patients aged 10-35 years underwent tonsillectomy in a period of 10 months. Out of them 12 patients underwent laser tonsillectomies. The data of each patient included intra-operative blood loss, operation time, postoperative pain and postoperative healing. Results: All Patients were admitted for 24 hours. Intra operative blood loss was dramatically less with the use of CO2 laser than that of conventional method (5ml vs. 18ml). Profuse bleeding did not prolong this time especially in laser technique. The incidence of postoperative reactionary hemorrhage were not significantly different between two techniques. 2 patients suffered with secondary haemorrhage in conventional technique and in laser technique one patient had secondary haemorrhage. There was statistically significant difference in duration of operating time (15 vs. 40 min). Both methods of surgery had non-identical effect on post operative pain. Postoperative pain was less in laser technique than that of conventional technique in 7 days postoperative follow up. Leukocytic membrane formation and separation and final healing were earlier in laser technique than in conventional technique. Conclusion: CO2 laser is a safe and acceptable method for tonsillectomy. CO2 laser tonsillectomy reduces operation time and intraoperative blood loss. Postoperative pain is less than conventional technique and healing is also earlier in laser technique. Key Words: CO2 laser, tonsillectomy, ventilation.DOI: 10.3329/bjo.v15i1.4304 Bangladesh J of Otorhinolaryngology 2009; 15(1): 6-9

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Guillotine versus dissection tonsillectomy: randomised, controlled trial

The Journal of Laryngology & Otology ◽

10.1017/s002221511200196x ◽

2012 ◽

Vol 126 (11) ◽

pp. 1142-1149 ◽

Cited By ~ 7

Author(s):

S J Frampton ◽

M J A Ward ◽

V S Sunkaraneni ◽

H Ismail-Koch ◽

Z A Sheppard ◽

...

Keyword(s):

Randomised Controlled Trial ◽

Blood Loss ◽

Operative Time ◽

Controlled Trial ◽

Operative Blood Loss ◽

Post Operative Pain ◽

Significant Difference ◽

Secondary Haemorrhage ◽

Randomised Controlled ◽

Cold Steel Dissection

AbstractObjective:This trial aimed to compare the guillotine technique of tonsillectomy with ‘cold steel’ dissection, the current ‘gold standard’.Design:A single centre, randomised, controlled trial.Methods:One hundred children aged 3 to 11 years who were listed for bilateral tonsillectomy were recruited. Patients had one tonsil removed by each technique, and were blinded to the side. The operative time, intra-operative blood loss, haemostasis requirement and post-operative pain scores were recorded and compared.Results:Operative time and intra-operative blood loss were both significantly less for the guillotine technique (p < 0.001) and there was a significantly reduced haemostasis requirement (p < 0.001). Pain was also less on the guillotine side (p < 0.001). There were no tonsillar remnants or palatal trauma for either technique. There was no significant difference between techniques in the frequency of secondary haemorrhage.Conclusion:This study provides level Ib evidence that guillotine tonsillectomy in children with mobile tonsils is an effective and time-efficient procedure which produces less intra-operative blood loss and post-operative pain than cold steel dissection.

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The microdebrider, a step forward or an expensive gadget?

Rhinology Journal ◽

10.4193/rhino11.250 ◽

2012 ◽

Vol 50 (2) ◽

pp. 191-198

Author(s):

M.E. Cornet ◽

S.M. Reinartz ◽

C. Georgalas ◽

E. van Spronsen ◽

W.J. Fokkens

Keyword(s):

Blood Loss ◽

Controlled Trial ◽

Operating Time ◽

Operation Time ◽

Sinus Surgery ◽

Operative Blood Loss ◽

User Friendliness ◽

Double Blind ◽

Estimated Blood Loss ◽

Significant Difference

Background: Although the use of the microdebrider (shaver) is well known in endoscopic sinus surgery (FESS), there is lack of evidence from comparative studies focussing on the difference in operating time, intra-operative blood loss and user-friendliness between the microdebrider and traditional operating techniques. In this study we compared the use of the microdebrider to conventional instruments in FESS in these areas. Methods: A prospective randomised double blind controlled trial in 60 patients with chronic rhinosinusitis with nasal polyposis (CRSwNP) undergoing bilateral FESS. Each subject received FESS using only traditional instruments (Blakseley forceps) on one side and the other side with the additional use of the microdebrider, this way serving as their own control. The primary outcome was operation time, intra-operative blood loss and user friendliness and secondly safety and postoperative healing with a follow-up period at different time points up to three months postoperative. Results: We found a 37% longer operating time when operating without a microdebrider. This difference was highly significant. The microdebrider scored significantly higher on every different parameter of user friendliness, except on the preparation of the instrument needed before surgery. For estimated blood loss during surgery we found no differences. Also there was no significant difference in postoperative healing at any point of time. Conclusions: This study demonstrates that operating patient with CRSwNP with the microdebrider is efficient and that the microdebrider at the same time is safe and easy to use.

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Coblation Versus Diode Laser Tonsillectomy: A Comparative Study

10.21203/rs.3.rs-582705/v1 ◽

2021 ◽

Author(s):

Ameer A. Alaqeedy ◽

Rasheed Ali Rashid ◽

Raid M. Al-Ani

Keyword(s):

Postoperative Pain ◽

Blood Loss ◽

Comparative Study ◽

Diode Laser ◽

Operative Time ◽

Postoperative Bleeding ◽

P Value ◽

Intraoperative Blood Loss ◽

Laser Technique ◽

Significant Difference

Abstract Introduction: The study aimed to compare the 2 procedures of tonsillectomy (coblation and diode laser) concerning the operative time, the amount of blood loss, postoperative pain, and other complications. Materials and Methods: A comparative study was conducted at many Private Hospitals, Baghdad, Iraq from February 2019- February 2020. Coblation and laser tonsillectomy were performed on the same patient (one for each side) which was blinded to the patients or their caregivers and the surgeon who did the tonsillectomy. Data concerning the age, gender, indications for tonsillectomy, operative time, the amount of the blood loss, post-tonsillectomy pain by VAS scores, and other complications were recorded for each patient. Results: Out of 62 participants, there were 34 (54.8%) females. The majority were from the age group ≤18 years (n=54, 87.1%). The operative time and amount of the intraoperative blood loss were significantly lower in the coblation than a diode laser tonsillectomy. However, the postoperative pain scores in the diode laser were a statistically significant difference less than the coblation group at the periods 3 hours, 8 hours, 24 hours, and 7 days (P-value<0.05). While there was no statistically significant difference between the two groups at 2 weeks postoperative period (P-value=0.392). No primary or secondary postoperative bleeding in all patients. Conclusion: coblation was better than diode laser because of shorter operative time and less intraoperative blood loss. However, the diode laser technique had lesser postoperative pain at the postoperative periods 3 hours, 8 hours, 24 hours, and 7 days than coblation.

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Local administration of epsilon-aminocaproic acid reduces post-operative blood loss from surgery for closed, Sanders III–IV calcaneal fractures

International Orthopaedics ◽

10.1007/s00264-021-05268-y ◽

2022 ◽

Author(s):

Lang Zhong ◽

Yangbo Xu ◽

Yongcai Wang ◽

Yu Liu ◽

Qiu Huang

Keyword(s):

Blood Loss ◽

Aminocaproic Acid ◽

Wound Complications ◽

Local Administration ◽

Control Group ◽

Calcaneal Fractures ◽

Operative Blood Loss ◽

Significant Difference ◽

Operative Drainage ◽

And Control

Abstract Purpose To investigate whether local administration of epsilon-aminocaproic acid (EACA) is effective and safe in reducing the post-operative blood loss in surgery for Sanders III–IV calcaneal fractures. Methods Patients with Sanders III–IV calcaneal fractures who were hospitalized in our hospital from January 2016 to February 2021 and underwent open reduction internal fixation (ORIF) via lateral approach with an L-shaped incision were included in the current study. Eighty five patients were randomly divided into two groups, EACA group (43) and control group (42). Twenty milliliters of 5% EACA solution or normal saline was perfused into the incision of patients in EACA group and control group, respectively. The volume of post-operative drainage was investigated as the primary outcome. Post-operative blood test, coagulation test, and wound complications were analyzed as the secondary outcomes. Results The volume of post-operative drainage at 24 and 48 h was 164.8 ± 51.4 ml, 18.9 ± 3.8 ml for patients in EACA group, and 373.0 ± 88.1 ml, 21.2 ± 4.4 ml for patients in the control group, respectively. EACA greatly reduced the post-operative blood loss compared to the control (normal saline). The difference between the two groups was statistically significant. No statistically significant difference was found between EACA group and control group with regard to the pre-operative, baseline characteristics. Post-operative blood test results demonstrated that haemoglobin and hematocrit were significantly higher in EACA compared to those of control group. No significant difference was found between EACA group and control group in terms of the platelet counts, prothrombin time (P.T.), activated partial prothrombin time (APTT), and wound complications. Conclusion Local administration of EACA is effective in post-operative blood loss reduction in ORIF surgeries for Sanders III–IV types of calcaneal fractures without increasing the incidence of periwound complication.

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A comparative study of coblation assissted adenotonsillectomy and cold dissection adenotonsillectomy in children

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20164814 ◽

2016 ◽

Vol 3 (1) ◽

pp. 122 ◽

Cited By ~ 1

Author(s):

Nithya V. ◽

Angshuman Dutta ◽

Sabarigirish K.

Keyword(s):

Postoperative Pain ◽

Blood Loss ◽

Postoperative Period ◽

P Value ◽

Intraoperative Blood Loss ◽

Pain Scores ◽

Significant Difference ◽

Duration Of Surgery ◽

The Mean ◽

Cold Dissection

Background: The aim of the present study was to compare intraoperative blood loss, operative duration and postoperative pain between coblation-assisted adenotonsillectomy and cold dissection adenotonsillectomy in children.Methods: A prospective, randomized, single-blind trial of pediatric patients aged 7 to 13 years undergoing adenotonsillectomy was conducted. Patients were randomized to undergo either cold dissection or coblation-assisted adenotonsillectomy. Measured intraoperative parameters included surgical duration and intraoperative blood loss. Measured postoperative parameters included a daily pain rating using the visual analog scale on the postoperative evening, postoperative day 1 and day 7. Intraoperative and postoperative measures were statistically compared between the two groups. Results: Sixty children were randomized and included in the study. 30 patients underwent cold dissection adenotonsillectomy and 30 coblation-assisted adenotonsillectomy. Mean age was 8.7 years in the coblation group and 9.1 years in the cold dissection group. Intraoperative blood loss was lower for the coblation assisted adenotonsillectomy group versus the cold dissection adenotonsillectomy group which was proved statistically (mean bleeding was 16.67 in coblation group and 58.67 in cold dissection group and p value <0.0001).There was statistically no significant difference in the mean pain scores in the 2 groups in the postoperative evening and on postoperative day 1. The mean pain scores on postoperative day 7 were found to be 3.4 in the coblation group and 2.47 in the cold dissection group with a significant p value of 0.0087. The average duration of surgery in the coblation group was 55.6 minutes as against 34.1 minutes in the cold dissection group. The p- value was found to be less than 0.0001 which makes the difference statistically significant. Conclusions: This study found that the intraoperative blood loss was significantly less in Coblation adenotonsillectomy than in cold dissection adenotonsillectomy. The duration of surgery in Coblation assisted adenotonsillectomy is significantly greater than the duration of surgery in cold dissectionadenotonsillectomy. While the postoperative pain scores are similar with coblation and cold dissection adenotonsillectomy in the early postoperative period, it is significantly more with coblation in the late postoperative period.

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