Ultrasound imaging of biliodigestive anastomoses

10.12737/6673 ◽  
2014 ◽  
Vol 8 (1) ◽  
pp. 0-0 ◽  
Author(s):  
Рязанцев ◽  
A. Ryazantsev ◽  
Благовестнов ◽  
D. Blagovestnov ◽  
Гончарова ◽  
...  
Keyword(s):  
Ultrasound Imaging ◽  
Postoperative Period ◽  
Medical Records ◽  
Postoperative Mortality ◽  
Magnetic Resonance Tomography ◽  
Abdominal Ultrasound ◽  
Early Postoperative Period ◽  
Ultra Sound ◽  
Reflux Cholangitis ◽  
Late Postoperative Period

The authors conducted a retrospective analysis of medical records of 71 patients operated on biliary obstruction with biliodigestive anastomoses. In the early postoperative period of 71 patients with various types of complications were observed in 14 (19,7%) patients of еarly postoperative mortality was 5,6% (4 patients) and 56 patients were observed from 1 year to 7 years after surgery. All patients in the postoperative period were performed trans-abdominal ultrasound imaging, tomography, magnetic resonance tomography, fistulography. The technique of improving ultrasonic visualization of the distal bile duct and area BDA and ultrasound semiotics state of biliodigestive anastomoses in the early and late postoperative period were developed. Ultra-sound criteria of insolvency biliodigestive anastomoses in the early postoperative period, and signs of scarring biliodigestive anastomoses and development of reflux cholangitis in the late postoperative period were carried out and systematized. High precision of data of ultrasonic imaging with a clinical diagnosis was noted. The sen-sitivity of ultrasound in detecting reflux cholangitis amounted to 100%; specificity – 83,7%; accuracy was 87,5%. The sensitivity of ultrasound in detecting scar stricture biliodigestive anastomoses amounted to 87,5%; the specificity was 93,8% of the respondents; the accuracy of 92,9%.

scholarly journals Long-term postoperative opioid prescription after cholecystectomy or gastric by-pass surgery: a retrospective observational study

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Viktoria Larsson ◽  
Cecilia Nordenson ◽  
Pontus Karling
Keyword(s):  
Observational Study ◽  
Postoperative Period ◽  
Medical Records ◽  
Early Postoperative Period ◽  
Retrospective Observational Study ◽  
Opioid Use ◽  
Opioid Prescription ◽  
Post Surgery ◽  
Gastric By Pass

Abstract Objectives Opioids are commonly prescribed post-surgery. We investigated the proportion of patients who were prescribed any opioids 6–12 months after two common surgeries – laparoscopic cholecystectomy and gastric by-pass (GBP) surgery. A secondary aim was to examine risk factors prior to surgery associated with the prescription of any opioids after surgery. Methods We performed a retrospective observational study on data from medical records from patients who underwent cholecystectomy (n=297) or GBP (n=93) in 2018 in the Region of Västerbotten, Sweden. Data on prescriptions for opioids and other drugs were collected from the patients` medical records. Results There were 109 patients (28%) who were prescribed opioids after discharge from surgery but only 20 patients (5%) who still received opioid prescriptions 6–12 months after surgery. All 20 of these patients had also been prescribed opioids within three months before surgery, most commonly for back and joint pain. Only 1 out of 56 patients who were prescribed opioids preoperatively due to gallbladder pain still received prescriptions for opioids 6–12 months after surgery. Although opioid use in the early postoperative period was more common among patients who underwent cholecystectomy, the patients who underwent GBP were more prone to be “long-term” users of opioids. In the patients who were prescribed opioids within three months prior to surgery, 8 out of 13 patients who underwent GBP and 12 of the 96 patients who underwent cholecystectomy were still prescribed opioids 6–12 months after surgery (OR 11.2; 95% CI 3.1–39.9, p=0,0002). Affective disorders were common among “long-term” users of opioids and prior benzodiazepine and amitriptyline use were significantly associated with “long-term” opioid use. Conclusions The proportion of patients that used opioids 6–12 months after cholecystectomy or GBP was low. Patients with preoperative opioid-use experienced a significantly higher risk of “long-term” opioid use when undergoing GBP compared to cholecystectomy. The indication for being prescribed opioids in the “long-term” were mostly unrelated to surgery. No patient who was naïve to opioids prior surgery was prescribed opioids 6–12 months after surgery. Although opioids are commonly prescribed in the preoperative and in the early postoperative period to patients with gallbladder disease, there is a low risk that these prescriptions will lead to long-term opioid use. The reasons for being prescribed opioids in the long-term are often due to causes not related to surgery.

scholarly journals РЕЗУЛЬТАТЫ ХИРУРГИЧЕСКОГО ЛЕЧЕНИЯ ПАЦИЕНТОК С ПЕРВИЧНЫМ РАКОМ ГРУДНОЙ ЖЕЛЕЗЫ

World Science ◽  
2019 ◽  
Vol 1 (7(47)) ◽  
pp. 48-50
Author(s):  
Макаров В. В. ◽  
Цивенко А. И. ◽  
Королевская А. Ю.
Keyword(s):  
Breast Cancer ◽  
Postoperative Period ◽  
Radical Surgery ◽  
Postoperative Mortality ◽  
Disease Recurrence ◽  
Early Postoperative Period ◽  
Treatment Results ◽  
Surgical Interventions ◽  
Postoperative Wound ◽  
Primary Radical

The treatment results of 172 patients with breast cancer, who underwent radical surgery on the breast, were analyzed. During the last 4 years, the implementation of combined surgical interventions — radical surgery with removal of the tumor with D2 lymphnode dissection and the simultaneous installation of a silicone implant (in 17 patients — 17.4%) takes attention. In most cases, the early postoperative period proceeded safely. During the early postoperative period, complications occurred in 30 (17.4%) patients: long postoperative lymphorrhea - 25 (14.5%) cases, which in 6 (3.6%) patients leaded to the development of seroma, and in two (1.2 %) of them - suppuration of the postoperative wound. Diastasis of wound edges was noted in 4 (2.3%) patients. In 1 (0.6%) case, bleeding was observed on the first day after surgery. Postoperative mortality rate was 0%. 10 (5.8%) patients were admitted for the surgery during the period from 1 to 3 years after the primary radical surgery due to a local recurrence of breast cancer. Despite the arsenal of modern diagnostic, anesthetic and surgical support, the issue of postoperative complications prevention and the disease recurrence prevention of the patients with breast cancer remains relevant.

scholarly journals Comparative Efficacy of Ondansetron Versus Granisetron to Prevent Perioperative Nausea and Vomiting in Patients undergoing Gynaecological Surgery under Spinal Anaesthesia

2017 ◽  
Vol 6 (1) ◽  
pp. 1371
Author(s):  
Robina Makker ◽  
Amit Bhardwaj ◽  
Arwinder Pal Singh ◽  
Asha Anand
Keyword(s):  
Spinal Anaesthesia ◽  
Postoperative Period ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Study Groups ◽  
Early Postoperative Period ◽  
Nausea And Vomiting ◽  
Gynaecological Surgery ◽  
Significant Difference ◽  
Late Postoperative Period

<p><strong>Background</strong>: Posotoprative nausea and vomiting remains a persistent and distressing problem inspite of many advances on perioperative care and anti-emetic drugs. A newer antiemetic drug Granisetron has not been studied in patients undergoing gynaecological surgery under spinal anaesthesia.</p><p><strong>Objective</strong>: A randomized double blind study was conducted to compare Ondansetron and Granisetron for prevention of postoperative nausea and vomiting in patients undergoing gynaecological surgery under spinal anaesthesia.</p><p><strong>Material and methods</strong>: 60 consecutive patients, age between 20-65 years, ASA grade I and II undergoing gynaeacologicla surgery under spinal anaesthesia were randomized into two goups of 30 each. One group received intravenous Ondansetron 4.0 mg and the second received intravenous Granisetron 2.0 mg 5 minutes before induction of anaesthesia. For the first 24 hours postoperatively all episodes of nausea and vomiting were recorded. A complete response to the drug was considered if there was no nausea or vomiting and no need for rescue anti-emetic. The observations were tabulated and analysed.</p><p><strong>Results</strong>: During early postoperative period (0-3 hrs) there was statistically no significant difference in the study groups. Statistically significant difference was found in the study groups in the late postoperative period (3-24 hrs).</p><p><strong>Conclusion</strong>: In the early postoperative period both Ondansetron and Granisetron are equally effective in preventing postoperative nausea and vomiting in patients undergoing gynaecological surgery under spinal anaesthesia. Granisetron is better than Ondansetron in the late postoperative period of upto 24 hrs.</p>

scholarly journals Repair of Saphenofemoral Transition: Reşat Operation for Patients With Venous Reflux

2018 ◽  
Vol 102 (9-10) ◽  
pp. 446-458
Author(s):  
Ilker Alat
Keyword(s):  
Postoperative Period ◽  
Valsalva Maneuver ◽  
Color Doppler ◽  
Early Postoperative Period ◽  
Venous Reflux ◽  
Surgical Interventions ◽  
First Choice ◽  
Physical Examinations ◽  
Late Postoperative Period

Objective: To develop a new solution superior to the current surgical interventions in patients with venous reflux in the great saphenous vein (GSV). Materials and Methods: Patients with the symptoms of venous incompetence in their legs like pain, edema, and cramp were also examined with color Doppler ultrasonography (CDU). One hundred ninety-one extremities with venous reflux at the saphenofemoral transition (SFT) were subjected to surgery over 8 years. A newly designed operation, the Reşat operation, was performed in all of the patients. The Reşat Operation was performed only in the patients with continuous reflux at their saphenofemoral transition during the entire Valsalva maneuver. The follow-up time spanned more than 8 years. The patients' complaints, physical examinations, and CDU findings were evaluated. Results: All of the patients had continuous reflux at the SFT for the duration of the entire Valsalva maneuver preoperatively. However, 67.88% of the patients had no reflux postoperatively (P &lt; 0.001). Additionally, 95.76% of the patients recovered to different degrees in the early postoperative period ultrasonographically (P &lt; 0.001). All of the patients reported being satisfied with the result in the early postoperative period (P &lt; 0.001). In the late postoperative period, although the CDU reports of some patients showed reflux at the GSV, no patient complained about their condition. Conclusion: The Reşat operation is a well-tolerated operation and reconstitutes the saphenofemoral transitions successfully. Its early and late postoperative results are satisfactory. The Reşat operation should be the first-choice surgical treatment in patients with venous reflux at the saphenofemoral transition.

scholarly journals Penetrating Keratoplasty For Treatment Of Bullous Keratopathy

2015 ◽  
Vol 8 (2) ◽  
pp. 133-136
Author(s):  
Snezhana V. Murgova ◽  
Chavdar B. Balabanov
Keyword(s):  
Postoperative Period ◽  
Penetrating Keratoplasty ◽  
Early Postoperative Period ◽  
University Hospital ◽  
Bullous Keratopathy ◽  
Additional Risk ◽  
Early Postoperative Complications ◽  
Important Complication ◽  
Late Postoperative Period ◽  
Eye Clinic

Summary The aim of the retrospective study was to analyze results after penetrating keratoplasties in patients with bullous keratopathy. The study included 60 patients with bullous keratopathy who underwent penetrating keratoplasty for the period 1990-2011, at the Eye Clinic of Pleven University Hospital. The average age of patients was 67 years (range 29-84 years). Additional risk factors were registered in 22.67% of the patients. Early postoperative complications occurred in 56.79%. In the early postoperative period, 81.31% of the patients had clear graft and improvement of visual acuity was achieved in 83.77%. In the late postoperative period, the graft failed in 28.95% of the patients. These results suggest that bullous keratopathy is an important complication after cataract surgery, and improvement of vision is possible only with keratoplasty.

scholarly journals Use of autologous conditioned platelet-rich plasma in the surgery of rhegmatogenous retinal ­detachment with large and multiple breaks, abruption from the dentate line

2019 ◽  
Vol 100 (4) ◽  
pp. 606-610
Author(s):  
D G Arsyutov
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Postoperative Period ◽  
Rhegmatogenous Retinal Detachment ◽  
Platelet Rich Plasma ◽  
Vitreoretinal Surgery ◽  
Dentate Line ◽  
Early Postoperative Period ◽  
Multiple Breaks ◽  
Late Postoperative Period

Aim. To evaluate the effectiveness of surgical treatment of rhegmatogenous retinal detachment with large and multiple breaks, abruption from the dentate line with the use of 25, 27 Ga subtotal vitrectomy, pneumoretinopexy or silicone tamponade with blocking of retinal defects with the use of autologous conditioned platelet-rich plasma without endolaser coagulation around retinal defects. Methods. The surgery included 25, 27 Ga vitrectomy, posterior hyaline membrane removal, pneumoretinopexy, instillation of 2–3 layers of autologous conditioned platelet-rich plasma deprived of leukocytes and containing 1.5–2 times more platelets than in whole blood into the area of retinal detachment, its break or along the edge of retinotomy till the retinal defect is totally covered. A total of 27 patients with visual acuity 0.03 to 0.9 were treated. Results. In the early postoperative period 93% of patients had total retinal reattachment, in whim retinal detachment was blocked; 2 patients were reoperated. In the late postoperative period (1–12 months) 4 recurrent retinal detachments were registered, which also required reoperation. Visual acuity of the operated patients in the late postoperative period was 0.1–1.0. Conclusion. 25, 27 Ga vitreoretinal surgery of rhegmatogenous retinal detachment with large retinal breaks, abruption from the dentate line, including retinotomy and retinal defects blockage with the use of autologous conditioned platelet-rich plasma without the use of endolaser coagulation is a method which allows achieving total reattachment of retina, better function of the operated eye in most cases.

scholarly journals Dynamics of platelets functional activity data in patients after infrarenal aortic aneurysm stentgrafting

2019 ◽  
Vol 18 (3) ◽  
pp. 44-52
Author(s):  
A. V. Svetlikov ◽  
G. G. Khubulava ◽  
A. I. Ermakov ◽  
L. B. Gaikovaya ◽  
V. S. Gurevich
Keyword(s):  
Postoperative Period ◽  
Functional Activity ◽  
Abdominal Aortic Aneurysms ◽  
Early Postoperative Period ◽  
Aortic Aneurysms ◽  
Long Term Results ◽  
Positive Correlation ◽  
Abdominal Aortic ◽  
Significant Difference ◽  
Late Postoperative Period

It is known that hemostatic, immune and autoimmune reactions can play a role in the development and progression of abdominal aortic aneurysms (AAA), including the activation of platelets and CEC However the role of those in pathogenesis of AAA remains unclear.The aim of this study was to study the influence of EVAR on functional activity of platelets and number of circulating endothelial cells (CEC) in comparison with small abdominal aortic aneurysms – AAA (less than 5 cm)Material and methods. Platelets activity has been analyzed due to the assessment of quantity of GP IIb/IIIa receptors and expression of P-selectin. CD14-FITC/CD16-PE/ HLADR-PC5/CD45-PC7 has been used to assess the monocytes activity CEC were counted by flow cytometry in blood samples of patients before EVAR, within 4 weeks and in 18 months after the operation in comparison with non-operated patients due to small diameter AAA. Markers (CD146 + CD45) were used to identify CEC.Results. The amount of Р-selectin, СD62 in patients with small aneurysms (SAAA) in comparison of aneurysms more the 5 cm (BAAA). has been increased (р<0,05). There was the statistically significant difference in amount of GP IIb/IIIa in SAAA and BAAA(р=0,04). The number of monocytes were less in SAAA Positive correlation between CEC and monocytes and between the size of aneurysms in BAAA before the operation have been revealed. We found the positive correlation between CEC number and P-selectin (CD62), in patients at early postoperative period. The significant difference (р=0,02) (GP) IIb/IIIa receptors in patients before and at late postoperative period has been found ><0,05). There was the statistically significant difference in amount of GP IIb/IIIa in SAAA and BAAA(р=0,04). The number of monocytes were less in SAAA Positive correlation between CEC and monocytes and between the size of aneurysms in BAAA before the operation have been revealed. We found the positive correlation between CEC number and P-selectin (CD62), in patients at early postoperative period. The significant difference (р=0,02) (GP) IIb/IIIa receptors in patients before and at late postoperative period has been found.Conclusion. The change in the quantitative characteristics of CEC, platelets and monocytes during the growth of AAA confirms the idea about the activation of innate immunity as an important pathogenetic link in the development of this disease, closely associated with the destruction of the vascular wall and, in particular, of its endothelial lining. The obtained data partly explain the unsatisfactory long-term results of the EVAR and provide an opportunity for developing new approaches for prevention of postoperative complications and the treatment of AAA. 

scholarly journals Assessment of postoperative risk of complications on inguinal hernioplasty and its relation to risk factors

2020 ◽  
Vol 66 (5) ◽  
pp. 623-629
Author(s):  
Maurício Chibata ◽  
Oona Tomiê Daronch
Keyword(s):  
Postoperative Period ◽  
Medical Records ◽  
Early Postoperative Period ◽  
World Population ◽  
Inguinal Hernioplasty ◽  
Chronic Complications ◽  
Cross Sectional ◽  
Postoperative Risk ◽  
High Prevalence ◽  
The City

SUMMARY INTRODUCTION Abdominal wall hernias are a highly prevalent pathology, considering that 55 percent of the world population is affected by this disease at some point in their lives. As a large part of these patients present comorbidities, it is important to correlate the incidence of complications with the presence of previous pathologies. OBJECTIVES To evaluate whether the presence of comorbidities in patients submitted to inguinal hernioplasty increases the risk of acute and chronic complications in the postoperative period, as well as to explain which of these prior diseases present a greater association with the incidence of complications. METHODS This is a cross-sectional descriptive study carried out through the retrospective analysis of 313 medical records of patients submitted to open inguinal hernioplasty surgery between March and June 2017 at the General Surgery Service of the Cruz Vermelha Hospital - Paraná Branch, located in the City of Curitiba, state of Paraná, Brasil. RESULTS Of the 313 cases studied, the most prevalent comorbidities were: 107 patients with hypertension (34.19%), 52 smokers (16.61%), 30 cases with diabetes (9.58%), 14 with hypothyroidism (4,47%) and 10 with COPD (3.19%). Regarding the total of the sample evaluated, 130 patients (41.53%) did not present any comorbidity. When evaluating the complications, there were 49 cases (15.65%) of complications in the early postoperative period and 9 cases (2.88%) of chronic complications. The comorbidities that presented significant statistical influence (p <0.05) on the incidence of acute complications were hypertension (p = 0.02927) and smoking (p = 0.03196). CONCLUSION It is important to note the presence of acute postoperative complications of inguinal hernioplasty in patients who have hypertension or smoke, high prevalence diseases.

scholarly journals Laser treatment of macular retinal folds in late postoperative period after retinal detachment repair

2021 ◽  
Author(s):  
KhP Takhchidi ◽  
EKh Takhchidi ◽  
TA Kasmynina ◽  
EP Tebina
Keyword(s):  
Retinal Detachment ◽  
Postoperative Period ◽  
Rhegmatogenous Retinal Detachment ◽  
Clinical Symptoms ◽  
Vascular Occlusion ◽  
Early Postoperative Period ◽  
Repeat Surgery ◽  
Retinal Vascular Occlusion ◽  
Retinal Folds ◽  
Late Postoperative Period

Macular retinal folds are a rare yet grave complication of surgical rhegmatogenous retinal detachment repair. Clinical symptoms vary depending on the location and severity of folding. Fold located in the periphery of the ocular fundus can be asymptomatic, but macular retinal folds cause diminished visual acuity and metamorphopsia. Currently, the most effective treatment for retinal folds is repeat surgery. Its serious disadvantage is the risk of complications in the early postoperative period, including hemophthalmia, inflammation, secondary glaucoma, cataracts, RRD recurrence, macular tears, retinal vascular occlusion, etc. The clinical case described below demonstrates the potential of combination laser therapy for the treatment of macular retinal folds based on the use of modern diagnostic and therapeutic methods.

scholarly journals A clinical investigation of the association between perioperative oral management and prognostic nutritional index in patients with digestive and urinary cancers

2020 ◽  
Vol 27 (5) ◽  
Author(s):  
H. Otagiri ◽  
S. Yamada ◽  
M. Hashidume ◽  
A. Sakurai ◽  
M. Morioka ◽  
...  
Keyword(s):  
Postoperative Period ◽  
Medical Records ◽  
Clinical Investigation ◽  
Oral Intake ◽  
Prognostic Nutritional Index ◽  
Early Postoperative Period ◽  
Patients With Cancer ◽  
Positive Effects ◽  
Management Interventions ◽  
Nutritional Index

Background The prognostic nutritional index (pni) is a simple metric calculated using serum albumin and the peripheral lymphocyte count. It was reported that a low pni score is significantly associated with major postoperative complications and poor prognosis. The purpose of the present study was to investigate the effects of perioperative oral management (pom) on the perioperative pni profiles of patients with digestive system or urinary cancers. Study Design The medical records of 181 patients with cancer who underwent surgery and for whom a pni could be calculated were retrospectively reviewed. Results The intervention rate with pom was 34.8%. The median preoperative pni score was 48.25 in all patients with a pom intervention [25% to 75% interquartile range (iqr): 44.38–54.13] and 47.25 in those without an intervention (iqr: 42.0–53.5). Compared with patients not receiving pom, those who received pom had significantly higher pni scores from the early postoperative period (p < 0.05). Notably, of patients who could resume oral intake within 3 days after surgery, those who received pom intervention, compared with those who did not, had significantly higher pni scores from the early postoperative period (p < 0.05). Conclusions Perioperative oral management interventions might have positive effects on the postoperative pni scores of patients with cancer.

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