Surgery for a fracture of the hip within 24 hours of admission is independently associated with reduced short-term  post-operative complications

Background: Haemorrhoids are the most common benign anorectal problems worldwide. Treatments of third and fourth degree hemorrhoids include surgical haemorrhoidectomy. Milligan Morgan haemorrhoidectomy (MMH) as described in 1937 has remained the most popular among many techniques proposed. In order to avoid the postoperative drawbacks of Milligan Morgan haemorrhoidectomy, a new surgical treatment for prolapsing haemorrhoids has been described by Longo in 1995, procedure called stapled haemorrhoidopexy which is associated with less postoperative pain and a quicker recovery. The objective of this study was to compare the short-term outcome between stapled hemorrhoidopexy and Milligan-Morgan hemorrhoidectomy.Methods: Prospective randomized study of 120 patients with grade 3 and grade 4 haemorrhoids requiring surgical treatment either MMH or SH, 60 in each group for the period of 18 months from June 2014 to November 2015. Post-operative pain, duration of surgery, duration of hospital stays, post-operative complications and time taken to return to work were compared with mean follow up period of 6 months.Results: Duration of surgery is significantly low in stapled group with P <0.001, duration of hospital stay is significantly low in stapled group with P <0.001, post-operative pain low in staple group with P <0.05, time taken to return to work is significantly early in stapled group with P <0.001. Post-operative complications incontinence not found in the present study but recurrence of two cases in each group noted.Conclusion: Stapled hemorrhoidopexy is associated with less postoperative pain, shorter duration of surgery and hospital stay, earlier return to work as compared with Milligan-Morgan open hemorrhoidectomy. The procedure is not associated with major post-operative complications.

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Prognostic Indicators and Short Term Outcomes for Operated Patients with Peritonitis: Prospective Cohort Hospital Based Study in Northern Tanzania

10.21203/rs.3.rs-99974/v1 ◽

2020 ◽

Author(s):

Nassib Daud Msuya ◽

Julius Pius Alloyce ◽

David Msuya ◽

Kondo Chilonga ◽

Ayesiga Herman ◽

...

Keyword(s):

Postoperative Complications ◽

Prospective Cohort ◽

Prognostic Indicators ◽

Short Term ◽

Female Ratio ◽

Purulent Peritonitis ◽

Operative Complications ◽

Duration Of Operation ◽

Complications And Mortality ◽

Post Operative Complications

Abstract Background: Peritonitis is one of the most common surgical emergencies all over the world and is associated with significant complications and mortality. The spectrum of aetiology of peritonitis differs between high income countries and low income countries. Majority of the patients present late with purulent peritonitis and septiceamia. Surgical treatment of peritonitis is highly demanding and very complex, however, if the outcome in these patients can be correctly predicted, then better management can be instituted in order to achieve optimal patients’ care and hence improve treatment outcome.Methods: Prospective cohort hospital based study was conducted among patients admitted due to peritonitis at Kilimanjaro Christian medical center (KCMC) from October 2018 to March 2019.Documentary review and interview methods were employed to obtain data using electronic structured questionnaire. Data was summarized using median, Inter-quartile range (IQR), frequency and percentage. Both bivariate and multivariate logistic regression analyses were used to identify prognostic indicators for post-operative complications and mortality. A 95% CI and P <0.05 used for significance test.Results: The study enrolled 70 patients with predominance of male, giving a male to female ratio of 4.1:1. A total number of 33(47.1%) developed complications and 16(22.9%) died. Only 1(1.43%) patient presented to the hospital within 24 hours since the onset of illness. Delay in care, longer duration of operation, and low potassium were the prognostic indicators noted to have influence on short term complications. The major influence for mortality were comorbidity (AOR=3.02; 95%CI: 2.25-42.90) and postoperative complications (dyselectrolaemia) with (AOR=9.27; 95%CI: 1.21-70.83).Conclusion: Mortality and complications resulted from peritonitis is unacceptably high. Delay in care, longer duration of operation and preoperative low serum potassium levels were the prognostic indicators for the post-operative complications. Comorbidity and postoperative complications such as dyselectrolaemia had influence for the mortality. Correct prediction of these adverse outcomes will help to institute better management for the patients with peritonitis.

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Comparing short-term AIS post-operative complications between ACS-NSQIP and a surgeon study group

Spine Deformity ◽

10.1007/s43390-020-00170-w ◽

2020 ◽

Vol 8 (6) ◽

pp. 1247-1252

Author(s):

Jennifer M. Bauer ◽

◽

Suken A. Shah ◽

Paul D. Sponseller ◽

Amer F. Samdani ◽

...

Keyword(s):

Study Group ◽

Short Term ◽

Acs Nsqip ◽

Operative Complications ◽

Post Operative Complications

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The experience of surgical treatment of the patients with extended cicatricial esophageal strictures

Wiadomości Lekarskie ◽

10.36740/wlek202002104 ◽

2020 ◽

Vol 73 (2) ◽

pp. 229-234

Author(s):

Valeriy V. Boyko ◽

Serhii O. Savvi ◽

Alla Yu. Korolevska ◽

Serhii Yu. Bytyak ◽

Vitalii V. Zhydetskyi ◽

...

Keyword(s):

Surgical Treatment ◽

Comparison Group ◽

Life Quality ◽

Main Group ◽

Single Step ◽

Treatment Results ◽

Short Term ◽

Operative Complications ◽

Post Operative Complications

The aim of the researce was the improvement of treatment results of patients with extended post-burn esophageal cicatricial strictures. Materials and methods: The treatment results are presented for 102 patients which were divided into two groups. In 49 patients with extended post-burn esophageal cicatricial strictures of the main group modified esophagoplasty were performed. Traditional esophagoplasty in 53 patients of the comparison group was performed. Results: A trend was observed on reduction in both short-term and long-term post-operative complications and lethality. The comparative analysis showed statistically valid reduction in number of complications caused by radical surgery: in the main group the frequency of short-term post-operative complications was 10,2 %, in the comparison group – 45,3 %, the frequency of long-term post-operative complications being in the main group 8,2 %, and in the comparison group 26,4%. A trend was observed on reduction of both local and general complications, which may be explained by both peculiarities of the operative interventions with application of improved surgical treatment methods and by more efficient pre-operation preparation of the patients. Post-operative lethality level was 2,0 % in the main group, and 3,8% in the comparison group. Life quality parameters in the main group patients in the long-term post-operation period were statistically significantly better. Conclusions: In patients with extended post-burn esophageal cicatricial stricture application of the proposed surgical tactics, modified method of single-step esophagoplasty and esophagoplasty as Step II of the surgical treatment for persons who have a formed contact gastrostomy is an efficient means for patients’ treatment improvement.

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P-OGC10 Long-term survival is not affected by complications after oesophagectomy

British Journal of Surgery ◽

10.1093/bjs/znab430.138 ◽

2021 ◽

Vol 108 (Supplement_9) ◽

Author(s):

Edward J Nevins ◽

Jakub Chmelo ◽

Joshua Brown ◽

Pooja Prasad ◽

Alexander W Phillips

Keyword(s):

Survival Rates ◽

Short Term ◽

Term Survival ◽

Long Term Survival ◽

Kaplan Meier ◽

Operative Complications ◽

Short Term Mortality ◽

Index Hospital ◽

Post Operative Complications

Abstract Background Outcomes following oesophagectomy for oesophageal cancer continue to improve, but complications are common and can result in significant morbidity. Post-operative complications are known to impact upon peri-operative and short-term survival but the effect on long-term survival remains unclear. The aim of this study is to investigate the effect of post-operative complications on long-term survival following oesophagectomy. Methods A contemporaneously maintained database from a single centre was reviewed. All patients who underwent oesophagectomy between January 2010 and January 2019 were included. Patients were separated into three groups, those who experienced no or very minor complications (Clavien-Dindo 0 or 1), minor complications (Clavien-Dindo 2), and major complications (Clavien-Dindo 3-4). Those who died during the index hospital admission were excluded to correct for short-term mortality effects. Overall survival was analysed using Kaplan-Meier and log rank testing. Results Seven hundred and twenty-three patients underwent oesophagectomy during this time. Seventeen (2.4%) died during their index hospital stay, and were excluded from the survival analysis. The 30- and 90- day mortality was 1.1% (8/723) and 2.4% (17/723) respectively. There were 43.2% (305/706), 30.2% (213/706) and 26.6% (188/706) in the Clavien-Dindo 0-1, Clavien-Dindo 2, and Clavien-Dindo 3-4 group respectively. Median survival across the three groups was equivalent (50, 57 and 51 months). Across all three groups, overall long-term survival rates were equivalent at 1 (87.5%, 84.9%, 83.5%), 5 (44.2%, 48.9%, 44.7%) and 10 years (36.7%, 36.0%, 36.7%) (p = 0.730). Conclusions Long term survival is not affected by complications, irrespective of severity, following oesophagectomy.

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P-OGC74 Effect of pre-operative anaemia on short-term outcomes following oesophagectomy: a 10-year retrospective cohort study

British Journal of Surgery ◽

10.1093/bjs/znab430.202 ◽

2021 ◽

Vol 108 (Supplement_9) ◽

Author(s):

Siobhan Chien ◽

Khurram Khan ◽

Lewis Gall ◽

Liam Deboys ◽

Carol Craig ◽

...

Keyword(s):

Cohort Study ◽

Blood Transfusion ◽

Hospital Stay ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Length Of Hospital Stay ◽

Short Term ◽

Operative Complications ◽

The Impact ◽

Post Operative Complications

Abstract Background Pre-operative anaemia is associated with increased length of hospital stay, requirement for allogenic blood transfusion, post-operative complications and mortality. Oesophagectomy is a complex procedure associated with significant physiological insult, thus pre-operative patient optimisation is imperative to improve clinical outcomes. This study aimed to determine the impact of pre-operative anaemia on short-term outcomes following oesophagectomy for benign and malignant disease. Methods A retrospective cohort study of all oesophagectomies performed in a single tertiary referral centre between 1 January 2010 and 31 December 2019 was performed. Patients were identified from a prospectively collected database and individual patient electronic records were interrogated. Patients were dichotomised into two groups, based on the most recent pre-operative haemoglobin. Patients with pre-operative anaemia (haemoglobin <130mg/L in males and <120mg/L in females) were compared to those without pre-operative anaemia. Patients with missing data were excluded from the study. Patients were followed up for a median of 32 months (IQR 18-66). Results Of 352 patients eligible for inclusion, 173 (49.1%) patients were anaemic immediately pre-operatively. Patients with pre-operative anaemia were older (66 vs. 64 years, p = 0.031), with a lower anaerobic threshold (11.7 vs. 12.3ml/min/kg, p = 0.011), and were significantly more likely to have undergone neoadjuvant chemotherapy (91.3% vs. 78.8%, p < 0.001). Patient comorbidities and disease-related characteristics were similar between the two groups. Patients with pre-operative anaemia were significantly more likely to require post-operative blood transfusion (34.7% vs. 16.8%; p < 0.001). However, pre-operative anaemia was not associated with increased post-operative complications, intensive care admission, length of hospital stay, or 30- and 90-day mortality rates following oesophagectomy. Conclusions Patients with anaemia immediately prior to undergoing an oesophagectomy were significantly more likely to require post-operative blood transfusion. However, pre-operative anaemia was not associated with an increased rate of post-operative morbidity or mortality. In addition, pre-operative iron transfusion is becoming increasingly utilised to minimise the incidence of pre-operative anaemia: this was not analysed in this study.

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Short-term outcomes following mini-open repair of chronic gluteus medius tendon tears using a double-row technique

Journal of Hip Preservation Surgery ◽

10.1093/jhps/hnab060 ◽

2021 ◽

Author(s):

Marc Barrera ◽

Hugo Bothorel ◽

Lazaros Poultsides ◽

Panayiotis Christofilopoulos

Keyword(s):

Open Repair ◽

Gluteus Medius ◽

Harris Hip Score ◽

Short Term ◽

Double Row ◽

Operative Complications ◽

Tendon Tears ◽

Mini Open ◽

Post Operative Complications

ABSTRACT Gluteal tendon tears represent a common but underreported cause of lateral hip pain and dysfunction. In case of conservative management failure, a surgical procedure must be performed to relieve patient symptoms. Current operative treatments, either open or endoscopic, have been however associated with different drawbacks which led to the introduction of the mini-open technique. The aim of this study was to evaluate and report the short-term outcomes of patients operated through the aforementioned surgical technique for gluteus medius (GM) chronic tears. We retrospectively analysed the records of 14 consecutive patients operated at the La Tour hospital by mini-open repair using a double-row technique for full-thickness GM chronic tears. Intra- and post-operative complications were recorded. The pre- and post-operative pain on visual analogue scale (pVAS), modified Harris Hip score (mHHS), abduction strength and gait dysfunction were assessed for all patients. Pre- and post-operative values were compared to evaluate whether improvements were statistically significant and clinically relevant. The study cohort comprised 13 women (93%) and 1 man (3%) aged 62.4 ± 18.0 at index surgery. No intra- or post-operative complications were noted. Compared to pre-operative values, patients reported a significant improvement in mHHS (59.1 ± 7.1 vs 92.7 ± 4.6) and pVAS (7.4 ± 1.0 vs 1.3 ± 1.3) at last follow-up. Patients exhibited a perfect improvement in muscle strength (3.6 ± 0.5 vs 5.0 ± 0.0), and the proportion of patients with a positive Trendelenburg sign decreased from 71% to 0%. Mini-open repair of chronic GM tendon tears using a double-row technique demonstrated excellent clinical and functional outcomes at short follow-up. Level of Evidence: IV.

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