scholarly journals A new minimally invasive surgical technique for the treatment of ovarian cysts in children

2021 ◽  
Vol 23 (5) ◽  
pp. 677-682
Author(s):  
O. V. Spakhi ◽  
A. H. Zaporozhchenko ◽  
V. V. Morhun ◽  
O. P. Pakholchuk
Keyword(s):  
Surgical Technique ◽  
Minimally Invasive ◽  
Hospital Stay ◽  
Ovarian Neoplasms ◽  
Abdominal Cavity ◽  
Length Of Hospital Stay ◽  
Ovarian Cysts ◽  
Group Iii ◽  
Group I ◽  
Duration Of Surgery

The topical issue of pediatric surgery is the treatment of ovarian cysts based on the development of new technologies for surgical correction of the disease. Aim. To analyze the effectiveness of using a new minimally invasive method for removal of cystic ovarian neoplasms in children. Material and methods. A retrospective analysis of 77 female patients with ovarian cysts, aged from 3 months to 17 years, was carried out. The patients were divided into 3 groups depending on the various surgical techniques used for their treatment. Group I consisted of 32 (41 %) girls who underwent cystectomy according to the new transabdominal technique for removing ovarian cysts in children. Group II included 19 (25 %) children who underwent a laparoscopic surgery. Group III comprised 26 (34 %) children who underwent a hybrid laparoscopy-assisted cystectomy. The following indicators were analyzed: the age of patients, the nature and number of complications of the disease course, the size of cystic neoplasms, the duration of surgical interventions, the number of cases accompanied by cyst contents leaking into the abdominal cavity during surgical manipulations, and the length of hospital stay. Results. The mean age of all patients was 11.23 ± 0.57 years. Planned hospitalizations amounted to 46 (59.7 %) cases. The duration of surgery in group I was almost 1.5 times lower (P < 0.05) than that in patients of group II and 2 times shorter than in children of group III (P < 0.05). Free cyst contents leaking into the abdominal cavity was observed in 35 (91.4 %) patients of Group III, which required additional measures aimed at the abdominal cavity sanation. The proposed minimally invasive transabdominal surgical technique prevented this complication in all 32 patients of Group I. The length of hospital stay did not differ significantly (P > 0.05) between children groups I and II and did not exceed 7.50 ± 0.35 (M ± SEM) days. This indicator was almost 1.5 times higher in Group III patients. Conclusions. The new minimally invasive transabdominal method for removing cystic ovarian neoplasms in children provided minimal trauma with maximum ablasticity and cosmetic effect of the operation. The proposed technique made it possible to prevent the development of intraoperative and postoperative complications, significantly reduce the duration of surgery and the recovery time of patients.

Abdominal sacrohysteropexy UV prolapse and preservation of reproduction.

2021 ◽  
Vol 28 (05) ◽  
pp. 652-655
Author(s):  
Robina Ali ◽  
Riffat Ehsan ◽  
Ghazala Niaz ◽  
Fatima Abid
Keyword(s):  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Uterovaginal Prolapse ◽  
Prolapse Recurrence ◽  
Gynecology And Obstetrics ◽  
Duration Of Surgery ◽  
Operative Complications ◽  
Operative Recovery ◽  
Post Operative Complications

Objectives: The purpose of this study was to assess the safety of sacrohystcopxy by determining intraoperative and post-operative complications and its effectiveness by pelvic organ prolapse recurrence on follow up. Study Design: Prospective study. Setting: Department of Gynecology and Obstetrics Unit-II DHQ Hospital PMC, Faisalabad. Period: Jan-2014 to Jan-2017. Material & Methods: Patients with uterovaginal prolapse, admitted through OPD were selected for abdominal sacrohysteropexy. Variables of study including duration of surgery, any intra-operative and post operative complications, need of intra operative blood transfusion, post operative hospital stay; recurrence of POP, number of pregnancies in 06 moths follow up were recorded. Results: During this study period, 319 patients were admitted with uterovaginal prolapse. 32 (10.03%) cases were selected for abdominal sacrohysteropexy. In these 32 patients, 03 (9.37%) were <30years of age, 21(65.62%) were between 30-35 years and 8 (25%) were between 35-40 years of age. About 2(6.25%) were unmarried, while 30(93.7%) were married. In these married women 14(43.75%) were multiparas, another 14(43.75%) were para 1 or 2, while 4(12.5%) were para 3 or more. Duration of surgery was 40-45 minutes in 31(96.87%) patients. In 28(87.5%) cases per operative blood loss was <150ml while in 4(12.5%) it was estimated to be >150ml but less than 300ml. Post operatively only 1(3.12%) case developed wound sepsis and it was the only one (3.12%) who was discharged on 7th post operative day, while rest 31(96.87%) were discharged on 3rd post operative day. No recurrence was noticed in 06 moths follow up, while 2(6.25%) patients became pregnant. Conclusion: Abdominal sacrohysteropexy is a safe and an effective treatment in terms of overall anatomical and functional outcome, complications, post operative recovery, length of hospital stay and sexual functioning, in women who desire uterine and hence fertility preservation.

scholarly journals Is Obesity a Risk Factor for Spinal Surgeries? A Retrospective Study in a Specialized Orthopedic Spine Center

2021 ◽  
Vol 8 (1) ◽  
pp. 37-42
Author(s):  
Hasan Ghandhari ◽  
◽  
Ebrahim Ameri ◽  
Mohsen Motalebi ◽  
Mohamad-Mahdi Azizi ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Obese Group ◽  
Obese Patients ◽  
Number Of Patients ◽  
Significant Difference ◽  
Duration Of Surgery

Background: Various studies have shown the effects of morbid obesity on the adverse consequences of various surgeries, especially postoperative infections. However, some studies have shown that the complications of spinal surgery in obese and non-obese patients are not significantly different. Objectives: This study investigated and compared the duration of surgery, length of hospital stay, and complications after common spinal surgeries by orthopedic spine fellowship in obese and non-obese patients in a specialized spine center in Iran. Methods: All patients who underwent decompression with or without lumbar fusion were included in this retrospective study. These patients were classified into two groups: non-obese (BMI <30 kg/m2) and obese (BMI ≥30 kg/m2). The data related to type and levels of surgery, 30-day hospital complications, length of hospital stay, rate of postoperative wound infection, blood loss, and need for transfusion were all extracted and compared between the two groups. Results: A total of 148 patients (74%) were in the non-obese group and 52 patients (26%) in the obese group. The number of patients that need packed cells was significantly higher in the obese group (51.8% vs 32.6%) (P=0.01). Otherwise, there were not a significant difference between type of treatment (fusion or only decompression) (P=0.78), interbody fusion (P=0.26), osteotomy (P=0.56), duration of surgery (P=0.25), length of hospital stay (P=0.72), mean amount of blood loss (P=0.09), and postoperative complications (P=0.68) between the two groups. Conclusion: Our results suggest that duration of surgery, length of hospital stay, and postoperative complications are not associated with the BMI of the patients.

Evaluation of the effectiveness of vacuum-assisted closure in the treatment of Fournier gangrene

2021 ◽  
pp. 1
Keyword(s):  
Hospital Stay ◽  
Wound Closure ◽  
Length Of Hospital Stay ◽  
Vacuum Assisted Closure ◽  
Analgesic Requirement ◽  
Vac Therapy ◽  
Fournier Gangrene ◽  
Group I ◽  
Group Ii ◽  
Closure Method

Background and objective: To evaluate the effectiveness of vacuum-assisted closure (VAC) in the treatment of Fournier gangrene (FG). Material and methods: Forty-eight male patients treated for Fournier gangrene were included in the study. The patients were divided into two groups (Group I: conventional dressing, Group II: VAC therapy). Characteristics of the patients, laboratory parameters, number of debridement procedures, daily number of dressings, visual analogue scale (VAS) during dressing, analgesic requirement, colostomy requirement, time from the first debridement to wound closure, wound closure method, length of hospital stay, and mortality rates were compared. Results: Group I comprised 33 patients and Group II comprised 15 patients. The number of dressings, VAS score and daily analgesic requirement were statistically significantly lower in Group II (p < 0.05) than in Group I. The number of debridement procedures, colostomy requirement, orchiectomy rate, time from first debridement to wound closure, length of hospital stay, wound closure method and mortality rate were similar between these two groups (p > 0.05). Conclusion: The clinical results of conventional dressing and VAC therapy were similar for treating FG. VAC therapy is an effective postoperative wound care method that offers less requirement for dressing changes, less pain, less analgesic requirement and more patient satisfaction compared to conventional dressing.

Abstract 12048: Minimally Invasive Access for Aortic Valve Surgery in Octogenarians: Is it Still Justified in the Days of TAVI ?

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Udo Boeken ◽  
Sudharson Rajah ◽  
Jan Philipp Minol ◽  
Payam Akhyari ◽  
Artur Lichtenberg
Keyword(s):  
Aortic Valve ◽  
Minimally Invasive ◽  
Hospital Stay ◽  
Surgical Techniques ◽  
Valve Surgery ◽  
Aortic Valve Surgery ◽  
Partial Sternotomy ◽  
Number Of Patients ◽  
Duration Of Surgery ◽  
Minimally Invasive Access

Introduction: Increasing life expectancy in the western world and improvements in surgical techniques and postoperative care have resulted in a significant number of patients aged over 80 undergoing cardiac operations. At times of transapical and transfemoral AVR we aimed to evaluate the feasibility of partial sternotomy for patients over 80 years of age and to compare these results with a historical group of octogenarians who underwent aortic valve surgery via full sternotomy in our department between 1998 and 2006. Methods: 72 of the 275 patients (26.2 %) who underwent aortic valve replacement (AVR) after partial sternotomy between 8/2009 and 05/2013 were octogenarians. Mean age was 83.1 ± 3.9 years (group ps). We compared this group with 165 patients (mean age 81.6 ± 3.1 years) who underwent AVR via full sternotomy between 1998 and 2006 (group fs). Results: ICU- and hospital stay were significantly reduced in patients with partial sternotomy (ps: 28 ± 9 hours, 12.8 ± 4.7 days vs. fs: 59 ± 15 h, 14.7 ± 3.5 d, p<0.05). We found a higher in-hospital mortality in group fs, but without significance (4.2 vs. 2.8 % in ps). Duration of operation, of extracorporeal circulation, and of aortic cross-clamping was tendentially prolonged in patients with partial sternotomy (p>0.05). Necessity for re-operation due to bleeding was comparable in both groups (ps: 2.8 % vs. fs: 3.0 %). The incidence of postoperative complications did not differ significantly between both groups: neurological complications (ps: 2.8 vs. fs: 3.0 %), sternal wound infections (2.8 % vs. 2.4 %) and postoperative LCOS (4.2 % vs. 5.5 %). Conclusions: We could prove the feasibility of ministernotomy for aortic valve surgery for patients over 80 years of age. Despite a tendentially prolonged duration of surgery compared to procedures via full sternotomy, we found a comparable morbidity and a reduced mortality after partial sternotomy. From an economic perspective, the reduction of intensive care unit- and hospital stay after minimally invasive access was the most interesting finding. Moreover, our results after minimally invasive AVR have to be considered carefully when selecting patients for a conventional or for a TAVI procedure.

P175 TRANSLATION OF MINIMALLY INVASIVE ESOPHAGECTOMY FROM RANDOMIZED CONTROLLED TRIAL SETTING (TIME) TO NATIONAL PRACTICE (DUCA) IN NETHERLANDS

2019 ◽  
Vol 32 (Supplement_2) ◽  
Author(s):  
R Markar Sheraz ◽  
Ni Melody ◽  
Gisbertz Suzanne ◽  
Straatman Jennifer ◽  
van der Peet Donald ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Postoperative Complications ◽  
Minimally Invasive ◽  
Hospital Stay ◽  
Minimally Invasive Esophagectomy ◽  
Univariate Analysis ◽  
Length Of Hospital Stay ◽  
Time Trial ◽  
Reoperation Rate ◽  
Invasive Esophagectomy

Abstract Aims The TIME trial showed reduced pulmonary complications from minimally invasive esophagectomy (MIE) over an open approach, and led to widespread adoption of MIE in the Netherlands. The aim of this study was to compare clinical outcomes from minimally invasive esophagectomy in the DUCA (national dataset) and the TIME trial (RCT) for transthoracic esophagectomy1. Methods Original patient data from the TIME trial1 was extracted along-with data from the Dutch National Cancer Audit (DUCA) (2011-2017). Initially univariate analysis was used to compare patient and tumor demographics and clinical and pathological outcomes from patients receiving MIE in the TIME trial and in the DUCA-dataset. Secondly multivariate analysis, with adjustment patient and tumor factors, was performed for the effect of MIE vs. Open esophagectomy on clinical outcomes in both datasets. Thirdly the datasets were combined and multivariate analysis, was performed for the effect of patient inclusion in TIME trial or DUCA-dataset. Results 115 patients from TIME (59 MIE vs. 56 open) and 4605 patients from the DUCA-dataset (2652 MIE vs. 1953 open) were included. Univariate analysis showed, in TIME trial, MIE reduced postoperative complications and length of hospital stay. However in the DUCA-dataset, MIE increased postoperative complications, re-intervention rate and length of hospital stay, however pathological benefits included increased proportion of R0 margin and lymph nodes harvested. Multivariate analysis confirmed the TIME data showed MIE reduced postoperative complications (OR=0.38, 95%CI 0.16–0.90). In the DUCA-dataset, MIE was associated with increased postoperative complications (OR=1.37, 95%CI 1.20–1.55), re-intervention (OR=1.84, 95%CI 1.57–2.14), and length of hospital stay (Coeff=1.57, 95%CI 0.06–3.08). Pathological benefits to MIE in the DUCA-dataset included a reduction in proportion of R1 margin, and increased lymph node harvest. Multivariate analysis of the combined dataset, showed inclusion in the TIME trial was associated with a reduction in postoperative complications (OR=0.23, 95%CI 0.15–0.36) and reoperation rate (OR=0.34, 95%CI 0.17–0.66). Conclusions MIE when adopted nationally outside the TIME-trial, was associated with an increase in postoperative complications and reoperation rate, which may reflect surgeons on a national level going through their proficiency-gain curve in the technique and outside of expert MIE centers.

1423 IMPACT OF A COMMON CLINICAL PATHWAY ON LENGTH OF HOSPITAL STAY FOR PATIENTS UNDERGOING OPEN AND MINIMALLY INVASIVE KIDNEY SURGERY

2012 ◽  
Vol 187 (4S) ◽  
Author(s):  
Tatum Tarin ◽  
Andrew Feifer ◽  
Simon Kimm ◽  
Ling Chen ◽  
Daniel Sjoberg ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Hospital Stay ◽  
Clinical Pathway ◽  
Length Of Hospital Stay ◽  
Kidney Surgery

Effect of length of hospital stay on infection and readmission after minimally invasive hysterectomy

2019 ◽  
Vol 145 (3) ◽  
pp. 293-299 ◽  
Author(s):  
Lauren D. Schiff ◽  
Kristin J. Voltzke ◽  
Paula D. Strassle ◽  
Michelle Louie ◽  
Erin T. Carey
Keyword(s):  
Minimally Invasive ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Minimally Invasive Hysterectomy

scholarly journals Implementation of Minimally Invasive Esophagectomy From a Randomized Controlled Trial Setting to National Practice

2020 ◽  
Vol 38 (19) ◽  
pp. 2130-2139 ◽  
Author(s):  
Sheraz R. Markar ◽  
Melody Ni ◽  
Suzanne S. Gisbertz ◽  
Leonie van der Werf ◽  
Jennifer Straatman ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Minimally Invasive ◽  
Hospital Stay ◽  
Minimally Invasive Esophagectomy ◽  
Univariate Analysis ◽  
Length Of Hospital Stay ◽  
Time Trial ◽  
Pulmonary Complications ◽  
Invasive Technique ◽  
Invasive Esophagectomy

PURPOSE The aim of this study was to examine the external validity of the randomized TIME trial, when minimally invasive esophagectomy (MIE) was implemented nationally in the Netherlands, using data from the Dutch Upper GI Cancer Audit (DUCA) for transthoracic esophagectomy. METHODS Original patient data from the TIME trial were extracted along with data from the DUCA dataset (2011-2017). Multivariate analysis, with adjustment for patient factors, tumor factors, and year of surgery, was performed for the effect of MIE versus open esophagectomy on clinical outcomes. RESULTS One hundred fifteen patients from the TIME trial (59 MIE v 56 open) and 4,605 patients from the DUCA dataset (2,652 MIE v 1,953 open) were included. In the TIME trial, univariate analysis showed that MIE reduced pulmonary complications and length of hospital stay. On the contrary, in the DUCA dataset, MIE was associated with increased total and pulmonary complications and reoperations; however, benefits included increased proportion of R0 margin and lymph nodes harvested, and reduced 30-day mortality. Multivariate analysis from the TIME trial showed that MIE reduced pulmonary complications (odds ratio [OR], 0.19; 95% CI, 0.06 to 0.61). In the DUCA dataset, MIE was associated with increased total complications (OR, 1.36; 95% CI, 1.19 to 1.57), pulmonary complications (OR, 1.50; 95% CI, 1.29 to 1.74), reoperations (OR, 1.74; 95% CI, 1.42 to 2.14), and length of hospital stay. Multivariate analysis of the combined and MIE datasets showed that inclusion in the TIME trial was associated with a reduction in reoperations, Clavien-Dindo grade > 1 complications, and length of hospital stay. CONCLUSION When adopted nationally outside the TIME trial, MIE was associated with an increase in total and pulmonary complications and reoperation rate. This may reflect nonexpert surgeons outside of high-volume centers performing this minimally invasive technique in a nonstandardized fashion outside of a controlled environment.

scholarly journals Comparative Efficacy of Nebulized 3% Hypertonic Saline versus 0.9% Normal Saline in Children with Acute Bronchiolitis

2018 ◽  
Vol 42 (3) ◽  
pp. 130-137 ◽  
Author(s):  
Khandaker Tarequl Islam ◽  
Abid Hossan Mollah ◽  
Abdul Matin ◽  
Mahmuda Begum
Keyword(s):  
Hospital Stay ◽  
Hypertonic Saline ◽  
Normal Saline ◽  
Severity Score ◽  
Oxygen Therapy ◽  
Length Of Hospital Stay ◽  
Clinical Severity ◽  
Acute Bronchiolitis ◽  
Group I ◽  
Group Ii

Background: Acute bronchiolitis is leading cause of hospitalization in infants below 2 years of age. Bronchiolitis being a viral disease, there is no effective treatment. 3% nebulized hypertonic saline and 0.9% nebulized normal saline are often used, although there is disagreement over their efficacy. The aim of this study was to evaluate the efficacy of 3% hypertonic saline in children with acute bronchiolitis in reducing clinical severity and length of hospital stay. Methodology: A randomized control trial carried out in the Department of Pediatrics, Dhaka Medical College Hospital from January 2013 to December 2013.Ninty children from 1 month to 2 years of age hospitalized with clinical bronchiolitis were randomized to receive 3% nebulized hypertonic saline(Group-I) or 0.9% nebulized normal saline (Group-II). Nebulization was done 8 hourly until discharge. Outcome variable were clinical severity score, duration of oxygen therapy and length of hospital stay. Results: Baseline clinical severity score and O2 saturation were in group-I 9.0±1.0 and 94.9±1.7 and in group- II 9.3±1.8 and 94.6±2.6 respectively (p>0.05). At 72 hours, the mean severity score for the group-I was 1.64±0.99 and that for the group-II was 3.0 ± 1.48 (95% CI -2.17 to - 0.53, p=0.002). The cases of group-I required a shorter duration of oxygen therapy compared to those of group-II (15.0±6.0 hours vs 26.4±5.37 hours, 95% CI -20.35 to -2.44, p<0.05). Forty two (93.3%) of the group-I children recovered by the end of72 hours and discharged whereas 26 (57.8%) of the group-II children recovered during the same period (p<0.05). Length of hospital stay was shorter in group-I compared to group-II (58.1±22.0 hours vs 74.7±27.2 hours, 95% CI -26.89 to- 6.17, p=0.002). None of the cases encountered any side-effects. Conclusion: Nebulization with 3% hypertonic saline significantly reduced clinical severity, length of hospital stay and duration of oxygen therapy in case of acute bronchiolitis in comparison to 0.9% normal saline and was safe. Bangladesh J Child Health 2018; VOL 42 (3) :130-137

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