scholarly journals Effects of Different Anesthesia Techniques on Intraoperative Blood Loss in Acetabular Fractures undergoing the Modified Stoppa Approach

2019 ◽  
Author(s):  
Ahmet Emrah Acan
Keyword(s):  
Blood Loss ◽  
Acetabular Fractures ◽  
Intraoperative Blood Loss ◽  
Stoppa Approach

scholarly journals Oblique-ilioischial Plate Technique: A Novel Method for Acetabular Fractures Involving Low Level Posterior Column

2021 ◽  
Author(s):  
Zhong Chen ◽  
Zhaoxiang Wu ◽  
Ge Chen ◽  
Yi Ou ◽  
Hongjie Wen
Keyword(s):  
Blood Loss ◽  
Operative Time ◽  
Iliac Fossa ◽  
Posterior Column ◽  
Acetabular Fractures ◽  
Intraoperative Blood Loss ◽  
Low Level ◽  
Plate Technique ◽  
Stoppa Approach ◽  
Hip Function

Abstract Background: Complex acetabular fractures involving the anterior and posterior columns are an intractable clinical challenge. The study investigated the safety and efficacy of oblique-ilioischial plate technique for acetabular fractures involving low level posterior column. Methods: A retrospective analysis of 18 patients operated with the oblique-ilioischial plate technique by the modified Stoppa approach (or combined with iliac fossa approach) between August 2016 and July 2021 for low level posterior column acetabular fractures was conducted. The anterior column was fixed with a reconstructed plate from the iliac wing along the iliopectineal line to the pubis. The low level posterior column was fixed with the novel oblique-ilioischial plate running from the ilium to the ischial ramus. Operative time, intraoperative blood loss, reduction quality, and postoperative hip function were recorded.Results: Out of the 18 patients, 10 were male and 8 were female (mean age: 48.6±10.2 years, range: 45–62 years; mean interval from injury to operation: 7.2±1.4 days, range: 5–19 days; mean operative time: 2.1±0.3 h, range: 1. 0–3.2 hours; mean intraoperative blood loss: 300±58.4 mL, range: 200–500 mL). Postoperative reduction (Matta’s criteria) was deemed as excellent (n = 9), good (n = 4), and fair (n = 5). At the final follow-up, the hip function (modified Merle d’Aubigne-Postel scale) was deemed as excellent (n = 11), good (n = 3), and fair (n = 4). The mean union time was 4.5±1.8 months (range: 3–6 months). No implant failure, infection, heterotopic ossification, or neurovascular injury were reported. Conclusion: The oblique-ilioischial plate technique via anterior approach for acetabular fractures involving low level posterior column offers reliable fixation, limited invasion, little intraoperative bleeding, and fewer complications. However, larger multicenter control studies are warranted.

scholarly journals Mid-term results of an anterior ilioischial plating for complex acetabular fractures with a combined anterior approach: a retrospective cohort study

2019 ◽  
Author(s):  
Weikun Meng ◽  
Yi Ou ◽  
Zhaoxiang Wu ◽  
Hongchang Yang ◽  
Ge Chen ◽  
...  
Keyword(s):  
Blood Loss ◽  
Anterior Approach ◽  
Operative Time ◽  
Fracture Reduction ◽  
Acetabular Fractures ◽  
Time Interval ◽  
Intraoperative Blood Loss ◽  
Ilioinguinal Approach ◽  
Stoppa Approach ◽  
Hip Function

Abstract Background: Bi-columnar plating via combined anterior and posterior approaches is routinely applied treatment for complex acetabular fractures with noteworthy shortcomings. The goal of this study was to evaluate the effectiveness of the anterior plating with an ilioischial plate through the combined anterior approach for complex acetabular fracture treatment. Methods: Patients with complex acetabular fractures treated at our trauma centre between January 2015 and December 2016 were retrospectively reviewed. Fractures were stabilized with an ilioischial plate via a modified Stoppa approach combined with the 1st window of the ilioinguinal approach. Interval between injury and surgery, operative time and intraoperative blood loss were recorded. Fracture reduction was evaluated radiographically with the modified Matta's criteria at 3 days postoperatively. Postoperative hip function was assessed using the modified Merle d'Aubigne and Postel clinical grading system over at least 1 year postoperatively. Results: Twenty patients were included with an average follow-up of 17 months (range, 13-28). The mean time interval between injury and surgery was 7.0 days (range, 3-13 days), operative time was 2.0 hours (range, 1.4-3.2 hours), and intraoperative blood loss was 320 mL (range, 220-450 mL). Fracture reduction was excellent in 15 cases (75%), good in 3 cases (15%), fair in 1 case (5%), and poor in 1 case (5%). Final hip function was excellent in 13 cases (68%), good in 3 cases (16%), fair in 2 cases (11%), and poor in 1 case (5%). Bony healing was achieved in all cases and few complications were reported including recoverable obturator nerve injuries in 2 patients (10%) and traumatic arthritis in 1 patient (5%). Conclusions: Anterior fixation of complex acetabular fractures with an ilioischial plate via the combined anterior approach yielded clinically satisfactory mid-term outcomes, providing a potentially effective alternative to the conventional treatment algorithm.

scholarly journals Comparison of Therapeutic Outcomes of Transabdominal Pararectus Approach and Modified Stoppa Approach in Treating Pelvic and Acetabular Fractures

2022 ◽  
Author(s):  
Wei Liu ◽  
Hongbin Yang ◽  
Zhenyan Yu ◽  
Yu Zhao ◽  
Jigong Hu ◽  
...  
Keyword(s):  
Blood Loss ◽  
Operation Time ◽  
Fracture Reduction ◽  
Acetabular Fractures ◽  
Therapeutic Effects ◽  
Function Score ◽  
Incision Length ◽  
Stoppa Approach ◽  
Hip Function ◽  
Pararectus Approach

Abstract Objective Pelvic and acetabular fractures are common orthopedic diseases, and this research was to investigate the therapeutic effects of pararectus and Stoppa approaches in treating complex pelvic acetabular fractures. Methods The clinical information of patients with pelvic and acetabular fractures treated surgically in Lu'an Hospital of Chinese medicine, China from January 2016 to April 2020 was analyzed. There were 30 cases each in the transabdominal pararectus approach and modified Stoppa approach groups. The operation time, incision length, blood loss, and postoperative complications of both groups were recorded according to the Merle d'Aubigné-Postel hip score. The recovery of hip function was evaluated 6 months after surgery, and the clinical and therapeutic efficacies of the two groups were compared. Results The patients were followed up for 6–7 months (average, 6.5 months). The average operation time, incision length, and blood loss in the pararectus and Stoppa approach groups were 180 ± 41.105 min, 8.667 ± 1.373 cm, 259.667 ± 382 mL and 202.667 ± 32.793 min, 11.600 ± 1.958 cm, and 353.667 ± 590 mL, respectively. The satisfactory rate of fracture reduction, excellent and good rate of hip function score, and incidence of complications were 28/30, 27/30, 1/30 and 25/30, 25/30, 3/30, respectively. There were significant differences in operation time, incision length, and blood loss between the two groups (p < 0.05). However, there was no significant difference in the excellent and good rate of hip function score, fracture reduction satisfaction, and complication rate between both groups (p > 0.05). Conclusions The pararectus approach can reveal the better anatomical structure of the pelvis and acetabulum, such as the corona mortis and quadrilateral plate, for conducive fracture reduction and fixation. It can also effectively shorten the length of the incision, reduce operative blood loss, and shorten the operation time. It is a better choice for the clinical treatment of complex pelvic and acetabular fractures.

THE FEASIBILITY OF FAST TRACK PROTOCOL FOR ELDERELY PATIENTS WITH COLORECTAL CANCER

2016 ◽  
pp. 26-29
Author(s):  
D. . Zitta ◽  
V. . Subbotin ◽  
Y. . Busirev
Keyword(s):  
Colorectal Cancer ◽  
Colorectal Surgery ◽  
Blood Loss ◽  
Elderly Patients ◽  
Fast Track ◽  
Randomized Study ◽  
Conventional Group ◽  
Intraoperative Blood Loss ◽  
Elective Colorectal Surgery ◽  
Complications Rate

Fast track protocol is widely used in major colorectal surgery. It decreases operative stress, shortens hospital stay and reduces complications rate. However feasibility and safety of this approach is still controversial in patients older than 70 years. The AIM of the study was to estimate the safety and effectiveness of fast track protocol in elderly patients with colorectal cancer. MATERIALS AND METHODS. Prospective randomized study included 138 elective colorectal resectionfor cancer during period from 1.01.10 till 1.06.15. The main criteria for the patients selection were age over 70 years and diagnosis of colorectal cancer. 82 of these patients received perioperative treatment according to fast track protocol, other 56 had conventional perioperative care. Patients underwent following procedures: right hemicolectomy (n=7), left hemicolectomy (n=12), transverse colectomy (n=1), sigmoidectomy (n=23), abdomeno-perineal excision (n=19) and low anterior resection of rectum (n=76). Following data were analized: duration of operation, intraoperative blood loss, time offirst flatus and defecation, complications rates. RESULTS. Mean age was 77,4 ± 8 years. There were no differences in gender, co morbidities, body mass index, types of operations between groups. Duration of operations didn't differ significantly between 2 groups. Intraoperative blood loss was higher in conventional group. The time of first flatus and defecation were better in FT-group. There was no mortality in FT-group vs 1,8 %o mortality in conventional group. Complications rate was lower in FT-group: wound infections 3,6% vs 9 %, anastomotic leakage 4,8 %o vs 9 %o, ileus 1,2 vs 5,4 %o, peritonitis 2,4 %o vs 3,6%o, bowel obstruction caused by the adhesions 6 % vs 5,3 %. Reoperation rate was similar 4,8 % vs 3,6 %. CONCLUSION. Fast track protocol in major elective colorectal surgery can be safely applied in elderly patients. The application of fast track protocol in elderly patients improves the restoration of bowel function and reduces the risk of postoperative complication.

Double-blind, randomized controlled trial of tranexamic acid in minor lumbar spine surgery: no effect on operative time, intraoperative blood loss, or complications

2019 ◽  
Vol 31 (2) ◽  
pp. 194-200 ◽  
Author(s):  
Signe Elmose ◽  
Mikkel Ø. Andersen ◽  
Else Bay Andresen ◽  
Leah Yacat Carreon
Keyword(s):  
Placebo Group ◽  
Lumbar Spine ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Spine Surgery ◽  
Operative Time ◽  
Decompressive Surgery ◽  
Lumbar Spine Surgery ◽  
Intraoperative Blood Loss ◽  
Double Blind

OBJECTIVEThe purpose of this study was to investigate the effect of tranexamic acid (TXA) compared to placebo in low-risk adult patients undergoing elective minor lumbar spine surgery—specifically with respect to operative time, estimated blood loss, and complications. Studies have shown that TXA reduces blood loss during major spine surgery. There have been no previous studies on the effect of TXA in minor lumbar spine surgery in which these variables have been evaluated.METHODSThe authors enrolled patients with ASA grades 1 to 2 scheduled to undergo lumbar decompressive surgery at Middelfart Hospital into a double-blind, randomized, placebo-controlled, parallel-group study. Patients with thromboembolic disease, coagulopathy, hypersensitivity to TXA, or a history of convulsion were excluded. Patients were randomly assigned, in blocks of 10, to one of 2 groups, TXA or placebo. Anticoagulation therapy was discontinued 2–7 days preoperatively. Prior to the incision, patients received either a bolus of TXA (10 mg/kg) or an equivalent volume of saline solution (placebo). Independent t-tests were used to compare differences between the 2 groups, with statistical significance set at p < 0.05.RESULTSOf the 250 patients enrolled, 17 patients were excluded, leaving 233 cases for analysis (117 in the TXA group and 116 in the placebo group). The demographics of the 2 groups were similar, except for a higher proportion of women in the TXA group (TXA 50% vs placebo 32%, p = 0.017). There was no significant between-groups difference in operative time (49.53 ± 18.26 vs 54.74 ± 24.49 minutes for TXA and placebo, respectively; p = 0.108) or intraoperative blood loss (55.87 ± 48.48 vs 69.14 ± 83.47 ml for TXA and placebo, respectively; p = 0.702). Postoperative blood loss measured from drain output was 62% significantly lower in the TXA group (13.03 ± 21.82 ml) than in the placebo group (34.61 ± 44.38 ml) (p < 0.001). There was no significant difference in number of dural lesions or postoperative spinal epidural hematomas, and there were no thromboembolic events.CONCLUSIONSTranexamic acid did not have a statistically significant effect on operative time, intraoperative blood loss, or complications. This study gives no evidence to support the routine use of TXA during minor lumbar decompressive surgery.Clinical trial registration no.: NCT03714360 (clinicaltrials.gov)

scholarly journals Efficacy evaluation of three-dimensional printing assisted osteotomy guide plate in accurate osteotomy of adolescent cubitus varus deformity

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Yuan-Wei Zhang ◽  
Xin Xiao ◽  
Wen-Cheng Gao ◽  
Yan Xiao ◽  
Su-Li Zhang ◽  
...  
Keyword(s):  
3D Printing ◽  
Blood Loss ◽  
Three Dimensional ◽  
Operation Time ◽  
Varus Deformity ◽  
Conventional Group ◽  
Intraoperative Blood Loss ◽  
Cubitus Varus ◽  
Guide Plate ◽  
Significant Difference

Abstract Background This present study is aimed to retrospectively assess the efficacy of three-dimensional (3D) printing assisted osteotomy guide plate in accurate osteotomy of adolescent cubitus varus deformity. Material and methods Twenty-five patients (15 males and 10 females) with the cubitus varus deformity from June 2014 to December 2017 were included in this study and were enrolled into the conventional group (n = 11) and 3D printing group (n = 14) according to the different surgical approaches. The operation time, intraoperative blood loss, osteotomy degrees, osteotomy end union time, and postoperative complications between the two groups were observed and recorded. Results Compared with the conventional group, the 3D printing group has the advantages of shorter operation time, less intraoperative blood loss, higher rate of excellent correction, and higher rate of the parents’ excellent satisfaction with appearance after deformity correction (P < 0.001, P < 0.001, P = 0.019, P = 0.023). Nevertheless, no significant difference was presented in postoperative carrying angle of the deformed side and total complication rate between the two groups (P = 0.626, P = 0.371). Conclusions The operation assisted by 3D printing osteotomy guide plate to correct the adolescent cubitus varus deformity is feasible and effective, which might be an optional approach to promote the accurate osteotomy and optimize the efficacy.

scholarly journals Predictive factors for intraoperative blood loss in surgery for adolescent idiopathic scoliosis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Chris Yuk Kwan Tang ◽  
Vijay H. D. Kamath ◽  
Prudence Wing Hang Cheung ◽  
Jason Pui Yin Cheung
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Blood Loss ◽  
Idiopathic Scoliosis ◽  
Spinal Fusion ◽  
Predictive Factors ◽  
Posterior Spinal Fusion ◽  
Male Gender ◽  
Intraoperative Blood Loss ◽  
Operative Blood Loss ◽  
Operation Duration

Abstract Background Adolescent idiopathic scoliosis (AIS) is a common spinal deformity. Posterior spinal fusion remains an important surgical treatment for AIS. This study aims to determine the predictive factors for intraoperative blood loss in AIS surgery. Methods Patients who had undergone posterior spinal fusion for adolescent idiopathic scoliosis in a single university hospital were reviewed over a 7-year period. Predictive factors for intra-operative blood loss were studied by multivariate analysis to derive a regression model. Receiver operating characteristic analysis was performed to determine the cut-off values of factors contributing to significant intraoperative blood loss (≥500 ml). Results Two hundred and twelve patients were included. Intraoperative blood loss was found to be correlated with gender (rs = 0.30 (0.17–0.43)), preoperative hemoglobin level (rs = 0.20 (0.04–0.31)), preoperative Cobb angle (rs = 0.20 (0.02–0.29)), number of fused levels (rs = 0.46 (0.34–0.58)), operation duration (rs = 0.65 (0.54–0.75)), number of anchors (rs = 0.47 (0.35–0.59)), and p-value ranged from < 0.001 to < 0.05. Significant intraoperative blood loss was influenced by the male gender, operation duration greater than 257.5 min and more than 10 anchors used. Conclusions Male gender, increased operation duration and higher number of anchors predicted higher intra-operative blood loss.

Sign in / Sign up

Export Citation Format

Share Document