Vyresnio amžiaus žmonių apendicito ypatumai

Donatas Venskutonis1, Virmantas Daubaras1, Juozas Kutkevičius1, Jelena Kornej21 Kauno medicinos universiteto Bendrosios chirurgijos klinika, 2-oji Kauno klinikinė ligoninė2 Kauno medicinos universitetas Įvadas / tikslas Apendicitas yra viena iš dažniausių ūminių chirurginių pilvo ligų. Per gyvenimą ūminiu apendicitu suserga apie 7 % visos populiacijos. Literatūros duomenimis, ūminis apendicitas sudaro apie 5 % visų ūminių pilvo ligų vyresnio amžiaus grupėje. Šio darbo tikslas – išanalizuoti KMU Bendrosios chirurgijos klinikoje (II KKL) 1991–2000 metais gydytų vyresnio amžiaus žmonių apendicito formas, diagnostinio laikotarpio trukmę, bendrą gulėjimo stacionare laiką, komplikacijų ir baigčių aspektus, šiuos duomenis palyginti su jaunesnių kaip 65 metų ūminiu apendicitu sergančių ligonių grupe. Metodai Tyrimo metu retrospektyviai buvo išanalizuotos 1991–2000 m. gydytų nuo įvairių ūminio apendicito formų asmenų ligos istorijos, siekiant įvertinti ligos trukmę, diagnostinio laikotarpio trukmę, ligos formą, gulėjimo stacionare trukmę, komplikacijas, mirštamumą ir palyginti šiuos duomenis dviejų amžiaus grupių: iki 65 metų ir daugiau kaip 65 metų. Tiriant istorijas buvo kreipiamas dėmesys į diagnostinio laikotarpio trukmę iki operacijos, operacijos metu nustatytą apendicito formą, stacionarinio gydymo trukmę, buvusias komplikacijas ir baigtį. Rezultatai 1991–2000 m. nuo įvairių ūminio apendicito formų iš viso buvo gydyti 2378 ligoniai: pirmoje grupėje (iki 65 m.) buvo 2220 ligonių (92,51 %), antroje – 158 ligoniai (7,49 %). Pirmos grupės operuota 2130 ligonių (95,94 %), antros – 145 ligoniai (91,7 %). Vertinant apendicito formas, antroje amžiaus grupėje buvo gerokai daugiau gangreninių perforacinių nei pirmoje grupėje (p = 0,0014), o šioje – daugiau flegmoninių (p < 0,0010). Pirmos grupės ligoniai iki operacijos ligoninėje gulėjo 2,3 val., antros – 4,11 val. (p < 0,05). Bendras gulėjimo laikas pirmos grupės ligonių buvo 6,77 paros, antros – 11,14 paros (p < 0,05).Pooperacinių komplikacijų pirmoje grupėje buvo 151 (7,1 %), antroje – 31 (21,3 %), (p = 0,0151). Mirštamumas antroje grupėje sudarė 3,4 %, pirmoje grupėje mirusių nebuvo. Išvados Vyresnio amžiaus žmonės serga sunkesnėmis apendicito formomis, jų ikioperacinis ir bendras gulėjimo laikas yra ilgesnis (skirtumas statistiškai patikimas), pooperacinės komplikacijos sunkesnės ir dažnesnės (skirtumas statistiškai patikimas), visi mirusieji buvo vyresnio amžiaus žmonės, sirgę sunkiomis perforacinio apendicito formomis. Prasminiai žodžiai: apendicitas, vyresnio amžiaus ligoniai. Appendicitis - peculiarities in elderly patients Donatas Venskutonis1, Virmantas Daubaras1, Juozas Kutkevičius1, Jelena Kornej2 Background / objective Appendicitis is one of the most prevailing acute surgical abdominal diseases. According to literature data, acute appendicitis makes 5% of all acute diseases among elderly patients. The aim is to analyse the forms of appendicitis among elderly patients treated in KMU General Surgery Clinic (II KKL) in 1991–2000, as well as the duration of the diagnostic period, general duration of patients’ stay in hospital, the aspects of complications and mortality as compared to those in patients under 65 years of age. Methods Medical histories of the patients treated for acute appendicitis in 1991–2000 were analysed retrospectively. The patients were divided into two age groups: group 1 – under 65 years of age; group 2 – older than 65. The following criteria were evaluated: form of the disease, duration of diagnostic period; duration of stay in hospital; complications, mortality. These data were compared in both age groups. Results In 1991–2000, a total of 2378 patients were treated for various forms of acute appendicitis. There were 2220 patients (91.1%) in group 1 and 158 (7.49%) in group 2. In group 1, 2130 patients (95.94%) and in group 2, 145 (91.7%) were operated on. In group 2 there were more gangrenous perforated acute appendicitis forms than in group 1 (p = 0.0014) and in group 1 there were more phlegmonic forms of appendicitis (p < 0.001). As to the time of stay in hospital before operation, in group 1 it was 2.3 h and in group 2 4.11 h (p < 0.05). The mean stay in hospital in group 1 was 6.77 days and in group 2 11.14 days (p < 0.05). The number of postoperative complications was 151 (7.1%) in group 1 and 31 (21.3 %) in group 2 (p = 0.0151). Mortality in group 2 was 3.4%, while in group 1 nobody died. Conclusions Elderly people fall ill with more grave forms of appendicitis; their stay in hospital before the operation and total stay in hospital is longer, the postoperative complications are more severe and more fequent; the differences are statistically reliable; all lethal cases were elderly patients ill with severe forms of perforated appendicitis. Keywords: appendicitis, elderly patients.

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Comparison of Risk Factors for Postoperative Complications Across Age Groups in Patients Undergoing ORIF of the Ankle

Foot & Ankle Orthopaedics ◽

10.1177/2473011419s00299 ◽

2019 ◽

Vol 4 (4) ◽

pp. 2473011419S0029

Author(s):

Haley McKissack ◽

Matthew Anderson ◽

John T. Wilson ◽

Leonardo V. M. Moraes ◽

Gean C. Viner ◽

...

Keyword(s):

Risk Factors ◽

Postoperative Complications ◽

Elderly Patients ◽

Illicit Drugs ◽

Age Groups ◽

Wound Dehiscence ◽

Implant Failure ◽

Increased Risk ◽

Group 2 ◽

Group 1

Category: Ankle, Trauma Introduction/Purpose: Ankle fractures are commonly-seen orthopaedic injuries across all age groups, and often warrant operative management. Postoperative complications are particularly common among elderly patients, and can lead to a progressive culmination of negative outcomes. Although several studies have focused on the risk factors for and prevention of such complications in elderly patients, a paucity of literature exists addressing risk of postoperative complications in younger patient populations. The purpose of this study was to compare the incidence of and risk factors for various postoperative complications between younger and older patient populations. Methods: Patients who underwent open reduction and internal fixation for an ankle fracture at a single institution between the years 2008 and 2018 were retrospectively identified based on seven different Current Procedural Terminology (CPT) codes: 27829, 27784, 27822, 27814, 27769, 27792, and 27766. Patient charts were reviewed for demographic data and comorbid conditions. Patients with open fractures, pilon fractures, and polytraumatic injuries were excluded. The sample was stratified into two cohorts based on age in years: 18-49 (group 1), and 50 and older (group 2). Incidence of various postoperative complications—including infection, wound dehiscence, sepsis, DVT, implant failure, revision surgery, and non-union— was compared between groups. Secondary analysis was conducted to compare risk factors for these complications between ages 18- 49 and older than 50. Results: 881 patients were included. A significantly greater number of patients in group 2 experienced wound dehiscence (p = 0.033) and nonunion (p<0.001) postoperatively in comparison to those in group 1. Risk of infection was significantly increased among patients with hypertension, CHF, and CKD compared to patients without these comorbidities in both group 1 and group 2. Risk of wound dehiscence was significantly increased among patients using tobacco and illicit drugs in group 1 (RR=3.39, p=0.0223 and RR=3.07, p=0.0201 respectively), but not in group 2 (RR = 1.12, p = 0.8021 and RR = 1.77, p = 0.4203 respectively). Risk of implant failure was significantly increased among tobacco users in group 2 (RR=3.82, p = 0.0005), but not in group 1 (RR = 0.75, p=0.4709). Conclusion: Patients age 50 and older may be at significantly increased risk for postoperative wound dehiscence and nonunion in comparison to patients who are younger than 50. Additionally, younger patients who use tobacco and illicit drugs may be at increased risk of wound dehiscence, while tobacco use among patients 50 years and older may increase risk of implant failure. Understanding the risk factors associated with negative outcomes may help physicians to optimize individual patient care based on existing comorbidities and age.

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Impact of Renal Function on the Surgical Outcomes of Displaced Femoral Neck Fracture in Elderly Patients

Journal of Clinical Medicine ◽

10.3390/jcm8081149 ◽

2019 ◽

Vol 8 (8) ◽

pp. 1149 ◽

Cited By ~ 2

Author(s):

Kwon ◽

Lim ◽

Yang ◽

Lee ◽

Jeon ◽

...

Keyword(s):

Postoperative Complications ◽

Femoral Neck ◽

Renal Impairment ◽

Femoral Neck Fracture ◽

Bipolar Hemiarthroplasty ◽

Neck Fracture ◽

Group 3 ◽

Group 2 ◽

Complications And Mortality ◽

Group 1

Background: The aim of this study was to investigate the relationship between estimated glomerular filtration rate (eGFR) and outcomes of bipolar hemiarthroplasty for femoral neck fracture in elderly patients, and to compare postoperative complications and mortality among groups according to eGFR. Methods: A total of 181 patients who underwent bipolar hemiarthroplasty for displaced femoral neck fracture were divided into three groups according to eGFR. Data were retrospectively analyzed. Group 1 had 96 patients with eGFR greater than or equal to 60 mL/min/1.73 m2; Group 2 had 54 patients with eGFR greater than or equal to 30 mL/min/1.73 m2 and lower than 60 mL/min/1.73 m2; and Group 3 had 31 patients with eGFR lower than 30 mL/min/1.73 m2. Postoperative complications and mortality were compared between groups at a minimum 2-year follow-up. Results: Patients in Group 3 had the longest hospital stay of the three groups (p = 0.001). The rates of medical complications did not differ significantly among groups. However, Group 2 and 3 had higher rates of surgical complications (p = 0.001) and mortality (p = 0.043) than Group 1. Severe renal impairment was associated with increased risk of postoperative complications compared to mild renal impairment (odds ratio (95% confidence interval) = 4.33 (1.32–13.19), p = 0.015). Conclusion: Patients with moderate or severe decreased eGFR associated with chronic kidney disease (CKD) could have higher postoperative complications and mortality after bipolar hemiarthroplasty compared to patients with CKD stage 1 or 2.

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The Results of Trabeculectomy with Antimetabolites in Elderly Patients: A Retrospective Study

Acta Medica ◽

10.32552/2021.actamedica.582 ◽

2021 ◽

pp. 1-5

Author(s):

Özlem Dikmetaş ◽

Sepideh Lotfisadigh, ◽

Merve Kaşıkçı ◽

Ali Bülent Çankaya ◽

Sibel Kocabeyoğlu

Keyword(s):

Intraocular Pressure ◽

Retrospective Study ◽

Elderly Patients ◽

Mitomycin C ◽

Open Angle Glaucoma ◽

Success Rates ◽

Topical Medication ◽

The Mean ◽

Group 2 ◽

Group 1

Objective: To examine the effectiveness and results of primary trabeculectomy with 5-fluorouracil (group 1) or mitomycin-C (group 2) in elderly patients. Materials and Methods: This was a retrospective study including 67 eyes with primary open-angle glaucoma that underwent primary trabeculectomy with group 1 or group 2. Patients who were followed up for less than 1 year or were under 55 years of age were excluded from the study. Surgical success was evaluated according to a decrease in cup/disk ratio and reduction of intraocular pressure without any topical medication. Results: The mean ages of participants were 65.7 years (range 59–88) and 65.9 years (range 59–74) in groups 1 and 2, respectively. The mean preoperative and postoperative intraocular pressure values were 31.3 ± 5.7 mmHg (range 17–46) and 14.8 ± 0.4 mmHg (range 10–21) in group 1 (p < 0.001) and 31.5 ± 7.4 mmHg (range 18–52) and 14.8 ± 2.9 mmHg (range 10–21) in group 2 (p < 0.001). Conclusion: The use of 5-fluorouracil or mitomycin-C during primary trabeculectomy is associated with high postoperative success rates. There were no significant differences between 5-fluorouracil and mitomycin-C in terms of intraocular pressure reduction.

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How safe are elective craniotomies in elderly patients in neurosurgery today? A prospective cohort study of 1452 consecutive cases

Journal of Neurosurgery ◽

10.3171/2020.2.jns193460 ◽

2020 ◽

pp. 1-9

Author(s):

Ralph T. Schär ◽

Shpend Tashi ◽

Mattia Branca ◽

Nicole Söll ◽

Debora Cipriani ◽

...

Keyword(s):

Cohort Study ◽

Blood Loss ◽

Elderly Patients ◽

Age Groups ◽

Head Ct ◽

Estimated Blood Loss ◽

Group 3 ◽

Group 2 ◽

The Impact ◽

Group 1

OBJECTIVEWith global aging, elective craniotomies are increasingly being performed in elderly patients. There is a paucity of prospective studies evaluating the impact of these procedures on the geriatric population. The goal of this study was to assess the safety of elective craniotomies for elderly patients in modern neurosurgery.METHODSFor this cohort study, adult patients, who underwent elective craniotomies between November 1, 2011, and October 31, 2018, were allocated to 3 age groups (group 1, < 65 years [n = 1008], group 2, ≥ 65 to < 75 [n = 315], and group 3, ≥ 75 [n = 129]). Primary outcome was the 30-day mortality after craniotomy. Secondary outcomes included rate of delayed extubation (> 1 hour), need for emergency head CT scan and reoperation within 48 hours after surgery, length of postoperative intensive or intermediate care unit stay, hospital length of stay (LOS), and rate of discharge to home. Adjustment for American Society of Anesthesiologists Physical Status (ASA PS) class, estimated blood loss, and duration of surgery were analyzed as a comparison using multiple logistic regression. For significant differences a post hoc analysis was performed.RESULTSIn total, 1452 patients (mean age 55.4 ± 14.7 years) were included. The overall mortality rate was 0.55% (n = 8), with no significant differences between groups (group 1: 0.5% [95% binominal CI 0.2%, 1.2%]; group 2: 0.3% [95% binominal CI 0.0%, 1.7%]; group 3: 1.6% [95% binominal CI 0.2%, 5.5%]). Deceased patients had a significantly higher ASA PS class (2.88 ± 0.35 vs 2.42 ± 0.62; difference 0.46 [95% CI 0.03, 0.89]; p = 0.036) and increased estimated blood loss (1444 ± 1973 ml vs 436 ± 545 ml [95% CI 618, 1398]; p <0.001). Significant differences were found in the rate of postoperative head CT scans (group 1: 6.65% [n = 67], group 2: 7.30% [n = 23], group 3: 15.50% [n = 20]; p = 0.006), LOS (group 1: median 5 days [IQR 4; 7 days], group 2: 5 days [IQR 4; 7 days], and group 3: 7 days [5; 9 days]; p = 0.001), and rate of discharge to home (group 1: 79.0% [n = 796], group 2: 72.0% [n = 227], and group 3: 44.2% [n = 57]; p < 0.001).CONCLUSIONSMortality following elective craniotomy was low in all age groups. Today, elective craniotomy for well-selected patients is safe, and for elderly patients, too. Elderly patients are more dependent on discharge to other hospitals and postacute care facilities after elective craniotomy.Clinical trial registration no.: NCT01987648 (clinicaltrials.gov).

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Comparison of Different IOL Types in the Flanged IOL Fixation Technique

Journal of Ophthalmology ◽

10.1155/2020/8534028 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6

Author(s):

Yusaku Miura ◽

Yosuke Harada ◽

Yoshiaki Kiuchi

Keyword(s):

Postoperative Complications ◽

Case Series ◽

Operation Time ◽

University Hospital ◽

Fixation Technique ◽

The Mean ◽

Group 2 ◽

Iol Fixation ◽

Group 1

Purpose. To compare short-term clinical outcomes between two different intraocular lens (IOL) types in the flanged IOL fixation technique. Methods. This study was a retrospective case series and included the patients who underwent flanged IOL fixation between June 2017 and July 2018 at the Hiroshima University Hospital. Two different 3-piece IOLs (NX-70 and PN6A) were used. Recipients of NX-70 and PN6A IOLs were classed into groups 1 (15 eyes) and 2 (25 eyes), respectively. Patient characteristics, surgical results, and postoperative complications were analyzed. We excluded patients with a postoperative follow-up of <1 month. Results. The mean follow-up period was 13.3 ± 11.7 weeks. The postoperative best corrected visual acuity, in logarithm of the minimum angle of resolution (logMAR), was 0.10 ± 0.33 in group 1 and 0.26 ± 0.42 in group 2. The mean operation times for groups 1 and 2 were 11.2 ± 4.54 minutes and 7.00 ± 2.20 minutes, respectively (p=0.0024). Detachment of the IOL haptic from the optic during surgery occurred in four eyes in group 2 (16%), but did not occur in group 1. Iris capture of the optic was observed in 3 of the 13 eyes (23%) without a peripheral iridotomy in group 2. No peripheral iridotomies were performed on group-1 eyes, but iris capture did not occur in that group. Conclusions. There was a trend to fewer intraoperative and postoperative complications when using NX-70 IOLs. On the other hand, PN6A IOLs was easy to maneuver within the anterior chamber, and the operation time was shorter when using PN6A IOLs. Selection of optimal IOLs for flanged IOL fixation necessitates an understanding of their characteristics in terms of intraoperative and postoperative complications.

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The feasibility of shockwave lithotripsy for treating solitary, lower calyceal stones over 1 cm in size

Canadian Urological Association Journal ◽

10.5489/cuaj.473 ◽

2013 ◽

Vol 7 (3-4) ◽

pp. E156-160 ◽

Cited By ~ 5

Author(s):

Tae Beom Kim ◽

Sang Cheol Lee ◽

Khae Hawn Kim ◽

Han Jung ◽

Sang Jin Yoon ◽

...

Keyword(s):

Postoperative Complications ◽

Clinical Data ◽

Renal Calculi ◽

Shockwave Lithotripsy ◽

Lower Pole ◽

Stone Size ◽

The Mean ◽

Group 2 ◽

Anatomical Parameters ◽

Group 1

Introduction: Recently, few studies were reported about the treatment of large, solitary, renal calculi between shockwave lithotripsy (SWL) and percutaneous nephrolithotomy (PNL). We assess the feasibility of SWL for managing solitary, lower calyceal stones over 1 cm by comparing the results of lower pole calculi treatment between patients that underwent SWL or PNL.Methods: We retrospectively reviewed clinical data for patients who had undergone PNL or SWL due to lower calyceal stones over 1 cm. Group 1 consisted of patients who underwent SWL to treat lower pole renal calculi from 2010 to 2011. Group 2 included patients who underwent PNL to manage lower pole renal calculi from 2008 to 2009. We compared patient age, gender, stone size, comorbidities, postoperative complications, additional interventions and anatomical parameters between the two groups.Results: A total of 55 patients were enrolled in this study. The mean ages (±SD) of groups 1 (n = 33) and 2 (n = 22) were 55.1 (±13.0) and 50.0 (±10.6) years (p = 0.133) and mean stone sizes were 1.6 (±0.7) and 1.9 (±0.8) cm (p = 0.135), respectively. There were no significant differences in gender distribution, comorbidities or stone laterality between the two groups. No significant differences in various parameters were observed between patients with stones 1 to 2 cm and ones with stones 2 cm or larger.Conclusions: Our results demonstrated that SWL is a safe, feasible treatment for solitary, lower calyceal stones over 1 cm.

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Nitinol clips sternal osteosynthesis after heart/great arteries surgery as a method for prevention of postoperative complications

Patologiya krovoobrashcheniya i kardiokhirurgiya ◽

10.21688/1681-3472-2014-2-32-36 ◽

2015 ◽

Vol 18 (3) ◽

pp. 32

Author(s):

E. R. Charchyan ◽

A. B. Stepanenko ◽

N. A. Galeev ◽

A. A. Skvortsov ◽

A. P. Gens

Keyword(s):

Postoperative Complications ◽

Blood Loss ◽

Postoperative Period ◽

Classical Method ◽

Median Sternotomy ◽

Early Postoperative Period ◽

High Incidence ◽

The Mean ◽

Group 2 ◽

Group 1

The problem of sternal osteosynthesis after cardiac surgery is relevant because of a relatively high incidence of postoperative complications associated with inadequate sternal consolidation. The use of nitinol clips is one of the reliable and versatile methods of sternal osteosynthesis. Our research included 208 postoperative patients with different cardiac surgical pathologies. All interventions were carried out with cardiopulmonary bypass using median sternotomy. Patients were divided into 2 groups according to sternal fixation methods: group 1 (105 patients) - wire suture osteosynthesis, group 2 (103 patients) - nitinol clips closure. The short-term postoperative results were analyzed by using the major criteria for comparison. Radiographically confirmed varying degrees of sternal defects in the immediate postoperative period were observed in 15.2% of patients in group 1 and 3.8% of patients in group 2. In group 1 significant sternal defects requiring sternal refixation were observed in 4.8% of patients; in group 2 no such cases were identified. The mean blood loss in the drainages for 24 hours after surgery in group 1 was 351 65 ml; in group 2 - 192 43 ml. The total number of resternotomies for bleeding in group 1 was 6.7% of cases, with half of them being the patients with the source from the sternum in the site of wire sutures, while in group 2 4.9% patients underwent resternotomy, with no bleeding from the sites of clip fixation. Thus, the use of nitinol clips after longitudinal median sternotomy is a more reliable method of sternal osteosynthesis (as compared with the classical method), which enables us to minimize the risk of damage to the retrosternal structures, preserve sternal consolidation and reduce blood loss in the drainages in the early postoperative period.

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Real-world evaluation of the impact of radiotherapy and chemotherapy in elderly patients with glioblastoma based on age and performance status

Neuro-Oncology Practice ◽

10.1093/nop/npaa064 ◽

2020 ◽

Author(s):

Karine A Al Feghali ◽

Samantha M Buszek ◽

Hesham Elhalawani ◽

Neil Chevli ◽

Pamela K Allen ◽

...

Keyword(s):

Elderly Patients ◽

Treatment Effects ◽

Cox Regression ◽

Performance Status ◽

Age Groups ◽

Community Treatment ◽

Subtotal Resection ◽

Group 2 ◽

The Impact ◽

Group 1

Abstract Background This retrospective study investigated the impact of, in addition to age, the management and outcomes of elderly patients with glioblastoma (GBM). Methods The National Cancer Database was queried between 2004 and 2015 for GBM patients age 60 years and older. Three age groups were created: 60 to 69, 70 to 79, and 80 years and older, and 4 age/KPS groups: “age ≥ 60/ KPS < 70” (group 1), “age 60 to 69/KPS ≥ 70” (group 2), “age 70 to 79/KPS ≥ 70” (group 3), and “age ≥ 80/KPS ≥ 70” (group 4). Multivariable (MVA) modeling with Cox regression determined predictors of survival (OS), and estimated average treatment effects analysis was performed. Results A total of 48 540 patients with a median age of 70 years (range, 60-90 years) at diagnosis, and a median follow-up of 6.8 months (range, 0-151 months) were included. Median survival was 5.0, 15.2, 9.6, and 6.8 months in groups 1, 2, 3, and 4, respectively (P < .001). On treatment effects analysis, all groups survived longer with combined chemotherapy (ChT) and radiation therapy (RT), except group 1, which survived longer with ChT alone (P < .001). RT alone was associated with the worst OS in all groups (P < .01). Across all groups, predictors of worse OS on MVA were older age, lower KPS, White, higher comorbidity score, worse socioeconomic status, community treatment, tumor multifocality, subtotal resection, and no adjuvant treatment (all P < .01). Conclusions In elderly patients with newly diagnosed GBM, those with good KPS fared best with combined ChT and RT across all age groups. Performance status is a key prognostic factor that should be considered for management decisions in these patients.

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COMPARISON OF THE EFFECT OF TOPICAL BROMFENAC AND TOPICAL FLURBIPROFEN IN MAINTAINING MYDRIASIS DURING CATARACT SURGERY

INDIAN DRUGS ◽

10.53879/id.57.12.12678 ◽

2021 ◽

Vol 57 (12) ◽

pp. 56-60

Author(s):

Deepika T.H. ◽

N.G. Chandan ◽

Manjula T.R.

Keyword(s):

Postoperative Complications ◽

Cataract Surgery ◽

Pupillary Dilatation ◽

Prophylactic Administration ◽

Percentage Loss ◽

The Mean ◽

Group 2 ◽

Group 1

At the time of cataract surgery, one of the challenges a surgeon encounters is intraoperative miosis. This might increase the chances of intraoperative and postoperative complications. Thus, maintainence of adequate pupillary dilatation is necessary during cataract surgery. Aim of the study was to compare the effectiveness of prophylactic administration of topical bromfenac (0.09 % w/V) and topical flurbiprofen (0.03 % w/V) in maintaining mydriasis during the cataract surgery. A total of 100 patients were randomly divided into two groups of 50 each. Group 1 received topical bromfenac (0.09 %) and Group 2 received topical flurbiprofen (0.03 %). The mean percentage loss of mydriasis from the baseline was lesser in bromfenac group compared to flurbiprofen group (p < 0.001). Topical bromfenac was found to be more effective in maintaining mydriasis during the cataract surgery when compared to the topical flurbiprofen.

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Comparing Appendectomy and Conservative Treatment for Patients with Uncomplicated Acute Appendicitis

International Journal Of Medical Science And Clinical Invention ◽

10.18535/ijmsci/v5i4.12 ◽

2018 ◽

Vol 5 (4) ◽

pp. 3768-3771

Author(s):

Murat Kendirci

Keyword(s):

Acute Appendicitis ◽

Physical Examination ◽

Medical Treatment ◽

Radiological Examination ◽

Urgent Surgery ◽

Laboratory Values ◽

Hospitalization Period ◽

The Mean ◽

Group 2 ◽

Group 1

Background: Acute appendicitis is one of the most common causes of acute abdomen pain. Gold standard treatment of acute appendicitis is the appendectomy. In this study, we investigated in selected cases whether antibiotherapy can be preferred instead of urgent surgery. Material and Method: Patients who were admitted to the emergency room between January 1, 2016, and December 31, 2016, with abdominal pain and who were diagnosed with acute appendicitis as a result of physical examination, laboratory and radiological examination were divided into two groups. Patients who did not want to undergo surgery and received medical treatment were determined as group 1 antibiotherapy and who underwent appendectomy were determined as group 2. Physical examination, laboratory values, radiological examination results, scores according to the Alvarado scoring system, clinical follow-up data, receivedtreatment, complications were recorded. Hospitalization period, return period to work, post-treatment complaints, control findingsand laboratory values were compared. Results: Of the 133 patients included in the study, 59 (44.4%) were female and 74 (55.6%) were male. Mean age was 42.8 (18-92 years). Whereas antibiotherapy was given 54 patients (group 1, 40.6%), 79 patients were urgently preparedfor appendectomy (group 2, 59.4%). No differences were found between the two groups in terms of gender. The mean age was 53.8 (18-93 years) in group 1 and 35.3 (18-71 years) in group 2. The mean erythrocyte was 14844 (4400-22000/mm3) in the group 1 and 11800 (6500-21000/mm3) in the group 2. The mean C-reactive protein was 64.5% in the antibiotherapy group and 39.9% in the appendectomy group. The mean appendicitis diameter was determined as 9.4 (6-13 mm) in the group 1, and as 8.5 (6-13 mm) in the group 2. The mean Alvarado scores were 8.62 inthe group 1 and8.51 in the group 2. None of the 43 patients in group 1 have had relapsed acute appendicitis and appendectomy has not been performed again, even in another center. Conclusion: For acute appendicitis, patients who do not accept the operation for various reasons or who are at high risk of having surgery due to existing health problems, medical treatment approach instead of emergency surgery may be a safe and easy option.

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