scholarly journals Comparison between open and laparoscopic elective cholecystectomy in elderly, in a teaching hospital

2016 ◽  
Vol 43 (1) ◽  
pp. 2-5 ◽  
Author(s):  
Cássio Padilha Rubert ◽  
Roberta Alves Higa ◽  
Fabiano Vilas Boas Farias
Keyword(s):  
Hospital Stay ◽  
Conversion Rate ◽  
Laparoscopic Approach ◽  
Length Of Hospital Stay ◽  
Mato Grosso ◽  
Significant Difference ◽  
Stay Time ◽  
Hospital Stays ◽  
The Mean ◽  
Mato Grosso Do Sul

Objective: to analyze the differences in mortality rates, length of hospital stay, time of surgery and the conversion rate between elective open cholecystectomies (OC) and laparoscopic ones (LC) in elderly patients. Methods : we evaluated medical records of patients 65 years of age or older undergoing open or laparoscopic cholecystectomy at the Hospital Regional de Mato Grosso do Sul between January 2008 and December 2011. We excluded individuals operated in non-elective scenarios or who underwent intraoperative cholangiography. Results : we studied 113 patients, of whom 38.1% were submitted to the OC and 61.9%, to LC. Women accounted for 69% of patients and men, for 31%. The conversion rate was 2.9%. The mean age and duration of the procudure was 70.1 and 84 minutes, respectively, with no significant difference between OC and LC. Patients undergoing LC had shorter hospital stays (2.01 versus 2.95 days, p=0.0001). We identified operative complications in sixpatients (14%) after OC and in nine (12%) after LC, with no statistical difference. Conclusion : there was no difference in morbidity and mortality when comparing OC with LC. The laparoscopic approach led to shorter hospital stay. Operative time did not differ between the two access routes. The conversion rate was similar to other studies.

scholarly journals Staged Bilateral Hip or Knee Arthroplasties

2007 ◽  
Vol 15 (2) ◽  
pp. 159-162 ◽  
Author(s):  
FR Hashmi ◽  
K Barlas ◽  
CF Mann ◽  
FR Howell
Keyword(s):  
Hospital Admission ◽  
Hospital Stay ◽  
Operating Time ◽  
Length Of Hospital Stay ◽  
Mean Difference ◽  
Complication Rates ◽  
Early Complication ◽  
Early Complications ◽  
Hospital Stays ◽  
The Mean

Purpose. To compare the operating time, amount of blood transfused, length of hospital stay, and early complications (within 6 months) between 2-week staged bilateral arthroplasties and matched randomised controls undergoing unilateral arthroplasties. Methods. From October 1992 to October 2000, 90 patients who underwent bilateral hip or knee arthroplasties with a 2-week interval were compared with matched randomised controls undergoing unilateral arthroplasties. A single surgeon performed all procedures. Results. After the match-up process, 30 pairs of patients were included in the analysis. There were no significant differences in the operating times, amount of blood transfused, and early complication rates. The mean difference in length of hospital stay was significant ( t= −3.552, df=29, p<0.001). Conclusion. Compared to staged procedures with an interval months apart, staged sequential arthroplasty with a 7- to 10-day interval during one hospital admission is more efficient, as it facilitates earlier rehabilitation without higher complication rates, and entails shorter hospital stays.

Laparoscopic vs open surgery during the COVID-19 pandemic: what are the risks?

2021 ◽  
Author(s):  
C Hadjittofi ◽  
SS Seraj ◽  
A Uddin ◽  
ZJ Ali ◽  
PL Antonas ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Hospital Stay ◽  
Survival Data ◽  
Open Surgery ◽  
Virus Transmission ◽  
Laparoscopic Approach ◽  
Length Of Hospital Stay ◽  
Staff Members ◽  
Significant Difference ◽  
The Uk

Introduction The initial intercollegiate surgical guidance from the UK during the COVID-19 pandemic resulted in significant changes to practice. Avoidance of laparoscopy was recommended, to reduce aerosol generation and risk of virus transmission. Evidence on the safety profile of laparoscopy during the pandemic is lacking. This study compares patient outcomes and risk to staff from laparoscopic and open gastrointestinal operations during the COVID-19 pandemic. Methods Single-centre retrospective study of gastrointestinal operations performed during the peak of the COVID-19 pandemic. Demographic, comorbidity, perioperative and survival data were collected from electronic medical records and supplemented with patient symptoms reported at telephone follow up. Outcomes assessed were: patient mortality, illness among staff, patient COVID-19 rates, length of hospital stay and postdischarge symptomatology. Results A total of 73 patients with median age of 56 years were included; 55 (75%) and 18 (25%) underwent laparoscopic and open surgery, respectively. All-cause mortality was 5% (4/73), was related to COVID-19 in all cases, with no mortality after laparoscopic surgery. A total of 14 staff members developed COVID-19 symptoms within 2 weeks, with no significant difference between laparoscopic and open surgery (10 vs 4; p=0.331). Median length of stay was shorter in the laparoscopic versus the open group (4.5 vs 9.9 days; p=0.011), and postdischarge symptomatology across 15 symptoms was similar between groups (p=0.135–0.814). Conclusions With appropriate protective measures, laparoscopic surgery is safe for patients and staff during the COVID-19 pandemic. The laparoscopic approach maintains an advantage of shorter length of hospital stay compared with open surgery.

scholarly journals A comparative analysis of hysterectomies

Medicina ◽  
2007 ◽  
Vol 43 (2) ◽  
pp. 118 ◽  
Author(s):  
Rosita Aniulienė ◽  
Laima Varžgalienė ◽  
Manvydas Varžgalis
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Complication Rate ◽  
Vaginal Hysterectomy ◽  
Length Of Hospital Stay ◽  
Laparoscopic Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Obstetrics And Gynecology ◽  
Significant Difference ◽  
The Mean

The objective of this study was to evaluate and compare operative and postoperative results and differences among laparoscopic, vaginal, and abdominal hysterectomies performed at the Department of Obstetrics and Gynecology of Kaunas University of Medicine Hospital. Methods. A retrospective review of medical histories was performed for women who had undergone three different types of hysterectomies (laparoscopic, vaginal, and abdominal) at the Department of Obstetrics and Gynecology of Kaunas University of Medicine Hospital during 2004–2005. Results. A total of 602 hysterectomies were performed: 51 (8.5%) laparoscopic, 203 (33.7%) vaginal, and 348 (57.8%) abdominal. The lowest complication rate occurred in patients who underwent laparoscopic hysterectomy (n=5, 9.8%) and the highest – abdominal hysterectomy (n=88, 25.2%) (P<0.05). More complication occurred after abdominal as compared to vaginal hysterectomy (n=88, 25.2% vs. n=20, 9.9%, respectively; P<0.05). There was no statistically significant difference in complication rate comparing laparoscopic and vaginal hysterectomies (P=0.26). The amount of blood loss depended on the type of hysterectomy – less blood was lost during laparoscopic and more during abdominal hysterectomy (123.4 vs. 308.5 mL, respectively; P<0.01). A significantly higher blood loss was observed during abdominal hysterectomy as compared to vaginal (195.3 mL) and vaginal as compared to laparoscopic hysterectomy (P<0.01). The mean length of hospital stay differed comparing all three types of hysterectomies: the shortest stay of 8.6 days was after laparoscopic, the longest of 13.7 days – after abdominal hysterectomy. The mean hospital stay was statistically significant shorter for vaginal hysterectomy compared to abdominal hysterectomy (9.1 vs. 13.7 days, P<0.01). The difference in mean length of hospital stay was insignificant comparing laparoscopic and vaginal hysterectomies (P>0.05). Conclusions. Abdominal hysterectomy was the most common procedure performed. The type of hysterectomy influenced the rate of complications – the lowest complication rate was after laparoscopic and vaginal hysterectomies. The amount of blood loss depended on the type of hysterectomy – the lowest was during laparoscopic hysterectomy. Abdominal hysterectomy required on average a longer hospital stay compared with laparoscopic and vaginal hysterectomies.

scholarly journals Drain versus non drain in thyroid surgery

2016 ◽  
Vol 1 (2) ◽  
pp. 26-29
Author(s):  
Fadhil Ahmed Mohialdeen ◽  
Abdul-Wahid M Salih ◽  
Mohammed IM Gubari ◽  
Soran Ameen Hama-law
Keyword(s):  
Postoperative Pain ◽  
Hospital Stay ◽  
Total Thyroidectomy ◽  
Thyroid Surgery ◽  
Length Of Hospital Stay ◽  
Pain Patient ◽  
Histopathological Diagnosis ◽  
Suction Drain ◽  
Significant Difference ◽  
Hospital Stays

The use of a suction drain in thyroid surgery is common practice in order to avoid hematomas or seromas. The aim of this study was to determine the efficacy of inserting a routine drainage tube after thyroid surgery. In this retrospective study, 102 patients who underwent either a total thyroidectomy for thyroid disorders were assigned to either the drained or the non-drained groups. The length of hospital stays, postoperative pain, patient comfortability and complications were retrieved. Both groups were homogeneous according to age, gender, type of procedure performed, histopathological diagnosis residency and marital status. No significant difference was found between the two groups in post- operative complications, but the length of hospital stay was significantly reduced in non-drained group (p<0.0001), and drained group needed one more dose of analgesics compared to non-drained group to alleviate the post-operative pain.Our findings, suggesting that the use of drain for thyroid surgery cannot lower the incidence of complications. Furthermore, the use of drains may increase length of hospital stay, postoperative-pain,and the need of analgesic and contribute to the discomfort of the patients. Hence, the routine insertion of drains after total thyroidectomy for benign disorders might not be necessary.

scholarly journals Laparoskopska resekcija jeter zaradi zasevkov raka debelega črevesa in danke – rezultati zdravljenja

2017 ◽  
Vol 86 (3-4) ◽  
Author(s):  
Arpad Ivanecz ◽  
Vid Pivec ◽  
Irena Plahuta ◽  
Bojan Krebs ◽  
Tomaž Jagrič ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Conversion Rate ◽  
Liver Tumors ◽  
Operating Time ◽  
Length Of Hospital Stay ◽  
Morbidity And Mortality ◽  
Secondary Outcome ◽  
Estimated Blood Loss ◽  
The Mean

Background: In many referral centers, laparoscopic liver resection (LLR) is a well-established method for the management of colorectal liver metastases (CLM). The aim of this study is to review a single institution experience.Methods: Between April 2008 and September 2016, 58 patients underwent LLR for various benign and malignant liver tumors. The analysis included 12 patients operated on for CLM. The primary outcomes of this prospective non-randomized study included operative procedure and operating time (minutes), estimated blood loss (mL), conversion rate, R0 resections, resection margins (mm), length of hospital stay (days), post-operative morbidity, and mortality. The secondary outcome of the study was survival analysis.Results: Eight patients (67 %) had atypical LLR. The average operating time was 130 minutes (range 60–210 minutes). The mean estimated blood loss was 140 mL (range < 50–600 mL). In one patient LLR was converted to open procedure (conversion rate 8 %). Seven patients (58 %) had one liver metastasis. The mean metastasis size was 3.6 cm (range 1–9 cm). R0 resection was achieved in all cases. The mean resection margin was 6.8 mm (range 2–15 mm). Te mean length of hospital stay was 6 days (range 3–12 days). Morbidity and mortality rates were 0 %. The median follow-up for surviving patients was 13 months. Nine patients are alive with no evidence of disease, two patients are alive with disease and one patient died of disease.Conclusion: LLR is a feasible and safe method for the treatment of CLM and there is no compromise of oncological surgical principles.

scholarly journals P006 Initiation of Continuous Positive Airway Pressure as an inpatient in Patients with Obesity Hypoventilation Syndrome admitted to General Medical Unit

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A23-A23
Author(s):  
S Banjade ◽  
D Entesari-Tatafi
Keyword(s):  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Average Weight ◽  
Inpatient Setting ◽  
Obesity Hypoventilation Syndrome ◽  
Medical Unit ◽  
Significant Difference ◽  
The Mean ◽  
Hypoventilation Syndrome ◽  
Obesity Hypoventilation

Abstract Background With higher rates of obesity in regional and rural Australian population, there will be higher rates of Obesity Hypoventilation Syndrome (OHS). The cornerstone of the treatment of OHS is Positive Airways Pressure. We studied the initiation of Continuous Positive Airways Pressure (CPAP) in an inpatient setting in patients with OHS in the regional population of Ballarat and subsequent impact on their hospital stay/readmission. Methods We performed a retrospective study of 22 patients with OHS during the 6-month study period (01/07/2021–31/12/2021) admitted into General Medical Unit at Ballarat Base Hospital. Progress Complete Outcome/Impact The mean age in the cohort was 60 with average weight of 139.5 kg. The mean pCO2 and pH were 68.1 and 7.33 respectively. CPAP was initiated in 9 of 22 patients (40.1%) with mean of 7.3 days. Mean days of oxygen use was 4.7 days with mean length of hospital stay 10 days. We did not find any statistical difference in length of hospital stay, ICU stay, supplemental oxygen use or readmission rates between CPAP and non-CPAP group. Subgroup analysis showed that CPAP group had higher rates of COPD (44.4% vs 30.8%) and diabetes (44.4% vs 30.8%) with trend to lower FEV1 (mean FEV1 47.6% vs 57.2%). There were 4 deaths (16.7%), 3 of them did not have CPAP initiated. The longer duration to CPAP initiation is likely to explain the non-significant difference between the groups. Proactive measures to increase initiation of CPAP is likely to improve patient outcome in terms of their morbidity and mortality.

scholarly journals Clinical Outcomes of Modified versus Traditional Technique for the Surgery of Hydatid Cyst of the Liver: A Case Control Study

2019 ◽  
Vol 11 (3) ◽  
pp. 152-157 ◽  
Author(s):  
Asieh Sadat Fattahi ◽  
Seyed Hossein Fattahi Masoom ◽  
Farjad Lorestani ◽  
Mehrdad Fakhlai ◽  
Fatemeh Sadat Abtahi Mehrjerdi ◽  
...  
Keyword(s):  
Hydatid Cyst ◽  
Hospital Stay ◽  
Parasitic Infection ◽  
Length Of Hospital Stay ◽  
Modified Technique ◽  
Significant Difference ◽  
Postoperative Length ◽  
The Mean ◽  
Surgical Modality ◽  
Control Study

BACKGROUND Echinococcus granulosis is a parasitic infection most commonly involving the liver. Iran is a hyperendemic area for this disease according to WHO. Despite improvements in medical and interventional radiological techniques, surgery remains the gold standard of treatment; however evidence on different surgical modalities were explained. Considering the high population of referring patients presenting to Omid and Ghaem Hospitals, Mashhad, Iran, we decided to compare the complications of our modified technique with routine technique in hydatid cyst surgery. METHODS 56 patients with hydatid cyst of the liver who underwent modified and routine surgical treatment in Ghaem and Omid Hospitals Mashhad, Iran were studied during Aug 2013- Nov 2015. 27 patients underwent modified surgical technique, whereas the remaining 27 patients were treated by using routine surgical method. These two groups of patients were compared with each other according to their postoperative length of hospital stay and resulting complications. RESULTS The mean age of our patients was 41 years. 27 patients were male and 29 were female. Our results showed no statistically significant difference regarding the incidence of postoperative complications between the two groups. However, mean length of hospital stay was significantly different between the groups (4.5 ± 1.87 and 7.6 ± 2.25 days, respectively, p < 0.001). CONCLUSION The method of modified surgery with closed cyst drainage, which does not use external drains, is a safe surgical modality in the treatment of hydatid cyst disease of the liver if applied properly on appropriate patients.

Effect of Flap Selection on the Postoperative Success of Sacral Pressure Injuries: A Retrospective Analysis

2021 ◽  
Vol 33 (10) ◽  
pp. 271-276
Author(s):  
Serhat Şibar ◽  
Kemal Findikcioglu ◽  
Kirdar Guney ◽  
Serhan Tuncer ◽  
Suhan Ayhan
Keyword(s):  
Hospital Stay ◽  
Chronic Wounds ◽  
Length Of Hospital Stay ◽  
Long Term Results ◽  
Drain Removal ◽  
Significant Difference ◽  
Group 3 ◽  
The Mean ◽  
Group 2

Introduction. Pressure injuries (PIs) continue to be a substantial problem and burden for the present-day health care system and are the leading cause of chronic wounds worldwide. There is no current consensus on the long-term results of the use of flaps in sacral PI reconstruction and optimal flap choice. Objective. This study aimed to evaluate whether flap selection influences postoperative results in sacral PI reconstruction. Materials and Methods. Patients who underwent surgery for PIs in the authors’ clinic between 2002 and 2016 were retrospectively analyzed. A total of 63 patients with stage 3/stage 4 sacral PIs and who underwent reconstruction with fasciocutaneous (FC) flaps (group 1), musculocutaneous (MC) flaps (group 2), or perforator (P) flaps (group 3) were included in the study. The mean duration of the follow-up period was 14.4 months, and patients were evaluated in terms of their demographic data, length of hospital stay, complications, and recurrence. Results. The mean age, sex distribution, and ambulatory status were similar between the groups. In group 2 (MC), the mean length of hospital stay and mean drain removal time were significantly longer. The mean daily drainage amount was significantly higher in group 2 (MC) than in the other groups, and long-term relapses were less frequently observed in group 3 (P). A significant difference was observed between groups 2 (FC) and 3 (MC) in terms of wound dehiscence. The authors determined that P flaps were associated with a reduced mean length of hospital stay and daily drainage. Conclusions. For these patients, P flaps appear to be the optimal flap choice for sacral area reconstruction. However, new prospective randomized studies are needed to support these findings.

Preterm Infant Temperature Circadian Rhythm: Possible Effect of Parental Cosleeping

2002 ◽  
Vol 3 (3) ◽  
pp. 150-159 ◽  
Author(s):  
Karen A. Thomas ◽  
Robert Burr
Keyword(s):  
Circadian Rhythm ◽  
Confidence Interval ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Feeding Method ◽  
Abdominal Skin ◽  
Night Feeding ◽  
Stay Time ◽  
Postconceptional Age ◽  
The Mean

The purpose of this study was to describe the circadian rhythm of abdominal skin temperature and explore factors related to the timing of circadian rhythmacr ophase. Thirty-four preterminfants (gestational age 26 to 33 weeks) were studied in the home environment at 44 to 46 weeks postconceptional age. Insulated abdominal skin was monitored continuously, and parents recorded sleep/wake activity over a 24-h period. Circadian rhythmwas analyzed using cosinor analysis. Using MANCOVA, the effects of cosleeping, feeding method, night feeding, hospital stay, time home, and illness on acrophase were determined. Infants demonstrated evidence of developing circadian rhythmof temperature. Cosleeping and length of hospital stay were significantly related to acrophase. The mean acrophase for cosleeping infants was 07:44 (95% confidence interval = 05:12, 11:08), whereas that for non-cosleeping infants was 22.05 (95% confidence interval = 17:31, 01:42). Proximity with parents during nighttime hours may serve to entrain preterminfant circadian rhythm.

scholarly journals Retrospective Study of Three-port versus Standard Four-port Laparoscopic Cholecystectomy: A Single Surgical Unit Experience of 1456 Patients

2020 ◽  
Author(s):  
Vivek Srivastava ◽  
Mumtaz Ahmad Ansari ◽  
Vijay Kumar Shukla ◽  
Somprakas Basu
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Complications ◽  
Hospital Stay ◽  
Postoperative Period ◽  
Conversion Rate ◽  
Operating Time ◽  
Chronic Cholecystitis ◽  
Early Recovery ◽  
Significant Difference ◽  
The Mean

Introduction: Although laparoscopic surgeries have proven beyond doubt their benefit in terms of early recovery, better patient care and cost-effectiveness, the quest for reduction in either the size or number of ports still continues. Aim: To compare the safety, outcome, and advantages between three-port versus four-port Laparoscopic Cholecystectomy (LC) in acute and chronic cholecystitis. Materials and Methods: Medical records of 1456 patients that underwent LC (three- or four-port) for acute and chronic cholecystitis from January 2015 to December 2019 (60 months) were retrospectively analysed. All patients were given the same anaesthetic drugs for induction and maintenance, with standard anaesthetic protocol. The results were compared for both the techniques in terms of operating time, conversion rate, intraoperative complications, immediate postoperative complications, pain score, analgesic requirement and hospital stay. Results: Total 1456 patients underwent LC; 1282 were female and 174 were male. The mean age of the patients was 39.2 years (range 18-70 years). The three-port LC technique was performed on 816 (56.04%) patients, while the traditional four-port LC technique was performed on 640 (43.96%) patients. Visual Analog Score (VAS) in the postoperative period at six hour was 2.11±0.82 in three-port group versus 3.17±1.12 in four-port group, this suggests that there was a significant difference in pain in these two groups in the early postoperative period (p<0.001). In three-port group, the requirement of analgesic drug was significantly less as compared to four-port group (2.86±0.98 versus 3.22±0.87; p<0.001). There was no statistically significant difference in the mean operating time, duration of hospital stay, intra and postoperative complications, days to return to normal activity, satisfaction score and conversion rate (p=0.087, p=0.061, p=0.578, p=0.555, p=0.572 and p=0.145, respectively). Conclusion: Three-port LC is a feasible, effective and safe technique that further enhances the surgical outcome in terms of postoperative pain, fewer needs for analgesic medication.

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