scholarly journals LESSONS LEARNED ANALYZING COMPLICATIONS AFTER LAPAROSCOPIC TOTAL GASTRECTOMY FOR GASTRIC CANCER

2020 ◽  
Vol 33 (3) ◽  
Author(s):  
Italo BRAGHETTO ◽  
Enrique LANZARINI ◽  
Maher MUSLEH ◽  
Luis GUTIÉRREZ ◽  
Juan Carlos MOLINA ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Total Gastrectomy ◽  
Postoperative Mortality ◽  
Laparoscopic Total Gastrectomy ◽  
Lessons Learned ◽  
Medical Complications ◽  
Inclusion Criteria ◽  
Duodenal Stump ◽  
Exclusion Criteria ◽  
The Relationship

ABSTRACT Background: Laparoscopic surgery has been gradually accepted as an option for the surgical treatment ofgastric cancer. There are still points that are controversial or situations that are eventually associated with intra-operative difficulties or postoperative complications. Aim: To establish the relationship between the difficulties during the execution of total gastrectomy and the occurrence of eventual postoperative complications. Method: The operative protocols and postoperative evolution of 74 patients operated for gastriccancer, who were subjected to laparoscopic total gastrectomy (inclusion criteria) were reviewed. The intraoperative difficulties recorded in the operative protocol and postoperative complications of a surgical nature wereanalyzed (inclusion criteria). Postoperative medical complications were excluded (exclusion criteria). For the discussion, an extensive bibliographical review was carried out. Results: Intra-operative difficulties or complications reported correspond to 33/74 and of these; 18 events (54.5%) were related to postoperative complications and six were absolutely unexpected. The more frequent were leaks of the anastomosis and leaks of the duodenal stump; however, other rare complications were observed. Seven were managed with conservative measures and 17 (22.9%) required surgical re-exploration, with a postoperative mortality of two patients (2.7%). Conclusion: We have learned that there are infrequent and unexpected complications; the treating team must be mindful of and, in front of suspicion of complications, anappropriate decision must be done which includes early re-exploration. Finally, after the experience reported, some complications should be avoided.

Risk factors associated with early postoperative complications following laparoscopic total gastrectomy: Experience from the Chinese Laparoscopic Gastrointestinal Surgery Study (CLASS) group.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15544-e15544
Author(s):  
Jingdong Liu ◽  
Haojie Li ◽  
Gang Zhao ◽  
Zekuan Xu ◽  
Guoxin Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Postoperative Complications ◽  
Total Gastrectomy ◽  
Multivariable Analysis ◽  
Laparoscopic Total Gastrectomy ◽  
Morbidity And Mortality ◽  
Reconstruction Method ◽  
Factors Associated ◽  
Early Postoperative Complications

e15544 Background: The incidence rate of proximal gastric cancer has been rising steadily, and laparoscopic total gastrectomy (LTG) has been widely adopted. However, the safety of LTG still lacks solid evidence to prove. The aim of this study was to evaluate morbidity and mortality of LTG, and determine the risk factors associated with early postoperative complications. Methods: A retrospective multicenter study was carried out in China, and medical records of 109 gastric cancer patients receiving LTG during September 2014 and June 2016 were retrieved from the database. Patient characteristics, surgical outcomes, and postoperative morbidities and mortalities were analyzed. Results: Morbidity and mortality rates were 22.0% and 0% respectively. Pulmonary infection (13.8%, n = 15) was the most common complication. Most complications were grade II (15.5%, n = 17) according to the Clavien-Dindo classification. Multivariable analysis identified comorbidity, type of reconstruction method (TLTG) were independent risk factors of early postoperative complications. Comorbidity was the only independent risk factor of complications graded more than II. Diabetes mellitus was found correlated with surgical complication in subgroup analysis. Conclusions: LTG is safe and technically feasible in treating gastric cancer. Careful selection of patients without comorbidity and applying laparoscopy-assisted total gastrectomy instead of totally laparoscopic total gastrectomy may decrease postoperative complications.

scholarly journals Relation between Attachment and Obesity in Preschool Years: A Systematic Review of the Literature

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3572
Author(s):  
Ana F. Santos ◽  
Mariana C. Martins ◽  
Carla Fernandes ◽  
Kelly K. Bost ◽  
Manuela Veríssimo
Keyword(s):  
Empirical Studies ◽  
Intervention Programs ◽  
Inclusion Criteria ◽  
Exclusion Criteria ◽  
Cross Sectional ◽  
Effective Prevention ◽  
Attachment Quality ◽  
Underlying Mechanisms ◽  
The Relationship

Increasing evidence suggests that attachment plays an important role in obesity. However, few studies examined this relationship in preschool children. This study aimed to systematically examine the empirical, peer-reviewed evidence regarding the relationship between attachment quality and obesity in the preschool years. Using established guidelines, relevant peer-reviewed literature published between 2000 and July 2021 was searched through EBSCO. This yielded a total of 1124 records for review. Established inclusion criteria comprised: empirical studies published in peer-review journals; include at least one anthropometric measure and/or food consumption measure. Exclusion criteria comprised: attachment measures not following Bowlby-Ainsworth conceptualization of the construct; children in institutionalized settings; context of severe mental illness, documented substance use disorders, or eating disorders; include only a measure of the psychological aspects of eating; intervention programs. After exclusions, eight studies with a total of 9225 participants met the inclusion criteria. Results support the role of attachment in weight-related outcomes, suggesting that considering attachment in the risk of obesity could contribute to the elaboration of effective prevention and intervention programs. Limitations included the small number of studies, predominately cross-sectional designs, the diversity of methodologies, most samples not including fathers, and lack of evidence about the developmental mechanisms underlying the association between attachment and obesity. More evidence is needed to determine how attachment and obesity are linked, and the potential underlying mechanisms accounting for this relationship.

scholarly journals Textbook outcome and survival of robotic versus laparoscopic total gastrectomy for gastric cancer: a propensity score matched cohort study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Chul Kyu Roh ◽  
Soomin Lee ◽  
Sang-Yong Son ◽  
Hoon Hur ◽  
Sang-Uk Han
Keyword(s):  
Gastric Cancer ◽  
Survival Rate ◽  
Propensity Score ◽  
Total Gastrectomy ◽  
Postoperative Mortality ◽  
Laparoscopic Total Gastrectomy ◽  
Relapse Free Survival ◽  
Negative Resection Margin ◽  
Intraoperative Complication ◽  
Free Survival

AbstractTextbook outcome is a composite quality measurement of short-term outcomes for evaluating complex surgical procedures. We compared textbook outcome and survival of robotic total gastrectomy (RTG) with those of laparoscopic total gastrectomy (LTG). We retrospectively reviewed 395 patients (RTG, n = 74; LTG, n = 321) who underwent curative total gastrectomy for gastric cancer via minimally invasive approaches from 2009 to 2018. We performed propensity score matched analysis to adjust for potential selection bias. Textbook outcome included a negative resection margin, no intraoperative complication, retrieved lymph nodes > 15, no severe complication, no reintervention, no unplanned intensive care unit admission, hospitalization ≤ 21 days, no readmission after discharge, and no postoperative mortality. Survival outcomes included 3-year overall and relapse-free survival rates. After matching, 74 patients in each group were selected. Textbook outcome was similar in the RTG and LTG groups (70.3% and 75.7%, respectively), although RTG required a longer operative time. The quality metric least often achieved was the presence of severe complications in both groups (77.0% in both groups). There were no differences in the 3-year overall survival rate (98.6% and 89.7%, respectively; log-rank P = 0.144) and relapse-free survival rate between the RTG and LTG groups (97.3% and 87.0%, respectively; log-rank P = 0.167). Textbook outcome and survival outcome of RTG were similar to those of LTG for gastric cancer.

scholarly journals Puppets in the Development of Communicative Competencies in Elementary School Students

2021 ◽  
Vol 12 (6) ◽  
pp. 2439-2446
Author(s):  
Lina Veronica Yanac-Leon, Juan Mendez Vergaray, Edward Flores
Keyword(s):  
Systematic Review ◽  
Elementary School Students ◽  
Communication Skills ◽  
Research Articles ◽  
Inclusion Criteria ◽  
School Students ◽  
Exclusion Criteria ◽  
Communicative Skills ◽  
Quantitative Studies ◽  
The Relationship

The objective of this systematic review is to analyze the relationship between the use of puppets in the development of communication skills in children. Methodology: 20 articles obtained from the Scopus, EBSCO, Dialnet, Redalyc databases during the months of January and February of this year were used for the research; the study was carried out using the Prisma methodology; the inclusion criteria were research articles, systematic reviews and quantitative studies that addressed the relationship between puppets and communicative skills, and as exclusion criteria: those that did not collect the necessary data for the study, that is, with methodological deficiencies, or those that were not directly related to the categories. Results: 160 documents, 150 articles and 10 theses were reviewed, and 114 research studies were selected after eliminating duplicates, having been excluded 36 articles and 26 theses that did not respond to the categories and methodology; likewise, the evaluation of 32 full-text articles was determined, of which 32 studies were excluded for not meeting the inclusion criteria; and 11 articles and 9 theses were used in the study. Conclusion: It was found that there is a cause-effect relationship between puppets and communicative competencies, insofar as they favor attention and motivation to communicate children's thoughts, feelings and ideas.

scholarly journals Textbook outcome and survival of robotic versus laparoscopic total gastrectomy for gastric cancer: A propensity score matched cohort study

2021 ◽  
Author(s):  
Chul Kyu Roh ◽  
Soomin Lee ◽  
Sang-Yong Son ◽  
Hoon Hur ◽  
Sang-Uk Han
Keyword(s):  
Gastric Cancer ◽  
Survival Rate ◽  
Propensity Score ◽  
Total Gastrectomy ◽  
Postoperative Mortality ◽  
Laparoscopic Total Gastrectomy ◽  
Relapse Free Survival ◽  
Negative Resection Margin ◽  
Intraoperative Complication ◽  
Free Survival

Abstract Introduction Textbook outcome is a composite quality measurement of short-term outcomes for evaluating complex surgical procedures. We compared textbook outcome and survival of robotic total gastrectomy(RTG) with those of laparoscopic total gastrectomy(LTG).Methods We retrospectively reviewed 395patients(RTG,n = 74;LTG,n = 321) who underwent curative total gastrectomy for gastric cancer via minimally invasive approaches from 2009 to 2018. We performed propensity score matched analysis to adjust for potential selection bias. Textbook outcome included a negative resection margin, no intraoperative complication, retrieved lymph nodes > 15, no severe complication, no reintervention, no unplanned intensive care unit admission, hospitalisation ≤ 21days, no readmission after discharge, and no postoperative mortality. Survival outcomes included 5-year overall and relapse-free survival rates.Results After matching, 74patients in each group were selected. Textbook outcome was similar in the RTG and LTG groups(70.3% and 75.7%,respectively), although RTG required a longer operative time. The quality metric least often achieved was the presence of severe complications in both groups(77.0% in both groups). There were no differences in the 5-year overall survival rate(90.7% and 85.9%,respectively;log-rank P = 0.144) and relapse-free survival rate between the RTG and LTG groups(89.5% and 85.2%,respectively;log-rank P = 0.167).Conclusion Textbook outcome and survival outcome of RTG were comparable to those of LTG for gastric cancer.

Immediate results of pneumonectomy in the complex treatment of patients with destructive pulmonary tuberculosis

MedAlliance ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 54-65
Keyword(s):  
Postoperative Complications ◽  
Pulmonary Tuberculosis ◽  
Drug Sensitivity ◽  
Early Postoperative Period ◽  
P Value ◽  
Comprehensive Treatment ◽  
Inclusion Criteria ◽  
Exclusion Criteria ◽  
X Ray ◽  
Surgical Methods

Introduction. Currently, surgical methods in the compre-hensive treatment of patients with pulmonary tuberculosis remain in demand all over the world. Among them, pneu-monectomy is performed in 10.3–21.8% of cases and is of-ten accompanied by various postoperative complications.Objective. Study of the immediate results of pneu-monectomy in the comprehensive treatment of patients with destructive pulmonary tuberculosis.Material and methods. A continuous retrospective study was carried out in 2012 through 2017. Inclusion criteria: pa-tients between 18 and 75 years; diagnosis verified by cul-ture technique; total destructive lesion of one of the lungs; chemotherapy for at least 6 months, taking into account the data on MTB drug sensitivity. Exclusion criteria: pre-sence of a destructive lesion in the contralateral lung. 129 patients were enrolled into the study. Patients’ sex, age, duration of the disease, complications of pulmonary tuber-culosis before surgery, MTB drug sensitivity, bacterial shed-ding, X-ray changes, respiratory function, lung perfusion, comorbidity and degree of activity of a specific process were studied, as well as the characteristics of surgical inter-ventions, intraoperative and postoperative complications. Postoperative complications were assessed in accordance with TM&M classification. Differences between groups were determined using the χ2 test. A p value less than 0.05 was considered to be statistically significant.Results. Complications in the early postoperative period developed in 52 (40.4%) patients; 26 (20.2%) patients had minor complications, 26 (20.2%) major ones. In postope-rative period 1 (0.8%) patient died. Postoperative compli-cations were eliminated in 125 (96.9%) patients. Among bacillary patients, bacterial shredding ceased in 80 (91%). Satisfactory immediate result was achieved in 120 (93%) patients, unsatisfactory, in 9 (7%). In the group of patients with major postoperative complications there were sig-nificantly more patients with a disease duration of more than 36 months, as well as those with HCV infection and MDR/XDR MTB (p<0.05).Conclusion. Pneumonectomy is a highly effective opera-tion in the comprehensive treatment of patients with uni-lateral destructive pulmonary tuberculosis

scholarly journals The Influence of Anaesthetic Choice on Electroconvulsive Therapy Parameters; Etomidate Versus Methohexital

2021 ◽  
Author(s):  
Laila Chomrikh¹ ◽  
Mustafa Ahmadi ◽  
Martijn Kuijper ◽  
Joris J.B. Van der Vlugt ◽  
Seppe J.H.A. Koopman
Keyword(s):  
Electroconvulsive Therapy ◽  
Drug Dosage ◽  
Negative Association ◽  
Inclusion Criteria ◽  
Exclusion Criteria ◽  
Seizure Duration ◽  
The Mean ◽  
Number Of Treatment ◽  
Relationship Of ◽  
The Relationship

Abstract Background Many of the anaesthetic drugs used for electroconvulsive therapy have anticonvulsant properties and may influence efficacy of electroconvulsive therapy. With this study we aim to provide more information on the effect of etomidate and methohexital on seizure duration. We explore the relationship between induction drug, motor and electroencephalography seizure duration. Moreover, we study the relationship of seizure duration and number of therapies. Methods In this retrospective study we collected data from patient records from 2005 until 2016. Inclusion criteria were the use of etomidate and/or methohexital and documentation of dosage, electroconvulsive therapy dosage and seizure duration. Exclusion criteria were missing data on either induction drug, dosage or seizure duration. Results Thirty seven patients were analysed. The mean age was 52 years and seventy six percent were female. Most patients were suffering from affective disorders (81%). Motor and electroencephalography seizure duration were analysed in 679 and 551 electroconvulsive therapies, respectively. Compared to methohexital, motor and electroencephalography seizures under etomidate were 7 and 13 seconds longer, respectively. Furthermore, there was a negative association between seizure duration and number of treatment and a negative association between seizure duration and electroconvulsive therapy dosage. Conclusions This study demonstrates significant longer motor and electroencephalography seizure duration using etomidate compared to methohexital. Etomidate might therefore increase the effectiveness of electroconvulsive therapy. Moreover, we observed a negative association between seizure duration, number of treatment and electroconvulsive therapy dosage. With this study we contribute to the available literature comparing methohexital and etomidate as induction agents for electroconvulsive therapy.

Terson sign:

2020 ◽  
Vol 2 (1) ◽  
pp. 38-43
Author(s):  
Luiz Severo Bem Junior ◽  
Gustavo De Souza Andrade ◽  
Joao Ribeiro Memória Júnior ◽  
Hildo Rocha Cirne de Azevedo Filho
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Early Recognition ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Case Reports ◽  
Clinical Status ◽  
Vitreous Hemorrhage ◽  
Anterior Communicating Artery ◽  
Inclusion Criteria ◽  
Relationship Of ◽  
The Relationship

Terson's sign (TS) is classically defined as vitreous hemorrhage associated with subarachnoid hemorrhage of aneurysmal origin, being an important predictor of severity, indicating greater morbidity and mortality when compared to patients without the sign. The objective of this study is to review the relationship of Terson syndrome/Terson sign with the prognosis of aneurysmal subarachnoid hemorrhage. A search for original articles, research and case reports was performed on the PubMed, Scielo, Cochrane and ScienceDirect platform, with the following descriptors: Terson sign and subarachnoid hemorrhage. Retrospective, prospective articles and case reports published in the last 5 years and which were in accordance with the established objective and inclusion criteria were selected. Ten (10) articles were selected, in which the available results show an unfavorable prognostic relationship of TS and subarachnoid hemorrhage, because these patients had a worse clinical status assessed on the Glasgow scales ≤ 8, Hunt & Hess > III, Fisher > 3, in addition to intracranial hypertension and location of the aneurysm in the anterior communicating artery complex. The early recognition of this condition described by Albert Terson in 1900 brought an important contribution to neurosurgery, being recognized until nowadays.

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