scholarly journals Surgical treatment of liver echinococcosis

2021 ◽  
Vol 38 (3) ◽  
pp. 32-40
Author(s):  
M. F. Zarivchatskiy ◽  
I. N. Mugatarov ◽  
E. D. Kamenskikh ◽  
M. V. Kolyvanova ◽  
N. S. Teplykh
Keyword(s):  
Surgical Treatment ◽  
Liver Resection ◽  
Postoperative Complications ◽  
Hospital Stay ◽  
Average Length ◽  
Enzyme Linked Immunosorbent Assay ◽  
Percutaneous Puncture ◽  
Echinococcal Cyst ◽  
Duration Of Surgery ◽  
Methods Of Treatment

Objective. To improve the results of treatment of patients with liver echinococcosis and carry out a comparative assessment of techniques of surgical treatment depending on the nature of postoperative complications, hospital stay and antirecurrent efficacy. Materials and methods. The experience of complex examination and treatment of 65 patients with liver echinococcosis for the period of 1999-2019 was analyzed. Open echinococectomy was performed in 21 patients, atypical liver resection in 18 patients, anatomical liver resection in 14 patients, pericystectomy in 10, laparoscopic echinococectomy in 1, percutaneous puncture of an echinococcal cyst under ultrasound control in 1 patient. Results. The time of inpatient treatment of patients after open echinococectomy was 23.5 4.3 days, after pericystectomy 19.8 1.4 days, after liver resection 14.4 2.7 days, after laparoscopic echinococcectomy 6, after percutaneous puncture echinococcal cyst 7 days. Postoperative complications were observed in 52.4 % of patients who underwent open echinococectomy, in 20 % of patients after pericystectomy, and in 15.6 % after liver resection. There were no relapses of liver echinococcosis in all the groups. Mortality was 1.5 % and was recorded after open echinococectomy. Conclusions. The most effective techniques for preventing postoperative complications are pericystectomy and liver resection. The duration of surgery and the average length of hospital stay with minimally invasive methods of treatment are shorter. However, the use of these methods of treatment remains controversial due to the possibility of intra-abdominal spread of the parasite. Patients with parasitic liver cysts after surgical treatment are subjected to dynamic follow-up observation (ultrasound examination of the liver, enzyme-linked immunosorbent assay, computed tomography of the abdominal organs) after 3-6 months for at least 5 years.

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.

Treatment of the pilonidal sinus in children using laser radiation

2021 ◽  
Vol 24 (4) ◽  
pp. 32-36
Author(s):  
D. S. Zolotukhin ◽  
I. V. Krochek ◽  
S. V. Sergiyko
Keyword(s):  
Comparative Analysis ◽  
Surgical Treatment ◽  
Hospital Stay ◽  
Pain Syndrome ◽  
Surgical Excision ◽  
Duration Of Surgery ◽  
Invasive Method ◽  
Open Excision ◽  
Interstitial Thermotherapy ◽  
Late Postoperative Period

The work carried out a comparative analysis of the results of surgical treatment of the epithelial-coccygeal course of ECC in 133 children aged 3 to 17 years, using laser-induced interstitial thermotherapy (LIT) and open excision. Comparative analysis was carried out according to the following criteria: duration of surgery, average time of hospital stay, duration of pain syndrome on a 10-point scale (VAS), the presence of complications in the early and late postoperative period. In the main group, the average time of hospital stay was 4.9 ± 0.3; the duration of surgical treatment was 17.2 ± 2.8 minutes. The duration of the pain syndrome was 5.3 ± 2.1 hours, and its severity was 2.7 ± 0.8 points. Average terms of epithelialization of fistulas are 3.1 ± 2.8 days. Recurrence of ECC was observed in 7 patients (11.7%), which required re-intervention. In 3 (5.0%) patients, LIT was used, and in 4 (6.7%), excision using plastics according to the Bascom method. In the comparison group, the duration of surgical treatment was 32.6 ± 5.4 minutes. The duration of inpatient treatment is 16.7 ± 1.4 days. Pain syndrome averaged 71.8 ± 11.9 hours, severity 6.5 ± 2.3 points. The number of relapses was 9 (12.3%), of which 5 (6.8%) children underwent laser treatment, and 4 (5.5%) repeated surgical excision with Bascom with recovery. This technique is an effective and minimally invasive method for treating ECC, which makes it possible to recommend this method for use in pediatric surgical practice.

scholarly journals Effect of anaesthesia on the perioperative outcomes of pelvi-acetabular fracture surgeries in the apex trauma centre of a developing country–a retrospective analysis

2015 ◽  
Vol 3 ◽  
pp. 1-6
Author(s):  
Naveen Yadav ◽  
Suma Rabab Ahmad ◽  
Nisha Saini ◽  
Babita Gupta ◽  
Chhavi Sawhney ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Blood Loss ◽  
Hospital Stay ◽  
General Anaesthesia ◽  
Acetabular Fracture ◽  
Regional Anaesthesia ◽  
Trauma Centre ◽  
Intraoperative Blood Loss ◽  
Duration Of Hospital Stay ◽  
Duration Of Surgery

Abstract Background Regional anaesthesia has been proposed to reduce intraoperative blood loss, duration of hospital stay and in-hospital complications with improved postoperative pain control. General anaesthesia is advantageous for prolonged surgeries. We hypothesized that combined regional and general anaesthesia would offer advantages of both in pelvi-acetabular fracture surgeries. Methods We identified 71 patients who underwent open reduction and internal fixation of pelvi-acetabular fractures from May 2012 to 2013 in our trauma centre. We excluded patients with incomplete records (n = 4) and other injuries operated along (n = 8). Hence, 59 patients were divided into three groups: G group (general anaesthesia), R group (regional anaesthesia) and GR group (combined regional and general anaesthesia). Main outcome measurements studied were intraoperative blood loss, duration of hospital stay, duration of surgery and intraoperative and postoperative complications. Results No differences were obtained in between the groups in terms of age, gender, Injury Severity Score, number of comorbidities, or duration from injury to surgery. No significant differences were found between the three groups for intraoperative blood loss, days of hospital stay and duration of surgery. Intraoperative and postoperative complications were also comparable between the groups (p &gt; 0.05). Conclusions There is no specific significant advantage of the technique of anaesthesia on the observed perioperative complications in pelvi-acetabular fracture surgeries.

scholarly journals A comparative study of short term results of open haemorrhoidectomy and stapler haemorrhoidopexy

2017 ◽  
Vol 4 (10) ◽  
pp. 3358
Author(s):  
Chandrasekhar S. Neeralagi ◽  
Yogesh Kumar ◽  
Surag K. R. ◽  
Lakkanna Suggaiah ◽  
Preetham Raj
Keyword(s):  
Surgical Treatment ◽  
Postoperative Pain ◽  
Return To Work ◽  
Hospital Stay ◽  
Stapled Hemorrhoidopexy ◽  
Short Term ◽  
Post Operative Pain ◽  
Duration Of Surgery ◽  
Operative Complications ◽  
Post Operative Complications

Background: Haemorrhoids are the most common benign anorectal problems worldwide. Treatments of third and fourth degree hemorrhoids include surgical haemorrhoidectomy. Milligan Morgan haemorrhoidectomy (MMH) as described in 1937 has remained the most popular among many techniques proposed. In order to avoid the postoperative drawbacks of Milligan Morgan haemorrhoidectomy, a new surgical treatment for prolapsing haemorrhoids has been described by Longo in 1995, procedure called stapled haemorrhoidopexy which is associated with less postoperative pain and a quicker recovery. The objective of this study was to compare the short-term outcome between stapled hemorrhoidopexy and Milligan-Morgan hemorrhoidectomy.Methods: Prospective randomized study of 120 patients with grade 3 and grade 4 haemorrhoids requiring surgical treatment either MMH or SH, 60 in each group for the period of 18 months from June 2014 to November 2015. Post-operative pain, duration of surgery, duration of hospital stays, post-operative complications and time taken to return to work were compared with mean follow up period of 6 months.Results: Duration of surgery is significantly low in stapled group with P <0.001, duration of hospital stay is significantly low in stapled group with P <0.001, post-operative pain low in staple group with P <0.05, time taken to return to work is significantly early in stapled group with P <0.001. Post-operative complications incontinence not found in the present study but recurrence of two cases in each group noted.Conclusion: Stapled hemorrhoidopexy is associated with less postoperative pain, shorter duration of surgery and hospital stay, earlier return to work as compared with Milligan-Morgan open hemorrhoidectomy. The procedure is not associated with major post-operative complications.

Postoperative Complications After Distal Pancreatectomy Performed During Cytoreductive Surgery for Gynecologic Malignancies

2015 ◽  
Vol 25 (6) ◽  
pp. 1128-1133 ◽  
Author(s):  
Haider Mahdi ◽  
Peter G. Rose ◽  
Samantha Gonzalez ◽  
Robert DeBernardo ◽  
Jason Knight ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Hospital Stay ◽  
Distal Pancreatectomy ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Gynecologic Malignancies ◽  
Pancreatic Leak ◽  
Debulking Surgery ◽  
Perioperative Mortality ◽  
Time To Initiation

ObjectivesTo investigate the incidence of pancreatic leak and other postoperative complications after distal pancreatectomy performed during debulking surgery for gynecologic malignancies.MethodsAll patients who underwent distal pancreatectomy during their debulking surgery from 2010 to 2014 were identified. Postoperative complications within 30 days and pancreatic leak within 120 days after surgery were included.ResultsEighteen patients met the inclusion criteria. The median age was 62 years (36–78 years). Four patients (22%) were admitted to the intensive care unit, and the average length of hospital stay was 10 days. Nine patients developed postoperative complications within 30 days after surgery (50%) with no perioperative mortality up to 90 days after surgery. No patients required reexploration. The median time from surgery to initiation of chemotherapy was 39.5 days. Two patients developed pancreatic leak (11%). Among the patients who developed pancreatic leak, the average length of hospital stay was 11.5 days and time to initiation of chemotherapy was 75 days. Conservative management was successful in both cases.ConclusionIn this series, the rate of pancreatic leak was lower than previously reported with no perioperative mortality or surgical reexploration. However, the time to initiation of chemotherapy was delayed in those who developed pancreatic leak. These data are important in patient counseling and decision making at the time of debulking surgery. Gynecologic oncologists considering distal pancreatectomy should be familiar with perioperative management of these patients.

scholarly journals Laparoscopic Cholecystectomy Performed by Residents: A Retrospective Study on 569 Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Dario Pariani ◽  
Stefano Fontana ◽  
Giorgio Zetti ◽  
Ferdinando Cortese
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Retrospective Study ◽  
Postoperative Complications ◽  
Hospital Stay ◽  
Postoperative Hospital Stay ◽  
Daily Activities ◽  
Safe Procedure ◽  
Duration Of Surgery ◽  
Junior Residents

Introduction. Aim of this study was to evaluate the safety of laparoscopic cholecystectomy performed by residents.Materials and Methods. We retrospectively reviewed 569 elective laparoscopic cholecystectomies.Results. Duration of surgery was84±39min for residentsversus  66±47 min for staff surgeons,P<0.001. Rate of conversion was 3.2% for residentsversus2.7% for staff surgeons,P=0.7. There was no difference in the rates of intraoperative and postoperative complications for residents (1.2% and 3.2%)versusstaff surgeons (1.5% and 3.1%),P=0.7andP=0.9. Postoperative hospital stay was3.3±1.8days for residentsversus  3.4±3.2days for staff surgeons,P=0.6. One death in patients operated by residents (1/246) and one in patients operated by staff surgeons (1/323) were found,P=0.8. No difference in the time to return to normal daily activities between residents (11.3±4.2days) and staff surgeons (10.8±5.6days) was found,P=0.2. Shorter duration of surgery when operating the senior residents (75±31minutes) than the junior residents (87±27minutes),P=0.003.Conclusion. Laparoscopic cholecystectomy performed by residents is a safe procedure with results comparable to those of staff surgeons.

Hysterectomy by Vaginal Route: Not a Pressure

2017 ◽  
Vol 5 (1) ◽  
pp. 8-10
Author(s):  
Radha Vembu ◽  
Sithara Dharmalingam
Keyword(s):  
Postoperative Complications ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Rating Scale ◽  
Tertiary Care ◽  
Safe Procedure ◽  
Vaginal Route ◽  
Early Return ◽  
Duration Of Surgery ◽  
The Mean

ABSTRACT Introduction Vaginal route of hysterectomy is a safe procedure with less morbidity and hospital stay. So, there is a need to expand the indication for vaginal hysterectomy beyond uterovaginal prolapse. Aims To determine the feasibility and outcome of nondescent vaginal hysterectomy (NDVH) and to assess the pre- and postoperative complications, duration of surgery, and hospital stay. Materials and methods A prospective observational study was conducted between 2012 and 2014 at a tertiary care center. A total of 256 patients satisfying the selection criteria of hysterectomy for benign gynecological conditions, uterus size <16 weeks, and excluding stage IV endometriosis, genital tract malignancy, and uterine prolapse were included. The NDVH was performed by the standard technique, and the following parameters of age, parity, indication for surgery, duration of surgery, intraoperative and postoperative complications, and hospital stay were recorded. The data were analyzed using Statistical Package for the Social Sciences version 16.0 by frequency and percentage analysis and Chi-square test. Results All 256 patients were analyzed. The mean age was 44.4 ± 6.1 years; fibroid uterus was the commonest indication. About 89.4% had a uterine size ≤12 weeks and 59% had uterine volume <200 cm3. The mean duration of surgery was 83.5 ± 11.0 minutes; salpingo-oophorectomy was performed in 25.8% of the patients. Intraoperatively, 1.2% had bladder injury and 0.4% required conversion to laparotomy for pelvic hematoma. The mean duration of hospital stay was 4.9 ± 2.2 days, and the mean pain score in numerical rating scale pain scale was 3.0 ± 0.3. Intraoperative blood transfusion was required in 1.9% of the patients only. Conclusion The NDVH is a safe and feasible procedure for benign gynecological disorders. Clinical significance The NDVH is a boon in this techno-savvy era by reducing the morbidity and promising early return to work. How to cite this article Vembu R, Dharmalingam S. Hysterectomy by Vaginal Route: Not a Pressure. J South Asian Feder Menopause Soc 2017;5(1):8-10.

scholarly journals INCREASING SAFETY OF SURGICAL INTERVENTIONS IN PATIENTS WITH VENTRAL AND INCISIONAL HERNIA UNDER COMORBIDITY CONDITIONS WHEN PERFORMING DIFFERENT TYPES OF OPEN HERNIOPLASTY

2020 ◽  
pp. 135-139
Author(s):  
V. I. Piatnochka ◽  
I. Ya. Dziubanovskyi ◽  
A. M. Prodan
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Abdominal Wall ◽  
Ventral Hernia ◽  
Polypropylene Mesh ◽  
Immunosuppressive Agents ◽  
Technical Improvement ◽  
Surgical Interventions ◽  
Duration Of Surgery ◽  
Ventral Hernias

Abstract. In the period from 2001 to 2017, 1419 patients with ventral and postoperative ventral hernia were operated on. The unsatisfactory results of the surgical treatment of this pathology were due to a number of disadvantages: the choice of an inadequate method of hernioplasty in a specific clinical situation, an incomplete revision of the muscle-aponeurotic layer of the anterior abdominal wall, especially in patients with postoperative veterinary hernias, concomitant syndrome of undifferentiated connective tissue dysplasia and obesity, and weak points, the wrong choice of the type of mesh implant (“light” or “heavy” polypropylene mesh) and its size, the choice of an inappropriate type of suture material, as well as the high invasiveness of surgical intervention. Based on the given causes of complications in the operated patients with a high risk of their development, we have made a technical improvement of the existing methods of hernioplasty and development of new ones, which significantly reduced the number of postoperative complications and increased the safety of performing surgical interventions in patients with ventral and postoperative ventral hernia. Purpose. Based on the results of the analysis of surgical treatment of patients with comorbid conditions for primary and incisional ventral hernias to develop technical prerequisites for improving the safety of surgical interventions in this category of patients. Methods. Іn the period from 2001 to 2017, an in-depth comprehensive clinical-instrumental and laboratory examination of 1419 patients with primary ventral hernia (PVH) and postoperative ventral hernia (PVH) was conducted. The patients were divided into groups according to the periods of surgical treatment of patients. For this purpose, two periods were formed: from 2001 to 2009 and from 2010 to 2017. At the first period, 597 (42.07%) patients were examined and operated on. These patients formed a comparison group. The main group corresponding to patients who were treated in the period from 2010 to 2017 was 822 (57.93%) people. Results. Developed techniques for performing retromuscular allogernioplasty, which were based on controlled visualization of suturing when fixing polypropylene mesh to the posterior leaf of the vagina of the rectus muscle, allowed us to reliably and safely place and secure the implant in the retromuscular space, significantly reduce the trauma and duration of surgery. Kind of treatment using the mesh allograft with a liposomal complex with included antibacterial and immunosuppressive agents during the operation on the "onlay" method significantly reduced the number of local infectious complications. The location of the PRF membrane over the polypropylene mesh during retromuscular allogernioplasty improved neoangiogenesis at the mesh implantation site, increased fibroblast activity and the formation of collagen fibers around the mesh material, which provided maximum integration of the "light" abdominal wall with polypropylene tissue. Conclusion. These features of the dynamics of the used methods of surgical interventions and types of polypropylene nets with an individualized approach to each patient were reflected in a significant reduction in the number of both early local and general late postoperative complications, which improved the effectiveness of surgical treatment of patients with primary postoperative ventral hernias.

scholarly journals Our Experience in Epidural Analgesia Following Large Abdominal Surgeries.

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Nehat Bafti ◽  
R. Baftiu
Keyword(s):  
Liver Resection ◽  
Epidural Analgesia ◽  
Hospital Stay ◽  
Success Rate ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Neurological Complications ◽  
Post Operative Pain ◽  
Epidural Catheters ◽  
Dedicated Team

Background: Epidural analgesia is a gold standard in post-operative pain control in patients undergoing large abdominal interventions. Different studies report a failure ratio of epidural analgesia of 20-32%. The aim of this study is to analyze the success rate of epidural analgesia and its consequences in patients that have been subject to large abdominal surgeries. Materials and methods: We have prospectively collected the data of 50 patients that were subject to open abdominal surgeries during a 2 year timeframe (September 2015 – September 2017) at University Clinical Center of Kosovo. Experienced anesthesiologists inserted the epidural catheters. A dedicated team used the Verbal Scale to collect the data regarding post-operative pain during coughing or moving. The success rate of eidural catheter was measured in terms of: the scale of pain, pulmonary post-operative infection and length of hospital stay. Results: The study group included 33 males and 17 females, most of whom were subject to liver surgery. The secondary liver formations (70%), primary tumours (20%) as well as beningn liver disorders(10%) were an indication for liver resection. Large resections (≥3 segments) were completed in 44% of patients, small liver resections were (≤2 segments) completed in 48% of patients, while 8% of patients were considered inoperative. Epidural analgesia was successful in 46 patients (92%). Bacterial colonisation of the catheter was observed in only one case. There were no neurological complications. 5 (10%) patients showed radiologicalsigns of a pulmonary infection. Three patients (6%) had surgical wound infection. One patient died of hepatic insufficiency after massive right liver resection and cholecystectomy due to gallbladder carcinoma. The average length of hospital stay was 6 days. Conclusions: Our experience concludes that epidural analgesia is a safe and effective way of pain relief after abdominal surgeries.

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