scholarly journals Results of treatment of fifty children with persistent cloaca in one center

2021 ◽  
Vol 11 (3) ◽  
pp. 315-324
Author(s):  
Olga G. Mokrushina ◽  
Vasiliy S. Shumikhin ◽  
Marina V. Levitskaya ◽  
Madina A. Chundokova ◽  
Rashid V. Halafov ◽  
...  

BACKGROUND: The preserved cloaca is a particular type of anorectal anomaly. The combination of urological, genital, and rectal abnormalities makes radical reconstruction difficult. MATERIALS AND METHODS: This study examined operations performed in 50 patients with persistent cloaca treated from 2010 to 2021. Two groups are presented: the first with 35 children and a short canal (3 cm), and the second with 15 children and a long canal (3 cm). We examined the prognosis for bowel control, the type of operation, the need for vaginal reconstruction, complications after surgery, and the days of hospital stay. RESULTS: Anomalies of the Mllerian ducts in the second group (94%) were higher than in the first (36%) (p 0.001). The sacral index and myelodysplasia did not differ in both groups. The sacral index in the first group was 0.62 0.14, and in the second group, it was 0.58 0.14 (p = 0.520). Myelodysplasia in the first group was 33%, and in the second group, it was 38% (p = 0.744). Total urogenital mobilization (51%) was used in the first group, and abdominal reconstruction (54%) was used in the second group. Vaginal reconstruction was required in 28% of patients in the first group and 60% in the second group. Complications were 3.5 times more likely in the first group (60% versus 17% in the second) (p = 0.003). The length of hospital stay in patients in the second group was longer than that of patients in the first group. CONCLUSION: Our study data demonstrate that the reconstruction of a persistent cloaca requires individual planning of the operation, considering the length of the canal and the state of all structures forming the cloaca.

2018 ◽  
Vol 12 (6) ◽  
pp. 1665
Author(s):  
Denise Viana Rodrigues de Oliveira ◽  
João Pimenta ◽  
George Ximenes ◽  
Agueda Maria Ruiz Zimmer Cavalcante

RESUMOObjetivo: analisar os fatores de risco relacionados ao procedimento percutâneo por via radial e o tempo de permanência hospitalar. Método: estudo quantitativo, longitudinal, prospectivo, descritivo e unicêntrico. A coleta de dados foi realizada por meio de questionário, com 100 pacientes, em três fases (pré-procedimento, transprocedimento e pós-procedimento), em 24h e após sete dias. Para as variáveis quantitativas, foram utilizados os testes Mann-Whitnney ou t de Student; para as qualitativas, o teste exato de Fisher. Para a associação entre duas variáveis quantitativas, foi utilizado o coeficiente de correlação de Pearson com nível de significância ≤5%. Resultados: 100 pacientes realizaram o procedimento com média de internação de 6,6 dias. Após a associação entre o tempo de permanência e as variáveis clínicas, o p não mostrou valor significante. Conclusão: os resultados aproximam-se mais da realidade dos hospitais do Sistema Único de Saúde; não houve linearidade no tempo de permanência hospitalar quando associado a diferentes fatores relacionados à intervenção percutânea. Descritores: Intervenção Coronária Percutânea; Tempo de Internação; Artéria Radial; Sistema Único de Saúde; Síndrome Coronária Aguda; Fatores de Risco.ABSTRACTObjective: to analyze the risk factors related to the percutaneous radial procedure and length of hospital stay. Method: quantitative, longitudinal, prospective, descriptive and unicentric study. Data was collected through a questionnaire, with 100 patients, in three phases (pre-procedure, transprocedure and post-procedure), in 24 hours and after seven days. For the quantitative variables, the Mann-Whitnney or Student's t tests were used; for the qualitative, Fisher's exact test. For the association between two quantitative variables, the Pearson correlation coefficient was used with significance level ≤5%. Results: 100 patients had the procedure with mean hospitalization of 6.6 days. After the association between the length of stay and clinical variables, p did not show significant value. Conclusion: the results are closer to the reality of the hospitals of the Unified Health System; there was no linearity in the length of hospital stay when associated with different factors related to the percutaneous intervention. Descriptors: Percutaneous Coronary Intervention; Length of hospitalization; Radial Artery; Unified Health System; Acute Coronary Syndrome; Risk Factors.RESUMEN Objetivo: analizar los factores de riesgo relacionados con el procedimiento percutáneo por vía radial y el tiempo de permanencia hospitalaria. Método: Estudio cuantitativo, longitudinal, prospectivo, descriptivo y unicéntrico. La recolección de datos fue realizada por medio de un cuestionario, con 100 pacientes, en tres fases: (pre-procedimiento, transprocedimiento y post-procedimiento), en 24h y después de siete días. Para las variables cuantitativas, se utilizaron las pruebas Mann-Whitnney o t de Student; para las cualitativas, la prueba exacta de Fisher. Para la asociación entre dos variables cuantitativas, se utilizó el coeficiente de correlación de Pearson con nivel de significancia ≤5 %%. Resultados: 100 pacientes realizaron el procedimiento, con promedio de internación de 6,6 días. Después de la asociación entre el tiempo de permanencia y las variables clínicas, el p no mostró valor significativo. Conclusión: los resultados se acercaron más a la realidad de los hospitales del Sistema Único de Salud; no hubo linealidad en el tiempo de permanencia hospitalaria, cuando asociado a diferentes factores relacionados a la intervención percutánea. Descriptores: Intervención Coronaria Percutánea; Tiempo de Internación; Arteria Radial; Sistema Único de Salud; Síndrome Coronária Aguda; Factores de Riesgo.


New Medicine ◽  
2019 ◽  
Vol 23 (2) ◽  
Author(s):  
Tomasz Lis ◽  
Lidia Zawadzka-Głos

Introduction. Adenoidectomy and adenotonsillotomy are among the most common surgical procedures worldwide. Sleep-related breathing disorders and recurrent upper respiratory tract infections are two primary categories of indications for adenoidectomy and adenotonsillotomy. Aim. The aim of this study was to analyse selected adenoidectomy and adenotonsillotomy procedures performed in the Department of Paediatric Otorhinolaryngology of the Medical University of Warsaw in 2018. Material and methods. A total of 474 patients aged between 11 months and 18 years, who underwent adenoidectomy and adenotonsillotomy in the Department of Paediatric Otorhinolaryngology of the Medical University of Warsaw in 2018, were included in the study. Data on age, gender, length of hospital stay, as well as additional diagnoses in adenoid hypertrophy or adenoid and palatine tonsil hypertrophy were collected. Minor surgeries performed in addition to tonsillectomy were also evaluated. Results. A total of 472 patients underwent adenoidectomy and adenotonsillotomy in 2018. Adenotonsillotomy was almost twice more common. Tonsillar hypertrophy was accompanied by exudative otitis media in almost 1/3 of children, and ear ventilation tubes were needed in almost 1/5 of children. Mean hospital stay equaled 4.19 ± 1.44 days. Conclusions. We have shown that adenotonsillotomy was the most common procedure in the Department of Paediatric Otorhinolaryngology. Exudative otitis media was the most common concomitant diagnosis, and middle ear ventilation was the most common additional procedure. Hospital stay usually lasted 3 days.


2017 ◽  
Vol 2017 ◽  
pp. 1-10
Author(s):  
Gladys Amponsah ◽  
Alice Charwudzi

Introduction. Several studies suggest that preoperative anaemia (PA) is associated with adverse postoperative outcomes, but little is known about these outcomes in the Central Region of Ghana. This study aims to determine the prevalence of PA among noncardiac surgical patients and its implications for their postoperative outcomes.Methods. This study was designed as an observational study; data including demographics and clinical and laboratory results were collected from the patients’ records and through interviews.Results. A total of 893 inpatient surgical cases undergoing elective and emergency operations, aged 15 years and above with mean age of 44.2 ± 17.0 yrs, were enrolled. The prevalence of PA was 54.3%, mostly microcytic with or without hypochromia (57.2%). The prevalence was higher in females than males (p≤0.001). Preoperative anaemia was significantly associated with prolonged length of hospital stay (OR: 2.12 (95% CI: 1.49–3.10)). Allogeneic blood transfusion significantly prolonged the length of hospital stay (OR 4.48 (95% CI: 2.67–7.51)). 15.5% of the anaemic patients received oral iron supplements compared to 2.2% of nonanaemic patients (p≤0.001).Conclusion. Preoperative anaemia is common among noncardiac surgical patients. It is independently and significantly associated with prolonged hospital stay leading to the use of increased healthcare resources. It is also the main predictor for perioperative allogeneic blood transfusions and the use of haematinics.


Swiss Surgery ◽  
2002 ◽  
Vol 8 (6) ◽  
pp. 255-258 ◽  
Author(s):  
Perruchoud ◽  
Vuilleumier ◽  
Givel

Aims: The purpose of this study was to evaluate excision and open granulation versus excision and primary closure as treatments for pilonidal sinus. Subjects and methods: We evaluated a group of 141 patients operated on for a pilonidal sinus between 1991 and 1995. Ninety patients were treated by excision and open granulation, 34 patients by excision and primary closure and 17 patients by incision and drainage, as a unique treatment of an infected pilonidal sinus. Results: The first group, receiving treatment of excision and open granulation, experienced the following outcomes: average length of hospital stay, four days; average healing time; 72 days; average number of post-operative ambulatory visits, 40; average off-work delay, 38 days; and average follow-up time, 43 months. There were five recurrences (6%) in this group during the follow-up period. For the second group treated by excision and primary closure, the corresponding outcome measurements were as follows: average length of hospital stay, four days; average healing time, 23 days; primary healing failure rate, 9%; average number of post-operative ambulatory visits, 6; average off-work delay, 21 days. The average follow-up time was 34 months, and two recurrences (6%) were observed during the follow-up period. In the third group, seventeen patients benefited from an incision and drainage as unique treatment. The mean follow-up was 37 months. Five recurrences (29%) were noticed, requiring a new operation in all the cases. Discussion and conclusion: This series of 141 patients is too limited to permit final conclusions to be drawn concerning significant advantages of one form of treatment compared to the other. Nevertheless, primary closure offers the advantages of quicker healing time, fewer post-operative visits and shorter time off work. When a primary closure can be carried out, it should be routinely considered for socio-economical and comfort reasons.


2014 ◽  
Vol 155 (51) ◽  
pp. 2028-2033 ◽  
Author(s):  
Judit Hallay ◽  
Dániel Nagy ◽  
Béla Fülesdi

Malnutrition in hospitalised patients has a significant and disadvantageous impact on treatment outcome. If possible, enteral nutrition with an energy/protein-balanced nutrient should be preferred depending on the patient’s condition, type of illness and risk factors. The aim of the nutrition therapy is to increase the efficacy of treatment and shorten the length of hospital stay in order to ensure rapid rehabilitation. In the present review the authors summarize the most important clinical and practical aspects of enteral nutrition therapy. Orv. Hetil., 2014, 155(51), 2028–2033.


Author(s):  
Dr.Randa Mohammed AboBaker

Postoperative Ileus (POI) is one of the most common problems after obstetrics, gynecologic and abdominal surgeries. Sham feeding, such as gum chewing, accelerates the return of bowel function and the length of hospital stay. The present study aims to evaluate the effect of chewing gum on bowel motility in women undergoing post-operative cesarean section. Intervention study was used at the Postpartum Department of Maternity and Children Hospital, KSA. A randomized controlled clinical trial research design. Through a convenience technique, 80 post Caesarian Section (CS) women were included in the study. Data were collected through three tools: Tool (I): Socio-demographic data and reproductive history interview schedule. Tool (II): Postoperative Assessment Sheet. Tool (III): Outcomes of gum chewing and the length of hospital stay.  Method: subjects were assigned randomly into two groups of (40) the experimental and (40) the control. Subjects in the study group were asked to chew two pieces of sugarless gum for 30 min/three times daily in the morning, noon, and evening immediately after recovery from anesthesia and in Postpartum Department; while subjects in the control group followed the hospital routine care. Each woman in both groups was tested abdominally using a stethoscope to auscultate the bowel sounds and asked to report immediately the time of either passing flatus or stool. Results: illustrated that a highly statistically significant difference was observed between the two groups concerning their gum chewing outcomes. Where, P = 0.000. The study concluded that gum chewing is safe, well tolerated and appears to be effective in reducing the incidence and consequences of POI following CS.


2013 ◽  
Vol 22 (02) ◽  
pp. 160-163 ◽  
Author(s):  
Christopher A. Brown ◽  
Steven Olson ◽  
Robert Zura

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