scholarly journals Study of route of hysterectomy

2018 ◽  
Vol 8 (1) ◽  
pp. 243
Author(s):  
Dolly Gupta ◽  
Kavita Chandnani
Keyword(s):  
Complication Rate ◽  
Operating Time ◽  
Normal Diet ◽  
Wound Complications ◽  
Patient Profile ◽  
Early Return ◽  
Ureteral Injuries ◽  
Lower Complication ◽  
Lower Complication Rate ◽  
A Prospective Study

Background: The objective is to study complication rate, advantages and outcome of different route of hysterectomy.Methods: A prospective study of 175 women over a period of 1 year i.e. from 01/01/2011 to 31/12/2011 SSG hospital, Vadodara. Depending on the patient profile, experience of surgeon optimum route of hysterectomy was decided.Results mean operating time in AH group was 68.4±14.4min, which was 80±10.3min, 115.8±40.6min and 148.8±25.5min in NDVH, LAVH and TLH group respectively. TLH was performed by consultants. Febrile morbidity was significantly high in AH (23%). Bladder and ureteral injuries were seen in 4% and 3% cases of NDVH and AH group. Wound complications were seen in AH (10%), whereas vault complications were higher in TLH. The hospital stay was shortest in TLH. Women with TLH had early ambulation, early resumption to normal diet, early return to routine work and better sexual function.Conclusions: Women with excessively enlarged uteri, significant pelvic pathology, or cancer are obvious candidates for AH. On the other hand, VH is frequently chosen for the small uterus in a multiparous woman with a large pelvis and no prior pelvic inflammatory disease or surgery. Although TLH, LAVH have significantly lower complication rate than AH, but overall cost is higher owing to the high operating room charges. The final selection of hysterectomy route should be based on surgeon’s experience and indication for surgery.

Impact of the Use of Bowel for Urinary Diversion on Perioperative Complications and 90-Day Mortality in Patients Aged 75 Years or Older

2015 ◽  
Vol 94 (4) ◽  
pp. 394-400 ◽  
Author(s):  
Ingrid Berger ◽  
Clemens Wehrberger ◽  
Anton Ponholzer ◽  
Martina Wolfgang ◽  
Thomas Martini ◽  
...  
Keyword(s):  
Multicentre Study ◽  
Urinary Diversion ◽  
Complication Rate ◽  
Perioperative Complications ◽  
Operating Time ◽  
The Elderly ◽  
Wound Complications ◽  
Consecutive Series ◽  
Lower Complication ◽  
Muscle Invasive

Objective: A potential strategy to decrease the high complication rate of radical cystectomy (RC) in the elderly is to avoid the use of bowel for urinary diversion. The aim of this study was to address this issue in a multicentre study of patients aged ≥75 years. Patients and Methods: We performed a retrospective, multicentre study of a consecutive series of patients aged ≥75 years who underwent RC for muscle-invasive bladder cancer between 2006 and 2010. Medical, surgical and wound complications were graded according to the modified Clavien-Dindo classification. Results: A total of 256 patients (68% men, mean age 79.6 years) were analysed. 204 (80%) patients received a urinary diversion with use of bowel and 52 (20%) a ureterocutaneostomy (UC). Patients with UC were older (82.0 vs. 78.9 years, p < 0.001) and had a higher ASA score (2.6 vs. 2.3, p = 0.007), while the mean Charlson score was lower (4.2 vs. 5.6, p < 0.001). Patients with UC had a shorter operating time (279 vs. 311 min, p = 0.002) and a shorter period in the intensive care unit (0.9 vs. 2.2 days). The overall rate of severe complications graded as Clavien III-V was significantly lower in the UC group (11.5%) as compared to patients receiving bowel for urinary diversion (25.0%) (p = 0.003). Severe (Clavien grade III-V) medical (3.9 vs. 10.3%) and surgical (2.1 vs. 14.1%) complications were all less frequent in the UC group. Inpatient, 30- and 90-day mortality was 5.8, 7.7 and 17.3% in the UC group as compared to 3.9, 5.9 and 6.9% in the bowel cohort, respectively. Conclusion: UC following RC is associated with a lower complication rate in geriatric patients. The constantly increasing cohort of geriatric, multimorbid patients requiring cystectomy might justify reconsideration of this form of diversion.

Conventional Detachment Surgery in Rhegmatogenous Retinal Detachment; Indications and Techniques

2019 ◽  
pp. 187-196
Keyword(s):  
Retinal Detachment ◽  
Complication Rate ◽  
Rhegmatogenous Retinal Detachment ◽  
Subretinal Fluid ◽  
Scleral Buckling ◽  
Conventional Surgery ◽  
Surgical Method ◽  
Retinal Detachment Surgery ◽  
Lower Complication ◽  
Lower Complication Rate

Conventional surgery with a lower complication rate is recommended in cases of rhegmatogenous retinal detachment. Conventional retinal detachment surgery is still an appropriate technique for the treatment of most of the cases with rhegmatogenous retinal detachment even today. The main steps of the conventional retinal detachment surgeries are cryopexy, scleral buckling, encircling, and removal of subretinal fluid. Successful results have been reported in this surgical method in uncomplicated cases. This review mentions about the conventional detachment surgery in the main aspects.

scholarly journals Evaluation of the complications in laparoscopic retroperitoneal radical nephrectomy; An experience of high volume centre

2017 ◽  
Vol 89 (4) ◽  
pp. 266 ◽  
Author(s):  
Ali Serdar Gozen ◽  
Vitalie Gherman ◽  
Yigit Akin ◽  
Mustafa Suat Bolat ◽  
Muhammad Elmussareh ◽  
...  
Keyword(s):  
Learning Curve ◽  
Complication Rate ◽  
Radical Nephrectomy ◽  
High Volume ◽  
Safe Procedure ◽  
Number Of Patients ◽  
Lower Complication ◽  
Lower Complication Rate ◽  
Group A ◽  
Group B

Objectives: To provide a standardised report of complications after retroperitoneal laparoscopic radical nephrectomy (rLRN) in a high-volume centre using Clavien-Dindo classification. Materials and methods: We analysed records maintained in a prospective database of 330 consecutive patients that underwent rLRN between March 1995 and September 2016. All complications were graded according to the modified Clavien-Dindo classification. Three generations of surgeons were defined and the learning curve in rLRN was evaluated by comparing the first 100 cases (Group A) performed by firstgeneration surgeons with the last 100 cases (Group B) by thirdgeneration surgeons. Results: The mean age of our cohort was 66 ± 11.9 years. The overall complication rate was 19.7%. The majority of complications (12.7%) were Clavien 1 (5.1%) and Clavien 2 (7.6%) and did not require any interventions; blood transfusion was the most frequently encountered intervention (4.8%). Half of which were because of major intraoperative bleeding. Mortality rate was 0.9%. We found a trend towards lower complication rate in group B (19%) compared to group A (23%); this was mainly because of the reduction in the incidence of Clavien 1 and 2 complications. The pathological stage varied significantly in the two groups while the rate of negative surgical margins was comparable. Conclusions: rLRN is a safe procedure with an acceptable rate of complications. The learning curve was shorter for the thirdgeneration surgeons (group B); although these surgeons operated on a significantly higher number of patients with more advanced diseases. The Clavien-Dindo classification is suitable for assessing rLRN complications. Adopting this standardised system can help in the evaluation and comparison of surgical quality of LRN series.

Early nasojejunal feeding in acute pancreatitis is associated with a lower complication rate

Nutrition ◽  
2002 ◽  
Vol 18 (3) ◽  
pp. 259-262 ◽  
Author(s):  
Attila Oláah ◽  
Gáabor Pardavi ◽  
Tibor Beláagyi ◽  
Attila Nagy ◽  
ÁAkos Issekutz ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Complication Rate ◽  
Lower Complication ◽  
Lower Complication Rate ◽  
Nasojejunal Feeding

Transradial approach for pediatric interventions: A review and analysis of the literature

2020 ◽  
pp. 112972982094868
Author(s):  
Derrek Schartz ◽  
Emily Young ◽  
Stephen Guerin
Keyword(s):  
Complication Rate ◽  
Pediatric Patients ◽  
Surgical Intervention ◽  
Pediatric Population ◽  
Adult Population ◽  
Pooled Analysis ◽  
Transradial Access ◽  
Lower Complication ◽  
Lower Complication Rate ◽  
Pediatric Interventions

Background: Transradial access for interventions has been well studied in the adult population, but there is a paucity of literature of its use in the pediatric population. Methods: We conducted a systematic literature review and gathered and synthesized all of the available data into a cohesive resource for review and analysis of the topic. Results: Pooled analysis of the available data shows that transradial access in pediatric patients has a success rate of 91%, a vasospasm rate of 11.4%, and loss of pulse rate of 3.0% for a total complication rate of 14%. No permanent complications, or complications requiring surgery, were observed in any study. After stratifying for indication of intervention, neurological indications were associated with a lower complication rate compared to cardiac indications (0.1 vs 0.43, respectively, p = 0.004). In addition, studies published after 2013 were associated with a lower complication rate compared to those published during or before 2013 (0.11 vs 0.33, respectively, p = 0.01). Conclusion: Compared to prior studies on pediatric transfemoral access, transradial access has a higher complication rate. But there may be a lower rate of complications that require surgical intervention. Further studies are needed to clarify any advantages that transradial access may have over transfemoral access for pediatric patients.

scholarly journals Transtrochanteric approach can provide better postoperative care and lower complication rate in the treatment of hip fractures

2019 ◽  
Vol Volume 14 ◽  
pp. 137-143 ◽  
Author(s):  
Safa Gursoy ◽  
Mehmet Emin Simsek ◽  
Mustafa Akkaya ◽  
Metin Dogan ◽  
Murat Bozkurt
Keyword(s):  
Hip Fractures ◽  
Complication Rate ◽  
Postoperative Care ◽  
Lower Complication ◽  
Lower Complication Rate
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