scholarly journals A study on laparoscopic appendectomy at emergency theatre in B. P. Koirala Institute of Health Sciences

2021 ◽  
Vol 8 (10) ◽  
pp. 2876
Author(s):  
Subhash Chandra Mandal ◽  
Shiva Sharma Aryal ◽  
Shailesh Adhikary
Keyword(s):  
Retrospective Study ◽  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Conversion Rate ◽  
Health Sciences ◽  
Emergency Setting ◽  
Lower Abdomen ◽  
Efficient Procedure ◽  
Choice Of Treatment ◽  
Record Section

Background: Laparoscopic appendectomy is gaining its popularity as it has better patient compliance. Despite of not being “gold standard”, laparoscopic appendectomy is widely practiced in emergency setting and has become patient’s as well as surgeon’s choice of treatment. Our aim is to acknowledge the advantage and importance of laparoscopic appendectomy at emergency in a retrospective study. Our main objective was to study the efficacy of laparoscopic appendectomy, patients’ demographic profile as well as conversion rate of laparoscopic appendectomy to open appendectomy.Methods: This hospital based retrospective study was carried among 54 patients who had undergone emergency laparoscopic appendectomy at B. P. Koirala Institute of Health Sciences (BPKIHS) between March and April, 2016. The patient’s file was collected from medical record section, studied and analyzed.Results: During the study, it was observed that most of the patients were female (62.97%) and the patients were mostly between 20 to 40 years of age (Mean age 27 years±10.88 SD). Most of the patients presented within 24 hours of onset of symptoms, most commonly with pain in lower abdomen associated mostly with vomiting. Out of 54 patients, 48 patients (88.89%) were diagnosed with acute appendicitis. Frankly speaking, laparoscopic appendectomy was associated with shorter hospital stay (around 3 days) and also has less conversion rate (11.11%). There were minimal post-operative complications without any case of redo and mortality.Conclusions: Laparoscopic appendectomy is safe and efficient procedure with shorter hospital stay and less post-operative complication.

scholarly journals A retrospective study on laparoscopic appendectomy versus open appendectomy

2019 ◽  
Vol 6 (4) ◽  
pp. 1144
Author(s):  
P. Senthil Kumar ◽  
S. Edwin Kin’s Raj ◽  
Saranya Nagalingam
Keyword(s):  
Retrospective Study ◽  
Acute Appendicitis ◽  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Operative Time ◽  
Open Appendectomy ◽  
Laparoscopic Approach ◽  
Laparoscopic Group ◽  
Daily Activities ◽  
Early Return

Background: Appendectomy is the most common surgical procedure performed in emergency surgery. Open appendectomy is the “gold standard” for the treatment of acute appendicitis. Laparoscopic appendectomy though widely practiced has not gained universal approval. Our aim is to compare the safety and benefits of laparoscopic versus open appendectomy in a retrospective study.Methods: The study was done as a retrospective study among 387 patients diagnosed with appendicitis for a period of 18 months in the Dept of General Surgery. All patients included were 16 years and above and followed up for 3 weeks. In this study, 130 patients diagnosed as acute appendicitis - underwent open appendectomy and 257 patients diagnosed as sub-acute cases of appendicitis - underwent laparoscopic appendectomy. These two groups (open & laparoscopic) were compared for operative time, length of hospital stay, postoperative pain, complication rate, early return to normal activity.Results: Laparoscopic appendectomy was associated with a shorter hospital stay (around 4.5 days), with a less need for analgesia and with an early return to daily activities (around 11.5 days). Operative time was significantly shorter in the open group (35 mins), when compared with laparoscopic group (around 59 mins). Total number of complications was less in the Laparoscopic group with a significantly lower incidence of post-op pain and complications.Conclusions: The laparoscopic approach is a safe and efficient operative procedure and it provides clinically beneficial advantages over open appendectomy (including shorter hospital stay, an early return to daily activities and less post-op complications).

scholarly journals Primerjava laparoskopske apendektomije pri enostavnem in zapletenem vnetju slepiča

2017 ◽  
Vol 86 ◽  
Author(s):  
Matjaž Križaj ◽  
Erik Štrumbelj ◽  
Stanislav Mahne
Keyword(s):  
Postoperative Complications ◽  
Acute Appendicitis ◽  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Conversion Rate ◽  
Complicated Appendicitis ◽  
Early Postoperative Complications ◽  
Stump Closure ◽  
Significant Difference ◽  
Diagnostic Modalities

Background: Laparoscopic appendectomy has been gaining ground as a gold standard for the treatment of acute appendicitis. For complex inflammation there is no common opinion. A higher conversion rate, longer operative time, higher incidence of abscess formation and longer hospitalization are being reported. The aim of our study was to compare the diagnostic modalities, treatment and postoperative complications in uncomplicated and complicated appendicitis.Methods: In our institution laparoscopic appendectomy is the method of choice for the treatment of every type of appendicitis. In our retrospective analysis, all patients with acute appendicitis operated on in the years 2013 and 2014 were included. Among 273 patients, 19 were excluded due to primary open procedure and one who underwent revision surgery for other disease and had appendectomy performed. In 253 patients we observed the proportion of the postoperative complications in uncomplicated and complicated cases with respect to patients’ age, period of the year, duration of hospital stay, diagnostic modalities, drainage of the abdominal cavity, conversion rate and stump closure.Results: The analysis showed a steep increase of complicated appendicitis in elderly population, but there were no significant differences regarding period of the year (χ2 test, p = 0.158). The hospital stay was longer in complicated cases (5.94 days v. 3.049 days). When a preoperative CT scan was performed, cases were more often complicated (CT 0.654, no CT 0.229; χ2 test, p < 0.001), as was the proportion of drain insertions during surgery (0.5490 v. 0.065; χ2 test, p < 0.001). The proportion of clips for the stump closure was higher in the uncomplicated group (0.717 v. 0.521; χ2 test, p = 0.005). The rate of early postoperative complications and conversion rate revealed no significant difference.Conclusions: We have found out there is a difference in diagnostic modalities and treatment options in uncomplicated and complicated appendicitis, but no significant difference in the conversion rate and early postoperative complications. Our analysis suggests that laparoscopic appendectomy is a safe method in all types of appendicitis.

Breastfeeding initiation among women with preeclampsia with and without severe features

2020 ◽  
pp. 1-8
Author(s):  
L. Cordero ◽  
M.R. Stenger ◽  
M.B. Landon ◽  
C.A. Nankervis
Keyword(s):  
Retrospective Study ◽  
Breast Milk ◽  
Hospital Stay ◽  
Late Onset ◽  
Preterm Births ◽  
Severity Of Illness ◽  
Premature Delivery ◽  
Breastfeeding Initiation ◽  
Expressed Breast Milk ◽  
Timely Delivery

BACKGROUND: Timely delivery and magnesium sulfate (MgSO4) are mainstay in the treatment of preeclampsia with severe features (PWSF). Premature delivery, severity of illness and mother-infant separation may increase the risk for breastfeeding (BF) initiation failure. OBJECTIVE: To compare BF initiation among women with late-onset PWSF for women with late-onset preeclampsia without severe features (WOSF). METHODS: Retrospective study of 158 women with PWSF and 104 with WOSF who delivered at ≥34 weeks. Intention to BF, formula feed (FF) or partially BF was declared prenatally. At discharge, exclusive BF included direct BF or direct BF with expressed breast milk (EBM). RESULTS: PWSF and WOSF groups were similar in age, race, and obstetric history. PWSF and WSOF differed in primiparity (65 & 51%), late preterm births (73 vs 15%), admission to NICU (44 &17%) and mother (5 & 4d) and infant (6 & 3d) hospital stay. Both groups were similar in intention to BF (80 & 84%), to FF (16 & 13%) and to partially BF (5 & 5%). At discharge, exclusive BF (37 & 39%), partial BF (33 & 31%) and FF (30 & 30%) were similar. Exclusive BF in the PWSF group was 43% direct BF, 28% direct BF and EBM and 29% EBM alone whereas in the WOSF group exclusive BF was 93% direct BF and 7% direct BF and EBM. CONCLUSION: BF initiation rates for women with PWSF and WOSF were similar. EBM alone or with direct BF enabled infants in the PWSF group to exclusively BF at discharge.

scholarly journals Congenital cardiac interventions during the peak phase of COVID-19 pandemics in the country in a pandemics hospital in Istanbul

2020 ◽  
Vol 30 (9) ◽  
pp. 1288-1296
Author(s):  
Murat Ugurlucan ◽  
Yahya Yildiz ◽  
Didem Melis Oztas ◽  
Senay Coban ◽  
Metin Onur Beyaz ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Adverse Events ◽  
Hospital Stay ◽  
Surgical Procedures ◽  
Interventional Procedures ◽  
Preventive Measures ◽  
Cardiovascular Disorders ◽  
Cardiac Disorders ◽  
Corrective Procedures ◽  
Peak Phase

AbstractIntroduction:In this report, we aim to present our algorithm and results of patients with congenital cardiac disorders who underwent surgical or interventional procedures during the peak phase of the pandemics in our country.Patients and methods:The first COVID-19 case was diagnosed in Turkey on 11 March, 2020, and the peak phase seemed to end by the end of April. All the patients whom were referred, treated, or previously operated but still at the hospital during the peak phase of COVID-19 pandemics in the country were included into this retrospective study. Patient’s diagnosis, interventions, adverse events, and early post-procedural courses were studied.Results:Thirty-one patients with various diagnoses of congenital cardiovascular disorders were retrospectively reviewed. Ages of the patients ranged between 2 days and 16 years. Seventeen cases were males and 14 cases were females. Elective cases were postponed. Priority was given to interventional procedures, and five cases were treated percutaneously. Palliative procedures were preferred in patients whom presumably would require long hospital stay. Corrective procedures were not hesitated in prioritised stable patients. Mortality occurred in one patient. Eight patients out of 151 ICU admissions were diagnosed with COVID-19, and they were transferred to COVID-19 ICU immediately. Three nurses whom also took care of the paediatric cases became infected with SARS-CoV-2; however, the children did not catch the disease.Conclusion:Mandatory and emergent congenital cardiac percutaneous and surgical procedures may be performed with similar postoperative risks as there are no pandemics with meticulous care and preventive measures.

scholarly journals The need for nutritional assessment and interventions based on the prognostic nutritional index for patients with femoral fractures: a retrospective study

2021 ◽  
Author(s):  
Miao He ◽  
Qinghong Fan ◽  
Yuhang Zhu ◽  
Dexing Liu ◽  
Xingxing Liu ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Hospital Stay ◽  
Nutritional Assessment ◽  
Femoral Fractures ◽  
Prognostic Nutritional Index ◽  
Postoperative Hospital Stay ◽  
Adverse Outcomes ◽  
Perioperative Outcomes ◽  
Nutritional Index ◽  
Postoperative Intensive Care

Abstract Background The incidence of adverse perioperative outcomes in surgery for femoral fractures is quite high and is associated with malnutrition. This study aimed to identify independent factors and assess the predictive value of the prognostic nutritional index (PNI) for perioperative adverse outcomes in patients with femoral fractures. Methods This retrospective study included 343 patients who underwent surgery for a single femur fracture. Demographic characteristics, surgery and anaesthesia records, and blood test results at admission, 1 day postoperatively, and before discharge were evaluated using logistic regression analysis. The discriminatory ability of the independent factors was assessed using the receiver operating characteristic curve analysis, and DeLong's test was used to compare the area under the curve (AUC). Results Overall, 159 patients (46.4%) experienced adverse perioperative outcomes. Among these, 123 (35.9%) had lower limb vein thrombus, 68 (19.8%) had hospital-acquired pneumonia, 6 (1.7%) were transferred to the postoperative intensive care unit, 4 (1.2%) had pulmonary embolism, 3 (0.9%) died during hospitalisation, and 9 (2.6%) had other adverse outcomes, including incision disunion, renal and liver function impairment, acute heart failure, acute cerebral infarction, and stress gastroenteritis. The PNI at admission, age, postoperative hospital stay, time to admission, hypertension, combined injures, and surgery type were independent factors for adverse perioperative outcomes. Based on the AUC (PNI at admission: 0.772 (0.723–0.821), P < 0.001; age: 0.678 (0.622–0.734), P < 0.001; postoperative hospital stay: 0.608 (0.548–0.668), P = 0.001; time to admission: 0.585 (0.525–0.646), P = 0.006), the PNI at admission had optimal discrimination ability, indicating its superiority over other independent factors (age vs. PNI at admission, P = 0.002; postoperative hospital stay vs. PNI at admission, P < 0.001; time to admission vs. PNI at admission, P < 0.001). Conclusions Nutritional assessment and appropriate intervention strategies on admission are necessary for patients with femoral fractures, and the PNI at admission may be a good nutritional assessment indicator.

scholarly journals Inappropriate manipulation and drainage exacerbate post-operative pain and prolong the hospital stay after laparoscopic appendectomy for pediatric complicated appendicitis

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yi-Wen Tsai ◽  
Shin-Yi Lee ◽  
Jyun-Hong Jiang ◽  
Jiin-Haur Chuang
Keyword(s):  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Pediatric Patients ◽  
Complicated Appendicitis ◽  
Postoperative Hospital Stay ◽  
Postoperative Outcomes ◽  
Chang Gung Memorial Hospital ◽  
Abdominal Abscess ◽  
Penrose Drain ◽  
Drain Group

Abstract Background This study examined whether drain placement or not is associated with the postoperative outcomes of pediatric patients following trans-umbilical single-port laparoscopic appendectomy (TUSPLA) for complicated appendicitis. Methods The medical records of pediatric patients undergoing TUSPLA for acute complicated appendicitis from January 2012 to September 2018 in Kaohsiung Chang Gung Memorial Hospital were reviewed retrospectively. They were classified according to whether they received passive drainage with a Penrose drain (Penrose group) (19), active drainage with a Jackson-Pratt drain with a vacuum bulb (JP group) (16), or no drain (non-drain group) (86). The postoperative outcomes of the three groups were compared. Results Postoperative visual analog scale pain score was significantly higher in the non-drain group than in either the JP group or Penrose group. Patients in the Penrose group had a significantly longer postoperative hospital stay than those in the non-drain group and a higher rate of intra-abdominal abscess, while patients in the JP group had a significantly shorter postoperative hospital stay; moreover, no patient in JP group developed a postoperative intra-abdominal abscess. Conclusions Compared to passive drainage with a Penrose drain or no drain, active drainage with a JP drain shorter the postoperative hospital stay and decreased the risk of postoperative intra-abdominal abscess.

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.

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