scholarly journals SELECTIVE INTESTINAL DECONTAMINATION IN PATIENTS WITH ACUTE DIVERTICULITIS COMPLICATED BY COVERED PERFORATION AS A WAY TO REDUCE THE NUMBER OF POSTOPERATIVE COMPLICATIONS

2020 ◽  
Vol 74 (2) ◽  
pp. 114-117
Author(s):  
O.F. Vorontsov ◽  
◽  
C. Graeb ◽  
V.V. Tolochyk ◽  
I.V. Mikhin ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Surgical Complications ◽  
Acute Diverticulitis ◽  
Sigmoid Diverticulitis ◽  
Wound Complications ◽  
Oral Antibiotic ◽  
Group A ◽  
Intestinal Decontamination ◽  
Group B ◽  
Covered Perforation

The effect of selective perioperative intestinal decontamination in patients with acute sigmoid diverticulitis complicated by covered perforation on the number of postoperative complications was described. A prospective and partially retrospective study of the results of complex treatment of 196 patients with acute diverticulitis localized in the sigmoid colon, complicated by covered perforation, divided into group А – 66 patients with perioperative selective intestinal decontamination and group B – 130 patients without decontamination. Rectal resection by open, laparoscopic and robot-assisted methods with the formation of primary colorectal anastomoses was performed in all cases. Of the 196 patients included in our study, 122 (62,2 %) underwent surgery without complications. Abdominal postoperative complications directly caused by surgical interventions and related, according to the classification of Сlavien-Dindo surgical complications (C-D) to grades I, IIIb and IV, were noted in 9 (13,6 %) patients of group A and 36 (27,6 %) patients of group B, and extraabdominal (C-D I, IV), which included: pneumonia, acute renal failure, pyelonephritis, urosepsis, postoperative delirium and transient ischemic attack – in 8 (12,1 %) and 21 (16,1 %) patients of the corresponding groups. In group A, there was a significantly lower number of general abdominal and wound complications, as well as the total number of all postoperative complications (p = 0,03, p = 0,04 and p = 0,0111 respectively). There were no fatalities. The used scheme of oral antibiotic therapy, along with orthograde intestinal sanitation with osmolar solutions, significantly reduced the frequency of surgical and non-surgical complications.

scholarly journals LAPAROSCOPIC AND ROBOTIC-ASSISTED SURGERYFOR COMPLICATED DIVERTICU

2020 ◽  
Vol 10 (4) ◽  
pp. 96-99
Author(s):  
Oleg Vorontsov ◽  
Vadym Tolochyk ◽  
Igor Mikhin ◽  
Anastasiya Kitaeva ◽  
Christian Graeb
Keyword(s):  
Postoperative Complications ◽  
Wound Infection ◽  
Anastomotic Leakage ◽  
Complicated Diverticulitis ◽  
Sigmoid Diverticulitis ◽  
Sigmoid Colectomy ◽  
Robotic Assisted ◽  
Group A ◽  
Intestinal Decontamination ◽  
Group B

The article presents the results of a longtime experience with the effects of perioperative intestinal decontamination in patients with complicated diverticulitis on the incidence of postoperative complications following delayed minimally invasive sigmoid colectomy and colorectal anastomosis creation. Purpose. This work aims to evaluate the prophylactic potential of selective perioperative intestinal decontamination in patients with sigmoid diverticulitis due to perforation of the inflamed diverticula, as a form of diverticular disease; to study the incidence of postoperative complications in patients with complicated diverticulitis following laparoscopic and robotic-assisted surgery. Results. Of 179 patients included in the study, 136 (76%) did not develop postoperative complications. In Group A, 11 (12%) of 91 patients and in Group B, 17 (19.3%) of 88 patients developed postoperative complications specific to the type of surgery undertaken. The most common complications included colorectal anastomotic leakage, adhesive intestinal obstruction, anastomotic bleeding, intra-abdominal hemorrhage and localized peritonitis. A statistical comparison revealed no statistically significant differences between the groups studied. 8 (8.8%) of 91 patients in Group A and in 7 (8.0%) of 88 patients in Group B were diagnosed with extra-abdominal (nonsurgical) complications. Thus, the total postoperative complication rate was lower in Group A (n=19 (20.9%) than in Group B (n=24 (27.3%)) (Х2 =1.002, р=0.316). Colorectal anastomotic leakage rates were lower in Group A (n=1 (1.1.%)) than in Group B (n=4 (4.6%)) (F=0.205, p>0.05). Wound infection rates in Group A were 6.6% (n=6) patients and in Group В – 11.3% (n=10) patients (Х2*=6.483, р=0.01). No deaths were reported. CONCLUSION. Selective intestinal decontamination combined with oral decontaminating solutions has been shown to reduce the occurrence of colorectal anastomotic leaks, wound infection, surgical and general postoperative complications.

scholarly journals DIVERTICULAR DISEASE: FROM TRADITION TO INNOVATION

2020 ◽  
Vol 76 (4) ◽  
pp. 92-95
Author(s):  
O.F. Vorontsov ◽  
◽  
V.V. Tolochyk ◽  
I.V. Mikhin ◽  
A.V. Kitaeva ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Colorectal Anastomosis ◽  
Current Data ◽  
Sigmoid Diverticulitis ◽  
Elective Resection ◽  
Topical Antibacterial ◽  
Intestinal Decontamination ◽  
Covered Perforation ◽  
Acute Sigmoid Diverticulitis ◽  
Surgical Clinic

This article presents current data from the world medical literature and a five-year study of surgical clinic on the effect of perioperative intestinal decontamination in patients with acute complicated diverticulitis on the frequency of postoperative complications after elective resection of the sigmoid colon and the formation of primary colorectal anastomosis. The possibility of selective perioperative intestinal decontamination in patients with acute sigmoid diverticulitis complicated by covered perforation, the number of postoperative surgical and general complications was observed. The used scheme of topical antibacterial sanitation, along with orthograde intestinal cleansing with osmolar solutions, significantly reduced the frequency of insufficiency of colectal anastomoses, surgical (abdominal) and the total number of postoperative complications.

Comprehensive Nursing can Relieve the Negative Emotions of Patients undergoing Breast Cancer Resection and Reduce Postoperative

2021 ◽  
Vol 7 (5) ◽  
pp. 4234-4243
Author(s):  
Xiaoxia Lv ◽  
Lihua Wang ◽  
Yan Zhai
Keyword(s):  
Breast Cancer ◽  
Postoperative Complications ◽  
Quality Score ◽  
Cancer Resection ◽  
Upper Limb Function ◽  
Sf 36 ◽  
Group A ◽  
Group B ◽  
Nursing Quality

To explore the effect of comprehensive nursing on adverse emotions and postoperative complications of breast cancer patients undergoing mastectomy. Altogether 180 patients who received treatment in our hospital from May 2017 to May 2019 were selected as the research participants and divided into group A and group B. Among them, 100 cases in group A received comprehensive nursing, 80 cases in group B received routine nursing. The surgical indications, upper limb function, serum NGF, TK1 and CA15-3 expression level, VAS score, SAS, SDS score, quality of life SF-36 score were detected, and the incidence rate of postoperative complications and nursing quality score were compared. Compared with group B, group A had less postoperative bed time, intraoperative blood loss, length of hospital stay, better recovery of upper limb function, lower expression levels of serum NGF, TK1 and CA15-3, lower VAS score, SAS and SDS score, higher quality of life SF-36 score, lower incidence of postoperative complications and higher nursing quality score. Comprehensive nursing can relieve the negative emotions of patients undergoing breast cancer resection and reduce the incidence of postoperative complications.

scholarly journals Ablating Aspiration Needle Tract Prior to Microwave Ablation Can Improve Therapeutic Outcomes for Predominantly Cystic Thyroid Nodules

2021 ◽  
Vol 12 ◽  
Author(s):  
Haizhen Yang ◽  
Yanwei Chen ◽  
Baoding Chen ◽  
Shuangshuang Zhao ◽  
Zheng Zhang ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Microwave Ablation ◽  
Thyroid Nodules ◽  
Cyst Fluid ◽  
Cystic Fluid ◽  
Needle Tract ◽  
Intracystic Hemorrhage ◽  
Group A ◽  
Hospital Stays ◽  
Group B

PurposeTo investigate whether ablating the aspiration needle tract could improve the safety and efficacy of ultrasound-guided microwave ablation (MWA) for predominantly cystic thyroid nodules.Materials and MethodsThis retrospective study evaluated 41 predominantly cystic thyroid nodules that underwent MWA between June 2017 and August 2019. The nodules were stratified by different procedures into two groups: the aspiration needle tract was ablated before cyst fluid aspiration and MWA when treating 26 nodules in Group A, while the other 15 nodules in Group B underwent MWA directly after cyst fluid aspiration. Baseline characteristics, intervention time, hospital stays, nodules with intraoperative intracystic hemorrhage, and postoperative complications were compared between the two groups. Volume, volume reduction rate (VRR), compressive score (CS), and aesthetic score (AS) were evaluated during follow-up.ResultsBoth groups achieved decreases in volume, CS, and AS, as well as an increase in VRR. The volumes and VRRs in Group A at 1, 3, 6, and 12 months were significantly smaller and greater than those in Group B (p < 0.001). The incidence of intraoperative intracystic hemorrhage in Group A was significantly lower than that in Group B (p=0.035). Compared to Group B, hospital stays were much shorter in Group A (p=0.040). There were no significant differences in intervention time, cystic fluid volume or postoperative complications.ConclusionAspiration needle tract ablation dramatically reduces the incidence of intraoperative intracystic hemorrhage and markedly improves the efficacy of MWA for predominantly cystic thyroid nodules.

Postoperative Complication Assessments of Different Reconstruction Procedures after Total Pharyngolaryngoesophagectomy: Tubular Gastric Pull-Up versus Whole Gastric Pull-Up

2018 ◽  
Vol 84 (12) ◽  
pp. 1927-1931
Author(s):  
Zhenbo Dai ◽  
Qinghua He ◽  
Boyu Pan ◽  
Liren Liu ◽  
Dejun Zhou
Keyword(s):  
Postoperative Complications ◽  
Hypopharyngeal Cancer ◽  
Reconstruction Method ◽  
Observation Study ◽  
Reconstruction Procedure ◽  
Intrathoracic Stomach ◽  
Group A ◽  
Group B ◽  
Medical University ◽  
Gastric Pull Up

Hypopharynx carcinoma tends to be diagnosed at advanced stage and usually has a poor prognosis because of the high incidence of submucosal spreading and lymphatic metastasis. Total pharyngolaryngoesophagectomy (PLE) is mostly used as a curative intervention for this deadly disease, and a commonly used reconstruction method after PLE is gastric pull-up, which could be further divided into tubular gastric pull-up and whole gastric pull-up procedures. Aiming to achieve a precise guidance on optimal reconstruction method after PLE, the present study evaluated the postoperative complications involving in different gastric pull-up procedures in patients with hypopharynx cancer. A total of 52 consecutive patients with hypopharyngeal cancer who underwent total PLE with gastric pull-up reconstruction in Tianjin Medical University Cancer Institute and Hospital between 1996 and 2014 were analyzed in this study. Of these patients, 28 underwent tubular gastric pull-up reconstruction procedure (Group A), whereas 24 underwent whole gastric pull-up reconstruction procedure (Group B). We compared the postoperative complications between these two groups retrospectively. Postoperative anastomotic fistulas occurred in three patients in Group A (3/28) versus eight patients in Group B (8/24), leading to an incidence rate of 10.71 and 33.33 per cent, respectively. The incidence of intrathoracic stomach syndrome was 21.43 per cent in Group A (6/28) versus 58.33 per cent in Group B (14/24), and the incidence of reflux was 35.71 per cent in Group A (10/28) versus 66.67 per cent in Group B (16/24). All of the above postoperative complications exhibited statistical differences between two groups ( P ≤ 0.05). This retrospective observation study suggests that compared with whole gastric pull-up, tubular gastric pull-up is a better reconstruction procedure of choice after PLE, evidenced by reduced incidences of postoperative anastomotic fistula, intrathoracic stomach syndrome, and reflux.

Surgical Complications during Continuous Ambulatory Peritoneal Dialysis

1985 ◽  
Vol 5 (1) ◽  
pp. 39-42 ◽  
Author(s):  
Giovanni Valenti ◽  
Donata Cresseri ◽  
Maria Luisa ◽  
Bianchi Enzo ◽  
Corghi Marc Lorenz ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Surgical Complications ◽  
Abdominal Cavity ◽  
Temporary Change ◽  
Elderly Males ◽  
Group A ◽  
Main Factors ◽  
Group B ◽  
Diaphragmatic Hernias

In 30 patients (20 males and 10 females) undergoing CAPD, we observed 15 catheter-related complications -group A: leakage, dislodgement, slipping-out, protrusion of the external cuff, hemoperitonitis, and eight abdominal-cavity complications -group B: umbilical, inguinal, incisional and diaphragmatic hernias. Group A complications which occurred in 30% of the men and 80% of the women (mean age 47.2 ± 9) were easy to manage; group B complications developed mainly in elderly males (seven men and one woman, mean age 61.4 ± 5); these required temporary change of mode of dialysis in three, and permanent transfer from CAPD in two. From this review we have concluded that loss of anatomical integrity of the abdominal cavity is one of the main factors which prevents the continuation of CAPD.

Surgical management of synchronous colorectal liver metastases: Simultaneous versus staged resections.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 616-616
Author(s):  
Igor Shchepotin ◽  
Andrii Lukashenko ◽  
Olena Kolesnik ◽  
Anton Burlaka
Keyword(s):  
Colorectal Cancer ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Liver Metastases ◽  
Metastatic Cancer ◽  
Economic Effect ◽  
Hepatic Metastases ◽  
Group A ◽  
Bed Days ◽  
Group B

616 Background: Surgical treatment of metastatic colorectal cancer remains the only method that improves overall 5-year survival. This study aimed to compare the surgical outcome and survival benefit between synchronous and staged resection of liver metastases from colorectal cancer. Methods: Clinicopathologic data, treatments, and postoperative outcomes from 110 patients who underwent simultaneous (48 patients, group A) or staged (62 patients, group B) colorectal and hepatic resections at clinic of National cancer institute in period of 2008-2013 were reviewed. Results: Postoperative complications in patients with simultaneous resections (group A) were observed in 13 cases (27.1%), including 5, 1, 4, 2, 0, and 1 of grades I, II, IIIa, IIIb, IV, and V, respectively. Similar results have been reported in group B after staged resections, where overall postoperative complications registered in 16 patients (25.8 %), including 4, 3, 6, 3, 0 of grades I, II, IIIa, IIIb, and IV respectively. Overall level of post-operative complications in the groups A and B after surgical stages finishing did not differ statistically (p=0.96). Shorter operative intervention duration was registered in the group A – (311±10.1) min, whereas in the group B it was (496.6±16.2) min (р<0.001). Patients after staged resection stayed in clinic for a longer time – 23.9±0.8 bed-days, when simultaneous resections provided with shorter recovery terms in post-operative period – 9.8±0.5 bed-days (p<0.001). Overall 3-year survival in the group of patients with simultaneous resections (group А) was 42 % and in the group B 55 % (р=0.22). Conclusions: Analysis of our research indicated necessity of the development of differentiated approach in management of synchronous colorectal liver metastatic cancer. Simultaneous resections of colorectal cancer primary lesions and hepatic metastases were safe and could serve as a primary option for selected patients. Subsequent research should be directed towards study of prognosis factors and criteria for patients’ selection for surgical treatment groups, assessment of economic effect, and patients life quality.

Use of Perioperative Steroids with Microvascular Decompression Operations

Neurosurgery ◽  
1988 ◽  
Vol 22 (2) ◽  
pp. 353-357 ◽  
Author(s):  
Donald W. Marion ◽  
Peter J. Jannetta
Keyword(s):  
Postoperative Complications ◽  
Microvascular Decompression ◽  
Cranial Nerves ◽  
Wound Infections ◽  
Related Complication ◽  
Deep Wound ◽  
Life Threatening ◽  
Group A ◽  
Group B ◽  
Single Blind

Abstract Complications associated with the use of perioperative steroids in elective craniotomies were evaluated in a single-blind prospective study of 222 consecutive microvascular decompression operations. Patients were randomized into one of three groups: Group A received steroids preoperatively and for 4 days postoperatively, Group B received steroids preand postoperatively for 1 day, and Group C received no steroids. There were 17 complications in Group A; 12 of these were wound-related. There were significantly fewer complications in Groups B and C (P &lt; 0.01). Group B had 3 complications, Group C had 4, and there was only 1 wound-related complication in Group C. There were no deaths, deep wound infections, or life-threatening complications. Severe postoperative headaches, a symptom that steroids were intended to minimize, occurred in 38% of patients in Group A, 42% of patients in Group B, and 25% of patients in Group C. The use of perioperative steroids did not reduce the length of postoperative hospitalization. Duration of the operation had no significant effect on the incidence of postoperative complications or the length of postoperative hospitalization. We conclude that there is no indication for the routine perioperative use of steroids with microvascular decompression operations of the posterior fossa cranial nerves and that such use leads to a higher incidence of postoperative complications. (Neurosurgery 22:353-357, 1988)

Comparative study of the efficacy of topical steroid and antibiotic combination therapy versus oral antibiotic alone when treating acute rhinosinusitis

2015 ◽  
Vol 129 (5) ◽  
pp. 462-467 ◽  
Author(s):  
D M El-Hennawi ◽  
M R Ahmed ◽  
A M Farid ◽  
A M Al Murtadah
Keyword(s):  
Symptom Relief ◽  
Topical Steroid ◽  
Control Group ◽  
Nasal Discharge ◽  
Oral Antibiotic ◽  
Topical Antibiotic ◽  
Acute Rhinosinusitis ◽  
Group A ◽  
Acute Bacterial Rhinosinusitis ◽  
Group B

AbstractBackground:Acute rhinosinusitis arises as a consequence of viral rhinitis, and bacterial infection can subsequently occur. Intranasal antibiotics as an adjunct to corticosteroids usually demonstrate the greatest symptom relief.Aim:We wanted to clinically evaluate the effects of a topical antibiotic and steroid combination administered intranasally, versus an oral antibiotic alone when treating acute rhinosinusitis.Method:Forty patients with acute bacterial rhinosinusitis were divided into two groups. Group A received an antibiotic and steroid combination (ofloxacin 0.26 per cent and dexamethasone 0.053 per cent nasal drops) for 10 days, administered intranasally (5 drops in each nostril/8 hours). Group B, the control group, received an oral antibiotic alone (amoxicillin 90 mg/kg).Results:Eight hours after commencing treatment, facial pain was more severe in group B and nasal obstruction was reduced in both groups. Ten days after commencing treatment, anterior nasal discharge was 0.15 per cent in group A and absent in group B.Conclusion:The application of a topical antibiotic and steroid combination into the nasal cavity is an effective way of treating uncomplicated, acute bacterial rhinosinusitis with the theoretical advantages of easy administration, high local drug concentration and minimal systemic adverse effects.

The effect of recent chemotherapy in aorto-iliac aneurysm repair

Vascular ◽  
2013 ◽  
Vol 22 (2) ◽  
pp. 98-104 ◽  
Author(s):  
Nikolaos Tsilimparis ◽  
Joseph J Ricotta ◽  
Anand Dayama ◽  
James G Reeves ◽  
Sebastian Perez ◽  
...  
Keyword(s):  
Surgical Complications ◽  
Univariate Analysis ◽  
Iliac Aneurysm ◽  
Improvement Program ◽  
Risk Of Death ◽  
Elective Repair ◽  
Group A ◽  
Acs Nsqip Database ◽  
Group B ◽  
Aneurysm Repair

The aim of the study was to investigate the effect of recent chemotherapy (Chx) on outcome of aorto-iliac aneurysm (AAA) repair. The 2005–2010 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried to identify vascular patients undergoing AAA repair within 30 days after Chx. Seventy-one patients underwent AAA repair within 30 days of receiving Chx, group A (71 ± 8.4 years, 77.5% males) and 20,024 patients underwent AAA repair without prior Chx, group B (73 ± 9 years, 79.2% males). The two groups did not significantly differ with respect to open or endovascular repair (open repair A: 32%, B: 35%, P = 0.66). However, patients in group A presented more often as emergent cases (A: 27%, B: 12%, P = 0.001). Multivariable regression analysis for emergent cases after adjustment for relevant confounders also demonstrated that patients with recent Chx present more often as emergency ( P = 0.001, odds ratio [OR]: 2.4). Thirty-day non-surgical complications were more common in group A (A: 25%, B: 16.5%, P = 0.046) while surgical complications were equivalent (A: 15.5%, B: 12.3%, P = 0.414). Risk of death was significantly higher in group A in univariate analysis (A: 13%, B: 5%, P = 0.005, OR: 2.6). Patients who receive Chx within 30 days prior to AAA repair present more frequently as emergencies leading to higher mortality. The reason for this cannot be sufficiently explained by the current database but patient selection for elective repair or the effect of Chx on the natural course of AAA may play a role.

Sign in / Sign up

Export Citation Format

Share Document