scholarly journals Effects of Propofol and Sevoflurane on Cellular Immune Function and Postoperative Complications in Patients with NSCLC Undergoing Surgery

2021 ◽  
Author(s):  
Haijing Zhu ◽  
Shenglin Pei ◽  
Menghua Ge ◽  
Hongmeng Lan ◽  
Manyu Fu ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Recovery Time ◽  
Radical Surgery ◽  
Laboratory Data ◽  
Perioperative Period ◽  
Postoperative Hospital Stay ◽  
Postoperative Complication Rate ◽  
Extubation Time ◽  
Hospital Stays ◽  
Cellular Immune

Abstract Objective We explore the effects of propofol and sevoflurane on the immunity and postoperative complications of patients undergoing thoracoscopic NSCLC radical surgery. Methods 61 patients were selected. They were divided into two groups. Patients take the same drugs for induction of anesthesia. Propofol was used for maintenance of anesthesia in Group P. Sevoflurane was used for another group. Hemodynamics and related anesthesia doses and laboratory data were recorded during the perioperative period. Immune Functio,, postoperative complication rate were evaluated in two groups. Results Comparisons of MAP and HR under anesthesia in patients, Group P were more smoothly than Group S at OLV 1h and TLV 30min. The recovery time and extubation time were significantly longer in the Group S than Group P. NEU: Group P were significantly lower at T3. LYM : Group P were significantly higher at T1 and T2. CD8+ : Group P were significantly higher at T1, T2 and T3. NK cells were significantly higher in Group P at T3. CD4+/CD8+: Group P were significantly lower at T2 and T3. The incidence of pleural effusion: Group P were significantly higher at T3. The postoperative hospital stays were significantly shorter in the Group S. Conclusions Propofol anesthesia has more stable hemodynamics and better resuscitation effect. The immune system of patients in the perioperative period was suppressed to varying degrees after surgery, and the propofol group was less severe than the sevoflurane group. Houever, the postoperative hospital stay depends more on whether postoperative complications occur.

scholarly journals Double-balloon endoscopic retrograde cholangiography can make a reliable diagnosis and good prognosis for postoperative complications of congenital biliary dilatation

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Chiyoe Shirota ◽  
Hiroki Kawashima ◽  
Takahisa Tainaka ◽  
Wataru Sumida ◽  
Kazuki Yokota ◽  
...  
Keyword(s):  
Bile Duct ◽  
Postoperative Complications ◽  
Radical Surgery ◽  
Endoscopic Retrograde Cholangiography ◽  
Endoscopic Retrograde ◽  
Congenital Biliary Dilatation ◽  
Intrahepatic Stones ◽  
Biliary Dilatation ◽  
Double Balloon ◽  
Anastomotic Strictures

AbstractBile duct and anastomotic strictures and intrahepatic stones are common postoperative complications of congenital biliary dilatation (CBD). We performed double-balloon endoscopic retrograde cholangiography (DBERC) for diagnostic and therapeutic purposes after radical surgery. We focused on the effectiveness of DBERC for the treatment of postoperative complications of CBD patients. Bile duct and anastomotic strictures and intrahepatic stones are common postoperative complications of congenital biliary dilatation (CBD). We performed double-balloon endoscopic retrograde cholangiography (DBERC) for diagnostic and therapeutic purposes after radical surgery. We focused on the effectiveness of DBERC for the treatment of postoperative complications of CBD patients. This retrospective study included 28 patients who underwent DBERC (44 procedures) after radical surgery for CBD between January 2011 and December 2019. Strictures were diagnosed as “bile duct strictures” if endoscopy confirmed the presence of bile duct mucosa between the stenotic and anastomotic regions, and as “anastomotic strictures” if the mucosa was absent. The median patient age was 4 (range 0–67) years at the time of primary surgery for CBD and 27.5 (range 8–76) years at the time of DBERC. All anastomotic strictures could be treated with only by 1–2 courses of balloon dilatation of DBERC, while many bile duct strictures (41.2%) needed ≥ 3 treatments, especially those who underwent operative bile duct plasty as the first treatment (83.3%). Although the study was limited by the short follow-up period after DBERC treatment, DBERC is recommended as the first-line treatment for hepatolithiasis associated with biliary and anastomotic strictures in CBD patients, and it can be safely performed multiple times.

1239 Postoperative Complication Rate of Facial Injury Repairs Treated by Maxillofacial On-Call Team: Surgical Audit

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
G Dhanjal ◽  
M Ghouri ◽  
S Crank
Keyword(s):  
Soft Tissue ◽  
Postoperative Complications ◽  
Postoperative Complication ◽  
Complication Rate ◽  
Maxillofacial Surgery ◽  
General Anaesthetic ◽  
Facial Injury ◽  
Postoperative Complication Rate ◽  
Female Ratio ◽  
Facial Injuries

Abstract Introduction A significant aspect of Oral and Maxillofacial Surgery workload relates to trauma, particularly soft-tissue injuries. Contingent on the aetiology of injury, facial wounds require debridement and rapid closure to reduce risk of infection and degree of scarring. The aim was to identify possible risks and frequency of postoperative complications, including problems identified by patients following treatment of facial injuries by the Maxillofacial on-call team. Method Data was retrospectively collected from patients who sustained soft-tissue facial injuries treated by the Maxillofacial team and provided with follow-up appointments from January to August 2020. Computerised clinical notes were accessed to determine patient demographics, mechanism and site of injury, location and time of repair, operator grade and postoperative complications (if any). Results 153 patients required debridement and suturing of a facial injury under local or general anaesthetic. Among these, the male to female ratio was 65:35. 47% of facial injuries resulted from mechanical fall. Lips were found to be the most common site (31%) of injury. Postoperative complication rate was 8% within the 8-month period, with reports of infection, wound dehiscence and haematoma requiring further treatment. 58% of complications resulted from treatment carried out between 5pm-5am with a sole operator (DCT/SHO). 83% of complications followed treatment carried out within the Emergency Department rather than Maxillofacial clinical setting. Conclusion Following facial injury repair, just less than 8% of patients experienced complications, which required corrective treatment. Although facial injuries require immediate care, careful planning and performing treatment in a specialised setup may improve perioperative care, thus clinical outcomes.

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.

scholarly journals Efficacy of Neuroendoscopic Treatment for Septated Chronic Subdural Hematoma

2022 ◽  
Vol 12 ◽  
Author(s):  
Jianhong Deng ◽  
Fangyu Wang ◽  
Haojie Wang ◽  
Mingpei Zhao ◽  
Guorong Chen ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Hospital Stay ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Postoperative Hospital Stay ◽  
Bone Flap ◽  
Total Hospital ◽  
Safety And Efficacy ◽  
Total Hospital Stay ◽  
Large Bone

Objective: Neuroendoscopic treatment is an alternative therapeutic strategy for the treatment of septate chronic subdural hematoma (sCSDH). However, the safety and efficacy of this strategy remain controversial. We compared the clinical outcomes of neuroendoscopic treatment with those of standard (large bone flap) craniotomy for sCSDH reported in our center. Furthermore, the safety and efficacy of the neuroendoscopic treatment procedure for sCSDH were evaluated.Methods: We retrospectively collected the clinical data of 43 patients (37 men and six women) with sCSDH who underwent either neuroendoscopic treatment or standard (large bone flap) craniotomy, such as sex, age, smoking, drinking, medical history, use of antiplatelet drugs, postoperative complications, sCSDH recurrence, length of hospital stay, and postoperative hospital stay. We recorded the surgical procedures and the neurological function recovery prior to surgery and 6 months following the surgical treatment.Results: The enrolled patients were categorized into neuroendoscopic treatment (n = 23) and standard (large bone flap) craniotomy (n = 20) groups. There were no differences in sex, age, smoking, drinking, medical history, antiplatelet drug use, postoperative complications, and sCSDH recurrence between the two groups (p > 0.05). However, the patients in neuroendoscopic treatment group had a shorter length of total hospital stay and postoperative hospital stay as compared with the standard craniotomy group (total hospital stay: 5.26 ± 1.89 vs. 8.15 ± 1.04 days, p < 0.001; postoperative hospital stay: 4.47 ± 1.95 vs. 7.96 ± 0.97 days, p < 0.001). The imaging and Modified Rankin Scale at the 6-month follow-up were satisfactory, and no sCSDH recurrence was reported in the two groups.Conclusions: The findings of this study indicate that neuroendoscopic treatment is safe and effective for sCSDH; it is minimally invasive and could be clinically utilized.

PS02.137: SALVAGE ESOPHAGECTOMY AFTER DEFINITIVE CHEMORADIOTHERAPY: EXPERIENCES OF A SINGLE INSTITUTION

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 159-159
Author(s):  
Xufeng Guo ◽  
Zhigang Li
Keyword(s):  
Postoperative Complications ◽  
Perioperative Period ◽  
Clinical Staging ◽  
Recurrent Laryngeal Nerve Paralysis ◽  
Single Institution ◽  
Definitive Chemoradiotherapy ◽  
Term Survival ◽  
Nerve Paralysis ◽  
Salvage Esophagectomy

Abstract Background Definitive chemoradiotherapy (dCRT) is considered a standard treatment for locally advanced esophageal cancer. Despite of long-term survival of 15–20% after such treatment, locoregional recurrence occurs in around 40–60%. Further radiotherapy is often contraindicated because the maximal tolerable dose has been achieved. As for salvage chemotherapy, the treatment outcome is disappointing. Salvage surgery is another choice but its role still remains debatable. The present study was designed to evaluate the safety and efficacy of salvage esophagectomy. Methods 18 consecutive cases of salvage esophagectomy after dCRT by a single institution were analyzed. Results (1) 16 males and 2 females. There were 6 cases (33.3%) and 12 cases (66.7%) of recurrent and persistent tumor after dCRT respectively; (2) All the patients were treated with McKeown operation stytle combing thoracic and abdominal lymph nodes dissection. Esophagus was replaced by stomach of 15 cases and colon of 3 cases respectively. Radical resection (R0) was performed in 12 cases, palliative resection (R2) in 6 cases. There were 4 cases of pathological complete response (pCR); (3) The incidence of postoperative complications was 61.1% (11/18), including 6 cases of pulmonary infection, 4 cases of anastomotic leak, 2 cases of incision infection, one case of respiratory insufficiency, one case of recurrent laryngeal nerve paralysis, one case of chylothorax, one case of aortic bleeding caused by empyema; (4) One patient died in perioperative period because of aortic bleeding due to empyema. The follow-up period was from 2 to 26 months, and the median follow-up time was 9 months. There were 13 patients survived and 5 patients died at the last follow-up date including one death in perioperative period, 2 cases died of local-regional recurrence and metastasis respectively. Conclusion Salvage esophagectomy is a treatment option for the recurrent or persistent disease after dCRT, but the incidence of postoperative complications is high. Accurate clinical staging is especially important after dCRT and ycT4, ycN + patients should be avoided. R0 resection and recurrence after long disease free period are favorable prognostic factors. Disclosure All authors have declared no conflicts of interest.

PS02.125: NEOADJUVANT CHEMOTHERAPY PLUS SURGERY FOR NON-T4 CSTAGE II/III ESOPHAGEAL CANCER: A SINGLE INSTITUTION EXPERIENCE IN JAPAN

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 156-157
Author(s):  
Masahiko Ikebe ◽  
Mitsuhiko Ohta ◽  
Masahiko Sugiyama ◽  
Masaru Morita ◽  
Yasushi Toh
Keyword(s):  
Esophageal Cancer ◽  
Postoperative Complications ◽  
Neoadjuvant Chemotherapy ◽  
Adverse Events ◽  
Standard Treatment ◽  
Conflicts Of Interest ◽  
Radical Surgery ◽  
Hospital Death ◽  
Number Of Patients ◽  
Grade 3

Abstract Background In Japan, following the results of JCOG 9907 trial, neoadjuvant chemotherapy (NAC) and radical surgery has been a standard treatment for Non-T4 cStage II/III esophageal cancer. Since 2009 we have also positioned NAC as standard treatment. We examined treatment outcomes and problems in our institute. Methods From 2009 to 2015, there were 64 patients with non-T4 stage II/III esophageal cancer treated with chemotherapy who are planned to undergo curative surgery. The standard NAC regimen consists of 2 courses of CDDP/5-FU (CF) therapy. As standard surgical procedure, subtotal esophagectomy, cervical anastomosis, three regional lymph node dissection were performed. Results The number of patients was 23/41 cases of cStage II/III respectively. 53 patients (88%) completed two courses of NAC. At the end of first course, NAC was terminated due to adverse events in 4 cases and due to the increasing tendency of tumors in 7 cases. NAC-induced adverse events of grade 3 or higher consists of myelosuppression in 27 cases (42%), appetite loss in 5 cases and so on. Surgery was performed in 61 cases (95%), of which R0 operation in 56 cases (88%), R1 operation in 3 cases and R2 operation in 2 cases. Three patients did not undergo surgery due to progressive disease. There were 7 cases (11%) of postoperative complications of Grade 3 or higher, but there was no in-hospital death. In the histological therapeutic effect, there were 5/41/7/4/3 cases for Grade 0/1a/1b/2/3, respectively. Three-year and five-year overall survival rate of all 64 patients were 68% and 47%. In 56 patients who underwent R0 surgery, they were 76% and 61% respectively. Conclusion From the viewpoint of adverse events and postoperative complications, NAC plus radical surgery for cStage II/III esophageal cancer could be performed safely. Considering that more than 60% of the patients belong to cStage III, this treatment strategy resulted in relatively favorable prognosis. Disclosure All authors have declared no conflicts of interest.

scholarly journals Biologics and surgical outcomes in Crohn’s disease: is there a direct relationship?

2020 ◽  
Vol 13 ◽  
pp. 175628482093173
Author(s):  
Abel Botelho Quaresma ◽  
Takayuki Yamamoto ◽  
Paulo Gustavo Kotze
Keyword(s):  
Crohn’S Disease ◽  
Postoperative Complications ◽  
Crohn's Disease ◽  
Direct Relationship ◽  
Significant Proportion ◽  
Perioperative Period ◽  
Prospective Data ◽  
Treatment Algorithms ◽  
The Relationship ◽  
Necrosis Factor

Despite significant advances in medical therapy in the management of Crohn’s disease (CD), surgery is still required in a significant proportion of patients and constitutes an important tool in treatment algorithms. Recently, more options of biological agents have been made available, and most patients with CD undergoing surgical procedures have been previously exposed to this class of drugs. There is controversy in the literature as to whether anti-tumor necrosis factor (TNF) agents, anti-integrins, or anti-interleukins (ILs) have a direct relationship with increased postoperative complications. In this narrative review, the authors summarize the most important data regarding the effect of biologics on postoperative outcomes in CD. Most studies (with different designs) are based on the experience with anti-TNF agents, mostly with infliximab. Some studies outlined the relationship between vedolizumab and postoperative complications, and there is a lack of data with ustekinumab in this scenario. Most studies are retrospective, but few prospective data are available. A cause–effect (proof of concept) direct relationship between biologics and an increase in postoperative morbidity has not been demonstrated to date. Several confounding factors such as previous use of steroids, malnutrition, and unfavorable abdominal conditions have a definitely effect on postoperative complications in CD. Biologics seem safe to be used in the perioperative period, but available data are still controversial. Multidisciplinary individualized decisions should be made on a case-to-case basis, adapting the surgical strategy according to risk factors involved.

Crystalloid Administration Is Associated with the Recovery of Pediatric Elective Roux-en-Y Hepaticojejunostomy

2019 ◽  
Vol 30 (02) ◽  
pp. 187-192
Author(s):  
Xingqin Tan ◽  
Jianxia Liu ◽  
Chunbao Guo
Keyword(s):  
Postoperative Complications ◽  
Hospital Stay ◽  
Bowel Movement ◽  
Length Of Hospital Stay ◽  
Postoperative Recovery ◽  
Fluid Administration ◽  
Postoperative Complication Rate ◽  
Crystalloid Fluid ◽  
High Fluid ◽  
Crystalloid Administration

Abstract Introduction Intraoperative fluid administration is important for postoperative recovery and might be associated with postoperative complications. Materials and Methods This retrospective review included 471 patients who underwent Roux-en-Y hepaticojejunostomy. Patients were separated into two groups based on whether they received low (<15.27 mL/kg/h) or high (>15.27 mL/kg/h) volumes of corrected crystalloid fluids. Propensity score matching was performed to adjust for any potential selection bios for the two groups. In 192 matched patients, clinical outcomes, including postoperative complications and length of hospital stay, were compared. Results Higher use of diuresis (p = 0.027) was found in the high fluid group. Receiving low volumes of crystalloids was associated with postoperative gastrointestinal functional recovery, reflected by the first defecation (odds ratio [OR], 0.69; 95% confidence interval [CI], 0.31–1.07; p = 0.047) and first bowel movement (OR, 0.56; 95% CI, 0.38–0.98; p = 0.013). However, the occurrence of renal complications did not show significant differences between the groups. A lower postoperative complication rate (OR, 0.54; 95% CI, 0.42–0.94; p = 0.016) was noted in patients with low crystalloids compared with high crystalloids. The total length of hospital stay was longer in patients with high crystalloid fluid (9.21 ± 3.24 days) than patients with low volumes (7.83 ± 2.58 days; p = 0.012). Conclusion Low crystalloid fluid administration was associated with favorable postoperative outcomes.

scholarly journals The Efficacy Analysis on Nursing of Female Pelvic Floor Reconstruction Operation in Perioperative Period

2015 ◽  
Vol 4 (2) ◽  
pp. 1
Author(s):  
Ailing Peng ◽  
Yuling Zhang
Keyword(s):  
Pelvic Organ Prolapse ◽  
Postoperative Complications ◽  
Pelvic Floor ◽  
Perioperative Period ◽  
Pelvic Organ ◽  
Obstetrics And Gynecology ◽  
Pelvic Floor Reconstruction ◽  
Female Pelvic Floor ◽  
Efficacy Analysis ◽  
Reconstruction Operation

<p><strong>Objective:</strong> This paper is to observe and discuss the best nursing procedure and measure of pelvic floor reconstruction. <strong>Method:</strong> Retrospectively analyze<strong> </strong>the clinical data of 16 cases pelvic organ prolapse patients who have been admitted in Obstetrics and Gynecology Department of the Fifth People’s Hospital of Ningxia from January 2013 to May 2015, and implement measures of preoperative and postoperative nursing. <strong>Results: </strong>16 cases patients are recovered well after operation with no complications.<strong> Conclusion: </strong>Effective nursing measurement is the key to reduce postoperative complications and increase achievement ratio of operation.<strong></strong></p>

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