scholarly journals Minimally Invasive Myxoma Resection: A Single-center 5 Years’ Experience

2021 ◽  
Author(s):  
Feng Lu ◽  
Xin Yang ◽  
Jian-Jun Xu ◽  
Yong-Bing Wu ◽  
Shu-Qiang Zhu ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Minimally Invasive ◽  
Postoperative Hospital Stay ◽  
Transfusion Rate ◽  
Single Center ◽  
Stay Time ◽  
Postoperative Drainage ◽  
Hospital Stays ◽  
The Difference ◽  
Ventilator Time

Abstract BackgroundIncreasing demand for minimally invasive myxoma resection. This study aimed to investigate the safety and feasibility of minimally invasive myxoma resection. MethodsThis is a retrospective study, we collected information on 95 patients who underwent myxoma resection from January 2016 to December 2020. According to the operative approach, they were divided into a minimally invasive myxoma resection(Mini-MR) group (n=30) and a sternotomy myxoma resection(SMR) group (n=65), we compared the intraoperative and postoperative data between the two groups. ResultsPostoperative ventilator assisted time, CSICU time and postoperative hospital stay of Mini-AVR were shorter than SAVR [(13.05 ± 4.98) VS (17.07 ± 9.52)h ;(1.73 ± 0.29) VS (2.27 ± 1.53)d; (6.20 ± 1.50) VS (9.48 ± 3.37)d], the difference was statistically significant (P <0.05). Mini-AVR has lower postoperative drainage and blood transfusion rate of the first 24 h compared with SAVR [(38.93 ± 69.62) VS (178.25 ± 153.06)ml; 26.6% VS 63.1%], the differences were statistically significant (P <0.05). ConclusionMini-MR has the advantages of less CSICU stay time, less ventilator time, less postoperative drainage the first 24h, less blood transfusion, fewer postoperative hospital stays, and faster recovery. Mini-MR is a safe and feasible surgical procedure for the resection of myxoma.

Evaluation of Erythropoietin Stimulating Agents (ESA) and Their Effect on Blood Optimization for Cardiac Surgery

2020 ◽  
pp. 089719002096927
Author(s):  
Kristina S. Gill ◽  
Abigail D. Antigua ◽  
A. Kacee Barnett ◽  
Aubrey J. Hall ◽  
Charles T. Klodell
Keyword(s):  
Cardiac Surgery ◽  
Blood Transfusion ◽  
Retrospective Cohort ◽  
Blood Transfusions ◽  
Transfusion Rate ◽  
Blood Products ◽  
Single Center ◽  
Drug Reactions ◽  
Significant Difference ◽  
Erythropoietin Stimulating Agents

Background: Cardiovascular surgeries increase the risk of receiving blood transfusions. Erythropoietin stimulating agents (ESAs) have been used to decrease the transfusion rate. The objective of this study was to evaluate the administration of blood products post-cardiothoracic surgery after receiving ESAs. Methods: This is a single-center, retrospective cohort study. Results: Between May 2017 to May 2018, 52 adult patients underwent cardiac surgery and received ESAs pre-operatively and/or post-operatively. A total of 35 patients were included in the study and 21 (60%) patients did not require a blood transfusion while 14 (40%) patients required a blood transfusion ( p = 0.597). The change in hemoglobin (Hgb = 0.773 g/dL, 1.7 g/dL; p = 0.002) and hematocrit (Hct = 2.31%, 4.3%; p = 0.04) was significantly different in patients who received ESAs alone versus ESAs with blood transfusion. Adverse drug reactions showed no significant difference between groups. Conclusions: In patients undergoing cardiac surgery, ESAs did not significantly reduce the need for blood transfusion. Future and larger studies are necessary to evaluate the effect of ESAs on blood transfusion.

scholarly journals Efficacy and Cost Effectiveness of Universal Preoperative Iron Studies in Total Hip and Knee Arthroplasty

2021 ◽  
Author(s):  
Viju Daniel Varghese ◽  
David Liu ◽  
Donald Ngo ◽  
Suzanne Edwards
Keyword(s):  
Blood Transfusion ◽  
Knee Arthroplasty ◽  
Universal Screening ◽  
Intravenous Iron ◽  
Allogenic Blood Transfusion ◽  
Transfusion Rate ◽  
Allogenic Blood ◽  
Total Hip ◽  
Hip And Knee Arthroplasty ◽  
The Difference

Abstract Background Prevalence of anaemia in patients planned for total hip and knee arthroplasty is about 20%. Optimising preoperative haemoglobin levels by iron supplementation has been shown to decrease transfusion rates, complications and associated morbidity. The need for universal screening with iron studies of all elective arthroplasty patients is not clearly defined at present. Methods Retrospective review of 2 sequential cohorts of patients undergoing primary hip or knee arthroplasty by a single surgeon at a single centre between January 2013 and December 2017. The first group of patients underwent pre-operative iron studies only if found to be anaemic, with a haemoglobin below 12g/dL. From January 2015 all patients irrespective of the presence of anaemia were screened with a complete iron profile before surgery. Patients with a confirmed iron deficiency were administered with intravenous iron prior to surgery. The 2 cohorts were compared with regards to blood transfusion rate post-operatively and cost efficiency for universal screening with iron studies. Results There was a net decrease in allogenic blood transfusion rate from 4.76–2.92% when universal iron studies were introduced but the difference was not statistically significant. Obtaining universal pre-operative iron studies is cost neutral with the price of allogenic blood transfusion in a similar cohort. We also diagnosed 5 patients with occult malignancies. Conclusions Universal screening with pre-operative iron studies and iron infusion in elective arthroplasty patients may reduce allogenic blood requirements and is cost neutral. An additional benefit is the potential to diagnose asymptomatic malignancies. Further studies are required to show the true benefit of universal pre-operative iron screening.

scholarly journals Comparative Evaluation of Post-TURP Complications in Patients with BPH Presenting with and Without Acute Urinary Retention

2021 ◽  
Author(s):  
Veda Murthy Reddy Pogula ◽  
Ershad Hussain Galeti ◽  
Ifrah Ahmad ◽  
Bhargava Reddy Kanchi
Keyword(s):  
Blood Transfusion ◽  
Hospital Stay ◽  
Urinary Retention ◽  
Acute Urinary Retention ◽  
Statistical Significance ◽  
Length Of Hospital Stay ◽  
Transfusion Rate ◽  
P Values ◽  
Turp Syndrome ◽  
Hospital Stays

Abstract Background Benign prostatic hyperplasia (BPH) is a prevalent urological condition affecting men at an older age. Acute urinary retention (AUR) is a severe symptom of men who develop BPH. TURP is the gold standard as the management of BPH is concerned. Our study tried to compare the post-TURP complications between patients presented with and without AUR. Materials and Methods We enrolled 126 patients, out of which 74 were in the AUR group and 52 in the non-AUR group. The mean age of patients with AUR was 62.51 years, and that for patients without AUR was 61.06 years. Statistical significance was noted in our study in patients with AUR and without AUR regarding the prostate's grading by DRE, the volume of gland, PSA level, post-TURP UTI, recatheterization post TURP, length of hospital stays with p-values 0.000, 0.000, 0.006, 0.004, 0.007, and 0.000, respectively. Statistical significance was not noted in patients with AUR and without AUR with regard to the grading of hypertension, diabetes mellitus, ischemic heart disease, post-op TURP syndrome, post-TURP hematuria, patients needing a blood transfusion, post-TURP sepsis, LUTS, post-TURP stricture, resurgery for clot retention with p values of 0.918, 1.000, 1.000, 1.000, 0.523, 0.642, 1.000, 0.319, 1.000, and 1.000, respectively. Conclusion Our study shows that post-TURP complications such as hematuria, blood transfusion rate, post-op UTI, sepsis, recatheterization, lower urinary tract stricture, resurgery, TUR syndrome, and the length of hospital stay were higher in patients who presented with AUR than in those without AUR. Post-TURP UTI complications, recatheterization rate, and the length of hospital stay were statistically significant in the AUR group compared with the non-AUR group. Therefore, it is better to intervene earlier before the patients develop AUR to minimize the complications and maximize the outcomes.

scholarly journals Intraoperative and postoperative complications in the surgical treatment of craniosynostosis: minimally invasive versus open surgical procedures

2018 ◽  
Vol 21 (2) ◽  
pp. 112-118 ◽  
Author(s):  
Sebastian Arts ◽  
Hans Delye ◽  
Erik J. van Lindert
Keyword(s):  
Blood Transfusion ◽  
Minimally Invasive ◽  
Surgical Procedures ◽  
Neurosurgical Procedures ◽  
Transfusion Rate ◽  
Minimally Invasive Procedures ◽  
Invasive Procedures ◽  
Neurosurgical Department ◽  
Intraoperative Complication ◽  
Endoscopic Procedures

OBJECTIVETo compare minimally invasive endoscopic and open surgical procedures, to improve informed consent of parents, and to establish a baseline for further targeted improvement of surgical care, this study evaluated the complication rate and blood transfusion rate of craniosynostosis surgery in our department.METHODSA prospective complication registration database that contains a consecutive cohort of all pediatric neurosurgical procedures in the authors’ neurosurgical department was used. All pediatric patients who underwent neurosurgical treatment for craniosynostosis between February 2004 and December 2014 were included. In total, 187 procedures were performed, of which 121 were endoscopically assisted minimally invasive procedures (65%). Ninety-three patients were diagnosed with scaphocephaly, 50 with trigonocephaly, 26 with plagiocephaly, 3 with brachycephaly, 9 with a craniosynostosis syndrome, and 6 patients were suffering from nonsyndromic multisutural craniosynostosis.RESULTSA total of 18 complications occurred in 187 procedures (9.6%, 95% CI 6.2–15), of which 5.3% (n = 10, 95% CI 2.9–10) occurred intraoperatively and 4.2% (n = 8, 95% CI 2.2–8.2) occurred postoperatively. In the open surgical procedure group, 9 complications occurred: 6 intraoperatively and 3 postoperatively. In the endoscopically assisted procedure group, 9 complications occurred: 4 intraoperatively and 5 postoperatively. Blood transfusion was needed in 100% (n = 66) of the open surgical procedures but in only 21% (n = 26, 95% CI 15–30) of the endoscopic procedures. One patient suffered a transfusion reaction, and 6 patients suffered infections, only one of which was a surgical site infection. A dural tear was the most common intraoperative complication that occurred (n = 8), but it never led to postoperative sequelae. Intraoperative bleeding from a sagittal sinus occurred in one patient with only minimal blood loss. There were no deaths, permanent morbidity, or neurological sequelae.CONCLUSIONSComplications during craniosynostosis surgery were relatively few and minor and were without permanent sequelae in open and in minimally invasive procedures. The blood transfusion rate was significantly reduced in endoscopic procedures compared with open procedures.

scholarly journals Comparison of Vacuum-Assisted Sheath and Normal Sheath in Minimally Invasive Percutaneous Nephrolithotomy: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Ling Zhu ◽  
Zhenghao Wang ◽  
Ye Zhou ◽  
Liping Gou ◽  
Yan Huang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Transfusion ◽  
Minimally Invasive ◽  
Percutaneous Nephrolithotomy ◽  
Postoperative Infection ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Transfusion Rate ◽  
Minimally Invasive Percutaneous Nephrolithotomy

Abstract Background A systematic review and meta-analysis was conducted to compare the safety and efficacy between the vacuum-assisted sheath and conventional sheath in minimally invasive percutaneous nephrolithotomy (MPCNL) in the treatment of nephrolithiasis. Methods PubMed, Web of Science, Embase, EBSCO, and Cochrane library databases (updated March 2021) were searched for studies assessing the effect of vacuum-assisted sheath in patients who underwent MPCNL. The search strategy and study selection processes were managed according to the PRISMA statement. Results Three randomized controlled trials and two case-controlled trials that satisfied the inclusion criteria were enrolled in this meta-analysis. Overall, the stone-free rate (SFR) in patients who underwent vacuum-assisted sheath was significantly higher than those who underwent conventional sheath (RR = 1.18, 95% CI = 1.08,1.29; P = 0.0002), with insignificant heterogeneity among the studies (I2 = 44%, P = 0.13). In terms of the outcome of complications, vacuum-assisted sheath could bring a benefit to the postoperative infection rate (RR = 0.45, 95%CI = 0.33,0.61; P < 0.00001) with insignificant heterogeneity among the studies (I2 = 0%, P = 0.76). There was no significant difference in blood transfusion rate (RR = 0.54, 95%CI = 0.23,1.29; P = 0.17) with insignificant heterogeneity (I2 = 41%, P = 0.15,). Only two studies reported the perforation and the results were statistically insignificant (RR = 0.25, 95%CI = 0.05,1.17; P = 0.08) with insignificant heterogeneity (I2 = 0%, P = 0.43). Conclusions Using vacuum-assisted sheath in MPCNL improves the safety and efficiency compared to the conventional sheath. Vacuum-assisted sheath significantly increases the SFR and reduces complications like postoperative infection, blood transfusion, and perforation

The Difference in Surgical Site Infection Rates Between Open and Minimally Invasive Spine Surgery for Degenerative Lumbar Pathology: A Retrospective Single Center Experience of 1442 Cases

2018 ◽  
Vol 16 (6) ◽  
pp. 750-755 ◽  
Author(s):  
Kyle Mueller ◽  
David Zhao ◽  
Osiris Johnson ◽  
Faheem A Sandhu ◽  
Jean-Marc Voyadzis
Keyword(s):  
Minimally Invasive ◽  
Surgical Site Infection ◽  
Infection Rate ◽  
Open Surgery ◽  
Healthcare Resource Utilization ◽  
Site Infection ◽  
Single Center ◽  
Single Center Experience ◽  
Fold Reduction ◽  
The Difference

Abstract BACKGROUND Surgical site infection (SSI) in spinal surgery contributes to significant morbidity and healthcare resource utilization. Few studies have directly compared the rate of minimally invasive surgery (MIS) SSI with open surgery. OBJECTIVE To investigate whether MIS techniques had a lower SSI rate in degenerative lumbar procedures as compared with traditional open techniques. METHODS A single-center, retrospective review of a prospectively collected database was queried from January 2013 to 2016 for adult patients who underwent lumbar decompression and/or instrumented fusion for which the surgical indication involved degenerative disease. The SSI rate was determined for all procedures as well as in the open and minimally invasive groups. Risk factors associated with SSI were also reviewed for each patient. RESULTS A total of 1442 lumbar spinal procedures were performed during this time period. Of these, there were 961 MIS and 481 open (67% vs 33%, respectively). The overall SSI rate was 1.5% (21/1442). The surgical site infection rate for MIS was less than open techniques (0.5% vs 3.3%; P = .0003). For decompression only, the infection rate for MIS and open was 0.4% vs 3.9% (P = .04), and for decompression with fusion it was 0.7% vs 2.6%, respectively (P = .68). CONCLUSION Our study demonstrates a significant 7-fold reduction in SSIs when comparing MIS with open surgery. This significance was also demonstrated with a 10-fold reduction for procedures involving decompression alone. Procedures that require fusion as well as decompression showed a trend towards a decreased infection rate that did not reach clinical significance.

scholarly journals Assessment of the learning curve of total thoracoscopic mitral valve repair using cumulative sum analysis (CUSUM)

2021 ◽  
Author(s):  
Chao Song ◽  
YunLong Fan ◽  
Siming Zhu ◽  
Shengli Jiang
Keyword(s):  
Mechanical Ventilation ◽  
Mitral Valve ◽  
Minimally Invasive ◽  
Learning Curve ◽  
Hospital Stay ◽  
Mitral Valve Repair ◽  
Postoperative Hospital Stay ◽  
Valve Repair ◽  
Cumulative Sum Analysis ◽  
Postoperative Drainage

Objective: To evaluate the learning curve and safety of total thoracoscopic mitral valve repair (MVP). Background: Total thoracoscopic MVP is characterized by minimal trauma, minimal bleeding, and short postoperative recovery time. The learning curve of any new procedure needs to be evaluated for learning and replication. However, minimally invasive mitral valve technique is a wide-ranging concept, no further analysis of the outcomes and learning curve of total thoracoscopic mitral valve repair has been performed. Methods: One hundred and fifty consecutive patients who underwent minimally invasive MVP alone without concurrent surgery were evaluated. Using Cardiopulmonary bypass (CPB) time and Aortic clamping (AC) time as evaluation variables, we visualized the learning curve for total thoracoscopic MVP using Cumulative sum analysis. We also analyzed important postoperative variables such as postoperative drainage, duration of mechanical ventilation, ICU stay and postoperative hospital stay. Results: The slope of the fitted curve was negative after 75 procedures, and the learning curve could be crossed after the completion of the 75th procedure when AC and CPB time were used as evaluation variables. And as the number of surgical cases increased, CPB, AC, postoperative drainage, duration of mechanical ventilation, ICU stay and postoperative hospital stay all showed different degrees of decrease. The incidence of postoperative adverse events is similar to conventional mitral valve repair. Conclusions: Compared to conventional MVP, total thoracoscopic MVP provides the same satisfactory surgical results and stabilization can be achieved gradually after completion of the 75th procedure.

scholarly journals Efficacy and cost-effectiveness of universal pre-operative iron studies in total hip and knee arthroplasty

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Viju Daniel Varghese ◽  
David Liu ◽  
Donald Ngo ◽  
Suzanne Edwards
Keyword(s):  
Blood Transfusion ◽  
Knee Arthroplasty ◽  
Universal Screening ◽  
Intravenous Iron ◽  
Allogenic Blood Transfusion ◽  
Transfusion Rate ◽  
Allogenic Blood ◽  
Total Hip ◽  
Hip And Knee Arthroplasty ◽  
The Difference

Abstract Background The prevalence of anaemia in patients planned for total hip and knee arthroplasty is about 20%. Optimising pre-operative haemoglobin levels by iron supplementation has been shown to decrease transfusion rates, complications and associated morbidity. The need for universal screening with iron studies of all elective arthroplasty patients is not clearly defined at present. Methods Retrospective review of 2 sequential cohorts of patients undergoing primary hip or knee arthroplasty by a single surgeon at a single centre between January 2013 and December 2017. The first group of patients underwent pre-operative iron studies only if found to be anaemic, with a haemoglobin below 12g/dl. From January 2015, all patients irrespective of the presence of anaemia were screened with a complete iron profile before surgery. Patients with a confirmed iron deficiency were administered with intravenous iron prior to surgery. The 2 cohorts were compared with regard to blood transfusion rate post-operatively and cost efficiency for universal screening with iron studies. Results There was a net decrease in the allogenic blood transfusion rate from 4.76 to 2.92% when universal iron studies were introduced but the difference was not statistically significant. Obtaining universal pre-operative iron studies is cost neutral with the price of allogenic blood transfusion in a similar cohort. We also diagnosed 5 patients with occult malignancies. Conclusions Universal screening with pre-operative iron studies and iron infusion in elective arthroplasty patients may reduce allogenic blood requirements and is cost neutral. An additional benefit is the potential to diagnose asymptomatic malignancies. Further studies are required to show the true benefit of universal pre-operative iron screening.

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