scholarly journals Laparoscopy versus laparotomy in the treatment of benign ovarian cyst

2016 ◽  
Vol 11 (4) ◽  
Author(s):  
Humaira Akram ◽  
Sohail Khurshid Lodhi ◽  
Tabinda Rana
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Ovarian Cyst ◽  
Preoperative Evaluation ◽  
Normal Activity ◽  
Group I ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Laparoscopic Fenestration ◽  
Group Ii

Objective: To compare laparoscopy with laparotomy in the treatment of benign ovarian cyst in women under 40 years of age. Design: Experimental. Place and duration of study: The study was conducted over a period of one and half year from June 2003 to Nov 2004 in Obstetrics & Gynaecology Department, Unit-III, Lady Willingdon Hospital, Lahore. Subjects & Methods: The sixty consecutive patients of benign ovarian cysts who required surgical treatment underwent either Laparoscopy(group I). or laparotomy (group II). The laparoscopic fenestration, aspiration and cystectomies were performed in group I (30 patients). However, ovarian cystectomies, salpingo-oophorectomy and oophorectomy were performed by laparotomy in group II (30 patients). Results: The comparison was done with respect to duration of surgery intra-operative blood loss, time of mobilization, duration of hospital stay and amount of analgesia used, time to return to normal activity. The amount of analgesics used, time of mobilization, duration of hosp ital stay and time to return to normal activity was less (P<0.05) in Laparoscopy as compared to Laparotomy. There was statistically no significant difference in the duration of surgery, blood loss and post operative morbidity (P>0.05). Conclusion: With appropriate preoperative evaluation, laparoscopic surgery is safe and effective in treating benign ovarian cyst in women under 40 years of age where the risk of malignancy is low. It is associated with early mobilization, less use of analgesia, shorter hospital stay.

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.

Transcervical Drainage for Descending Necrotizing Mediastinitis May Be Sufficient

2011 ◽  
Vol 145 (5) ◽  
pp. 742-747 ◽  
Author(s):  
Ruey-Fen Hsu ◽  
Pei-Yin Wu ◽  
Chi-Kung Ho
Keyword(s):  
Mortality Rate ◽  
Hospital Stay ◽  
Chart Review ◽  
Medical Center ◽  
Case Series ◽  
Descending Necrotizing Mediastinitis ◽  
Group I ◽  
Significant Difference ◽  
Mediastinal Drainage ◽  
Group Ii

Objective. Descending necrotizing mediastinitis (DNM) is a serious form of mediastinitis with a high mortality rate. It is caused by the downward spread of an oropharyngeal or cervicofascial infection. The optimal surgical approach for this often fatal disease is controversial. This article describes the authors’ experience and characterizes the surgical strategies and treatment outcomes of patients with DNM. Study Design. Case series with chart review. Setting. A tertiary referral medical center. Subjects and Methods. This study conducted a retrospective chart review of patients with deep neck infections treated at a medical center from 1994 to 2007 and identified 29 patients with DNM. The clinical characteristics and outcomes were compared between patients treated with transcervical drainage alone (group I) and those with both cervical and thoracic drainage (group II). Results. There were 20 patients in group I and 9 patients in group II. The overall mortality rate was 10.3%. The mean duration of the hospital stay was 29.3 ± 15.5 days. There was no statistically significant difference in age, sex distribution, or duration from the appearance of symptoms to hospital admission between the 2 groups. The duration of hospital stay, tracheotomy rate, and mortality rate also did not differ significantly between the 2 groups. However, the numbers of surgeries were significantly higher in group II than in group I. Conclusion. Transthoracic mediastinal drainage is not a compulsory therapy, but timely, aggressive, transcervical mediastinal drainage with extensive debridement is very important for a good outcome when treating DNM patients.

Open cystectomy is still alive and well: Outcomes from a single-centre 6-year review

2018 ◽  
Vol 12 (3) ◽  
pp. 239-245
Author(s):  
Alexios Dosis ◽  
Blessing Dhliwayo ◽  
Patrick Jones ◽  
Iva Kovacevic ◽  
Jonathan Yee ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Radical Cystectomy ◽  
Length Of Hospital Stay ◽  
Categorical Variables ◽  
Complication Rates ◽  
Intraoperative Blood Loss ◽  
Single Centre ◽  
Significant Difference ◽  
Duration Of Surgery

Objectives: To compare perioperative and oncological outcomes between open and laparoscopic radical cystectomy in a single-centre setting. Materials and methods: This study was a retrospective cohort (level 2b evidence) non-randomised review of 228 radical cystectomies that were performed between January 2010 and February 2016. Primary outcome measures were operative time, complications, blood loss and length of hospital stay. Statistical analysis was performed using the SPSS v21.0. Quantitative values were compared with Student’s t-test; categorical variables with the chi-square test. Statistical significance was considered a result of an alpha value less than 0.05. A Kaplan–Meier survival analysis was also conducted. Results: Intraoperative blood loss was lower in laparoscopic surgery (855±673 vs. 716±570 mL, P=0.15), which had a significant impact on transfusion rates ( P=0.02). Operative times were lower in open surgery (339±52.9 vs. 353.1±67.1 minutes, P=0.10), while hospital stay was lower in the laparoscopic group (14.2±11.2 vs. 16.0±13.6 days, P=0.28). Five-year survival rates were superior for patients who underwent an open procedure but were not statistically significant ( P=0.10). Conclusion: This is, so far, the largest cohort to compare laparoscopic and open radical cystectomy. The laparoscopic approach can reduce the need for transfusion; however, there was no statistically significant difference in complication rates, duration of surgery, length of hospital stay or intraoperative blood loss, survival and margin positivity. Level of evidence: Not applicable for this multicentre audit.

scholarly journals Percutaneous endoscopic treatment of benign and malignant renal pelvis carcinoma: A single-center experience

2020 ◽  
Author(s):  
Xin Zhang ◽  
Wu Xiu Han ◽  
Sheng Yan Li ◽  
Hao Yuan Chen ◽  
Zhe Yu Tang ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Renal Pelvis ◽  
Operation Time ◽  
Laser Evaporation ◽  
Pathological Grade ◽  
Group I ◽  
Grade Ii ◽  
The Mean ◽  
Group Ii

Abstract Background Percutaneous nephrolithotomy (PCNL) is a safe and efficient treatment for intro-renal diseases, most of which are calculus disease. In this study, we carried out percutaneous endoscopic nephron-sparing ablation for renal carcinoma in carefully selected patients. Our aim was to evaluate whether percutaneous endoscopic nephron-sparing operation was feasible for patients with renal cell carcinoma.Methods A total of 15 patients with renal pelvis carcinoma were treated with laser evaporation under percutaneous endoscopy between January 2015 and September 2019 ( group I ). Another 13 patients who received standard radical nephroureterectomy were recruited as the control group (group II). We recorded demographic data of the patients, the indication for surgery, tumor pathological grade, size and side of tumor, and the intraoperative and postoperative outcome, including the duration of surgery, length of hospital stay, and complication rate, as well as progression-free survival (PFS).Results In both groups, all of the patients received flexible ureteroscopy. In group I, 14 patients had transitional renal cell carcinoma (UCC), four had pathological grade I, nine had grade II, and one had hemangiopericytoma. In group II, all patients had UCC, five had pathological grade I, and eight had grade II. In group I, the mean operation time was 118 min (65–236 min), the mean blood loss was 110 ml (55–220 ml), and the mean hospital stay was 9 days (7–12 days). During follow-up, two patients died and two had recurrence; among them, one had systematic bone metastasis. The PFS rate was 66.7% (10/15). In group II, the mean operation time was 265 min (185–436 min), the mean blood loss was 133 ml (85–240 ml), and the mean hospital stay was 13 days (9–16 days). During the follow-up, two patients died and there was no local or systematic metastasis. The PFS rate was 84.6% (11/13). There was no significant difference in blood loss between the groups. However, the operation time and mean hospital stay were significantly shorter in group I compared with that in group II ( P < 0.05). But the PFS rate was significantly higher in group II than in group I (P < 0.05).Conclusions This study shows that laser evaporation under percutaneous endoscopy for renal pelvis carcinoma is a safe, effective, and technically feasible procedure for treating benign and malignant renal pelvis carcinoma.

scholarly journals Evaluation of idiopathic scoliosis by anterior and posterior arthrodesis

2015 ◽  
Vol 14 (2) ◽  
pp. 88-92 ◽  
Author(s):  
Jean Carlo Frigotto Queruz ◽  
Allan Kato ◽  
Carlos Abreu de Aguiar ◽  
Luiz Muller Avila ◽  
Luis Eduardo Munhoz da Rocha
Keyword(s):  
Idiopathic Scoliosis ◽  
Hospital Stay ◽  
Posterior Approach ◽  
Thoracolumbar Spine ◽  
Average Hospital ◽  
Icu Stay ◽  
Group I ◽  
Number Of Patients ◽  
Significant Difference ◽  
Group Ii

<sec><title>OBJECTIVE:</title><p> To evaluate comparatively surgical treatment of adolescent idiopathic scoliosis type 5CN by anterior and posterior approach.</p></sec><sec><title>METHODS:</title><p> The study consists of a comparative retrospective study of two groups of patients with the thoracolumbar spine arthrodesis technique by anterior and posterior approach. Twenty and two patients were sequentially selected, 11 operated by anterior approach - called Group I - and 11 by posterior approach - Group II. Anamnesis and physical examination were performed, as well as length of hospital stay and ICU stay, degree of correction, comorbidities and pre and postoperative radiographic images data were gathered.</p></sec><sec><title>RESULTS:</title><p> The mean age was 13.7 years in Group I and 14 years in Group II. The average hospital stay was 5.81 days for Group I and 5 for Group II. The average ICU stay was 2.81 and 2 days, respectively. Considering the operated levels, Group I presented an average of 4.81 vertebrae (4-6 levels), and Group II presented an average of 6.36 vertebrae (5-11 levels). Complications did not show statistically significant difference.</p></sec><sec><title>CONCLUSION:</title><p> Despite the limited number of patients in groups, it was demonstrated that the posterior approach reduces the number of days of hospitalization and ICU stay. However, it was found increased levels included in the arthrodesis.</p></sec>

scholarly journals Single- and multistage surgical treatment of patients with degenerative sagittal imbalance

2021 ◽  
Vol 18 (2) ◽  
pp. 44-53
Author(s):  
E. S. Baikov ◽  
A. V. Peleganchuk ◽  
A. J. Sanginov ◽  
O. N. Leonova ◽  
A. V. Krutko
Keyword(s):  
Surgical Treatment ◽  
Blood Loss ◽  
Charlson Comorbidity Index ◽  
Sagittal Imbalance ◽  
Group I ◽  
Duration Of Surgery ◽  
Comorbidity Index ◽  
Group Ii ◽  
Clinical And Radiological Results ◽  
High Charlson Comorbidity Index

Objective. To analyze the nearest clinical and radiological results of simultaneous and staged surgical treatment of patients with degenerative sagittal imbalance.Material and Methods. Retrospective monocentric cohort study included analysis of data from 54 patients who underwent simultaneous combination of surgical methods with obligatory corrective anterior fusion at the L4–L5 or at L4–L5 and L5–S1 levels (Group I, n = 27) or similar surgical intervention though divided into stages with an interval of 5 days or more (Group II, n = 27). A comparison of clinical, radiological, and operational data during inpatient treatment was carried out.Results. The duration of surgery was 410.93 ± 76.34 minutes in Group I and 594.63 ± 102.61 minutes in Group II (p = 0.000001); the  blood loss was 926.67 ± 378.63 ml versus 1345.19 ± 522.97 ml, respectively (p = 0.001575). Postoperative clinical and radiological parameters did not differ between groups: VAS back (p = 0.248647), VAS leg (p = 0.196140), PT (p = 0.115965), SVA (p = 0.208449), LL (p = 0.023654), LDI (p = 0.931646), PI-LL (p = 0.693045), GAP (p = 0.823504), and restoration of the ideal Russoly type (p = 0.111476). The incidence of perioperative complications in groups was comparable: 17 (62.96 %) in Group I and 15 (55.56 %) in Group II (p = 0.583171). Patients with a high Charlson comorbidity index had a significantly higher incidence of complications (p = 0.023471). The index of surgical invasiveness in Group I had a significant correlation with the total number of complications (r = 0.421332).Conclusion. Clinical and radiological results and the incidence of complications are comparable between single- and multistage approaches to correct sagittal balance disorders. In staged treatment, the total duration of surgery and the volume of blood loss are significantly higher. With a high Charlson comorbidity index and Mirza surgical invasiveness index, a multistage approach to the treatment of patients with sagittal imbalance is preferred.

scholarly journals Short Course versus Standard Course Antibiotic Treatment for Neonatal Sepsis

2017 ◽  
Vol 13 (1) ◽  
pp. 124-127
Author(s):  
Tahsinul Amin ◽  
Ayesha Najma Nur
Keyword(s):  
Clinical Outcome ◽  
Antibiotic Therapy ◽  
Hospital Stay ◽  
Developmental Delay ◽  
Antibiotic Treatment ◽  
Neonatal Sepsis ◽  
Group I ◽  
Short Course ◽  
Significant Difference ◽  
Group Ii

Introduction: Neonatal sepsis remains an important cause of morbidity and mortality and often requires prompt empiric treatment. However, only a minority of babies who receive antibiotics for suspected sepsis have an infection. Antimicrobial exposure in infancy has important short-term and long-term consequences. There is no consensus regarding empirical antimicrobial regimens. Objective: To compare efficacy and benefits of short course (5 days) over the standard course (7 days) antibiotic treatment for neonatal sepsis. Materials and Methods: The study was a randomized controlled trial done in the neonatal ward in a tertiary level hospital comprising total 100 term neonates equally divided in to two groups by randomization where Group-I (5 days antibiotic therapy) was compared against Group-II (7 days antibiotic therapy) in clinical recovery, hospital stay, morbidity such as seizure, developmental delay etc and mortality. Results: The study results showed that both the Group-I and Group-II were comparable in baseline clinical data and predisposing factors; however, there was no significant difference between the two groups in clinical features e.g. hypotonia (24% vs 26%, p>0.05), poor primitive reflexes (46% vs 52%, p>0.05), temperature instability (34% vs 28%, p>0.05), feeding intolerance (16% vs 14%, p>0.05), apnea / respiratory distress (28% vs 34%, p>0.05) and in clinical outcome e.g. hospital stay (5.24±0.78 vs 7.86±0.42, p>0.05), recovery (86% vs 90%, p>0.05), death (14% vs 10%, p>0.05), seizure disorder (8% vs 6%, p>0.05) and developmental delay (6% vs 4%, p>0.05). Conclusion: This study showed that there was no significant difference between the study groups in clinical outcome, however, short course antibiotic (5 days) is equally effective but economically more beneficial to standard course antibiotic (7 days) therapy for neonatal sepsis. Journal of Armed Forces Medical College Bangladesh Vol.13(1) 2017: 124-127

scholarly journals Early same-admission laparoscopic cholecystectomy for acute mild biliary pancreatitis: a retrospective study

2019 ◽  
Author(s):  
yunxiao lyu ◽  
Yunxiao Cheng ◽  
Bin Wang
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Optimal Time ◽  
Control Group ◽  
Biliary Pancreatitis ◽  
Group I ◽  
Estimated Blood Loss ◽  
Conversion To Open Cholecystectomy ◽  
Duration Of Surgery ◽  
Group Ii

Abstract Background As the standard procedure for the surgical treatment for gallbladder stones, we investigated the controversy surrounding the optimal time for laparoscopic cholecystectomy (LC) for acute mild biliary pancreatitis.Methods This retrospective study included medical records of all patients who were admitted with a diagnosis of acute mild biliary pancreatitis at Dongyang People’s Hospital from July 2011 to June 2018. Main outcomes included perioperative characteristics, length of hospital stay, complications, morbidity, and mortality.Results A total of 119 patients were divided into an early LC group (Group I; 52 patients) and a control group (Group II; 67 patients). The mean age was 60.5 years (range, 30–79 years). Conversion to open cholecystectomy (COC) was performed in 17 patients (6 patients in Group I and 11 patients in Group II, P=0.62). There were no significant differences in terms of estimated blood loss and duration of surgery (P=0.08 and P=0.64, respectively). Bile duct injury (BDI) occurred in one patient from each group. The overall hospital stays in Group I were significantly less than in Group II (10.86±3.21 vs 13.29±4.51, P=0.001). Compared with postoperative bile leakage (P=0.72) and postoperative morbidity (P=0.97) and mortality, there were no significant differences between the groups.Conclusions Early LC during the same admission is safe for acute mild biliary pancreatitis and has the advantage of shortening overall hospital stay. There was no significant increase in COC, BDI, and complications.

Preoperative Angiography and Transarterial Embolization in the Management of Carotid Body Tumor: A Single-Center, 10-Year Experience

Neurosurgery ◽  
2010 ◽  
Vol 67 (4) ◽  
pp. 941-948 ◽  
Author(s):  
Jiaping Li ◽  
Shenming Wang ◽  
Chishing Zee ◽  
Jianyong Yang ◽  
Wei Chen ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Carotid Body ◽  
Operation Time ◽  
Class Ii ◽  
Preoperative Embolization ◽  
Intraoperative Blood Loss ◽  
Class Iii ◽  
Group I ◽  
Group Ii

Abstract BACKGROUND: Sixty percent of paragangliomas are located unilaterally at the carotid bifurcation. These are referred to as carotid body tumors (CBTs). OBJECTIVE: To present our 10-year experience in the management of patients with CBTs, and to evaluate the efficacy of angiography and preoperative embolization technique in this retrospective study. METHODS: Sixty-two patients with surgically removed CBTs (Shamblin class II and III), were divided into two groups. Group I, the preoperative embolization group, included 33 patients with 11 class II lesions and 25 class III lesions. Group II, the group that had surgery only, without preoperative embolization, included 29 patients with 9 class II lesions and 21 class III lesions. Comparisons were made between the groups in terms of mean intraoperative blood loss, mean operation time, mean postoperative hospital stay, and clinical complications. RESULTS: In group I, post-embolization angiography demonstrated complete tumor devascularization in 25 (76%) lesions and partial devascularization in 11 (24%) lesions. All but 1 (2%) lesion were completely excised. Mean intraoperative blood loss, mean operation time, and mean hospital stay were 354.8 ± 334.4 mL, 170.3 ± 75.4 min, 8.0 ± 2.1days in group I and 656.4 ± 497.4 mL, 224.6 ± 114.0 min, 9.5 ± 3.5days in group II, respectively. In group II, 27 lesions (91%) were completely removed. The transient ischemic attack (TIA) and cranial nerve injury incidence rates were 10.3% and 13.8% in group II and only 3% for TIA in group I. CONCLUSION: These results suggest angiography is highly valuable for the diagnosis of CBT. Preoperative selective embolization of CBT is an effective and safe adjunct for surgical resection, especially for Shamblin class II and III tumors.

scholarly journals Which Criterion for Wound Drain Removal is Better Following Posterior 1-Level or 2-Level Lumbar Fusion With Instrumentation: Time Driven or Output Driven?

2021 ◽  
pp. 219256822110137
Author(s):  
Hang Shi ◽  
Zhi-Hao Huang ◽  
Yong Huang ◽  
Lei Zhu ◽  
Zan-Li Jiang ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Lumbar Fusion ◽  
Demographic Characteristics ◽  
Total Blood ◽  
Duration Of Hospital Stay ◽  
Drain Removal ◽  
Group I ◽  
Wound Drain ◽  
Group Ii

Study Design: Case-control study. Objectives: To compare the outcomes of 2 different criteria (time driven and output driven) for wound drain removal and identify which one is better. Methods: 743 patients who underwent posterior lumbar fusion with instrumentation involving 1 or 2 motion segments were enrolled in this study. Based on the different criteria for drain removal, the patients were divided into 2 groups. The drains were discontinued by time driven (postoperative day 2) in group I and output driven (<50 ml per day) in group II. Demographic characteristics, perioperative parameters and clinical outcomes were compared between the 2 groups. Results: The demographic characteristics in both groups were comparable. The postoperative drain output, total blood loss, postoperative timing of ambulation, and postoperative duration of hospital stay in group I were lower than those in group II ( P < 0.001). There was a higher proportion of patients requiring postoperative blood transfusion in group II, but not to a level of statistical significance ( P = 0.054). There was no statistical significant difference in the incidence of surgical site infection (SSI) or symptomatic spinal epidural hematoma (SEH) between the 2 groups ( P > 0.05). Conclusions: This study reveals that there are more benefits of wound drain removal by time driven than that by output driven for patients undergoing posterior 1-level or 2-level lumbar fusion with instrumentation, including less postoperative drain output, less total blood loss, earlier postoperative timing of ambulation and less postoperative duration of hospital stay without increasing the incidence of postoperative SSI or symptomatic SEH.

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