scholarly journals Methods of Diagnostic Laparoscopy

2016 ◽  
Vol 23 (3) ◽  
Author(s):  
M G Gonchar ◽  
A Ye Bogush ◽  
L D Pryymak

During the period of three years, 1,414 patients underwent laparoscopic surgery. 18 patients underwent diagnostic laparoscopy under local anaesthesia. All these patients in addition to the suspected pathology of the abdominal cavity were diagnosed with severe concomitant cardiopulmonary pathology including acute myocardial infarction, ischemic and hemorrhagic stroke, coma of various genesis, pneumonia. The proposed technique included a local anaesthesia around the navel, laparolifting, the insertion of a laparoscope and a short inspection (3-5 min) of the abdominal organs. Sometimes, especially in patients with hypertension, spinal or epidural anesthesia was used. While diagnosticating the pathology, if necessary, the anaesthesia was given, carboperitonium was applied and the necessary surgery was performed. 

2008 ◽  
Vol 54 (1) ◽  
pp. 84
Author(s):  
Jin Hun Chung ◽  
Yong Han Seo ◽  
Ki Ryang Ahn ◽  
Chun Sook Kim ◽  
Kyu Sik Kang ◽  
...  

Author(s):  
Ruizhi Shi ◽  
Yun Wang ◽  
Judith H Lichtman ◽  
Kumar Dharmarajan ◽  
Frederick A Masoudi ◽  
...  

Background: Elderly survivors of acute myocardial infarction (AMI) are at elevated risk for hemorrhagic stroke, which has a mortality rate of approximately 50%. Increasing use of warfarin for arterial fibrillation and anti-platelet agents for AMI combined with an increasing aging population may have influenced the risk of post-AMI strokes. We sought to characterize temporal trends in the risk for and mortality from hemorrhagic stroke over 12 years among older AMI survivors of different age, sex, race, revascularization status, and region within the US. Methods: We used 100% of Medicare inpatient claims data to identify all fee-for-service (FFS) patients aged> 64 years who were hospitalized for AMI in 1999-2010. We excluded patients who died during the hospitalization or were transferred. Revascularization procedures were identified during the index admission. We used a Cox proportional-hazards regression model to estimate the risk-adjusted annual changes in one-year hemorrhagic stroke hospitalization after AMI, overall and by subgroups. Changes were adjusted by age, gender, race, medical history and comorbidities. We calculated the 30-day mortality among patients readmitted for hemorrhagic stroke. Stroke belt regions were defined as the states with high stroke hospitalization rates in the southeast United States. Results: Among 2,433,036 AMI hospitalizations and 4,852 hemorrhagic stroke readmissions, the risk-adjusted one-year post-AMI hemorrhagic stroke rate remained stable from 1999 to 2010 (range, 0.2% to 0.3%). No significant trends were found for post-AMI stroke rates across all age-sex-race groups and all treatment groups (Figure). Thirty-day mortality rates for stroke after AMI did not show significant changes (1999, 46.7%, 95% CI 39.9%-53.7%; 2010, 50.7%, 95% CI 45.3%-56.1%; range: 46.5% to 54.6%). No difference was found in post-AMI hemorrhagic stroke rates between the stroke belt and non-stroke belt regions. Conclusions: From 1999 to 2010, the overall hospitalization rates of hemorrhagic stroke after AMI were relatively stable without significant changes across all subgroups. Thirty-day mortality rates remained largely unchanged over time. Stroke risk in the stroke belt was not found significantly higher comparing with non-stroke belt states.


2021 ◽  

A few months after the onset of the coronavirus Disease 2019 (COVID-19) pandemic, the worse prognoses of acute myocardial infarction, ischemic and hemorrhagic stroke, and cardiac arrest were reported. This study aimed to investigate the changes in the characteristics and prognoses of these diseases in the emergency department (ED) over a year after pandemic’s onset. This was a retrospective observational study. The year 2019 was defined as the pre-period, while the year from February 2020 to January 2021 was defined as the post-period. Adult patients diagnosed with acute myocardial infarction, ischemic stroke, hemorrhagic stroke, or cardiac arrest during the study period were included. The primary outcome was in-hospital mortality. Time series analyses using autoregressive integrated moving average (ARIMA)(p,d,q) model were performed to evaluate the changes between periods. A multivariable logistic regression analysis of factors affecting in-hospital mortality was performed. The proportions of patients with acute myocardial infarction (0.8% vs. 1.1%, p < 0.001), hemorrhagic stroke (1.0%vs. 1.2%, p = 0.011), and cardiac arrest (0.9% vs. 1.1%, p = 0.012) increased in the post-period. The post-period was independently associated with in-hospital mortality in acute myocardial infarction (adjusted odds ratio (aOR) 2.54, 95% confidence interval (95% CI) 1.06–6.08, p = 0.037) and hemorrhagic stroke (aOR 1.74, 95% CI 1.11–2.73, p = 0.016), but not for ischemic stroke or cardiac arrest. Over a year after onset of the COVID-19 pandemic in Korea, the number of patients with acute myocardial infarction, hemorrhagic stroke, and cardiac arrest in the ED increased. An independent association between the post-period and mortality was observed for acute myocardial infarction, and hemorrhagic stroke. This study provides important information for future studies and policies.


1999 ◽  
Vol 14 (4) ◽  
pp. 197-200 ◽  
Author(s):  
Shinji Uchida ◽  
Mika Yamamoto ◽  
Yoshiko Masaoka ◽  
Hiroshi Mikouchi ◽  
Yoshitomo Nishizaki

Stroke ◽  
1998 ◽  
Vol 29 (1) ◽  
pp. 235-238 ◽  
Author(s):  
Victor L. Serebruany ◽  
Paul A. Gurbel ◽  
Andrew R. Shustov ◽  
Margaret R. Dalesandro ◽  
Cindy I. Gumbs ◽  
...  

2020 ◽  
Vol 10 (2) ◽  
Author(s):  
Tư Hoàng lê ◽  
Tiến Thành Nguyễn

Tóm tắt Đặt vấn đề: Chấn thương bụng kín (CTBK) rất khó chẩn đoán. Phẫu thuật nội soi (PTNS) nhìn rõ tổn thương có thể điều trị, liệu có thể là biện pháp chẩn đoán hỗ trợ trong cấp cứu? Phương pháp nghiên cứu: Nghiên cứu tiến cứu, các người bệnh (NB) bị CTBK khó chẩn đoán được ứng dụng PTNS chẩn đoán. Kết quả: 34 NB bị CTBK được ứng dụng PTNS để chẩn đoán. 73,5% có chấn thương phối hợp, 47% có tổn thương 2 tạng trở lên trong ổ bụng. 26 NB (76,5%) được chỉ định nội soi ổ bụng (NSOB) thăm dò chẩn đoán. 8 NB (23,5%) cần loại trừ tổn thương phối hợp. PTNS phát hiện được hết các tổn thương nhất là tổn thương tạng rỗng, mạc treo trừ tổn thương tạng đặc nhỏ sâu trong nhu mô và sau phúc mạc. Không có biến chứng do PTNS chẩn đoán gây ra. Kết luận: PTNS là biện pháp chẩn đoán xâm lấn tối thiểu có thể chẩn đoán an toàn, chính xác tổn thương trong ổ bụng ở NB bị CTBK. Ngoài ra có thể sửa chữa những tổn thương không quá phức tạp. Abstract Introduction: Diagnosis of blunt abdominal trauma (BAT) is challenging. Laparoscopy surgery allows us to see the lesions clearly for proper treatment, assist - it as a diagnostic method in emergency? Materials and Methods: Perspective descriptive study for all patients with BAT, very difficulty in diagnosis, were operated laparoscopically for this purpose. Results: Diagnostic laparoscopy was carried out in 34 BAT. 73,5% of patients had multiple traumas, 47% had more 1 injured organs in abdominal cavity. 26 patients (76,5%) was indicated to laparoscopic surgery for diagnosis purpose. It is necessery to exclude the associated lesions in 8 patiens (23,5%). Almost lesions were detected by laparoscopic surgery such lesions of hollow viscera, mesenteric lesions excepted the small lesions located deeply in parenchyme of solid viscera or retroperitoneal. No complication due to diagnostic laparoscopy occurred . Conclusion: Laparoscopic surgery is a minimally invasive, safe and accurate diagnostic approach for BAT. It also can repair the simple lesions during operation. Keywords: Diagnostic laparoscopy, abdominal trauma.


Sign in / Sign up

Export Citation Format

Share Document