scholarly journals Laparoscopy or laparotomy for high-risk caesarean scar pregnancy: a retrospective study

2020 ◽  
Author(s):  
Ronghua Liu ◽  
Pengfei Cui ◽  
wenwen wang ◽  
Ting Zhou ◽  
SHIXUAN WANG
Keyword(s):  
Retrospective Study ◽  
High Risk ◽  
Caesarean Scar ◽  
Caesarean Scar Pregnancy

scholarly journals Laparoscopy or laparotomy for high risk caesarean scar pregnancy？a retrospective study

2020 ◽  
Author(s):  
Ronghua Liu ◽  
Ting Zhou ◽  
Pengfei Cui ◽  
wenwen wang ◽  
SHIXUAN WANG
Keyword(s):  
Retrospective Study ◽  
High Risk ◽  
Caesarean Scar ◽  
Caesarean Scar Pregnancy

scholarly journals Laparoscopy or Laparotomy for High-risk Caesarean Scar Pregnancy: A Retrospective Study

2021 ◽  
Author(s):  
Ting Zhou ◽  
Shixuan Wang ◽  
Peiying Fu ◽  
Pengfei Cui ◽  
Ronghua Liu
Keyword(s):  
Laparoscopic Surgery ◽  
High Risk ◽  
Arterial Occlusion ◽  
Vascular Occlusion ◽  
Transfusion Rate ◽  
Advantages And Disadvantages ◽  
Caesarean Scar ◽  
Caesarean Scar Pregnancy ◽  
Treatment Measures ◽  
Β Hcg

Abstract Background: Caesarean scar pregnancy (CSP) can have catastrophic consequences. A standardized diagnosis and treatment for CSP are still lacking. The currently available treatment methods are confusing, and at least 10 different treatment measures exist. The aim of this study was to compare the outcomes of with laparotomy or laparoscopy in the treatment of high-risk CSP. Methods: We reviewed 935 patients with CSP from 1 January 2013 and 31 December 2018. A total of 278 patients were included in the study, of whom 121 were treated with laparoscopy and 157 were treated with laparotomy.Results: We compared and analysed the characteristics of the laparoscopic and open surgeries in the treatment of high-risk CSP and the advantages and disadvantages of different methods of vascular pretreatment. Intraoperative bleeding, transfusion rate, total days of hospitalization and postoperative hospital stay were better in laparoscopy than in laparotomy (P < 0.05). There was no difference in the factors (β-HCG decrease, reoperation and tissue residues) closely related to the success of the surgery in the two groups. Furthermore, we pretreated blood vessels differently before the operation in some patients. Tissue residue, reoperation and intraoperative blood transfusion rates in patients with temporary vascular occlusion were better than in patients with permanent vascular occlusion. Conclusions: This study revealed that laparoscopic surgery is superior to laparotomic surgery in the treatment of high-risk CSP. Patients benefited from temporary arterial occlusion in both groups. Temporary arterial occlusion under laparoscopic surgery may be the best treatment for high-risk CSP.

scholarly journals Perioperative use of serum creatinine and postoperative acute kidney injury: a single-centre, observational retrospective study to explore physicians’ perception and practice

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Gianluca Villa ◽  
Silvia De Rosa ◽  
Caterina Scirè Calabrisotto ◽  
Alessandro Nerini ◽  
Thomas Saitta ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Retrospective Study ◽  
High Risk ◽  
Abdominal Surgery ◽  
Serum Creatinine ◽  
Malignant Disease ◽  
Kidney Injury ◽  
Major Surgery ◽  
Single Centre

Abstract Background Postoperative acute kidney injury (PO-AKI) is a leading cause of short- and long-term morbidity and mortality, as well as progression to chronic kidney disease (CKD). The aim of this study was to explore the physicians’ attitude toward the use of perioperative serum creatinine (sCr) for the identification of patients at risk for PO-AKI and long-term CKD. We also evaluated the incidence and risk factors associated with PO-AKI and renal function deterioration in patients undergoing major surgery for malignant disease. Methods Adult oncological patients who underwent major abdominal surgery from November 2016 to February 2017 were considered for this single-centre, observational retrospective study. Routinely available sCr values were used to define AKI in the first three postoperative days. Long-term kidney dysfunction (LT-KDys) was defined as a reduction in the estimated glomerular filtration rate by more than 10 ml/min/m2 at 12 months postoperatively. A questionnaire was administered to 125 physicians caring for the enrolled patients to collect information on local attitudes regarding the use of sCr perioperatively and its relationship with PO-AKI. Results A total of 423 patients were observed. sCr was not available in 59 patients (13.9%); the remaining 364 (86.1%) had at least one sCr value measured to allow for detection of postoperative kidney impairment. Among these, PO-AKI was diagnosed in 8.2% of cases. Of the 334 patients who had a sCr result available at 12-month follow-up, 56 (16.8%) developed LT-KDys. Data on long-term kidney function were not available for 21% of patients. Interestingly, 33 of 423 patients (7.8%) did not have a sCr result available in the immediate postoperative period or long term. All the physicians who participated in the survey (83 out of 125) recognised that postoperative assessment of sCr is required after major oncological abdominal surgery, particularly in those patients at high risk for PO-AKI and LT-KDys. Conclusion PO-AKI after major surgery for malignant disease is common, but clinical practice of measuring sCr is variable. As a result, the exact incidence of PO-AKI and long-term renal prognosis are unclear, including in high-risk patients. Trial registration ClinicalTrials.gov, NCT04341974.

scholarly journals The effects of a preoperative multidisciplinary conference on outcomes for high-risk patients with challenging surgical treatment options: a retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masayoshi Koike ◽  
Mie Yoshimura ◽  
Yasushi Mio ◽  
Shoichi Uezono
Keyword(s):  
Patient Safety ◽  
Retrospective Study ◽  
High Risk ◽  
Treatment Plan ◽  
Treatment Options ◽  
High Risk Patients ◽  
Appropriate Treatment ◽  
Risk Patients ◽  
Treatment Plans ◽  
Multidisciplinary Conference

Abstract Background Surgical options for patients vary with age and comorbidities, advances in medical technology and patients’ wishes. This complexity can make it difficult for surgeons to determine appropriate treatment plans independently. At our institution, final decisions regarding treatment for patients are made at multidisciplinary meetings, termed High-Risk Conferences, led by the Patient Safety Committee. Methods In this retrospective study, we assessed the reasons for convening High-Risk Conferences, the final decisions made and treatment outcomes using conference records and patient medical records for conferences conducted at our institution from April 2010 to March 2018. Results A total of 410 High-Risk Conferences were conducted for 406 patients during the study period. The department with the most conferences was cardiovascular surgery (24%), and the reasons for convening conferences included the presence of severe comorbidities (51%), highly difficult surgeries (41%) and nonmedical/personal issues (8%). Treatment changes were made for 49 patients (12%), including surgical modifications for 20 patients and surgery cancellation for 29. The most common surgical modification was procedure reduction (16 patients); 4 deaths were reported. Follow-up was available for 21 patients for whom surgery was cancelled, with 11 deaths reported. Conclusions Given that some change to the treatment plan was made for 12% of the patients discussed at the High-Risk Conferences, we conclude that participants of these conferences did not always agree with the original surgical plan and that the multidisciplinary decision-making process of the conferences served to allow for modifications. Many of the modifications involved reductions in procedures to reflect a more conservative approach, which might have decreased perioperative mortality and the incidence of complications as well as unnecessary surgeries. High-risk patients have complex issues, and it is difficult to verify statistically whether outcomes are associated with changes in course of treatment. Nevertheless, these conferences might be useful from a patient safety perspective and minimize the potential for legal disputes.

Reply to “Caesarean scar pregnancy: Look at a leopard through a tube”

2021 ◽  
Vol 61 (1) ◽  
Author(s):  
Natalie Drever ◽  
Scott Gregory Petersen ◽  
Julia Bertolone ◽  
Sarah Janssens
Keyword(s):  
Caesarean Scar ◽  
Caesarean Scar Pregnancy

scholarly journals Retrospective study of myiasis in ruminants at Babuganj Upazilla Veterinary Hospital of Barisal district

2018 ◽  
Vol 5 (1) ◽  
pp. 57-64
Author(s):  
Most Tahmina Khan ◽  
Md Tahmid Rahman Pavel ◽  
Imam Hasan ◽  
Md Monowarul Islam ◽  
Md Muket Mahmud ◽  
...  
Keyword(s):  
Retrospective Study ◽  
High Risk ◽  
Descriptive Analysis ◽  
Wound Management ◽  
Occurrence Rate ◽  
Treatment Protocols ◽  
Local Breed ◽  
Duration Of Illness ◽  
Veterinary Hospital ◽  
Structured Questionnaire

The study was conducted to know the occurrence of myiasis in cattle and goats at Babuganj Upazilla Veterinary Hospital, Barisal, Bangladesh. A total of 160 animals were examined. Among them 46 animals were found to be myiasis infested. A structured questionnaire was used to collect data on species, breed, age, sex, body condition of the animal, onset and duration of illness, affected sites of myiasis. The study was conducted during March 2014 to May 2015. All the data that were collected were entered into MS excel. Descriptive analysis was done by column and pie charts. It was possible to follow the response of treatment using two treatment protocols. The overall occurrence of myiasis was 28.75% where 39.13% in cattle and 60.87% in goat. The occurrence was higher in cross breed cattle (55.56%) than the local (44.44%). Similarly the occurrence rate was higher in cross breed goat (42.86%) than local breed (28.57%). Less than 6 months aged animals (71.73%) and females (cattle-61.11% and goat-64.29%) were more prone to myiasis. The frequency of maggot infestation was higher in navel region (54.35%) followed by vaginal (28.26%) and rectal (10.87%) regions respectively. The percentage of recovery to Inj. SP vet, Inj. Asta vet and Inj. Vermic were 67.86%. Myiasis is the major problem in livestock production in our country. Animals at high risk should be managed properly to avoid wound and special attention on wound management should be given after castration and parturition to prevent myiasis.Res. Agric., Livest. Fish.5(1): 57-64, April 2018

Morbidity and Mortality of Carotid Endarterectomy under Local Anesthesia: A Retrospective Study

Neurosurgery ◽  
1988 ◽  
Vol 23 (4) ◽  
pp. 445-450 ◽  
Author(s):  
Mario Zuccarello ◽  
Hwa-shain Yeh ◽  
John M. Tew
Keyword(s):  
Retrospective Study ◽  
High Risk ◽  
Carotid Endarterectomy ◽  
Local Anesthesia ◽  
Perioperative Complications ◽  
Minor Stroke ◽  
Perioperative Mortality ◽  
Occlusive Vascular Disease ◽  
Risk Patients ◽  
Ischemic Attack

Abstract It has been shown that carotid endarterectomy reduces the incidence of stroke in patients with symptomatic extracranial occlusive vascular disease in the absence of major perioperative complications such as stroke or death. We present a retrospective study of 106 carotid endarterectomies performed under local anesthesia in 100 patients in whom transient ischemic attack (TIA) or minor stroke had occurred. Nonfatal stroke occurred in 2%, and TIA occurred in 1%. There was no perioperative mortality. Our study suggests that, under local anesthesia, even high risk patients can be operated safely and the majority of carotid endarterectomies can be performed without the use of an indwelling shunt. Meticulous surgical technique is of great importance for achieving low perioperative complications.

Sign in / Sign up

Export Citation Format

Share Document