Plantago ovata (Laxomucil) after hemorrhoidectomy

Background Intraoperative hypovolemia is common and is a potential cause of organ dysfunction, increased postoperative morbidity, length of hospital stay, and death. The objective of this prospective, randomized study was to assess the effect of goal-directed intraoperative fluid administration on length of postoperative hospital stay. Methods One hundred patients who were to undergo major elective surgery with an anticipated blood loss greater than 500 ml were randomly assigned to a control group (n = 50) that received standard intraoperative care or to a protocol group (n = 50) that, in addition, received intraoperative plasma volume expansion guided by the esophageal Doppler monitor to maintain maximal stroke volume. Length of postoperative hospital stay and postoperative surgical morbidity were assessed. Results Groups were similar with respect to demographics, surgical procedures, and baseline hemodynamic variables. The protocol group had a significantly higher stroke volume and cardiac output at the end of surgery compared with the control group. Patients in the protocol group had a shorter duration of hospital stay compared with the control group: 5 +/- 3 versus 7 +/- 3 days (mean +/- SD), with a median of 6 versus 7 days, respectively ( = 0.03). These patients also tolerated oral intake of solid food earlier than the control group: 3 +/- 0.5 versus 4.7 +/- 0.5 days (mean +/- SD), with a median of 3 versus 5 days, respectively ( = 0.01). Conclusions Goal-directed intraoperative fluid administration results in earlier return to bowel function, lower incidence of postoperative nausea and vomiting, and decrease in length of postoperative hospital stay.

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Comparative analysis of retrograde intrarenal surgery and modified Ultra-mini percutaneous nephrolithotomy in management of lower pole renal stones (1.5-3.5 cm)

10.21203/rs.2.14792/v1 ◽

2019 ◽

Author(s):

Zhuohang Li ◽

Cong Lai ◽

Arvind K. Shah ◽

Weibin Xie ◽

Cheng Liu ◽

...

Keyword(s):

Hospital Stay ◽

Length Of Hospital Stay ◽

Renal Stones ◽

Postoperative Hospital Stay ◽

Lithotomy Position ◽

Base Line ◽

Retrograde Intrarenal Surgery ◽

The Mean ◽

Stone Characteristics ◽

Illness Condition

Abstract Purpose To compare the safety and efficacy of retrograde intrarenal surgery (RIRS) and modified Ultra-mini percutaneous nephrolithotomy (UMP) in semi-supine combined lithotomy position for the management of 1.5-3.5 cm lower pole renal stones (LPSs). Methods A total of 63 patients with 1.5-3.5 cm LPSs who underwent RIRS (n= 33) or modified UMP (n= 30) in diameter between January 2017 and January 2019 were analyzed retrospectively. Modified UMP was performed in semi-supine combined lithotomy position and a 9.5/11.5 F ureteral access sheath (UAS) was inserted during the procedure in order to maintain low pelvic pressure and to facilitate the removal of stone fragments. Base-line parameters, stone characteristics, illness condition, operation time, postoperative hemoglobin (Hb) drop, postoperative creatinine (Cr) elevation, length of hospital stay, length of postoperative hospital stay, stone-free rate (SFR) and complications were compared between the two groups. Results There were no significant differences between the two groups in base-line parameters, stone characteristics and illness condition. The mean operating time of RIRS group was longer than UMP group (95.61 ± 21.9 vs. 55.0 ± 16.1 min, p< 0.001). The mean postoperative Hb drop was less in RIRS group (7.42 ± 4.7 vs. 15.70 ± 9.8 g/L, p< 0.001). The length of hospital stay and postoperative hospital stay for RIRS were shorter than UMP (4.76 ± 1.1 vs. 5.83 ± 0.8 d, p< 0.001, 2.97 ± 0.9 vs. 4.07 ± 0.9 d, p< 0.001). The Early SFR was higher in UMP group (54.5 vs. 80.0%, p< 0.050) while SFR at 1-month and 3-months postoperatively was similar in both groups (p= 0.504, p= 0.675). There were no significant differences between the two groups in complications (p= 0.228). Conclusion For patients with 1.5-3.5 cm LPSs, both modified UMP and RIRS are safe and viable. The modified UMP technique was used in this study, application semi-supine combined lithotomy position and the retention of UAS can improve the surgical efficiency and maintain low pressure perfusion in the kidney, which resulted in superior treatment efficacy. Therefore, we highly recommend this technique for LPSs with heavy stone burdens.

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Development and Feasibility of the Early Rehabilitation Program on Postoperative Enhanced Recovery Following Minimally Invasive Esophagectomy: A Prospective Randomized Controlled Trial

10.21203/rs.3.rs-115850/v1 ◽

2020 ◽

Author(s):

Funa Yang ◽

Lijuan Li ◽

Yanzhi Mi ◽

Limin Zou ◽

Xiaofei Chu ◽

...

Keyword(s):

Hospital Stay ◽

Physical Function ◽

Enhanced Recovery ◽

Rehabilitation Program ◽

Postoperative Hospital Stay ◽

Early Rehabilitation ◽

Control Group ◽

Function Recovery ◽

Significant Difference ◽

Physical Function Recovery

Abstract Background: Perioperative rehabilitation management is essential to enhanced recovery after surgery. Few reports, however, focused on quantitative, detailed early activity plans for patients after esophagectomy. Aim: The purpose of this research was to estimate the effect of the Early Rehabilitation Program (ERP) on the recovery of bowel function and physical function for patients undergoing esophagectomy. Method: In this single-blind, 2-arm, parallel-group, randomized pilot clinical trial, patients were selected from June 2019 to February 2020 and assigned to the intervention group (IG) or the control group(CG) randomly. The participants in IG received an ERP strategy during the perioperative period, and the CG received routine care. The recovery of bowel and physical function, readiness for hospital discharge (RHD) and postoperative hospital stay were evaluated on the day of discharge. Results: 215 cases were enrolled and randomized to the CG (n=108) or IG (n=107). There was no significant difference between the two groups in terms of demographic and clinical characteristics and baseline physical function. After the ERP intervention, the IG group presented a significantly shorter time to first flatus (P<0.001) and to first bowel movement postoperative (P=0.024), and a better physical function recovery (P＜0.001), compared with the CG group. The analysis also showed that participants in the IG have higher scores of RHD and shorter length of postoperative stay than the CG (P＜0.05). Conclusion: The findings suggest that the ERP can improve bowel and physical function recovery, ameliorate patients' RHD, and shorten postoperative hospital stay for patients undergoing MIE.Trial registration：ClinicalTrials.gov Identifier: NCT01998230

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National randomized clinical trial on subdural drainage time after chronic subdural hematoma evacuation

Journal of Neurosurgery ◽

10.3171/2021.10.jns211608 ◽

2021 ◽

pp. 1-8

Keyword(s):

Hospital Stay ◽

Subdural Hematoma ◽

Chronic Subdural Hematoma ◽

Length Of Hospital Stay ◽

Burr Hole ◽

Drainage Time ◽

Postoperative Length ◽

The Mean ◽

Burr Hole Evacuation

OBJECTIVE Placement of a subdural drain reduces recurrence and death after evacuation of chronic subdural hematoma (CSDH), but little is known about optimal drainage duration. In the present national trial, the authors investigated the effect of drainage duration on recurrence and death. METHODS In a randomized controlled trial involving all neurosurgical departments in Denmark, patients treated with single burr hole evacuation of CSDH were randomly assigned to 24 hours or 48 hours of postoperative passive subdural drainage. Follow-up duration was 90 days, and the primary study outcome was recurrent hematoma requiring reoperation. Secondary outcome was death. In addition, complications and length of hospital stay were recorded and analyzed. RESULTS Of the 420 included patients, 212 were assigned 24-hour drainage and 208 were assigned 48-hour drainage. The recurrence rate was 14% in the 24-hour group and 13% in the 48-hour group. Four patients died in the 24-hour group, and 8 patients died in the 48-hour group; this difference was not statistically significant. The ORs (95% CIs) for recurrence and mortality (48 hours vs 24 hours) were 0.94 (0.53–1.66) and 2.07 (0.64–7.85), respectively, in the intention-to-treat analysis. The ORs (95% CIs) for recurrence and mortality per 1-hour increase in drainage time were 1.0005 (0.9770–1.0244) and 1.0046 (0.9564–1.0554), respectively, in the as-treated sensitivity analysis that used the observed drainage times instead of the preassigned treatment groups. The rates of surgical and drain-related complications, postoperative infections, and thromboembolic events were not different between groups. The mean ± SD postoperative length of hospital stay was 7.4 ± 4.3 days for patients who received 24-hour drainage versus 8.4 ± 4.9 days for those who received 48-hour drainage (p = 0.14). The mean ± SD postoperative length of stay in the neurosurgical department was significantly shorter for the 24-hour group (2 ± 0.9 days vs 2.8 ± 1.6 days, p < 0.001). CONCLUSIONS No significant differences in the rates of recurrent hematoma or death during 90-day follow-up were identified between the two groups that randomly received either 24- or 48-hour passive subdural drainage after burr hole evacuation of CSDH.

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Efficacy, Safety, and Duration of a Frameless Fiducial-Less Brain Biopsy versus Frame-based Stereotactic Biopsy: A Prospective Randomized Study

Journal of Neurological Surgery Part A Central European Neurosurgery ◽

10.1055/s-0037-1602697 ◽

2017 ◽

Vol 79 (01) ◽

pp. 031-038 ◽

Cited By ~ 7

Author(s):

John Ellul ◽

Elisabeth Chroni ◽

Constantine Constantoyannis ◽

Miltiadis Georgiopoulos

Keyword(s):

Hospital Stay ◽

Stereotactic Biopsy ◽

Randomized Study ◽

Length Of Hospital Stay ◽

Brain Biopsy ◽

Stereotactic Frame ◽

The Mean ◽

Frameless Biopsy ◽

Conclusive Diagnosis ◽

Made In

Background/Objective We compared the efficacy, duration, safety, length of hospital stay of a frameless fiducial-less brain biopsy with those of the standard frame-based stereotactic biopsy. Patients and Methods This prospective cohort study enrolled 56 adult patients: (1) for whom no conclusive diagnosis could be reached noninvasively; (2a) who had lesions involving deep-seated and eloquent areas, multifocal lesions, or lesions for which craniotomy and lesion removal was not indicated, or (2b) were poor candidates for craniotomy (> 80 years of age and/or with serious comorbidities). Frameless and frame-based biopsy were performed in 28 patients each Results A diagnosis was not made in four cases (14.3%) of the frame-based biopsy group and in three cases (10.7%) of the frameless biopsy group, in spite of accurate targeting (p = 1.0). The mean duration of the whole procedure (preparatory steps outside the operating room [OR], inside the OR, surgery) was 111.3 minutes for the frame-based biopsy and 79.1 minutes for the frameless biopsy (p = 0.001). No statistically significant differences between the two methods were found concerning new neurologic symptoms, new abnormal findings in postoperative computed tomography (CT) and length of postoperative hospital stay (LOS). The smallest diameter of a successfully biopsied lesion was 15 mm for both groups. Conclusions The frameless fiducial-less brain biopsy was equally efficacious and safe compared with the standard stereotactic frame-based biopsy. The overall duration of frameless biopsy is shorter than that of frame-based biopsy, mainly because the preparatory steps in frameless biopsy require less time. However, the overall time spent in the OR did not differ between the two groups. The LOS also did not differ significantly.

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Clinical Outcomes of Modified versus Traditional Technique for the Surgery of Hydatid Cyst of the Liver: A Case Control Study

Middle East Journal of Digestive Diseases ◽

10.15171/mejdd.2019.142 ◽

2019 ◽

Vol 11 (3) ◽

pp. 152-157 ◽

Cited By ~ 1

Author(s):

Asieh Sadat Fattahi ◽

Seyed Hossein Fattahi Masoom ◽

Farjad Lorestani ◽

Mehrdad Fakhlai ◽

Fatemeh Sadat Abtahi Mehrjerdi ◽

...

Keyword(s):

Hydatid Cyst ◽

Hospital Stay ◽

Parasitic Infection ◽

Length Of Hospital Stay ◽

Modified Technique ◽

Significant Difference ◽

Postoperative Length ◽

The Mean ◽

Surgical Modality ◽

Control Study

BACKGROUND Echinococcus granulosis is a parasitic infection most commonly involving the liver. Iran is a hyperendemic area for this disease according to WHO. Despite improvements in medical and interventional radiological techniques, surgery remains the gold standard of treatment; however evidence on different surgical modalities were explained. Considering the high population of referring patients presenting to Omid and Ghaem Hospitals, Mashhad, Iran, we decided to compare the complications of our modified technique with routine technique in hydatid cyst surgery. METHODS 56 patients with hydatid cyst of the liver who underwent modified and routine surgical treatment in Ghaem and Omid Hospitals Mashhad, Iran were studied during Aug 2013- Nov 2015. 27 patients underwent modified surgical technique, whereas the remaining 27 patients were treated by using routine surgical method. These two groups of patients were compared with each other according to their postoperative length of hospital stay and resulting complications. RESULTS The mean age of our patients was 41 years. 27 patients were male and 29 were female. Our results showed no statistically significant difference regarding the incidence of postoperative complications between the two groups. However, mean length of hospital stay was significantly different between the groups (4.5 ± 1.87 and 7.6 ± 2.25 days, respectively, p < 0.001). CONCLUSION The method of modified surgery with closed cyst drainage, which does not use external drains, is a safe surgical modality in the treatment of hydatid cyst disease of the liver if applied properly on appropriate patients.

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Comparative analysis of retrograde intrarenal surgery and modified Ultra-mini percutaneous nephrolithotomy in management of lower pole renal stones (1.5-3.5 cm)

10.21203/rs.2.14792/v5 ◽

2020 ◽

Author(s):

Zhuohang Li ◽

Cong Lai ◽

Arvind K. Shah ◽

Weibin Xie ◽

Cheng Liu ◽

...

Keyword(s):

Hospital Stay ◽

Length Of Hospital Stay ◽

Renal Stones ◽

Postoperative Hospital Stay ◽

Lithotomy Position ◽

Base Line ◽

Retrograde Intrarenal Surgery ◽

The Mean ◽

Stone Characteristics ◽

Illness Condition

Abstract Background：To compare the safety and efficacy of retrograde intrarenal surgery (RIRS) and modified Ultra-mini percutaneous nephrolithotomy (UMP) in semi-supine combined lithotomy position for the management of 1.5-3.5 cm lower pole renal stones (LPSs). Methods: A total of 63 patients with 1.5-3.5 cm LPSs who underwent RIRS (n= 33) or modified UMP (n= 30) in diameter between January 2017 and January 2019 were analyzed retrospectively. Modified UMP was performed in semi-supine combined lithotomy position and a 9.5/11.5 F ureteral access sheath (UAS) was inserted during the procedure in order to maintain low pelvic pressure and to facilitate the removal of stone fragments. Base-line parameters, stone characteristics, illness condition, operation time, postoperative hemoglobin (Hb) drop, postoperative creatinine (Cr) elevation, length of hospital stay, length of postoperative hospital stay, stone-free rate (SFR) and complications were compared between the two groups. Results: There were no significant differences between the two groups in base-line parameters, stone characteristics and illness condition. The mean operating time of RIRS group was longer than UMP group (95.61 ± 21.9 vs. 55.0 ± 16.1 min, p< 0.001). The mean postoperative Hb drop was less in RIRS group (7.42 ± 4.7 vs. 15.70 ± 9.8 g/L, p< 0.001). The length of hospital stay and postoperative hospital stay for RIRS were shorter than UMP (4.76 ± 1.1 vs. 5.83 ± 0.8 d, p< 0.001, 2.97 ± 0.9 vs. 4.07 ± 0.9 d, p< 0.001). The Early SFR was higher in UMP group (54.5 vs. 80.0%, p< 0.050) while SFR at 1-month and 3-months postoperatively was similar in both groups (p= 0.504, p= 0.675). There were no significant differences between the two groups in complications (p= 0.228). Conclusion：For patients with 1.5-3.5 cm LPSs, both modified UMP and RIRS are safe and viable. The modified UMP technique was used in this study, application semi-supine combined lithotomy position and the retention of UAS can improve the surgical efficiency and maintain low pressure perfusion in the kidney, which resulted in superior treatment efficacy. Therefore, we highly recommend this technique for LPSs with heavy stone burdens.

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Comparative analysis of retrograde intrarenal surgery and modified Ultra-mini percutaneous nephrolithotomy in management of lower pole renal stones (1.5-3.5 cm)

10.21203/rs.2.14792/v2 ◽

2019 ◽

Author(s):

Zhuohang Li ◽

Cong Lai ◽

Arvind K. Shah ◽

Weibin Xie ◽

Cheng Liu ◽

...

Keyword(s):

Hospital Stay ◽

Length Of Hospital Stay ◽

Renal Stones ◽

Postoperative Hospital Stay ◽

Lithotomy Position ◽

Base Line ◽

Retrograde Intrarenal Surgery ◽

The Mean ◽

Stone Characteristics ◽

Illness Condition

Abstract Abstract Background：To compare the safety and efficacy of retrograde intrarenal surgery (RIRS) and modified Ultra-mini percutaneous nephrolithotomy (UMP) in semi-supine combined lithotomy position for the management of 1.5-3.5 cm lower pole renal stones (LPSs). Methods: A total of 63 patients with 1.5-3.5 cm LPSs who underwent RIRS (n= 33) or modified UMP (n= 30) in diameter between January 2017 and January 2019 were analyzed retrospectively. Modified UMP was performed in semi-supine combined lithotomy position and a 9.5/11.5 F ureteral access sheath (UAS) was inserted during the procedure in order to maintain low pelvic pressure and to facilitate the removal of stone fragments. Base-line parameters, stone characteristics, illness condition, operation time, postoperative hemoglobin (Hb) drop, postoperative creatinine (Cr) elevation, length of hospital stay, length of postoperative hospital stay, stone-free rate (SFR) and complications were compared between the two groups. Results: There were no significant differences between the two groups in base-line parameters, stone characteristics and illness condition. The mean operating time of RIRS group was longer than UMP group (95.61 ± 21.9 vs. 55.0 ± 16.1 min, p< 0.001). The mean postoperative Hb drop was less in RIRS group (7.42 ± 4.7 vs. 15.70 ± 9.8 g/L, p< 0.001). The length of hospital stay and postoperative hospital stay for RIRS were shorter than UMP (4.76 ± 1.1 vs. 5.83 ± 0.8 d, p< 0.001, 2.97 ± 0.9 vs. 4.07 ± 0.9 d, p< 0.001). The Early SFR was higher in UMP group (54.5 vs. 80.0%, p< 0.050) while SFR at 1-month and 3-months postoperatively was similar in both groups (p= 0.504, p= 0.675). There were no significant differences between the two groups in complications (p= 0.228). Conclusion：For patients with 1.5-3.5 cm LPSs, both modified UMP and RIRS are safe and viable. The modified UMP technique was used in this study, application semi-supine combined lithotomy position and the retention of UAS can improve the surgical efficiency and maintain low pressure perfusion in the kidney, which resulted in superior treatment efficacy. Therefore, we highly recommend this technique for LPSs with heavy stone burdens.

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Comparative analysis of retrograde intrarenal surgery and modified Ultra-mini percutaneous nephrolithotomy in management of lower pole renal stones (1.5-3.5 cm)

10.21203/rs.2.14792/v4 ◽

2020 ◽

Author(s):

Zhuohang Li ◽

Cong Lai ◽

Arvind K. Shah ◽

Weibin Xie ◽

Cheng Liu ◽

...

Keyword(s):

Hospital Stay ◽

Length Of Hospital Stay ◽

Renal Stones ◽

Postoperative Hospital Stay ◽

Lithotomy Position ◽

Base Line ◽

Retrograde Intrarenal Surgery ◽

The Mean ◽

Stone Characteristics ◽

Illness Condition

Abstract Background：To compare the safety and efficacy of retrograde intrarenal surgery (RIRS) and modified Ultra-mini percutaneous nephrolithotomy (UMP) in semi-supine combined lithotomy position for the management of 1.5-3.5 cm lower pole renal stones (LPSs). Methods: A total of 63 patients with 1.5-3.5 cm LPSs who underwent RIRS (n= 33) or modified UMP (n= 30) in diameter between January 2017 and January 2019 were analyzed retrospectively. Modified UMP was performed in semi-supine combined lithotomy position and a 9.5/11.5 F ureteral access sheath (UAS) was inserted during the procedure in order to maintain low pelvic pressure and to facilitate the removal of stone fragments. Base-line parameters, stone characteristics, illness condition, operation time, postoperative hemoglobin (Hb) drop, postoperative creatinine (Cr) elevation, length of hospital stay, length of postoperative hospital stay, stone-free rate (SFR) and complications were compared between the two groups. Results: There were no significant differences between the two groups in base-line parameters, stone characteristics and illness condition. The mean operating time of RIRS group was longer than UMP group (95.61 ± 21.9 vs. 55.0 ± 16.1 min, p< 0.001). The mean postoperative Hb drop was less in RIRS group (7.42 ± 4.7 vs. 15.70 ± 9.8 g/L, p< 0.001). The length of hospital stay and postoperative hospital stay for RIRS were shorter than UMP (4.76 ± 1.1 vs. 5.83 ± 0.8 d, p< 0.001, 2.97 ± 0.9 vs. 4.07 ± 0.9 d, p< 0.001). The Early SFR was higher in UMP group (54.5 vs. 80.0%, p< 0.050) while SFR at 1-month and 3-months postoperatively was similar in both groups (p= 0.504, p= 0.675). There were no significant differences between the two groups in complications (p= 0.228). Conclusion：For patients with 1.5-3.5 cm LPSs, both modified UMP and RIRS are safe and viable. The modified UMP technique was used in this study, application semi-supine combined lithotomy position and the retention of UAS can improve the surgical efficiency and maintain low pressure perfusion in the kidney, which resulted in superior treatment efficacy. Therefore, we highly recommend this technique for LPSs with heavy stone burdens.

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The Effect of Family-Based Empowerment Program on the Weight and Length of Hospital Stay of Preterm Infants in the Neonatal Intensive Care Unit

Galen Medical Journal ◽

10.31661/gmj.v2i3.66 ◽

2013 ◽

Vol 2 (3) ◽

pp. 114-119

Author(s):

Noushin Beheshtipoor ◽

Zohreh Shaker ◽

Mitra Edraki ◽

Mostajab Razavi ◽

Najaf Zare

Keyword(s):

Hospital Stay ◽

Preterm Infants ◽

Neonatal Intensive Care ◽

Length Of Hospital Stay ◽

Control Group ◽

Duration Of Hospital Stay ◽

The Family ◽

The Mean ◽

Family Centered ◽

Empowerment Program

Background: Preterm infants need to be hospitalized in the Neonatal Intensive Care Unit (NICU) and receive specific systematic care in order to survive. Nonetheless, long hospital stay leads to parents’ separation from the infant and disturbance in the family life. It also has many undesirable effects on the infant. The present study aimed to determine the effect of family-centered empowerment program on the weight and duration of hospital stay of the infants in NICU. Methods: In this clinical trial, 100 mothers with preterm infants hospitalized in NICU were divided into an intervention and a control groups. The mothers in the empowerment group took part in a multi-stage training program and received the necessary information regarding preterm infants and how to cooperate in taking care of them through face-to-face training, working at the bedside, educational film, and illustrated booklet. Then, the weight of the infants in the two groups and duration of hospital stay were compared.Results: The mean length of hospital stay was 10.5±7.7 and 17.4±11.2 days in the intervention and the control group, respectively, and the results of independent T-test showed that the difference was statistically significant (P=0.001). The mean of weight changes was -42.4±172.9 grams in the control group and -22.6±162.0 grams in the intervention group; no significant difference was found between the two groups (P=0.556).Conclusion: The family-centered empowerment program in the NICU significantly reduced the infants’ length of hospital stay, but had no effects on their weights.

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