scholarly journals Prolonged postoperative ileus after elective colorectal cancer surgery

2018 ◽  
Vol 75 (8) ◽  
pp. 780-786
Author(s):  
Milica Nestorovic ◽  
Goran Stanojevic ◽  
Branko Brankovic ◽  
Vanja Pecic ◽  
Ljiljana Jeremic
Keyword(s):  
Prospective Study ◽  
Surgical Site Infection ◽  
Hospital Stay ◽  
Anastomotic Leakage ◽  
Postoperative Ileus ◽  
Length Of Hospital Stay ◽  
Site Infection ◽  
Significant Difference ◽  
Prolonged Postoperative Ileus ◽  
The Impact

Background/Aim. Postoperative ileus is a frequent and frustrating occurence for both, patients and surgeons after abdominal surgery. Besides clinical importance of postoperative ileus, its economic aspect is also important. The aim of this prospective study was to analyze development of prolonged postoperative ileus after elective colorectal surgery for cancer and its impact on early postoperative outcome. Methods. This prospective study included all eligible patients, 18 years or older, scheduled for open colorectal resection for cancer from June, 2015 to February, 2016. Patients with metastatic disease, prior hemoirradiation or any resection other then curative were excluded. The study duration was up to 30 days postoperatively. Primary outcome measure was development of prolonged postoperative ileus according to strict definition. The impact of prolonged postoperative ileus on other outcome measures such as postoperative complications, surgical site infections, anastomotic leakage, reoperations, mortality and length of hospital stay were of great interest, too. Results. This prospective study included 103 patients, 64 (37.9%) men and 39 (62.1%) women, mean age 66 years. Prolonged postoperative ileus developed in 12 (11.3%) patients. One third of the patients had some type of surgical site infection, while 47.6% had complications. Ten (9.7%) patients required reoperation. Comparing the group of patients with prolonged postoperative ileus with those without, there were no statistically significant differences in rates of surgical site infection and anastomotic leakage. There was statistically significant difference in terms of complications (_2 = 34.966; p < 0.001), complications grade III (_2 = 23.43; p < 0.001) and reoperations (_2 = 15.724; p <0.001). Patients who developed prolonged postoperative ileus had statistically significant longer postoperative hospital stay (Z = 2.291, p = 0.022) and longer total length of hospital stay (Z = 2.377, p = 0.015). According to regression analyzes prolonged postoperative ileus represents a risk factor for reoperations [odds ratio (OR) = 12.286; p = 0.001]. Conclusion. Prolonged postoperative ileus, although not life-threatening complication effects recovery, increases length of hospital stay and contributes to poor surgical outcome.

Clinical impact of obesity-related factors in perioperative management of esophageal cancer.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 39-39
Author(s):  
HIROYA TAKEUCHI ◽  
Yuji Kikuchi ◽  
Hirofumi Kawakubo ◽  
Koichi Suda ◽  
Yuko Kitagawa
Keyword(s):  
Esophageal Cancer ◽  
Surgical Site Infection ◽  
Anastomotic Leakage ◽  
The Body ◽  
Obese Patients ◽  
Site Infection ◽  
Related Factors ◽  
Significant Difference ◽  
The Impact ◽  
High Bmi

39 Background: Obese patients with esophageal cancer have been increasing worldwide. However, the impact of obesity on esophagectomy still remains controversial. In this study, we clarified the relations between obesity and postoperative outcomes after esophagectomy in patients with esophageal cancer. Methods: A total of 215 patients who underwent esophagectomy for esophageal cancer between 2008 and 2014 were retrospectively assessed. We qualified the body mass index (BMI), visceral fat area (VFA) and subcutaneous fat area (SFA) using CYNAPSE VINCENT™. Clincopathological factors, postoperative morbidity, and survival after esophagectomy were assessed with these obesity-related factors. Results: The mean BMI, VFA, and SFA were 22.0 kg/m², 83.0cm², and 87.3cm². BMI, VFA and SFA were significantly correlated each other (P < 0.001). The prevalence of diabetes mellitus and hypertension were significantly more in high SFA than normal SFA (20% vs 10%, 30% vs 14%). When the patients were divided to two groups according to BMI (< 25 or ≥25kg/m²), VFA ( < 100 or ≥100cm²) and SFA ( < 100 or ≥100cm²), operative time was significantly longer in high SFA (P = 0.03) than normal SFA, and tended to be longer in high BMI, but blood loss were similar in each groups. Maximum level of postoperative CRP was significantly higher in high BMI (P < 0.001), in high VFA (P < 0.001), and in high SFA (P < 0.001). Length of systemic inflammatory response syndrome was significantly longer in high BMI than normal BMI (1.9 days vs 1.4 days P = 0.04), and length of ventilator support was significantly longer in high SFA than normal SFA (3.0 days vs 2.2 days P = 0.006). The incidence of anastomotic leakage and surgical site infection were significantly higher in high SFA than normal SFA (27% vs 10%, 37% vs 19%). There were no significant difference in overall survival, however, patients in high VFA tended to be longer survival than those in normal VFA (P = 0.078). Conclusions: Anastomotic leakage and surgical site infection occurred more frequently in high SFA. It might be useful to examine SFA preoperatively in obese patients with esophageal cancer for prevention of postoperative complications. Patients in high VFA tended to be longer survival than those in normal VFA.

Impact of Postdischarge Surveillance on the Rate of Surgical Site Infection After Orthopedic Surgery

2006 ◽  
Vol 27 (12) ◽  
pp. 1324-1329 ◽  
Author(s):  
Kaisa Huotari ◽  
Outi Lyytikäinen ◽  
Keyword(s):  
Surgical Site Infection ◽  
Hospital Stay ◽  
Orthopedic Surgery ◽  
Femur Fracture ◽  
Length Of Hospital Stay ◽  
Site Infection ◽  
Median Length ◽  
The Impact ◽  
Incisional Ssis

Objective. To evaluate the impact of postdischarge surveillance on surgical site infection (SSI) rates after orthopedic surgery. Setting. Nine hospitals participating in the Finnish Hospital Infection Program. Patients. All patients who underwent hip or knee arthroplasty or open reduction of a femur fracture during 1999-2002. Results. The date of discharge was available for 11,812 procedures (90%). The median length of hospital stay was 8 days (range per hospital, 6-9 days). The overall SSI rate was 3.3% (range, 0.8%-6.4%). Of 384 SSIs detected, 216 (56%; range, 28%-90%) were detected after discharge: 93 (43%) were detected on readmission to the hospital, 73 (34%) at completion of a postdischarge questionnaire, and 23 (11%) at a follow-up visit. For 27 postdischarge SSIs (13%), the location of detection was unknown. Altogether, 32 (86%) of 37 of organ/space SSIs, 57 (80%) of 71 deep incisional SSIs, and 127 (46%) of 276 superficial incisional SSIs were detected after discharge. Most SSIs (70%) detected on readmission were severe (organ/space or deep incisional), whereas most SSIs (86%) detected at follow-up visits or at completion of a postdischarge questionnaire were superficial. Of all SSIs, 78% (range, 48%-100%) were microbiologically confirmed. Microbiologic confirmation was less common after discharge than during postoperative hospital stay (66% vs 93%; P&lt; .001). Conclusions. Postdischarge surveillance had a large impact on the rate of SSI detected after orthopedic surgery. However, postdischarge surveillance conducted by means of a questionnaire detected only a minority of deep incisional and organ/space SSIs.

EP.TH.959Meta-analysis of temporary loop ileostomy closure during or after adjuvant chemotherapy following rectal cancer surgery: An ongoing dilemma

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Shahin Hajibandeh ◽  
Shahab Hajibandeh ◽  
Pratik Bhattacharya ◽  
Reza Zakaria ◽  
Christopher Thompson ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Adjuvant Chemotherapy ◽  
Surgical Site Infection ◽  
Hospital Stay ◽  
Perioperative Complications ◽  
Loop Ileostomy ◽  
Length Of Hospital Stay ◽  
Ileostomy Closure ◽  
Site Infection ◽  
Cancer Resection

Abstract Aims To evaluate comparative outcomes of temporary loop ileostomy closure during or after adjuvant chemotherapy following rectal cancer resection. Methods We systematic searched MEDLINE; EMBASE; CINAHL; CENTRAL; the World Health Organization International Clinical Trials Registry; ClinicalTrials.gov; ISRCTN Register, and bibliographic reference lists. Overall perioperative complications, anastomotic leak, surgical site infection, ileus and length of hospital stay were the evaluated outcome parameters. Combined overall effect sizes were calculated using fixed-effect or random-effects models. Results We identified 4 studies reporting a total of 436 patients comparing outcomes of temporary loop ileostomy closure during (n = 185) or after (n = 251) adjuvant chemotherapy following colorectal cancer resection. There was no significant difference in overall perioperative complications (OR 1.39; 95% CI 0.82-2.36, p = 0.22), anastomotic leak (OR 2.80; 95% CI 0.47-16.56, p = 0.26), surgical site infection (OR 1.97; 95% CI 0.80-4.90, p = 0.14), ileus (OR 1.22; 95% CI 0.50-2.96, p = 0.66) or length of hospital stay (MD 0.02; 95% CI -0.85-0.89, p = 0.97) between two groups. Between-study heterogeneity was low in all analyses. Conclusions The meta-analysis of best, albeit limited, available evidence suggests that temporary loop ileostomy closure during adjuvant chemotherapy following rectal cancer resection may be associated with comparable outcomes to closure of ileostomy after adjuvant chemotherapy. We encourage future research to concentrate on completeness of chemotherapy and quality of life which can determine appropriateness of either approach.

The Effect of Omentoplasty on the Rate of Anastomotic Leakage after Intestinal Resection: A Randomized Controlled Trial

2017 ◽  
Vol 83 (2) ◽  
pp. 157-160 ◽  
Author(s):  
Shirzad Nasiri ◽  
Babak Mirminachi ◽  
Reyhaneh Taherimehr ◽  
Roya Shadbakhsh ◽  
Mohsen Hojat
Keyword(s):  
Hospital Stay ◽  
Anastomotic Leakage ◽  
Controlled Trial ◽  
Randomized Study ◽  
Intestinal Resection ◽  
Length Of Hospital Stay ◽  
Fistula Formation ◽  
Intestinal Surgery ◽  
Increased Risk ◽  
Significant Difference

Anastomotic leakage is a major postoperative complication after intestinal surgery leading to increased risk of morbidity and mortality. Omentoplasty has been evaluated to prevent anastomotic leakage in several studies. However, there is no consensus regarding whether or not omentoplasty should be used to decrease the rate of anastomotic leakage after intestinal resection. A prospective, randomized study was conducted to evaluate the influence of omentoplasty on anastomotic leakage after intestinal resection. A total of 124 patients who underwent intestinal resection were enrolled in this prospective study. Patients were randomly assigned to receive either the omentoplasty or nonomentoplasty. In the omentoplasty group, the omentum was wrapped around the anastomotic region. Age, gender, site and type of anastomosis, duration of hospital stay, and performance of omentoplasty were recorded. This study was registered in Iranian Registry of clinical trial (number: IRCT201412316925N3). The rate of anastomotic leakage was significantly lower in the omentoplasty group (P = 0.04). Patients in the omentoplasty group developed a significantly lower rate of postoperative infection and peritonitis (P < 0.05). There was no significant difference of abscess and fistula formation between the two groups (P > 0.05). The length of hospital stay was longer in the nonomentoplasty group, compared with that for omentoplasty patients (P < 0.05). No death occurred in the omentoplasty subjects, while six nonomentoplasty patients died (P < 0.05). Our data demonstrated that omentoplasty is useful to lower the rate of postoperative complications in patients underwent intestinal surgery.

Surgical Site Infection in a Tertiary Neonatal Surgery Centre

2018 ◽  
Vol 29 (03) ◽  
pp. 260-265 ◽  
Author(s):  
Adiam Woldemicael ◽  
Sarah Bradley ◽  
Caroline Pardy ◽  
Justin Richards ◽  
Paolo Trerotoli ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Model ◽  
Surgical Site Infection ◽  
Hospital Stay ◽  
Logistic Regression Model ◽  
Length Of Hospital Stay ◽  
Neonatal Surgery ◽  
Site Infection ◽  
Increased Risk

Introduction Surgical site infection (SSI) is a key performance indicator to assess the quality of surgical care. Incidence and risk factors for SSI in neonatal surgery are lacking in the literature. Aim To define the incidence of SSI and possible risk factors in a tertiary neonatal surgery centre. Materials and Methods This is a prospective cohort study of all the neonates who underwent abdominal and thoracic surgery between March 2012 and October 2016. The variables analyzed were gender, gestational age, birth weight, age at surgery, preoperative stay in neonatal intensive care unit, type of surgery, length of stay, and microorganisms isolated from the wounds. Statistical analysis was done with chi-square, Student's t- or Mann–Whitney U-tests. A logistic regression model was used to evaluate determinants of risk for SSI; variables were analyzed both with univariate and multivariate models. For the length of hospital stay, a logistic regression model was performed with independent variables. Results A total of 244 neonates underwent 319 surgical procedures. The overall incidence of SSIs was 43/319 (13.5%). The only statistical differences between neonates with and without SSI were preoperative stay (<4 days vs. ≥4 days, p < 0.01) and length of hospital stay (<30 days vs. ≥30 days, p < 0.01). A pre-operative stay longer than 4 days was associated with almost three times increased risk of SSI (odds ratio [OR] 2.96, 95% confidence interval [CI] 1.05–8.34, p = 0.0407). Gastrointestinal procedures were associated with more than ten times the risk of SSI compared with other procedures (OR 10.17, 95% CI 3.82–27.10, p < 0.0001). Gastroschisis closure and necrotizing enterocolitis (NEC) laparotomies had the highest incidence SSI (54% and 62%, respectively). The risk of longer length of hospital stay after SSI was more than three times higher (OR = 3.36, 95%CI 1.63–6.94, p = 0.001). Conclusion This is the first article benchmarking the incidence of SSI in neonatal surgery in the United Kingdom. A preoperative stay ≥4 days and gastrointestinal procedures were independent risk factors for SSI. More research is needed to develop strategies to reduce SSI in selected neonatal procedures.

scholarly journals Comparative study of single dose preoperative antibiotics versus both preoperative and postoperative antibiotics in laparoscopic appendicectomy for nonperforated appendicitis

2017 ◽  
Vol 4 (9) ◽  
pp. 3092
Author(s):  
Himabindu Bangaru ◽  
Varun V. Gaiki ◽  
M. V. Ranga Reddy
Keyword(s):  
Single Dose ◽  
Surgical Site Infection ◽  
Hospital Stay ◽  
Prophylactic Antibiotics ◽  
Postoperative Hospital Stay ◽  
Laparoscopic Appendicectomy ◽  
Site Infection ◽  
Significant Difference ◽  
Group A ◽  
Preoperative Antibiotics

Background: Antibiotics are being administered both preoperatively and postoperatively even in uncomplicated nonperforated appendicitis. Studies regarding role of postoperative antibiotics in laparoscopic appendicectomy for nonperforated appendicitis are sparse. The aim of the study is therefore to study the efficacy of single dose preoperative antibiotics versus both preoperative and postoperative antibiotics in reducing surgical site infection in laparoscopic appendicectomy for uncomplicated nonperforated acute appendicitis.Methods: This is a prospective study done in general surgery department at Malla Reddy institute of medical sciences from September to April 2016.162 patients with nonperforated appendicitis were randomly allocated into two groups. 80 patients in Group A were given single dose of preoperative prophylactic antibiotics. No further antibiotics were given. 82 patients in Group B were given both preoperative and postoperative antibiotics. Postoperative surgical site infection and duration of postoperative hospital stay were compared between both groups. Statistical analysis was done using ANOVA, Fisher’s Exact test and Chi-square test wherever necessary.Results: There was no significant difference in the rate of surgical site infection in both groups. The mean duration of postoperative hospital stay was shorter in preoperative antibiotics only group (Group A). Age and gender had no significant association with surgical site infection. There was no deep incisional or organ space infection in this study.Conclusions: Single dose prophylactic antibiotics would be sufficient in cases of laparoscopic appendicectomy for simple uncomplicated nonperforated acute appendicitis. Postoperative antibiotic administration would not be necessary in these cases.

scholarly journals LAPAROSOPIC ASSISTED RIGHT HEMICOLECTOMY

2015 ◽  
Vol 22 (08) ◽  
pp. 1020-1023
Author(s):  
Jahangir Sarwar Khan ◽  
Muhammad Salman Shafique
Keyword(s):  
Surgical Site Infection ◽  
Hospital Stay ◽  
Oral Intake ◽  
Length Of Hospital Stay ◽  
Right Hemicolectomy ◽  
Site Infection ◽  
Carcinoma Colon ◽  
Duration Of Operation ◽  
Age Range ◽  
Surgical Unit

Objective: Experience with Laparosopic assisted Right Hemicolectomy ispresented. Study Design: Prospective study. Setting: Surgical Unit-I, Holy Family Hospital,Rawalpindi, Pakistan. Period: 2010 to 2014. Materials and Methods: 20 patients underwentlaparosopic assisted right hemicolectomy. Duration of operation, postoperative pain, durationof post operative analgesia, frequency of surgical site infection and length of hospital stay werenoted. Results: There were 13 male and 7 female patients with the age range of 25-70 years(45±11years). Eleven (11) patients were suffering from carcinoma colon wheras nine (09)were suffering from Tuberculosis. Mean operative time was about 92 minutes. Only four opiodinjections were required as post-operative analgesia. Oral intake was started after 24 hours. Themean length of hospital stay was 5.5 days with no case of surgical site infection. Conclusion:Laparoscopic assisted right hemicolectomy is a safe and viable option in our setup.

scholarly journals Surgical Site Infection In Laparotomy

2018 ◽  
Vol 4 (1) ◽  
pp. 22-25
Author(s):  
Pashupati N. Bhatta ◽  
Umesh Kumar Yadav ◽  
Gorakh Nath Mishra ◽  
Randhir Jha ◽  
Kumar Shrestha
Keyword(s):  
Risk Factor ◽  
Surgical Site Infection ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Site Infection ◽  
Median Length ◽  
National Medical College ◽  
Medical College ◽  
National Medical ◽  
Duration Of Surgery

INTRODUCTION: Surgical site infection (ssi) is one of the most common surgical complications which increases the rate of morbidity and mortality and increases the health care cost by prolonging the hospital stay.  AIMS AND OBJECTIVES: The main objective of the study was to find out the incidence of ssi in emergency laparotomy in general surgery and to find out the associated risk factor for ssi.MATERIAL & METHODS: Study was carried out in national medical college, Birgunj from January 2011 to June 2012 after getting ethical clearance from Institutional Review Committee National Medical College. Total 200 cases were included in study and follow up done up to 30 days postoperatively. RESULTS: Out of 200 patients, 76 patients developed ssi. The total incidence of ssi was 38%.The rate ssi in clean-contaminated, contaminated and dirty wound were 18.2%, 33.3% & 45.5% respectively. Age, type of surgical operation and prolonged duration of surgery were the significant risk factor for ssi while sex, BMI were not statistically significant. The median length of hospital stay with ssi was 16 days while the median length of hospital stay without ssi was 10 days.CONCLUSION: The rate of ssi was found to be higher in our study in comparison to western study but neariy same when comparing to study of Asian countries. so, we emphasize for the need of  evidence based infection control and recommend for better surveillance program me for control of ssi in each hospital.Journal of Universal College of Medical Sciences (2016) Vol.04 No.01 Issue 13, Page: 22-25

scholarly journals Day of surgery: the impact on patient length of stay in a tertiary vascular unit

2020 ◽  
Vol 102 (2) ◽  
pp. 98-103 ◽  
Author(s):  
NC Holford ◽  
C Ní Ghuidhir ◽  
L Hands
Keyword(s):  
Length Of Stay ◽  
Hospital Stay ◽  
Support Services ◽  
Length Of Hospital Stay ◽  
Abdominal Aortic Aneurysm Repair ◽  
Significant Difference ◽  
Postoperative Length ◽  
The Difference ◽  
Aneurysm Repair ◽  
The Impact

Background Our hypothesis was that patients undergoing surgery earlier in the week would have better access to physiotherapy and other discharge services after surgery and, as a result, would have a shorter length of hospital stay compared with patients undergoing surgery later in the week. This study aimed to assess whether there is a significant difference in postoperative length of hospital stay between the groups with secondary assessment by operation subtype. Methods We identified all patients admitted for vascular surgery in 2015 from a prospectively collected database and divided the week into Monday to Wednesday and Thursday to Friday. Endovascular cases were included but day cases were excluded. Further analysis was performed with a breakdown in both groups by operation type. Statistical analysis was performed using SPSS version 16.0. Results We identified 652 patients who met our criteria. Within the elective patient group, there was a significantly longer length of stay of three days for the late-week group compared with two days for the early-week group (P = 0.016). Femoral artery procedures had a median length of stay of two days for those operated on early in the week compared with four days later in the week (P < 0.005). Open abdominal aortic aneurysm repair showed a trend to longer length of stay in the late-week group (P = 0.06). Conclusion Day of surgery appears to impact on patients’ length of stay following vascular procedures, with the greatest impact on medium-sized procedures. This difference could be explained by the difference in weekend support services, but further evaluation is required following introduction of weekend support services to assess this.

COMPARISION OF SURGICAL SITE INFECTION BETWEEN OPEN APPENDECTOMY AND LAPAROSCOPIC APPENDECTOMY

2021 ◽  
pp. 25-25
Author(s):  
J. Sudhakar ◽  
Manoj Karthik Gera
Keyword(s):  
Surgical Site Infection ◽  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Length Of Hospital Stay ◽  
Site Infection ◽  
Operative Complications ◽  
Bowel Movements ◽  
Perforated Appendix ◽  
Health Care Associated Infection

Appendectomy is most common surgical procedure in emergency surgery. Inamed appendix can be removed laparoscopically (laparoscopic appendectomy) or openly (open appendectomy). Surgical site infection is representative of health care associated infection in which it may effect on patients' morbidity and mortality. The aim of the study is to compare laparoscopic appendectomy and open appendectomy in terms of surgical site infection. The frequency of 60 patients who underwent appendectomy open appendectomy-40;laparoscopic appendectomy-20 between September 2019- march2020 which were retrospectively reviewed for demographic and pathological characteristic, recovery of bowel movements, length of hospital stay and post-operative complications. The frequency of purulent/gangrenous or perforated appendix were Laparoscopic appendectomy-10% and in open appendectomy 20%. The time of rst atus after surgery were 2.9 days and in open appendectomy were 2.97 days in laparoscopic appendectomy. Length of hospital stay were relatively short in laparoscopic appendectomy group and in open appendectomy group The frequency of overall surgical site infection were not that difference between the two groups laparoscopic appendectomy -15% open appendectomy group were22%But that of supercial surgical site infection was signicantly lower in laparoscopic appendectomy group5% open appendectomy group 15%.

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