scholarly journals Retroperitoneoscopic nephrectomy for a nonfunctioning kidney

2019 ◽  
Vol 76 (6) ◽  
pp. 577-581
Author(s):  
Vuk Sekulic ◽  
Jovo Bogdanovic ◽  
Ranko Herin ◽  
Senjin Djozic ◽  
Mladen Popov
Keyword(s):  
Blood Loss ◽  
Minimally Invasive ◽  
Hospital Stay ◽  
Demographic Data ◽  
Postoperative Mortality ◽  
Ct Urography ◽  
Average Hospital ◽  
Average Blood Loss ◽  
Duration Of Surgery ◽  
Functioning Kidney

Background/Aim. The minimally invasive laparoscopic nephrectomy was first performed in 1991. The objective of this paper was to present the surgical technique of retroperitoneoscopic nephrectomy and to our experience with this procedure in removal of non-functioning kidneys. Methods. This retrospective study enrolled 55 patients who underwent retroperitoneoscopic nephrectomy at our institution during the period from January 2011 to November 2016. All patients had a unilateral non-functioning kidney confirmed by intravenous or computed tomography (CT)- urography and renal scintigram. Their medical records were analyzed for demographic data, duration of surgery, average blood loss, duration of hospital stay as well as time to return to normal life activities. Results. The mean age of patients was 43 years (range 23?78). Perioperative or early postoperative mortality was not recorded. Mean operative time was 82 minutes (range 45?210). The average blood loss was 90 mL (40?450). The average hospital stay was 4 days (3?7). Return to life activity was in average after 12 days (9?15). Conclusions. Retroperitoneoscopic nephrectomy for a non-functioning kidney is a feasible, safe, and effective minimally invasive method. The length of hospital stay and convalescence was shorter than after open nephrectomy.

scholarly journals Comparison Between Minimally Invasive and Open Gastrectomy for Gastric Cancer in Europe: A Systematic Review and Meta-analysis

2016 ◽  
Vol 106 (1) ◽  
pp. 3-20 ◽  
Author(s):  
I. D. Kostakis ◽  
A. Alexandrou ◽  
E. Armeni ◽  
C. Damaskos ◽  
G. Kouraklis ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Blood Loss ◽  
Minimally Invasive ◽  
Hospital Stay ◽  
Postoperative Bleeding ◽  
Postoperative Mortality ◽  
Duodenal Stump ◽  
Conversion Rates ◽  
Pubmed Database ◽  
Duodenal Stump Leakage

Aims: We compared laparoscopic and robotic gastrectomies with open gastrectomies and with each other that were held for gastric cancer in Europe. Methods: We searched for studies conducted in Europe and published up to 20 February 2015 in the PubMed database that compared laparoscopic or robotic with open gastrectomies for gastric cancer and with each other. Results: We found 18 original studies (laparoscopic vs open: 13; robotic vs open: 3; laparoscopic vs robotic: 2). Of these, 17 were non-randomized trials and only 1 was a randomized controlled trial. Only four studies had more than 50 patients in each arm. No significant differences were detected between minimally invasive and open approaches regarding the number of retrieved lymph nodes, anastomotic leakage, duodenal stump leakage, anastomotic stenosis, postoperative bleeding, reoperation rates, and intraoperative/postoperative mortality. Nevertheless, laparoscopic procedures provided higher overall morbidity rates when compared with open ones, but robotic approaches did not differ from open ones. On the contrary, blood loss was less and hospital stay was shorter in minimally invasive than in open approaches. However, the results were controversial concerning the duration of operations when comparing minimally invasive with open gastrectomies. Additionally, laparoscopic and robotic procedures provided equivalent results regarding resection margins, duodenal stump leakage, postoperative bleeding, intraoperative/postoperative mortality, and length of hospital stay. On the contrary, robotic operations had less blood loss, but lasted longer than laparoscopic ones. Finally, there were relatively low conversion rates in laparoscopic (0%–6.7%) and robotic gastrectomies (0%–5.6%) in most studies. Conclusion: Laparoscopic and robotic gastrectomies may be considered alternative approaches to open gastrectomies for treating gastric cancer. Minimally invasive operations are characterized by less blood loss and shorter hospital stay than open ones. In addition, robotic procedures have less blood loss, but last longer than laparoscopic ones.

Efficacy of Thiol disulfide Homeostasis and Ischemia Modified Albumin Values in Estimating the Degree of Difficulty for Laparoscopic Cholecystectomy

2020 ◽  
Vol 23 ◽  
Author(s):  
Gökhan Akkurt ◽  
Burcu Akkurt ◽  
Emel Alptekın ◽  
Birkan Birben ◽  
Mehmet Keşkek ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Demographic Data ◽  
Previous History ◽  
Significant Negative Correlation ◽  
White Blood Count ◽  
Ischemia Modified Albumin ◽  
Total Thiol ◽  
Duration Of Surgery ◽  
History Of

Aim: The aim of this study is to investigate the efficacy of thiol disulfide homeostasis and Ischemia Modified Albumin (IMA) values in predicting the technical difficulties that might be encountered during laparoscopic cholecystectomy. Materials and Methods: The study included 65 patients who underwent laparoscopic cholecystectomy due to cholelithiasis at the General Surgery Clinic of Ankara Numune Training and Research Hospital. All patients’ demographic data, previous history of cholecystitis, a history of chronic illness, preoperative white blood count (WBC), liver function tests (AST, ALT), amylase and lipase levels, intra-operative adhesion score, the ultrasonographic appearance of gallbladder, duration on hospital stay, duration of operation, thiol disulfide and IMA values were evaluated. Results: Native thiol and total thiol averages were higher in patients without a history of cholecystitis, on the other hand, disulfide, disulfide/native thiol rate, disulfide/total thiol rate, native thiol/total thiol rate and IMA averages were higher in patients with a history of cholecystitis. While there was a statistically significant negative correlation between native and total thiol values and age, duration of surgery and duration of hospital stay; IMA, disulfide, disulfide/Total thiol, Native/Total thiol and disulfide/Native thiol rates were higher in older patients with a longer duration of surgery and hospital stay. In addition, preoperative IMA, disulfide, disulfide/Total thiol, Native/Total thiol and disulfide/Native thiol were observed to increase as the degree of intraoperative pericholecystic adhesion increased. Conclusion: We believe that the evaluation of thiol disulfide homeostasis and IMA parameters prior to laparoscopic cholecystectomy can be used as an effective method for predicting intraoperative difficulties.

scholarly journals Microsurgical unilateral laminotomy for bilateral decompression of degenerative lumbar canal stenosis: a comparative study

2019 ◽  
Vol 55 (1) ◽  
Author(s):  
Mohamed I. Refaat ◽  
Amr K. Elsamman ◽  
Adham Rabea ◽  
Mohamed I. A. Hewaidy
Keyword(s):  
Patient Satisfaction ◽  
Blood Loss ◽  
Minimally Invasive ◽  
Invasive Technique ◽  
Decompression Surgery ◽  
Microsurgical Decompression ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

Abstract Background The quest for better patient outcomes is driving to the development of minimally invasive spine surgical techniques. There are several evidences on the use of microsurgical decompression surgery for degenerative lumbar spine stenosis; however, few of these studies compared their outcomes with the traditional laminectomy technique. Objectives The aim of our study was to compare outcomes following microsurgical decompression via unilateral laminotomy for bilateral decompression (ULBD) of the spinal canal to the standard open laminectomy for cases with lumbar spinal stenosis. Subjects and methods Cases were divided in two groups. Group (A) cases were operated by conventional full laminectomy; Group (B) cases were operated by (ULBD) technique. Results from both groups were compared regarding duration of surgery, blood loss, perioperative complication, and postoperative outcome and patient satisfaction. Results There was no statistically significant difference between both groups regarding the improvement of visual pain analogue, while improvement of neurogenic claudication outcome score was significant in group (B) than group (A). Seventy-three percent of group (A) cases and 80% of group (B) stated that surgery met their expectations and were satisfied from the outcome. Conclusion Comparing ULBD with traditional laminectomy showed the efficacy of the minimally invasive technique in obtaining good surgical outcome and patient satisfaction. There was no statistically significant difference between both groups regarding the occurrence of complications The ULBD technique was found to respect the posterior spinal integrity and musculature, accompanied with less blood loss, shorter hospital stays, and shorter recovery periods than the open laminectomy technique.

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.

Abstract 12048: Minimally Invasive Access for Aortic Valve Surgery in Octogenarians: Is it Still Justified in the Days of TAVI ?

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Udo Boeken ◽  
Sudharson Rajah ◽  
Jan Philipp Minol ◽  
Payam Akhyari ◽  
Artur Lichtenberg
Keyword(s):  
Aortic Valve ◽  
Minimally Invasive ◽  
Hospital Stay ◽  
Surgical Techniques ◽  
Valve Surgery ◽  
Aortic Valve Surgery ◽  
Partial Sternotomy ◽  
Number Of Patients ◽  
Duration Of Surgery ◽  
Minimally Invasive Access

Introduction: Increasing life expectancy in the western world and improvements in surgical techniques and postoperative care have resulted in a significant number of patients aged over 80 undergoing cardiac operations. At times of transapical and transfemoral AVR we aimed to evaluate the feasibility of partial sternotomy for patients over 80 years of age and to compare these results with a historical group of octogenarians who underwent aortic valve surgery via full sternotomy in our department between 1998 and 2006. Methods: 72 of the 275 patients (26.2 %) who underwent aortic valve replacement (AVR) after partial sternotomy between 8/2009 and 05/2013 were octogenarians. Mean age was 83.1 ± 3.9 years (group ps). We compared this group with 165 patients (mean age 81.6 ± 3.1 years) who underwent AVR via full sternotomy between 1998 and 2006 (group fs). Results: ICU- and hospital stay were significantly reduced in patients with partial sternotomy (ps: 28 ± 9 hours, 12.8 ± 4.7 days vs. fs: 59 ± 15 h, 14.7 ± 3.5 d, p<0.05). We found a higher in-hospital mortality in group fs, but without significance (4.2 vs. 2.8 % in ps). Duration of operation, of extracorporeal circulation, and of aortic cross-clamping was tendentially prolonged in patients with partial sternotomy (p>0.05). Necessity for re-operation due to bleeding was comparable in both groups (ps: 2.8 % vs. fs: 3.0 %). The incidence of postoperative complications did not differ significantly between both groups: neurological complications (ps: 2.8 vs. fs: 3.0 %), sternal wound infections (2.8 % vs. 2.4 %) and postoperative LCOS (4.2 % vs. 5.5 %). Conclusions: We could prove the feasibility of ministernotomy for aortic valve surgery for patients over 80 years of age. Despite a tendentially prolonged duration of surgery compared to procedures via full sternotomy, we found a comparable morbidity and a reduced mortality after partial sternotomy. From an economic perspective, the reduction of intensive care unit- and hospital stay after minimally invasive access was the most interesting finding. Moreover, our results after minimally invasive AVR have to be considered carefully when selecting patients for a conventional or for a TAVI procedure.

scholarly journals Non-descent vaginal hysterectomy for large uterus-safety and feasibility

2018 ◽  
Vol 7 (9) ◽  
pp. 3563
Author(s):  
Rameshkumar R. ◽  
Sahana N. Naik ◽  
Dhanalakshmi .
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Cost Effective ◽  
Cost Effective Method ◽  
Duration Of Surgery ◽  
Operative Complications ◽  
Large Uterus ◽  
Duration Of Operation ◽  
Post Operative Complications

Background: Non Descent Vaginal Hysterectomy (NDVH) is removal of uterus through vagina in non-prolapsed uterus. The objective of the present study was to assess safety and feasibility of NDVH in patients with large uterus (>12 weeks size uterus).Methods: Retrospective study was conducted in Department of Obstetrics and Gynecology of Shree Dharmasthala Manjunatheshwara (SDM) College of Medical Sciences and Hospital, Dharwad, India from May2014 to May 2017. Effort was made to perform hysterectomies vaginally in women with benign conditions with large uterine size. Information regarding age, parity, uterine size, blood loss, duration of operation, number of fibroids, other surgical difficulties encountered, intra–operative and post-operative complications were recorded.Results: Total of 65 cases was selected for NDVH with large uterine size. All successfully underwent NDVH. 25 patients had uterus of 10-12 weeks size, 17 had uterine size of 12-14 weeks size. Mean duration of surgery was 90 min. Mean blood loss was 300ml. Post-operative complications were minimal. All patients had early mobility with faster resumption to daily activities. Mean hospital stay was 4-5 days.Conclusions: Non descent vaginal hysterectomy is safe, cost effective method of hysterectomy in women with large uterus requiring hysterectomy for benign conditions with less complications, shorter hospital stay and less morbidity.

scholarly journals Surgical Correction of Unicoronal Craniosynostosis with Frontal Bone Symmetrization and Staggered Osteotomies

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Seyed Esmail Hassanpour ◽  
Masoumeh Abbasnezhad ◽  
Hamidreza Alizadeh Otaghvar ◽  
Adnan Tizmaghz
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Frontal Bone ◽  
Surgical Correction ◽  
Average Weight ◽  
Average Hospital ◽  
Starting Time ◽  
Icu Stay ◽  
Estimated Blood Loss ◽  
Stay Time

Background. Craniosynostosis is the premature fusion of one or more cranial sutures that produce abnormal head shape. Plagiocephaly is a general term that describes unilateral flattening of the anterior or posterior quarter of the cranium. Anterior plagiocephaly is almost always due to unilateral coronal synostosis. Early surgical treatment is the best option for these patients. The aim of this study was to investigate the surgical correction results of unicoronal craniosynostosis with frontal bone symmetrization and staggered osteotomies. Methods. All unicoronal craniosynostosis cases treated surgically from 2013 to 2016 at our hospital, with frontal bone symmetrization and staggered osteotomies and fronto-orbital advancement, were reviewed. The following variables were analyzed: sex, age, weight, hospital stay time, ICU stay time, per os (PO) starting time, anesthetic time, estimated blood loss volume (ml), estimated blood loss as percentage of total volume, surgical complication, follow-up time, and Whitaker grade. All data were analyzed with SPSS. Results. The study consisted of 33 patients (19 females, 14 males). Average age was 10.24 months, average weight was 8.97 Kg, average hospital stay time was 7.84 days, average ICU stay time was 1.69 days, average PO starting time was 1.24 days after surgery, average anesthetic time was 397.72 minutes, average estimated blood loss was 213.78 ml, and estimated blood loss as percentage of total volume was 31.69%. One case (3.03%) needed reoperation and two cases had postoperative seizure. No mortality was seen. Conclusion. It is supposed that surgical correction of unicoronal craniosynostosis with frontal bone symmetrization and staggered osteotomies results in lower blood loss, lower complication rate and reoperation, and more durable results.

scholarly journals Acetabular Fracture: Retrospective Analysis of Thirty Three Consecutive Cases with Operative Management

2015 ◽  
Vol 12 (4) ◽  
pp. 279-287 ◽  
Author(s):  
D Shrestha ◽  
D Dhoju ◽  
R Shrestha ◽  
V Sharma
Keyword(s):  
Hospital Stay ◽  
Acetabular Fracture ◽  
Motor Vehicle ◽  
Demographic Data ◽  
Operative Management ◽  
Average Hospital ◽  
Vehicle Accidents ◽  
Radiographic Outcomes ◽  
Fracture Management

Background With the development of better imaging modalities including 3D CT scan and availability of technical expertise, operative management is increasingly performed for acetabular fracture but many patients in developing countries like Nepal, are still being treated with prolonged skeletal traction.Objective To analyses epidemiology, types of acetabular fracture and functional and radiological outcome of patients with acetabular fracture treated with open reduction and internal fixation (ORIF).Method Inpatients hospital records of patients treated with ORIF in between June 2007 to June 2014 were evaluated. Patient’s demographic data, mode of injury, injury hospital interval, injury surgery interval, associated injuries, surgical approach, total hospital stay and peri and post-operative complications were recorded and radiological and functional outcomes were evaluated.Result Thirty three patients (Male: 24 Female: 9) with average age 39 years (range: 21 to 65 years) were operated for acetabular fracture. Twenty one patients (63%) had injury related with motor vehicle accidents and nine (24%) of them had motorbike accidents. Injury hospital interval ranges from 7 to 36 days. Average injury-surgery interval was 21 days and average hospital stay was 22 days. Bicolumnar fractures were found in 15. Nine patients had dislocation of hip and 15 had concomitant other injuries. Biculumanr fixation was performed in 15 patients, posterior column and or wall in nine with Kocher Langenbeck approach and anterior column and or wall in other nine with ilio-inguinal approach. Radiological reduction was anatomical in 18; excellent/good functional outcome was in 26 and radiological outcomes were excellent in 14. Three patients had developed Hypertopic ossification. Follow up period ranged from 6 to 48 months and 15 patients (45%) had follow up >2 years.Conclusion Acetabular fractur can be effectively managed with ORIF and have predictable and comparable functional and radiographic outcomes. Upgrading the existing facilities and training of orthopedic surgeon for acetabular fracture management is important to shorten injury-surgery interval due to lack of such facilities.Kathmandu University Medical Journal Vol.12(4) 2014; 279-287

scholarly journals Non Descent Vaginal Hysterectomy: A Rational Surgical Approach

KYAMC Journal ◽  
2017 ◽  
Vol 6 (2) ◽  
pp. 637-641
Author(s):  
Arifa Akter Zahan ◽  
Kh Shahnewaz ◽  
Ummay Salma
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Average Duration ◽  
Uterine Prolapse ◽  
Rational Approach ◽  
Medical College ◽  
Gynecological Disorders ◽  
Estimated Blood Loss ◽  
Duration Of Surgery

Aims: To evaluate the rational approach of non-descent vaginal hysterectomy in advancing gynaecology practice.Study Design: Retrospective study and period from 1st July 2013 to 31st June 2014. Setting Kumudini Women's Medical College & Hospital, Mirzapur, Tangail.Patients: All selective patients requiring hysterectomy for benign gynecological disorders who did not have any uterine prolapse were recruited for this study. In bigger size uterus morcellation techniques like bisection, debulking, myomectomy, slicing, or combination of these were used to remove the uterus.Main outcome measures: Data regarding indication, age, parity, uterine size, estimated blood loss, length of operation, complication and hospital stay were recorded.Results: A total of 50 cases were selected for non-descent vaginal hysterectomy all of them successfully underwent non-descent vaginal hysterectomy. Commonest age group was (41-45 years) i.e. 46%. All patients were parous. Uterus size was less then 8 wks 21 cases, 8wks to 12 wks in 27 cases, more then 12 wks 02 cases. Commonest indication was DUB of uterus (44%). Mean duration of surgery was 50.5 minutes. Mean blood loss was 100ml. Blood transfusion was required in four cases. Average duration of hospital stay was 3.1 days. Complications were minimal which included UTI and Vault infection.Conclusions: NDVH is safe feasible and patient friendly. We suggest that our modern gynecologist will be more expertise and familiar to this procedure in near future.KYAMC Journal Vol. 6, No.-2, Jan 2016, Page 637-641

The Hand-Assisted Laparoscopic Approach to Resection of Pancreatic Mucinous Cystic Neoplasms: An Underused Technique?

2018 ◽  
Vol 84 (1) ◽  
pp. 56-62
Author(s):  
Lauren M. Postlewait ◽  
Cecilia G. Ethun ◽  
Mia R. Mcinnis ◽  
Nipun Merchant ◽  
Alexander Parikh ◽  
...  
Keyword(s):  
Blood Loss ◽  
Minimally Invasive ◽  
Hospital Stay ◽  
Distal Pancreatectomy ◽  
Operative Time ◽  
Operative Blood Loss ◽  
Specimen Length ◽  
Cystic Neoplasms ◽  
Invasive Approach ◽  
Mucinous Cystic Neoplasms

Pancreatic mucinous cystic neoplasms (MCNs) are rare tumors typically of the distal pancreas that harbor malignant potential. Although resection is recommended, data are limited on optimal operative approaches to distal pancreatectomy for MCN. MCN resections (2000–2014; eight institutions) were included. Outcomes of minimally invasive and open MCN resections were compared. A total of 289 patients underwent distal pancreatectomy for MCN: 136(47%) minimally invasive and 153(53%) open. Minimally invasive procedures were associated with smaller MCN size (3.9 vs 6.8 cm; P = 0.001), lower operative blood loss (192 vs 392 mL; P = 0.001), and shorter hospital stay(5 vs 7 days; P = 0.001) compared with open. Despite higher American Society of Anesthesiologists class, hand-assisted (n = 46) had similar advantages as laparoscopic/robotic (n = 76). When comparing hand-assisted to open, although MCN size was slightly smaller (4.1 vs 6.8 cm; P = 0.001), specimen length, operative time, and nodal yield were identical. Similar to laparoscopic/robotic, hand-assisted had lower operative blood loss (161 vs 392 mL; P = 0.001) and shorter hospital stay (5 vs 7 days; P = 0.03) compared with open, without increased complications. Hand-assisted laparoscopic technique is a useful approach for MCN resection because specimen length, lymph node yield, operative time, and complication profiles are similar to open procedures, but it still offers the advantages of a minimally invasive approach. Hand-assisted laparoscopy should be considered as an alternative to open technique or as a successive step before converting from total laparoscopic to open distal pancreatectomy for MCN.

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