scholarly journals Laparoscopic Adrenalectomy: Preventive Principles in Intra- and Postoperative Complications

2021 ◽  
Vol 11 (4) ◽  
pp. 284-287
Author(s):  
S. P. Muzhikov ◽  
M. Iu. Eremenko ◽  
A. G. Baryshev
Keyword(s):  
Postoperative Complications ◽  
Laparoscopic Adrenalectomy ◽  
Length Of Hospital Stay ◽  
Operation Technique ◽  
Surgical Trauma ◽  
Satisfactory Condition ◽  
Post Surgery ◽  
Long Term Prognosis ◽  
Definition Of

Background. Laparoscopic adrenalectomy is the current surgery of choice in most adrenal tumours, with a nearly 11 % complication rate and below 1 % mortality. Laparoscopy combines the advantages of minimally invasive surgery with well-known long-term prognosis of a traditional open surgery, at the same time requiring the surgeon’s skill of knowing the technique and avoiding complication.Aim. Concept definition of safe laparoscopic adrenalectomy.Materials and methods. A total of 28 patients with adrenal neoplasms were rendered laparoscopic adrenalectomy by same surgical team under benchmark recommendations during 2016–2019.Results. All patients have been discharged in satisfactory condition, with no intra-, postoperative complications or lethal outcomes.Discussion. Th e evidence presented displays feasibility of using the benchmark principles in laparoscopic adrenalectomy surgery. Laparoscopic adrenalectomy is superior in reducing the recovery time, surgical trauma, complication incidence, length of hospital stay, treatment cost, the improvement of overall wellbeing post-surgery and patients’ quality of life. Th ese principles proved effective to avoid intra- and postoperative complications of laparoscopic adrenalectomy and facilitated revamping of the operation technique in left -sided adrenalectomy.Conclusion. Th e benchmark principles of laparoscopic adrenalectomy enable the procedure higher efficacy and safety and require further implementation and long-term assessment of the outcome.

Bilateral Ventriculocordectomy via Ventral Laryngotomy for Idiopathic Laryngeal Paralysis in 88 Dogs

2012 ◽  
Vol 48 (4) ◽  
pp. 234-244 ◽  
Author(s):  
Cynthia Zikes ◽  
Timothy McCarthy
Keyword(s):  
Postoperative Complications ◽  
Surgical Trauma ◽  
Short Term ◽  
Laryngeal Paralysis ◽  
Long Term Follow Up ◽  
Short And Long Term ◽  
Low Incidence ◽  
Results Of Surgery

Bilateral ventriculocordectomy through a ventral median laryngotomy was performed for the treatment of idiopathic laryngeal paralysis in 88 dogs. The purpose of this retrospective analysis was to provide long-term follow-up for a large number of dogs surgically managed with this technique. A combination of medical record and completed client questionnaire information provided short-term (14 days) follow-up for 88 dogs and long-term (>6 mo) follow-up for 42 dogs. Major short-term postoperative complications were identified in 3 of 88 (3.4%) patients. Major long-term complications were identified in 3 of 42 (7.1%) patients. The results of surgery were considered to be very satisfactory in 93% and unsatisfactory in 7%. Three dogs in this series developed aspiration pneumonia. Bilateral ventriculocordectomy through a ventral median laryngotomy is associated with a low incidence of both short- and long-term complications. Due to the ease of this procedure, the minimal surgical trauma to the patient, and the satisfactory results, this surgery should be considered an option for the treatment of idiopathic laryngeal paralysis in the dog.

scholarly journals The influence of postoperative complications on long-term prognosis in patients with colorectal carcinoma

2020 ◽  
Vol 35 (6) ◽  
pp. 1055-1066 ◽  
Author(s):  
Clemens Beck ◽  
Klaus Weber ◽  
Maximilian Brunner ◽  
Abbas Agaimy ◽  
Sabine Semrau ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Colorectal Carcinoma ◽  
Long Term Prognosis

PS01.137: CLINICAL IMPACT OF SURGICAL APGAR SCORE IN PREDICTING POSTOPERATIVE COMPLICATIONS AND LONG-TERM PROGNOSIS AFTER ESOPHAGECTOMY

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 88-89
Author(s):  
Sonoko Ishida ◽  
Akio Nakagawa ◽  
Tetsu Nakamura ◽  
Taro Oshikiri ◽  
Hiroshi Hasegawa ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Postoperative Complications ◽  
Apgar Score ◽  
Scoring System ◽  
Clinical Stage ◽  
Risk Calculator ◽  
Poor Prognostic Factor ◽  
Long Term Prognosis ◽  
Surgical Apgar Score

Abstract Background Surgical Apgar Score (SAS) is a risk calculator, and is known to predict postoperative complications after surgery. Because it applies three intraoperative parameters, namely estimated blood loss, lowest mean arterial pressure, and lowest heart rate, actual surgical stress is reflected to its scoring system and many studies have reported its usefulness. And in recent years, close relationship between postoperative complications and long-term prognosis has been reported, but there are almost no studies about the relevance between risk calculator of complications and long-term prognosis. Methods A total of 400 patients who underwent esophagectomy for esophageal cancer between January 2007 and January 2017 at our institution were included in this study. Clinicopathological and intraoperative data to calculate SAS were collected from medical records, and a 10-point scoring system based on the original method was used to assign points. Complications classified as Clavien-Dindo grade III or higher were defined as postoperative complications. The relationship between SAS and postoperative complications and long-term prognosis was investigated. Results Postoperative complications occurred in 145 cases (36%). From ROC analysis, we set the SAS cut-off value to 5 points in this study. There were no significant differences in patient's background between the group of SAS ≤ 5 and > 5. Multivariate logistic regression analysis showed that hypertension (P = 0.049) and SAS ≤ 5 (P < 0.0001) were significant predictive factors for postoperative complications. In the prognostic analysis, log-rank analysis showed that patients with SAS ≤ 5 had a significantly poorer prognosis than those with SAS > 5 (P = 0.043), especially in clinical stage 2 or higher esophageal cancer (P = 0.027). In the multivariate analysis, SAS ≤ 5 was revealed to be a significantly poor prognostic factor in clinical stage 2 or higher esophageal cancer (P = 0.029). Conclusion The Surgical Apgar Score can predict postoperative complications, and is also useful to predict long-term prognosis after esophagectomy for esophageal cancer. Disclosure All authors have declared no conflicts of interest.

scholarly journals Modified Clavien-Dindo Classification to Analyze the Risk Factors of Early Complications after Radical Gastrectomy and the Impact of Complications on Long-Term Prognosis

2020 ◽  
Author(s):  
Jun Ma ◽  
Ying Wang ◽  
Shui-hong Yu ◽  
Chao-pin Zhou ◽  
Da-tian Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Postoperative Hospital Stay ◽  
Radical Gastrectomy ◽  
Early Complications ◽  
Independent Risk Factors ◽  
Long Term Prognosis ◽  
The Impact

Abstract Background The modified Clavien-Dindo classification system was employed to investigate the occurrence of early complications along with the related risk factors following a radical gastrectomy procedure, with the view of conducting an analysis into the impact of complications on long-term prognosis. Methods The clinical data of 525 patients who had previously undergone a radical gastrectomy procedure for gastric cancer were analyzed in a retrospective fashion. Results Postoperative hospital stay: Complication group (17.88±8.472) days, severe complications group (23.10±7.594) days, significantly higher than non-complication group (10.26±1.973) days and non-severe complications group (11.47±4.712) days (P=0.000<0.05).Multivariate analysis: age (OR = 1.781, P = 0.013), preoperative comorbidity (OR = 1.765, P = 0.020), blood loss (OR = 2.153, P = 0.001), surgical approach (OR = 3.137, P = 0.000) were identified as an independent risk factor associated with early complications. Blood loss (OR=13.053, P=0.013), type of resection (OR=7.936, P=0.047) and nerve involvement (OR=3.670, P=0.009) were identified to be independent risk factors for severe complications.Severe postoperative complications (HR=1.595, P=0.107) and postoperative complications (HR=1.078, P=0.670) were not independent risk factors affecting the 5-year over survival rate. Conclusion Complications following radical gastrectomy were closely related to age, preoperative comorbidity, blood loss, and surgical approach; severe complications were closely related to blood loss, total gastrectomy, and nerve involvement; complications and severe complications were not found to be independent risk factors associated with long-term survival, that being said, they were significantly prolonged postoperative hospital stay.

scholarly journals Prospective outcomes following drainless superficial parotidectomy with sternocleidomastoid flap reconstruction

2020 ◽  
Vol 49 (1) ◽  
Author(s):  
Jonathan C. Melong ◽  
Matthew H. Rigby ◽  
Martin Corsten ◽  
Jonathan R. B. Trites ◽  
Angela Bulter ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Cost Analysis ◽  
Functional Outcomes ◽  
Length Of Hospital Stay ◽  
Superficial Parotidectomy ◽  
Novel Technique ◽  
Rotational Flap ◽  
Drain Placement

Abstract Background Patients undergoing superficial parotidectomy for benign parotid lesions are at risk of postoperative complications, most notably cosmetic complications such as facial paralysis and contour defects, and functional complications including Frey’s syndrome. Traditionally, surgical drains have been placed at the end of surgery to prevent hematoma and sialocele formation. However, this can increase the risk of postoperative complications and contribute to a prolonged course in hospital. To try and prevent these risks and complications, we introduced a novel technique of a drainless parotidectomy by reconstructing the resulting parotid bed defect with a superiorly based sternocleidomastoid (SCM) rotational flap and by placement of gelfoam into the wound bed and a facelift dressing postoperatively to provide additional hemostasis and avoid drain placement. Methods All patients with benign parotid disease undergoing a drainless superficial parotidectomy and reconstruction with a superiorly based SCM rotational flap at our center were identified within a prospective cohort database between July 2010–2018. Primary outcomes included postoperative cosmetic and functional outcomes, complications and length of hospital stay. A secondary cost analysis was done to compare this novel technique to traditional superficial parotidectomy with surgical drain placement. Results Fifty patients were identified within the database and were included in the final analysis. The average length of hospital stay was 1.02 days. All patients were satisfied with their aesthetic outcome at 1 year. During long term follow-up, 63% of patients reported normal appearance of the operated side. Seven patient’s (14%) developed temporary facial paresis following surgery. All patients had resultant normal facial function at follow-up in 1 year. No patients developed subjective Frey’s Syndrome. Two patients (4%) developed a postoperative sialocele requiring drainage and one patient (2%) developed a hematoma on extubation requiring evacuation and drain placement. Cost analysis demonstrated a cost savings of approximately $975 per person following surgery. Conclusion In the current study, we introduced a novel approach of a drainless superficial parotidectomy using a superiorly based SCM flap, gelfoam and placement of a post-operative facelift dressing. This drainless approach was associated with good long-term cosmetic and functional outcomes with few postoperative complications. This new technique may also offer the potential for long-term savings to the health care system.

scholarly journals Early Postoperative Pneumothorax Might Not Be ‘True’ Recurrence

2021 ◽  
Vol 10 (23) ◽  
pp. 5687
Author(s):  
Wongi Woo ◽  
Chong Hoon Kim ◽  
Bong Jun Kim ◽  
Seung Hwan Song ◽  
Duk Hwan Moon ◽  
...  
Keyword(s):  
Temporal Patterns ◽  
Late Recurrence ◽  
Postoperative Recurrence ◽  
Recurrence Rates ◽  
True Recurrence ◽  
Potential Risk Factors ◽  
Multivariable Analyses ◽  
Long Term Prognosis ◽  
Definition Of

Objectives: To date, there is no consensual definition of what constitutes a postoperative recurrence of primary spontaneous pneumothorax (PSP), despite there being many studies reporting a high incidence of recurrence. This study aims to describe the long-term recurrence rates of pneumothorax and to suggest a possible way to differentiate recurrence events based on temporal patterns. Methods: This single-center study retrospectively evaluated all postoperative recurrence of PSP from January 2007 to May 2019. Patients’ demographics, history of pneumothorax, radiologic data, surgical technique, and the time between operation and recurrence were analyzed. Univariate and multivariable analyses were conducted to find potential risk factors related to long-term recurrence. Results: Of the 77 postoperative recurrent cases of pneumothorax, 21 (27.2%) occurred within 30 days after surgery and, thus, were classified as early recurrences (ER), while the remaining cases were classified as late recurrences (LR). There was no difference in preoperative variables between the two groups. However, the rate of incidence of second recurrence (SR), which represented a long-term prognosis, was significantly higher in the LR group (28.6% vs. 4.8%, p = 0.030). On univariate and multivariable analyses, late recurrence was the only significant factor predicting later recurrence events. Conclusion: Postoperative recurrence (PoR) within 30 days had a lower SR rate. Therefore, it might not be a ‘true’ postoperative recurrence with a favorable prognosis. Further studies investigating postoperative recurrence based on temporal patterns would be warranted to improve the classification of PoR.

The impact of compliance with Enhanced Recovery After Surgery (ERAS) protocol on short and long-term outcomes in patients after laparoscopic colorectal cancer surgery

2021 ◽  
Vol 8 ◽  
pp. 31-35
Author(s):  
Magdalena Pisarska-Adamczyk
Keyword(s):  
Colorectal Cancer ◽  
Postoperative Complications ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Long Term Results ◽  
Surgical Trauma ◽  
Short Term ◽  
Eras Protocol ◽  
The Impact

Patients undergoing surgery for colorectal cancer are a special group of patients. Not only performed resections are extensive, but also the underlying disease significantly depletes regenerative capacities of the body. It is well known that every surgical procedure is associated with an injury, the size of which is proportional to the type and extent of the intervention. The size of surgical trauma in postoperative period is proportional to the increase in insulin resistance which delays convalescence and increases the risk of postoperative complications. Hence, for several years, a specific program had been developed and introduced to reduce trauma associated with the surgery and its adverse consequences. The use of a modern multimodal care protocol for Enhanced Recovery After Surgery(ERAS) served this purpose. The aim of the study was to determine the impact of compliance to ERAS protocol on short-term results in a group of patients operated for colorectal cancer. In the next stage, it was checked whether it is possible to maintain high compliance of the protocol for a long time. Finally, I tried to determine the relationship between the compliance and distant oncological results. Consecutive patients with colon or rectal cancer undergoing laparoscopic resection were included in the study. In all patients the 16-item ERAS protocol was applied. The use of ERAS protocol improves short-term results: accelerates convalescence, reduces morbidity and reduces the length of hospital stay. However, its impact on short-term results correlates with the level of protocol implementation. The higher compliance with the protocol, the better the short-term results. Maintaining a high level of implementation of the protocol is possible despite the slight decrease over time. However, this has no adverse effect on short-term results. The compliance with ERAS protocol seems to also affect long-term results. Low compliance with ERAS protocol, along with the higher stage of cancer and postoperative complications, is an independent factor worsening long-term survival.

Postoperative Complications have Minimal Impact on Long-Term Prognosis in Immunodeficient Patients with Esophageal Cancer

2020 ◽  
Vol 27 (8) ◽  
pp. 3064-3070 ◽  
Author(s):  
Suguru Maruyama ◽  
Yoshihiko Kawaguchi ◽  
Hidenori Akaike ◽  
Katsutoshi Shoda ◽  
Ryo Saito ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Postoperative Complications ◽  
Minimal Impact ◽  
Long Term Prognosis

The impact of infectious complications on long-term prognosis after curative resection for gastric cancer.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 122-122
Author(s):  
Yukio Maezawa ◽  
Toru Aoyama ◽  
Hiroshi Tamagawa ◽  
Tsutomu Sato ◽  
Takashi Ogata ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Postoperative Complications ◽  
Anastomotic Leakage ◽  
Curative Resection ◽  
Operation Time ◽  
Significant Prognostic Factor ◽  
Long Term Prognosis ◽  
Postoperative Inflammatory Complications ◽  
The Impact

122 Background: Several studies have reported that postoperative complications such as anastomotic leakage affect long-term prognosis after gastric cancer surgery. This study aimed to determine whether or not long-term outcomes were affected by the postoperative inflammatory complications in patients who underwent curative resection for gastric cancer. Methods: The patients were retrospectively selected from the medical records of consecutive patients who underwent curative gastrectomy with nodal dissection for gastric cancer at Yokohama City University and Kanagawa Cancer Center from January 2000 to August 2015. Inflammatory complications were evaluated according to the Clavien-Dindo classification. Overall survival (OS) was compared between postoperative inflammatory complications (IC) and no-complication (NC) groups. Results: A total of 2,254 patients were eligible for inclusion in the present study. One hundred seventy-five patients had IC group, while 2,079 patients had not. Operation time (p < 0.001), blood loss (p < 0.001) was significantly greater in the IC group. The incidence of postoperative inflammatory complication grade 2 or higher was 8.5% in which, pancreatic fistula (2.8%), anastomotic leakage (1.8%) were occurred. The mortality rate was 0.18%. The five-year OS rates of the IC and NC groups were 74.9% and 83.2%, respectively. The difference was statistically significant (p = 0.015). Multivariate Cox’s proportional hazard analyses demonstrated that the postoperative inflammatory complications were a significant prognostic factor for OS. Conclusions: Postoperative inflammatory complications have an obvious impact on the OS in curatively resected gastric cancer patients. It is necessary to reduce the incidence of postoperative complications.

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