scholarly journals Interval versus external fixation for the treatment of pelvic fractures: a comparative study

2017 ◽  
Author(s):  
Xianping Ma ◽  
Xudong Zheng ◽  
Wei Zhao ◽  
Zifeng Lu ◽  
Lei Xu ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Postoperative Complications ◽  
Blood Loss ◽  
External Fixation ◽  
Operation Time ◽  
Pelvic Fractures ◽  
Efficacy And Safety ◽  
Postoperative Rehabilitation ◽  
Clinical Indicators ◽  
Postoperative Fever

Purpose: This retrospective study evaluated the efficacy and safety of internal fixation (IF) in the treatment of pelvic fractures (PF). Methods: A total of 263 unstable PF patients were treated from February 2009 to April 2015. Patients were divided into two groups according to type of fixation used to treat their PF: 136 cases received IF surgery (IF group); and, 127 cases received external fixation (EF) surgery (EF group). Postoperative follow-ups were conducted to record the clinical data, perioperative clinical indicators, Matta scores for fracture displacements, Majeed scores for hip functions and postoperative complications. Results: Operation time, blood loss, the total length of the wound, postoperative fever rate, hospitalization time and complication rate for the IF group were significantly decreased in comparison with the EF group, while the ratings of pain, working and sitting ability and Matta and Majeed scores of the IF group were significantly higher than those of the EF group. Conclusion: IF was found to be associated with shorter operation times, less blood loss and better postoperative rehabilitation in comparison with EF, suggesting that it is an effective therapy for the treatment of unstable PF and will lead to restoration of normal pelvis functions.

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.

scholarly journals Complications and Neurological Outcome Following Intraoperative Aneurysm Rupture in Adult Patients Undergoing Intracranial Aneurysmal Clipping: A Retrospective Study

2021 ◽  
Author(s):  
Nayani Radhakrishna ◽  
Ankur Khandelwal ◽  
Rajendra Singh Chouhan ◽  
Mihir Prakash Pandia ◽  
Sourav Burman ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Retrospective Study ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Neurological Outcome ◽  
Multiple Logistic Regression Analysis ◽  
Univariate Analysis ◽  
Adult Patients ◽  
Multiple Logistic Regression ◽  
Duration Of Surgery

Abstract Background Intraoperative aneurysmal rupture (IAR) is a catastrophic complication; however, its impact on neurological outcome is debatable. We studied the effects of IAR on intraoperative and postoperative complications and neurological outcome. Methods In this retrospective study, adult patients who underwent aneurysmal clipping over a period of 2 years were divided as follows: group R (with IAR) and group N (without IAR). Various perioperative parameters, intraoperative and postoperative complications were noted. Glasgow outcome scale (GOS) was noted at discharge from hospital and categorized as favorable (GOS IV and V) and unfavorable (GOS I, II and III). Collected data was statistically analyzed. Univariate and multiple logistic regression analyses were performed to identify predictors of IAR. A p value < 0.05 was considered significant. Results Thirty-two out of 195 (16.41%) patients suffered IAR, with majority involving anterior communicating artery aneurysm (46.88%). Duration of temporary clipping (p < 0.001), volume of blood loss, and fluid and blood transfusion were significantly more in group R. Postoperatively, significantly more patients in group R developed intracranial hematoma, cerebral infarct, and required prolonged ventilatory support (≥5 days). Unfavorable neurological outcome was observed more in group R (p = 0.013). In univariate analysis, blood loss > 500 mL, use of colloids, and duration of surgery > 5 hours were found to be associated with IAR. After multiple logistic regression analysis, only use of colloids and duration of surgery > 5 hours were the most predictive variables for IAR. Conclusions IAR is associated with serious intraoperative and postoperative complications and unfavorable neurological outcome.

scholarly journals BIPOLAR VAGINAL HYSTERECTOMY IN THE FUTURE AND PRESENT

2018 ◽  
Vol 5 (2) ◽  
pp. 93-96
Author(s):  
A. I Slobodyanyuk ◽  
Anton A. Ishchenko ◽  
A. I Ishchenko ◽  
B. A Slobodyanyuk
Keyword(s):  
Postoperative Complications ◽  
Blood Loss ◽  
Vaginal Hysterectomy ◽  
Operation Time ◽  
Pain Syndrome ◽  
Bipolar Coagulation ◽  
Prospective Comparison ◽  
The Future

Vaginal hysterectomy seems to be the optimal access, but this method does not take a worthy place in operative gynecology. In this study, a prospective comparison of 2 different techniques of vaginal hysterectomy was performed in 125 patients with the use of vicryl ligatures and 215 patients using bipolar coagulation devices (Gyrus and Emed) in different clinics. In the analysis of immediate and remote results, in the group with electrosurgery, blood loss, operation time and pain syndrome at 4 and 48 hours were found to be statistically significantly less. Also, we did not discern any differences in the number of postoperative complications, which allows us to make conclusions regarding the safety and effectiveness of the use of modern bipolar coagulation devices by experienced surgeons.

scholarly journals PRIMARY EXPERIENCE OF NATURAL ORIFICE SPECIMEN EXTRACTION SURGERY (NOSES) FOR RECTAL CANCER

2020 ◽  
Vol 19 (2) ◽  
pp. 69-82
Author(s):  
D. K. Puchkov ◽  
D. A. Khubezov ◽  
I. S. Ignatov ◽  
A. Y. Ogoreltsev ◽  
R. V. Lukanin ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Blood Loss ◽  
Operation Time ◽  
Rectal Cancer Surgery ◽  
Intraoperative Blood Loss ◽  
Natural Orifice ◽  
Specimen Extraction ◽  
Postoperative Rehabilitation ◽  
Intraoperative Complication ◽  
Natural Orifice Specimen Extraction

AIM: to demonstrate the first results of natural orifice specimen extraction surgery (NOSES) for rectal cancer.PATIENTS AND METHODS: in the period from June 2019 to October 2019 five NOSES for rectal cancer were performed in the hospital. The following factors were evaluated: age, gender, BMI, ASA, operation time, intraoperative blood loss, intraoperative and postoperative complications, duration of postoperative rehabilitation, need for narcotic analgesics.RESULTS: mean age of patients was 61.2 years. Mean BMI was 25.9 kg/m2 . Mean ASA score was 2. Mean operative time was 225 minutes. Mean intraoperative blood loss was 45 ml. One intraoperative complication occurred – defect of anastomosis in the point of crossing of 3 stapler sutures. One postoperative complication occurred – postoperative ileus. Narcotic analgesics were not used. Mean duration of postoperative stay was 9.8 days. The primary results demonstrate feasibility of NOSES for rectal cancer with adequate qualification of colorectal surgeon.CONCLUSION: NOSES is a promising technique for rectal cancer surgery. However, the further experience and randomized trials are required.

scholarly journals Modified Nuss operation using introducer-bar complex for pectus excavatum in adults: a retrospective study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Lei Wang ◽  
Juan Liu ◽  
Yao Li ◽  
Tienan Feng ◽  
Beibei Cao ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Blood Loss ◽  
Pectus Excavatum ◽  
Operation Time ◽  
Nuss Procedure ◽  
Plate Removal ◽  
Traditional Procedure ◽  
Group Outcomes ◽  
Significant Difference ◽  
Clinical Benefits

Abstract Background Shortcoming of traditional Nuss operation on adults is gradually found in the clinical practice. A new kind of introducer-bar complex was introduced. However, there is limited evidence regarding its safety and efficacy. Therefore, a single center, retrospective study was conducted to address this issue. Methods Patients with pectus excavatum who underwent surgery between January 2015 and June 2017 were consecutively enrolled in this study. In all, 52 patients underwent the modified procedure using the introducer-bar complex (new procedure group), whereas 48 underwent the traditional anti-Nuss procedure (traditional procedure group). Outcomes analysis of balanced baseline was performed to compare the intraoperative and postoperative short-term outcomes. Results All patients in the new procedure group had shorter operation duration (51.54 ± 20.32 vs. 79.45 ± 13.88 min, p = 0.017), postoperative hospitalizations (4.77 ± 1.62 vs. 6.86 ± 2.18 days, p = 0.028), plate removal surgery durations (39.30 ± 8.97 vs. 60.30 ± 10.49 min, p < 0.001), and less blood loss during operation (6.25 ± 4.88 vs. 10.90 ± 5.75 ml, p = 0.003) than patients in the traditional procedure group. There was no significant difference in the length of incision, postoperative Haller index, cost, number of steel bars, postoperative surgical outcome and incidence of complications between the two groups. Conclusion Through the main clinical outcome were similar, our results shown that modified procedure may have the shorter operation time, postoperative hospital stay, and operation time for plate removal and less blood loss, which may bring potential clinical benefits to patients.

scholarly journals Open Nephroureterectomy Compared to Laparoscopic in Upper Urinary Tract Urothelial Carcinoma: A Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Guihong Liu ◽  
Zeqin Yao ◽  
Guoqiang Chen ◽  
Yalang Li ◽  
Bing Liang
Keyword(s):  
Urinary Tract ◽  
Blood Loss ◽  
Urothelial Carcinoma ◽  
Meta Analysis ◽  
Operation Time ◽  
Upper Urinary Tract ◽  
Efficacy And Safety ◽  
Lower Blood ◽  
Urinary Tract Urothelial Carcinoma ◽  
Laparoscopic Nephroureterectomy

Background: In this meta-analysis, we will focus on evaluating the effects of open nephroureterectomy compared with laparoscopic nephroureterectomy on postoperative results in upper urinary tract urothelial carcinoma subjects.Methods: A systematic literature search up to January 2021 was performed, and 36 studies included 23,013 subjects with upper urinary tract urothelial carcinoma at the start of the study; of them, 8,178 were laparoscopic nephroureterectomy, and 14,835 of them were open nephroureterectomy. They were reporting relationships between the efficacy and safety of open nephroureterectomy compared with laparoscopic nephroureterectomy in the treatment of upper urinary tract urothelial carcinoma. We calculated the odds ratio (OR) or the mean difference (MD) with 95% CIs to evaluate the efficacy and safety of open nephroureterectomy compared with laparoscopic nephroureterectomy in the treatment of upper urinary tract urothelial carcinoma using the dichotomous or continuous method with a random or fixed-effect model.Results: Laparoscopic nephroureterectomy in subjects with upper urinary tract urothelial carcinoma was significantly related to longer operation time (MD, 43.90; 95% CI, 20.91–66.90, p &lt; 0.001), shorter hospital stay (MD, −1.71; 95% CI, −2.42 to −1.00, p &lt; 0.001), lower blood loss (MD, −133.82; 95% CI, −220.92 to −46.73, p = 0.003), lower transfusion need (OR, 0.56; 95% CI, 0.47–0.67, p &lt; 0.001), and lower overall complication (OR, 0.79; 95% CI, 0.70–0.90, p &lt; 0.001) compared with open nephroureterectomy.However, no significant difference was found between laparoscopic nephroureterectomy and open nephroureterectomy in subjects with upper urinary tract urothelial carcinoma in 2–5 years recurrence-free survival (OR, 0.90; 95% CI, 0.69–1.18, p = 0.46), 2–5 years cancer-specific survival (OR, 0.94; 95% CI, 0.69–1.28, p = 0.68), and 2–5 years overall survival (OR, 1.31; 95% CI, 0.91–1.87, p = 0.15).Conclusion: Laparoscopic nephroureterectomy in subjects with upper urinary tract urothelial carcinoma may have a longer operation time, shorter hospital stay, and lower blood loss, transfusion need, and overall complication compared to open nephroureterectomy. Further studies are required to validate these findings.

scholarly journals Treatment of irreducible atlantoaxial dislocation using one-stage retropharyngeal release and posterior reduction

2019 ◽  
Vol 27 (3) ◽  
pp. 230949901987046 ◽  
Author(s):  
Xianfeng Ren ◽  
Feng Gao ◽  
Siyuan Li ◽  
Jiankun Yang ◽  
Yongming Xi
Keyword(s):  
Blood Loss ◽  
Operative Time ◽  
Japanese Orthopaedic Association ◽  
Operation Time ◽  
Atlantoaxial Dislocation ◽  
Efficacy And Safety ◽  
Estimated Blood Loss ◽  
Irreducible Atlantoaxial Dislocation ◽  
The Mean

Introduction: Irreducible atlantoaxial dislocation (IAAD) has been challenging for spine surgeons. Various methods have been used to treat IAAD, but no consensus has been reached. This study aimed to retrospectively analyze the efficacy of anterior submandibular retropharyngeal release and posterior reduction and fixation for IAAD. Methods: From March 2007 to May 2015, 13 patients diagnosed with IAAD underwent anterior submandibular retropharyngeal release and sequential posterior reduction and fixation. The operation time, blood loss, postoperative complications, and Japanese Orthopaedic Association (JOA) scores were retrospectively recorded. Results: The surgeries were accomplished successfully. The mean operative time was about 3.8 h. The mean estimated blood loss was about 130 mL. The patients experienced postoperative pharyngeal pain. Only one patient had a vague voice and increased oral discharge postoperatively. At the final follow-up, JOA scores had significantly increased ( p < 0.05), and all the patients had solid bony fusion. Conclusion: The present study reinforces the efficacy and safety of anterior submandibular retropharyngeal release and posterior reduction and fixation for IAAD. It can achieve satisfactory clinical outcomes and is safe for experienced spine surgeons.

scholarly journals Application of near-infrared fluorescent cholangiography using indocyanine green in laparoscopic cholecystectomy

2020 ◽  
Vol 48 (12) ◽  
pp. 030006052097922
Author(s):  
Chusi Wang ◽  
Wenguang Peng ◽  
Jiarui Yang ◽  
Yuxuan Li ◽  
Jiawei Yang ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Near Infrared ◽  
Hepatic Duct ◽  
Operation Time ◽  
Common Hepatic Duct ◽  
Intraoperative Blood Loss ◽  
Real Time Identification

Objective Near-infrared fluorescence cholangiography (NIRF-C) can help to identify the bile duct during laparoscopic cholecystectomy. This retrospective study was performed to investigate the effect of NIRF-C in laparoscopic cholecystectomy. Methods Consecutive patients who underwent NIRF-C-assisted laparoscopic cholecystectomy (n = 34) or conventional laparoscopic cholecystectomy (n = 36) were enrolled in this study. Identification of biliary structures, the operation time, intraoperative blood loss, and postoperative complications were analyzed. Results Laparoscopic cholecystectomy was completed in all patients without conversion to laparotomy. The median operation time and intraoperative blood loss were not significantly different between the two groups. No intraoperative injuries or postoperative complications occurred in either group. In the NIRF-C group, the visualization rate of the cystic duct, common bile duct, and common hepatic duct prior to dissection was 91%, 79%, and 53%, respectively. The success rate of cholangiography was 100% in the NIRF-C group. NIRF-C was more effective for visualizing biliary structures in patients with a BMI of <25 than >25 kg/m2. Conclusions NIRF-C is a safe and effective technique that enables real-time identification of the biliary anatomy during laparoscopic cholecystectomy. NIRF-C helps to improve the efficiency of dissection.

Clinical outcome of Laparoscopic and Robot-assisted Radical Cystectomy for Bladder Cancer in a Retrospective Study

2021 ◽  
Author(s):  
YuChen Bai ◽  
Shuai Wang ◽  
Wei Zheng ◽  
Jing Quan ◽  
Fei Wei ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Retrospective Study ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Radical Cystectomy ◽  
Perioperative Outcomes ◽  
Robot Assisted ◽  
Long Term Outcome ◽  
Estimated Blood Loss

Abstract Background: With the rapid development of surgical technics and instruments, more and more bladder cancer patients are being treated by laparoscopic radical cystectomy (LRC) and robot-assisted radical cystectomy (RARC) .The aim of this retrospective study was to compare the perioperative and long-term outcomes of patients who underwent cystectomy by these two surgical approaches. Methods: We performed a retrospective review of the prospectively collected database of our hospital to identify patients with clinical stage Ta/T1/Tis to T3 who underwent RARC and LRC. Perioperative outcomes, recurrence, and overall survival (OS) were analyzed. Results: From March 2010 to December 2019, there were total of 218 patients, which including 82(38%) patients with LRC and 136(62%) patients with RARC. No perioperative death was observed in both groups. Tumor recurrence, death from any causes, and cancer-specific death occurred in 77, 55, and 39 patients respectively. The 5-year DFS, OS, and CSS rates for all included patients were 55.4%, 62.4%, and 66.4%, respectively. There were no significantly statistically differences between the RARC group and the LRC group for number of lymph nodes harvested, positive lymph node rate, positive margin rate and postoperative pathological stage (all P>0.05). Patients undergoing RARC had lower median estimated blood loss (180mL vs. 250 mL; P 0.015) and 90-days postoperative complications (30.8% vs. 46.3%; P 0.013) than LRC.Conclusions: For selected patients with RARC and LRC, both were safe and effective with a low complication rate and similar long-term outcome compared two groups. Moreover, the robotic approach resulted in lower median estimated blood loss and better outcome in postoperative complications.

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