Postoperative complications and follow up after abramson surgery

OBJECTIVERadiculopathy from the fractional curve, usually from L3 to S1, can create severe disability. However, treatment methods of the curve vary. The authors evaluated the effect of adding more levels of interbody fusion during treatment of the fractional curve.METHODSA single-institution retrospective review of adult patients treated for scoliosis between 2006 and 2016 was performed. Inclusion criteria were as follows: fractional curves from L3 to S1 > 10°, ipsilateral radicular symptoms concordant on the fractional curve concavity side, patients who underwent at least 1 interbody fusion at the level of the fractional curve, and a minimum 1-year follow-up. Primary outcomes included changes in fractional curve correction, lumbar lordosis change, pelvic incidence − lumbar lordosis mismatch change, scoliosis major curve correction, and rates of revision surgery and postoperative complications. Secondary analysis compared the same outcomes among patients undergoing posterior, anterior, and lateral approaches for their interbody fusion.RESULTSA total of 78 patients were included. There were no significant differences in age, sex, BMI, prior surgery, fractional curve degree, pelvic tilt, pelvic incidence, pelvic incidence − lumbar lordosis mismatch, sagittal vertical axis, coronal balance, scoliotic curve magnitude, proportion of patients undergoing an osteotomy, or average number of levels fused among the groups. The mean follow-up was 35.8 months (range 12–150 months). Patients undergoing more levels of interbody fusion had more fractional curve correction (7.4° vs 12.3° vs 12.1° for 1, 2, and 3 levels; p = 0.009); greater increase in lumbar lordosis (−1.8° vs 6.2° vs 13.7°, p = 0.003); and more scoliosis major curve correction (13.0° vs 13.7° vs 24.4°, p = 0.01). There were no statistically significant differences among the groups with regard to postoperative complications (overall rate 47.4%, p = 0.85) or need for revision surgery (overall rate 30.7%, p = 0.25). In the secondary analysis, patients undergoing anterior lumbar interbody fusion (ALIF) had a greater increase in lumbar lordosis (9.1° vs −0.87° for ALIF vs transforaminal lumbar interbody fusion [TLIF], p = 0.028), but also higher revision surgery rates unrelated to adjacent-segment pathology (25% vs 4.3%, p = 0.046). Higher ALIF revision surgery rates were driven by rod fracture in the majority (55%) of cases.CONCLUSIONSMore levels of interbody fusion resulted in increased lordosis, scoliosis curve correction, and fractional curve correction. However, additional levels of interbody fusion up to 3 levels did not result in more postoperative complications or morbidity. ALIF resulted in a greater lumbar lordosis increase than TLIF, but ALIF had higher revision surgery rates.

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Impact of distance on postoperative follow-up in patients of pediatric surgery: a retrospective review

World Journal of Pediatric Surgery ◽

10.1136/wjps-2020-000195 ◽

2020 ◽

Vol 3 (4) ◽

pp. e000195

Author(s):

Meagan E Wiebe ◽

Anna C Shawyer

Keyword(s):

Postoperative Complications ◽

Pediatric Surgery ◽

Descriptive Statistics ◽

Attendance Rates ◽

Urban Center ◽

Children's Hospital ◽

Median Distance ◽

Equivalent Rate ◽

Children’S Hospital

ObjectiveCentralization of medical services in Canada has resulted in patients travelling long distances for healthcare, which may compromise their health. We hypothesized that children living farther from a children’s hospital were offered and attended fewer follow-up appointments.MethodsWe reviewed children less than 17 years of age referred to the general surgery clinic at a tertiary children’s hospital during a 2-year period who underwent surgery. Descriptive statistics were performed.ResultsWe identified 723 patients. The majority were male (61%) with a median age of 7 years (range 18 days to16 years) and were from the major urban center (MUC) (56.3%). The median distance travelled to hospital for MUC patients was 8.9 km (range 0.9–22 km) vs 119.5 km (range 20.3–1950 km) for non-MUC patients. MUC children were offered more follow-up appointments (72.7% vs 60.8%, p<0.05). No significant differences existed in follow-up attendance rates (MUC 88.5% vs non-MUC 89.1%, p=0.84) or postoperative complications (9.8% vs 9.2%, p=0.78). There were no deaths.ConclusionsPatients living farther from a hospital were offered fewer follow-up appointments, but attended an equivalent rate of follow-ups when offered one. Telemedicine and remote follow-up are underused approaches that can permit follow-up appointments while reducing associated travel time and expenses.

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Impact of Diabetes Mellitus on Cervical Spine Surgery for Ossification of the Posterior Longitudinal Ligament

Journal of Clinical Medicine ◽

10.3390/jcm10153375 ◽

2021 ◽

Vol 10 (15) ◽

pp. 3375

Author(s):

Atsushi Kimura ◽

Katsushi Takeshita ◽

Toshitaka Yoshii ◽

Satoru Egawa ◽

Takashi Hirai ◽

...

Keyword(s):

Diabetes Mellitus ◽

Cervical Spine ◽

Postoperative Complications ◽

Spine Surgery ◽

Posterior Longitudinal Ligament ◽

Lower Extremity Function ◽

Cervical Spine Surgery ◽

The Impact

Ossification of the posterior longitudinal ligament (OPLL) is commonly associated with diabetes mellitus (DM); however, the impact of DM on cervical spine surgery for OPLL remains unclear. This study was performed to evaluate the influence of diabetes DM on the outcomes following cervical spine surgery for OPLL. In total, 478 patients with cervical OPLL who underwent surgical treatment were prospectively recruited from April 2015 to July 2017. Functional measurements were conducted at baseline and at 6 months, 1 year, and 2 years after surgery using JOA and JOACMEQ scores. The incidence of postoperative complications was categorized into early (≤30 days) and late (>30 days), depending on the time from surgery. From the initial group of 478 patients, 402 completed the 2-year follow-up and were included in the analysis. Of the 402 patients, 127 (32%) had DM as a comorbid disease. The overall incidence of postoperative complications was significantly higher in patients with DM than in patients without DM in both the early and late postoperative periods. The patients with DM had a significantly lower JOA score and JOACMEQ scores in the domains of lower extremity function and quality of life than those without DM at the 2-year follow-up.

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Brain Tumor Resection in Elderly Patients: Potential Factors of Postoperative Worsening in a Predictive Outcome Model

Cancers ◽

10.3390/cancers13102320 ◽

2021 ◽

Vol 13 (10) ◽

pp. 2320

Author(s):

Paolo Ferroli ◽

Ignazio Gaspare Vetrano ◽

Silvia Schiavolin ◽

Francesco Acerbi ◽

Costanza Maria Zattra ◽

...

Keyword(s):

Brain Tumor ◽

Postoperative Complications ◽

Elderly Patients ◽

Performance Status ◽

Tumor Resection ◽

Patient Specific ◽

Invasive Treatment ◽

Tertiary Referral Center ◽

Surgical Complexity

The decision of whether to operate on elderly patients with brain tumors is complex, and influenced by pathology-related and patient-specific factors. This retrospective cohort study, based on a prospectively collected surgical database, aims at identifying possible factors predicting clinical worsening after elective neuro-oncological surgery in elderly patients. Therefore, all patients ≥65 years old who underwent BT resection at a tertiary referral center between 01/2018 and 12/2019 were included. Age, smoking, previous radiotherapy, hypertension, preoperative functional status, complications occurrence, surgical complexity and the presence of comorbidities were prospectively collected and analyzed at discharge and the 3-month follow-up. The series included 143 patients (mean 71 years, range 65–86). Sixty-five patients (46%) had at least one neurosurgical complication, whereas 48/65 (74%) complications did not require invasive treatment. Forty-two patients (29.4%) worsened at discharge; these patients had a greater number of complications compared to patients with unchanged/improved performance status. A persistent worsening at three months of follow-up was noted in 20.3% of patients; again, this subgroup presented more complications than patients who remained equal or improved. Therefore, postoperative complications and surgical complexity seem to influence significantly the early outcome in elderly patients undergoing brain tumor surgery. In contrast, postoperative complications alone are the only factor with an impact on the 3-month follow-up.

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Comparative Analysis of the Safety and Functional Outcomes of Anterior versus Retropupillary Iris-Claw IOL Fixation

Journal of Ophthalmology ◽

10.1155/2018/8463569 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Paolo Mora ◽

Giacomo Calzetti ◽

Stefania Favilla ◽

Matteo Forlini ◽

Salvatore Tedesco ◽

...

Keyword(s):

Postoperative Complications ◽

Refractive Error ◽

Study Data ◽

Posterior Chamber ◽

Complicated Cataract ◽

Corrected Distance Visual Acuity ◽

Study Inclusion ◽

Capsular Support ◽

Iris Claw

Purpose. To compare the functional and clinical outcomes of the iris-claw intraocular lens (IOL) placed on the anterior versus posterior surface of the iris. Patients and Methods. A multicenter, retrospective study. Data on eyes that underwent anterior or retropupillary iris-claw IOL implantation because of inadequate capsular support secondary to complicated cataract surgery, trauma, and dislocated/opacified IOLs since January 2015 were analyzed. For study inclusion, evaluation results had to be available in the medical records both preoperatively and at 1 and 12 months after implantation. The following parameters were compared between the groups: best-corrected distance visual acuity (BCDVA), spherical and cylindrical refractive error, endothelial cell density (ECD), central macular thickness (CMT), and percentage and type of postoperative complications. Results. In total, 60 eyes of 60 patients aged 73 ± 13 years were included: 28 eyes (47%) involved anterior, and 32 eyes (53%) retropupillary, iris-claw IOL fixations. Preoperatively, the groups were similar in all parameters except for a significantly higher proportion of retropupillary fixations in patients who had previously experienced a closed-globe trauma (p=0.03). The groups showed comparable improvements in BCDVA after surgery (final BCDVA: 0.34 ± 0.45 vs. 0.37 ± 0.50 logMAR in the anterior and retropupillary placement groups, respectively). During follow-up, no group difference was observed in refractive error or CMT. Both groups experienced similarly marked ECD loss and showed similar incidence of postoperative complications, with cystoid macular edema being the most common complication. Multivariable linear regression showed that BCDVA at 1 month was the best predictor of the final BCDVA. Conclusions. Anterior chamber and posterior chamber iris-claw IOL fixations proved equally effective and safe for aphakic correction in eyes with inadequate capsular support.

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Inguinal Hernia Repair Using Self-adhering Sutureless Mesh: Adhesix™: A 3-Year Follow-up with Low Chronic Pain and Recurrence Rate

The American Surgeon ◽

10.1177/000313481608200212 ◽

2016 ◽

Vol 82 (2) ◽

pp. 112-116 ◽

Cited By ~ 3

Author(s):

Malek Tabbara ◽

Laurent Genser ◽

Manuela Bossi ◽

Maxime Barat ◽

Claude Polliand ◽

...

Keyword(s):

Chronic Pain ◽

Inguinal Hernia ◽

Postoperative Pain ◽

Postoperative Complications ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Recurrence Rate ◽

Initial Surgery ◽

Complications Rate

To review our experience and outcomes after inguinal hernia repair using the lightweight self-adhering sutureless mesh “Adhesix™” and demonstrate the safety and efficacy of this mesh. This is a 3-year retrospective study that included 143 consecutive patients who underwent 149 inguinal hernia repairs at our department of surgery. All hernias were repaired using a modified Lichtenstein technique. Preoperative, perioperative, and postoperative data were prospectively collected. Incidence of chronic pain, postoperative complications, recurrence, and patient satisfaction were assessed three years postoperatively by conducting a telephone survey. We had 143 patients with a mean age of 58 years (17–84), who underwent 149 hernia repairs using the Adhesix™ mesh. Ninety-two per cent (131 patients) were males. Only 10 patients (7%) had a postoperative pain for more than three years. In our series, neither age nor gender was predictive of postoperative pain. Only one patient had a hematoma lasting for more than one month and only four patients (2.8%) had a recurrence of their hernia within three years of their initial surgery. Ninety per cent of the patient expressed their satisfaction when surveyed three years after their surgery. In conclusion, the use of the self-adhering sutureless mesh for inguinal hernia repair has been proving itself as effective as the traditional mesh. Adhesix™ is associated with low chronic pain rate, recurrence rate, and postoperative complications rate, and can be safely adopted as the sole technique for inguinal hernia repair.

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When can total knee arthroplasty be safely performed following prior arthroscopy?

BMC Musculoskeletal Disorders ◽

10.1186/s12891-020-03859-1 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Jin-Ning Ma ◽

Xiao-Lin Li ◽

Pan Liang ◽

Sheng-Li Yu

Keyword(s):

Total Knee Arthroplasty ◽

Postoperative Complications ◽

Knee Arthroplasty ◽

Acl Injury ◽

Control Group ◽

Optimal Timing ◽

Complication Rates ◽

Increased Risk ◽

Total Knee

Abstract Background The optimal timing to perform a total knee arthroplasty (TKA) after knee arthroscopy (KA) was controversial in the literature. We aimed to 1) explore the effect of prior KA on the subsequent TKA; 2) identify who were not suitable for TKA in patients with prior KA, and 3) determine the timing of TKA following prior KA. Methods We retrospectively reviewed 87 TKAs with prior KA and 174 controls using propensity score matching in our institution. The minimum follow-up was 2 years. Postoperative clinical outcomes were compared between groups. Kaplan-Meier curves were created with reoperation as an endpoint. Multivariate Cox proportional hazards regressions were performed to identify risk factors of severe complications in the KA group. The two-piecewise linear regression analysis was performed to examine the optimal timing of TKA following prior KA. Results The all-cause reoperation, revision, and complication rates of the KA group were significantly higher than those of the control group (p < 0.05). The survivorship of the KA group and control group was 92.0 and 99.4% at the 2-year follow-up (p = 0.002), respectively. Male (Hazards ratio [HR] = 3.2) and prior KA for anterior cruciate ligament (ACL) injury (HR = 4.4) were associated with postoperative complications in the KA group. There was a non-linear relationship between time from prior KA to TKA and postoperative complications with the turning point at 9.4 months. Conclusion Prior KA is associated with worse outcomes following subsequent TKA, especially male patients and those with prior KA for ACL injury. There is an increased risk of postoperative complications when TKA is performed within nine months of KA. Surgeons should keep these findings in mind when treating patients who are scheduled to undergo TKA with prior KA.

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Total Knee Arthroplasty Is Safe in Jehovah's Witness Patients—A 12-Year Perspective

The Journal of Knee Surgery ◽

10.1055/s-0038-1676372 ◽

2019 ◽

Vol 33 (01) ◽

pp. 034-041 ◽

Cited By ~ 1

Author(s):

Theodore S. Wolfson ◽

David Novikov ◽

Kevin K. Chen ◽

Kelvin Y. Kim ◽

Afshin A. Anoushiravani ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Postoperative Complications ◽

Knee Arthroplasty ◽

Subgroup Analysis ◽

Blood Management ◽

Folate Supplementation ◽

Level Of Evidence ◽

Significant Difference ◽

Total Knee

AbstractDespite the evolution of blood management protocols, total knee arthroplasty (TKA) occasionally requires allogeneic blood transfusion. This poses a particular challenge for Jehovah's Witnesses (JW) who believe that the Bible strictly prohibits the use of blood products. The aim of this study was to compare JW and a matched-control cohort of non-JW candidates undergoing TKA to assess the safety using modern blood management protocols. Fifty-five JW patients (63 knees) who underwent TKA at our institution between 2005 and 2017 were matched to 63 non-JW patients (63 knees). Patient demographics, intraoperative details, and postoperative complications including in-hospital complications, revisions, and 90-day readmissions were collected and compared between the groups. Additionally, subgroup analysis was performed comparing JW patients who were administered tranexamic acid (TXA) between the two groups. Baseline demographics did not vary significantly between the study cohorts. The mean follow-up was 3.1 years in both the JW and non-JW cohorts. Postoperative complications, including in-hospital complications (7.9 vs. 4.8%; p = 0.47), revision TKA (1.6 vs. 1.6%; p = 1.00), and 90-day readmission (1.6 vs. 4.8%; p = 0.31) were not significantly different between the JW and non-JW groups. Subgroup analysis demonstrated JW patients who received TXA had a significantly lower decline in postoperative hemoglobin (Hgb) (8.6 vs. 14.0%; p < 0.01). At a follow-up of up to 12 years, JW patients who underwent TKA have outcomes equivalent to non-JW patients without the need for transfusion. Our findings support that surgeons are more likely to optimize JW patients preoperatively with iron and folate supplementation. Despite these variations in preoperative optimization efforts, no significant difference with regard to Hgb or hematocrit levels was demonstrated. Level of evidence is III, retrospective observational study.

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Comparison of the Outcomes of Manual Small Incision Cataract Surgery (MSICS) and Phacoemulsification (PHACO) in Ghana

Annals of African Surgery ◽

10.4314/aas.v18i3.4 ◽

2021 ◽

Vol 18 (3) ◽

pp. 143-149

Author(s):

Samuel Kyei ◽

Ebenezer Zaabaar ◽

Frank Assiamah ◽

Michael Agyemang Kwarteng ◽

Kofi Asiedu

Keyword(s):

Visual Acuity ◽

Postoperative Complications ◽

Cataract Surgery ◽

Medical Records ◽

Cross Sectional Study ◽

Small Incision Cataract Surgery ◽

Cross Sectional ◽

Small Incision ◽

Uncorrected Visual Acuity

Background: The growing middle-class population of Ghana has seen more people being employed in visually demanding occupations and hence there is an increased desire for quality post-cataract surgical visual outcomes. This study aimed at comparing the outcomes of manual small incision cataract surgery (MSICS) and phacoemulsification (PHACO) among Ghanaians. Methods: This was a retrospective cross-sectional study in which records of patients who underwent MSCIS or phacoemulsification by the same surgeon were reviewed. Results: Medical records of 248 eyes were reviewed, out of which 132 underwent PHACO and 116 had MSICS. A significant number of the PHACO group had good (6/6–6/18) uncorrected visual acuity (UCVA) compared to the MSICS group at 1–2 weeks follow-up (p = 0.003) and 4–6 weeks follow-up (p = 0.002). MSICS resulted in a higher total astigmatic change compared to PHACO (p < 0.001). The PHACO grouphad a higher number of postoperative complications compared with the MSICS group (p <0.001). Postoperative borderline and poor uncorrected visual acuity were associated with age, total astigmatic change, and postoperative complications. Conclusion: The postoperative UCVA outcomes at 4–6 weeks’ follow-up indicates that PHACO resulted in noticeably less spectacle dependency when compared to MSICS.

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Closed lateral Internal Sphincterotomy under local anesthesia in OPD in the treatment of chronic Anal Fissure

Annals of King Edward Medical University ◽

10.21649/akemu.v10i1.1133 ◽

2016 ◽

Vol 10 (1) ◽

Author(s):

Naved Ahmad ◽

Muzaffar Aziz ◽

Faizullah .

Keyword(s):

Postoperative Complications ◽

Anal Fissure ◽

Local Anesthesia ◽

Local Anaesthesia ◽

Chronic Anal Fissure ◽

Dentate Line ◽

Lateral Internal Sphincterotomy ◽

Internal Sphincterotomy ◽

Operative Complications

Objective of this study is to provide best therapy in terms of hospital stay and post operative complications after closed lateral internal sphincterotomy under local anaesthesia in the treatment of chronic anal fissure. It is descriptive type of study carried out at Nishtar Hospital Multan, from February 2001 to April 2001. Thirty patients underwent closed lateral internal sphicterotomy in local anaesthesia in OPD. Internal anal sphincter divided up to dentate line by introducing no.11 surgical blade in the intersphicteric groove. Pts were allowed to go home just after the surgery. Follow up for complications was done for the period of 6months. Mean postoperative stay was for 12 minutes. Postoperative complications were soiling (6.6%), incontinence to flatus (3.3%) and recurrence (3.3%). CLIS can be done safely under local anesthesia in OPD with low complication rate and less postop period of stay.

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