Surgical outcome for thoracic disc surgery in the postlaminectomy era

2000 ◽  
Vol 9 (4) ◽  
pp. 1-5 ◽  
Author(s):  
Thomas C. Chen
Keyword(s):  
Patient Satisfaction ◽  
Blood Loss ◽  
Surgical Outcome ◽  
Operative Time ◽  
Surgical Techniques ◽  
Axial Loading ◽  
Length Of Hospital Stay ◽  
Disc Surgery ◽  
Thoracic Discectomy ◽  
Thoracic Disc

In this article the author reviews outcomes of thoracic disc surgery reported in the literature. Care was taken to include only series in which none or a few patients underwent laminectomy for the treatment of thoracic disc lesions. The author found that thoracic discectomy may be performed in an efficacious and safe manner via the transthoracic, lateral extracavitary, transpedicular, or endoscopic approach. In the vast majority of patients, preoperative symptoms of pain (radiculopathy or axial loading pain) and myelopathy were improved after surgery. Measurements of operative time, blood loss, length of hospital stay, and patient satisfaction were often inadequately reported. Complications (systemic and neurological) were well documented and were not common. A plea is made for uniformity in documenting outcome in future series so that today's procedures for thoracic discectomy may be more accurately compared with future cases regardless of the inevitable advances in surgical techniques for removal of thoracic discs.

scholarly journals Endoscopic thoracic discectomy

2000 ◽  
Vol 9 (4) ◽  
pp. 1-8 ◽  
Author(s):  
J. Patrick Johnson ◽  
Aaron G. Filler ◽  
Duncan Q. McBride
Keyword(s):  
Blood Loss ◽  
Chest Tube ◽  
Operative Time ◽  
Surgical Techniques ◽  
Invasive Procedure ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Steep Learning Curve ◽  
Thoracic Discectomy

Object Thoracoscopic discectomy is a minimally invasive procedure simulating a thoracotomy and is an alternative to the costotransversectomy and transpedicular approaches. In recent studies authors have concluded that thoracoscopic discectomy is the preferred procedure; however, relative historical comparisons were difficult to interpret. The authors conducted a prospective nonrandomized study in which they compared data on 36 patients undergoing thoracoscopic discectomy with eight patients undergoing thoracotomy between 1995 and 1999. Methods Patients affected with one- or two-level lesions underwent a thoracoscopic discectomy, and patients with three-level lesions or more underwent thoracotomy and discectomy. Data were collected on operative time, blood loss, chest tube duration, narcotic agent use, and hospital length of stay (LOS). Longer-term follow-up study of pain-related symptoms and neurological function was conducted. Patients who underwent thoracoscopic discectomy had shorter operative times, less blood loss, a shorter period of chest tube drainage dependence, less narcotic usage, and a shorter LOS. These findings were statistically significant (p < 0.05) for narcotic usage and shorter LOS. Pain related to radiculopathy was improved by means of 75%, and no patients exprienced worsened pain. In patients with myelopathy there was an improvement of two Frankel grades in the thoracoscopic group and one Frankel grade in the thoracotomy discectomy group, but patients in the thoracotomy group were significantly worse preoperatively. One myelopathic patient from each group suffered a worsened outcome postoperatively, although this was not attributed to the method of surgery. The incidence of complications (minor and major) was 31% in the thoracoscopic group and greater than 100% (that is, more than one complication per patient) in the thoracotomy/discectomy group. Conclusions One advantage to thoracoscopic discectomy is its reduced incidence of morbidity compared with thoractomy, but its steep learning curve and unfamiliar surgical techniques make this procedure less practical for surgeons not performing it frequently. The more familiar costotransversectomy, transpedicular, and thoracotomy procedures remain viable alternatives for surgeons more experienced in these procedures.

scholarly journals Robotically Assisted Hysterectomy versus Vaginal Hysterectomy for Benign Disease: A Prospective Study

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
M. Carbonnel ◽  
H. Abbou ◽  
H. T. N’Guyen ◽  
S. Roy ◽  
G. Hamdi ◽  
...  
Keyword(s):  
Blood Loss ◽  
Prospective Study ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Operative Time ◽  
Group Versus ◽  
Length Of Hospital Stay ◽  
Benign Disease ◽  
Post Surgery ◽  
A Prospective Study

Objectives. A prospective study was carried out to compare vaginal hysterectomy (VH) and robotically assisted hysterectomy (RH) for benign gynecological disease.Materials and Methods. All patients who underwent hysterectomy from March 2010 to March 2012 for a benign disease were included. Patients’ demographics per and post surgery results were collected from medical files. A questionnaire was also conducted 2 months after surgery.Results. Sixty patients were included in the RH group and thirty four in the VH one. Operative time was significantly longer in the RH group ( versus  min; ). Blood loss and length of hospital stay were significantly reduced: versus  ml; , and versus days; , respectively. Less pain was reported at D1 and D2 by RH patients, and levels of analgesia were lower compared to those observed in the VH group. No differences were found regarding the rate of conversion to laparotomy, intra- or postoperative complications.Conclusion. Robotically assisted hysterectomy appears to reduce blood loss, postoperative pain, and length of hospital stay, but it is associated with longer operative time and higher cost. Specific indications for RH remain to be defined.

scholarly journals Modification of Combined Vibrated Power Assisted Liposuction with Periareolar Gland Excision in management of Gynecomastia

2018 ◽  
Vol 14 (1) ◽  
pp. 18-23
Author(s):  
Kurdo Akram Qradaghi
Keyword(s):  
Patient Satisfaction ◽  
Retrospective Study ◽  
Operative Time ◽  
Surgical Techniques ◽  
Satisfaction Rate ◽  
Areola Complex ◽  
Different Types ◽  
Aesthetic Results ◽  
The Mean ◽  
Patient Satisfaction Rate

Background: The recognized procedures that have been used to treat gynecomastia are said to have relatively a long operative time, less patient satisfaction rate, they are merely used, in mild to moderate gynecomastia, leaves a mild bulging over the nipple areola complex, resulting in aesthetically unsatisfactory results. The more the grade of gynecomastia, the more complicated the used surgical techniques. This study evaluates the success rate of these simplest surgical technique in higher grades of gynecomastia. Objectives: to present the experiences with use of Modification of Combined Vibrated Power Assisted Liposuction with Periareolar Gland Excision in management of in different type Gynecomastia Type of the study: This is a retrospective study Methods: The study  includes the use of a modification of combine vibrated power-assisted liposuction with periareolar gland excision applied for managing different types of gynecomastia. In 23 consecutive patients (46 breasts) treated between February of 2011 and March of 2016. Results: 23 patients (46 breasts) were successfully treated using this technique. Volume aspirated in both breast was 792 ml (range, 450 to 1600 ml). Using the periareolar excision technique, the mean operative time was 55 minutes (range, 45 to 90 minute). Complications were minimal (1.5 % per breasts), and no revisions were required. Conclusions: The modified Combined vibrated power assisted liposuction and the periareolartechnique have demonstrated to be a less time consuming versatileapproach, for the treatment of gynecomastia and consistently produces a smoothcontoured male breast, it is promising method to achieve good aesthetic results in gynecomastia surgerywhile resulting in an inconspicuous scar.

scholarly journals The Health Impact of Surgical Techniques and Assistive Methods Used in Cesarean Deliveries: A Systemic Review

2020 ◽  
Vol 17 (18) ◽  
pp. 6894
Author(s):  
Li-Hsuan Wang ◽  
Kok-Min Seow ◽  
Li-Ru Chen ◽  
Kuo-Hu Chen
Keyword(s):  
Blood Loss ◽  
Cesarean Delivery ◽  
Operative Time ◽  
Surgical Techniques ◽  
Systemic Review ◽  
Fetal Head ◽  
Advantages And Disadvantages ◽  
Cesarean Deliveries ◽  
Fundal Pressure

Cesarean delivery is one of the most frequently performed surgeries in women throughout the world. However, the most optimal technique to minimize maternal and fetal morbidities is still being debated due to various clinical situations and surgeons’ preferences. The contentious topics are the use of vacuum devices other than traditional fundal pressure to assist in the delivery of the fetal head and the techniques of uterine repair used during cesarean deliveries. There are two well-described techniques for suturing the uterus: The uterus can be repaired either temporarily exteriorized (out of abdominal cavity) or in situ (within the peritoneal cavity). Numerous studies have attempted to compare these two techniques in different aspects, including operative time, blood loss, and maternal and fetal outcomes. This review provides an overview of the assistive method of vacuum devices compared with fundal pressure, and the two surgical techniques for uterine repair following cesarean delivery. This descriptive literature review was performed to address important issues for clinical practitioners. It aims to compare the advantages and disadvantages of the assistive methods and surgical techniques used in cesarean deliveries. All of the articles were retrieved from the databases Medline and PubMed using the search terms cesarean delivery, vacuum, and exteriorization. The searching results revealed that after exclusion, there were 9 and 13 eligible articles for vacuum assisted cesarean delivery and uterine exteriorization, respectively. Although several studies have concluded vacuum assistance for fetal extraction as a simple, effective, and beneficial method during fetal head delivery during cesarean delivery, further research is still required to clarify the safety of vacuum assistance. In general, compared to the use of in situ uterine repairs during cesarean delivery, uterine exteriorization for repairs may have benefits of less blood loss and shorter operative time. However, it may also carry a higher risk of intraoperative complications such as nausea and vomiting, uterine atony, and a longer time to the return of bowel function. Clinicians should consider these factors during shared decision-making with their pregnant patients to determine the most suitable techniques for cesarean deliveries.

The Self-Retaining Barbed Suture for Parenchymal Repair in Laparoscopic Partial Nephrectomy: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 26 (6) ◽  
pp. 744-752
Author(s):  
Hailun Zhan ◽  
Chunping Huang ◽  
Tengcheng Li ◽  
Fei Yang ◽  
Jiarong Cai ◽  
...  
Keyword(s):  
Renal Function ◽  
Blood Loss ◽  
Hospital Stay ◽  
Partial Nephrectomy ◽  
Operative Time ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
The Self ◽  
Barbed Suture ◽  
Estimated Blood Loss

Objectives. The warm ischemia time (WIT) is key to successful laparoscopic partial nephrectomy (LPN). The aim of this study was to perform a meta-analysis comparing the self-retaining barbed suture (SRBS) with a non-SRBS for parenchymal repair during LPN. Methods. A systematic search of PubMed, Scopus, and the Cochrane Library was performed up to March 2018. Inclusion criteria for this study were randomized controlled trials (RCTs) and observational comparative studies assessing the SRBS and non-SRBS for parenchymal repair during LPN. Outcomes of interest included WIT, complications, overall operative time, estimated blood loss, length of hospital stay, and change of renal function. Results. One RCT and 7 retrospective studies were identified, which included a total of 461 cases. Compared with the non-SRBS, use of the SRBS for parenchymal repair during LPN was associated with shorter WIT ( P < .00001), shorter overall operative time ( P < .00001), lower estimated blood loss ( P = .02), and better renal function preservation ( P = .001). There was no significant difference between the SRBS and non-SRBS with regard to complications ( P = .08) and length of hospital stay ( P = .25). Conclusions. The SRBS for parenchymal repair during LPN can significantly shorten the WIT and overall operative time, decrease blood loss, and preserve renal function.

scholarly journals LDLT Portal Vein Thrombosis: Technical Advances

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M B Ahmed ◽  
M A Rady ◽  
M A Abd-errazik ◽  
A R M A Azzam
Keyword(s):  
Liver Transplantation ◽  
Blood Loss ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Operative Time ◽  
Surgical Techniques ◽  
Vein Thrombosis ◽  
Operative Complications ◽  
End Stage ◽  
Post Operative Complications

Abstract Background portal vein thrombosis (PVT) is a common complication of end-stage liver disease with an incidence of 0.6–16% in patients with well-compensated disease (1–3), increasing up to 35% in cirrhotic patients with hepatocellular carcinoma. Aim of the Work the aim of the study is to compare between thrombectomy of PVT using vascular clamps “eversion” & manual technique “modified eversion” during liver transplantation regarding operative time, degree of blood loss, portal vein rethrombosis, and post-operative complications. Patients and Methods This is a retrospective cohort study to compare between thrombectomy of PVT using vascular clamps “eversion” & manual technique “modified eversion” during liver transplantation regarding operative time, degree of blood loss, portal vein rethrombosis & post-operative complications. The study was conducted as retrospective study of 33 adult patients who underwent LDLT at Ain Shams Specialized Hospital, Ain Shams University, Cairo, Egypt, between January 2016 and July 2018. Results the mean child score was 9.55 and the median hospital stay was 12 days. Based on review manager statics program, the PVT recurrence was non-significant (P = 0.295, Test value: 1.096). However, the blood loss was significant (p &lt; 0.029, test value: -2.186) and the surgical time was significant (p = 0.013, test value: 2.633). Conclusion portal vein thrombosis (PVT) represents a significant technical challenge in liver transplantation and for many years was considered a relative contraindication. While advances in surgical techniques, axial imaging, and alternative inflow reconstruction options have made liver transplantation possible in transplant candidates with PVT.

scholarly journals 176 Efficiency of Spinal Anesthesia in Comparison to General Anesthesia in Lumbar Spine Surgery: A Retrospective Analysis of 544 Patients

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 245-246
Author(s):  
John Thomas Pierce ◽  
Prateek Agarwal ◽  
Paul J Marcotte ◽  
William Charles Welch
Keyword(s):  
Lumbar Spine ◽  
Blood Loss ◽  
Hospital Stay ◽  
General Anesthesia ◽  
Spinal Anesthesia ◽  
Spine Surgery ◽  
Operative Time ◽  
Length Of Hospital Stay ◽  
Lumbar Spine Surgery ◽  
Anesthesia Time

Abstract INTRODUCTION Lumbar spine surgery can be successfully performed using various anesthetic techniques. Previous studies have shown varying results in selected outcomes when directly comparing spinal anesthesia (SA) to general anesthesia (GA) in lumbar surgery. We sought to elucidate the more expedient anesthetic technique. METHODS Following IRB approval, a retrospective review of patients undergoing elective lumbar decompression surgery using GA or SA was performed. Demographic data known to influence perioperative morbidity was collected as well as safety and efficiency parameters. After controlling for patient and procedure characteristics, simple linear and multivariate regression analyses were performed to identify differences in operative blood loss, operative time, time from entering the OR until incision, time from bandage placement to exiting the OR, total anesthesia time, time in the post-anesthesia care unit (PACU), and length of hospital stay. RESULTS >544 consecutive lumbar laminectomy and discectomy surgeries were identified with 183 undergoing GA and 361 undergoing SA. The following times were all shorter for patients receiving SA than GA: operative time (97.4 vs. 151.8 min., P < 0.001), total anesthesia time (145.6 vs. 217.5 min., P < 0.001), time from entering the OR until incision (38.3 vs. 46.8 min., respectively, P < 0.001), time from bandage placement until exiting the OR (10.2 vs. 17.2 min., P < 0.001), and length of hospital stay (1.5 vs. 3.1 days, P < 0.001). The mean PACU length of stay was longer in the SA group than the GA group (178.0 vs. 116.5 min., P < 0.001). Estimated blood loss was less in the SA group than the GA group (62.1 vs. 176.3 mL, P < 0.001). CONCLUSION Spinal anesthesia may be the more expedient method of anesthesia in lumbar spinal surgery for all perioperative time points except for time in the PACU.

scholarly journals Evaluating the safety of two human experimental intestinal ischemia reperfusion models: A retrospective observational study

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253506
Author(s):  
Inca H. R. Hundscheid ◽  
Dirk H. S. M. Schellekens ◽  
Joep Grootjans ◽  
Marcel Den Dulk ◽  
Ronald M. Van Dam ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Blood Loss ◽  
Hospital Stay ◽  
Pancreatic Surgery ◽  
Intestinal Ischemia ◽  
Operative Time ◽  
Ischemia Reperfusion ◽  
Length Of Hospital Stay ◽  
Secondary Outcome ◽  
Complication Rates

Background We developed a jejunal and colonic experimental human ischemia-reperfusion (IR) model to study pathophysiological intestinal IR mechanisms and potential new intestinal ischemia biomarkers. Our objective was to evaluate the safety of these IR models by comparing patients undergoing surgery with and without in vivo intestinal IR. Methods A retrospective study was performed comparing complication rates and severity, based on the Clavien-Dindo classification system, in patients undergoing pancreatoduodenectomy with (n = 10) and without (n = 20 matched controls) jejunal IR or colorectal surgery with (n = 10) and without (n = 20 matched controls) colon IR. Secondary outcome parameters were operative time, blood loss, 90-day mortality and length of hospital stay. Results Following pancreatic surgery, 63% of the patients experienced one or more postoperative complications. There was no significant difference in incidence or severity of complications between patients undergoing pancreatic surgery with (70%) or without (60%, P = 0.7) jejunal IR. Following colorectal surgery, 60% of the patients experienced one or more postoperative complication. Complication rate and severity were similar in patients with (50%) and without (65%, P = 0.46) colonic IR. Operative time, amount of blood loss, postoperative C-reactive protein, length of hospital stay or mortality were equal in both intervention and control groups for jejunal and colon IR. Conclusion This study showed that human experimental intestinal IR models are safe in patients undergoing pancreatic or colorectal surgery.

scholarly journals Combination Use of Antibiotic-Loaded Calcium Sulfate Beads in Spinal Surgery for Patients with Spondylodiscitis：A Clinical Retrospective Study

2021 ◽  
Author(s):  
Xiaojie Tang ◽  
Jianyi Li ◽  
Chunxiao Wang ◽  
Fang Liu ◽  
Jianwei Guo ◽  
...  
Keyword(s):  
Calcium Sulfate ◽  
Operative Time ◽  
Demographic Data ◽  
Surgical Techniques ◽  
Length Of Hospital Stay ◽  
Infection Site ◽  
Spinal Stabilization ◽  
Positive Rate ◽  
The Mean

Abstract Background. Various surgical techniques for treating spondylodiscitis have been proposed, but the optimal surgical treatment remains controversial. In this study, we propose a new procedure that is implanting antibiotic-loaded calcium sulfate (CS) beads into the disc after infection site debrided by Quadrant channel combined with percutaneous fixation through a single-stage posterior approach for the treatment of spondylodiscitis. Thus, the purpose of this study is to assess the safety and efficacy of this procedure. Methods. This study collected 32 patients’ clinical data of whom had spine spondylodiscitis treated in our department from July of 2015 to August of 2020. The Demographic data included age, gender, involved segment and complications were collected. The intra-operative details, results of culture, functional outcome, radiologic outcome, and length of hospital stay, laboratory examination were recorded. Results. The mean age of the 32 patients was 61.1 ± 9.7 years old. The mean operative time was 135.0 ± 30.6 minutes, and the mean blood loss was 243.4 ± 92.1 ml. The positive rate of culture was 72%. The mean Visual analogue scale (VAS) and Oswestry Disability Index (ODI) score significantly improved from 7.5 to 1.6 and from 65–10%. Cobb angle was significantly improved and could be maintained at final follow-up. Solid bone fusion was achieved in all patients. There were no recurrences of infection in our study. Conclusions. The procedure we proposed is effective in the treatment of spondylodiscitis, the infection site can be debrided and controlled exactly, and spinal stabilization can also be achieved.

scholarly journals Mini-invasive robotic assisted pyelolithotomy: Comparison between the transperitoneal and retroperitoneal approach

2019 ◽  
Vol 91 (2) ◽  
Author(s):  
Daniele D'Agostino ◽  
Paolo Corsi ◽  
Marco Giampaoli ◽  
Federico Mineo Bianchi ◽  
Daniele Romagnoli ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Operative Time ◽  
Group Versus ◽  
Length Of Hospital Stay ◽  
Retroperitoneal Approach ◽  
Transperitoneal Approach ◽  
Robotic Assisted ◽  
Stone Free Rate ◽  
Free Rate

Objective: To compare the retroperitoneal with the transperitoneal approach in a series of patients underwent to robotic-assisted pyelolithotomy (RP). Materials and methods: From January 2015 to December 2018 we evaluated 20 patients subjected to robotic pyelolithotomy; 11 patients were treated with retroperitoneal approach (RRP) and 9 with transperitoneal approach (TRP). For each patient intra and perioperative data were recorded: operative time (OT), blood loss (BL), length of hospital stay (LOS), stone clearance, post-operative complications and time to remove the drain. The presence of stone fragments < 4 mm was considered as stone free rate. Results: The principal stone burden was greater in the TRP group than in the RRP group (48 ± 10 mm vs 32 ± 14 mm, p = 0.12). Preoperative hydronephrosis was present in 7 (64%) patients in RRP group and a mild hydronephrosis in 3 of TRP group (p = 0.04). The average operative time was higher in the RRP group than in the TRP group (203 ± 45 min vs 137 ± 31 min, p = 0.002). The average blood loss was 305 ± 175 ml in the RRP group versus 94 ± 104 ml in the TRP group (p = 0.005). The stone free rate was similar between the two groups, 36% (4 patients) in the RRP group and 44% (4 patients) in the TRP (p = 0.966). Conclusions: RP appears to be a safe and effective minimally invasive treatment for some patients with renal staghorn calculi or urinary tract malformations. The TRP may give lower operative time and better results in terms of blood loss and length of hospital stay.

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