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.

Open cystectomy is still alive and well: Outcomes from a single-centre 6-year review

2018 ◽  
Vol 12 (3) ◽  
pp. 239-245
Author(s):  
Alexios Dosis ◽  
Blessing Dhliwayo ◽  
Patrick Jones ◽  
Iva Kovacevic ◽  
Jonathan Yee ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Radical Cystectomy ◽  
Length Of Hospital Stay ◽  
Categorical Variables ◽  
Complication Rates ◽  
Intraoperative Blood Loss ◽  
Single Centre ◽  
Significant Difference ◽  
Duration Of Surgery

Objectives: To compare perioperative and oncological outcomes between open and laparoscopic radical cystectomy in a single-centre setting. Materials and methods: This study was a retrospective cohort (level 2b evidence) non-randomised review of 228 radical cystectomies that were performed between January 2010 and February 2016. Primary outcome measures were operative time, complications, blood loss and length of hospital stay. Statistical analysis was performed using the SPSS v21.0. Quantitative values were compared with Student’s t-test; categorical variables with the chi-square test. Statistical significance was considered a result of an alpha value less than 0.05. A Kaplan–Meier survival analysis was also conducted. Results: Intraoperative blood loss was lower in laparoscopic surgery (855±673 vs. 716±570 mL, P=0.15), which had a significant impact on transfusion rates ( P=0.02). Operative times were lower in open surgery (339±52.9 vs. 353.1±67.1 minutes, P=0.10), while hospital stay was lower in the laparoscopic group (14.2±11.2 vs. 16.0±13.6 days, P=0.28). Five-year survival rates were superior for patients who underwent an open procedure but were not statistically significant ( P=0.10). Conclusion: This is, so far, the largest cohort to compare laparoscopic and open radical cystectomy. The laparoscopic approach can reduce the need for transfusion; however, there was no statistically significant difference in complication rates, duration of surgery, length of hospital stay or intraoperative blood loss, survival and margin positivity. Level of evidence: Not applicable for this multicentre audit.

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 Effect of anaesthesia on the perioperative outcomes of pelvi-acetabular fracture surgeries in the apex trauma centre of a developing country–a retrospective analysis

2015 ◽  
Vol 3 ◽  
pp. 1-6
Author(s):  
Naveen Yadav ◽  
Suma Rabab Ahmad ◽  
Nisha Saini ◽  
Babita Gupta ◽  
Chhavi Sawhney ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Blood Loss ◽  
Hospital Stay ◽  
General Anaesthesia ◽  
Acetabular Fracture ◽  
Regional Anaesthesia ◽  
Trauma Centre ◽  
Intraoperative Blood Loss ◽  
Duration Of Hospital Stay ◽  
Duration Of Surgery

Abstract Background Regional anaesthesia has been proposed to reduce intraoperative blood loss, duration of hospital stay and in-hospital complications with improved postoperative pain control. General anaesthesia is advantageous for prolonged surgeries. We hypothesized that combined regional and general anaesthesia would offer advantages of both in pelvi-acetabular fracture surgeries. Methods We identified 71 patients who underwent open reduction and internal fixation of pelvi-acetabular fractures from May 2012 to 2013 in our trauma centre. We excluded patients with incomplete records (n = 4) and other injuries operated along (n = 8). Hence, 59 patients were divided into three groups: G group (general anaesthesia), R group (regional anaesthesia) and GR group (combined regional and general anaesthesia). Main outcome measurements studied were intraoperative blood loss, duration of hospital stay, duration of surgery and intraoperative and postoperative complications. Results No differences were obtained in between the groups in terms of age, gender, Injury Severity Score, number of comorbidities, or duration from injury to surgery. No significant differences were found between the three groups for intraoperative blood loss, days of hospital stay and duration of surgery. Intraoperative and postoperative complications were also comparable between the groups (p &gt; 0.05). Conclusions There is no specific significant advantage of the technique of anaesthesia on the observed perioperative complications in pelvi-acetabular fracture surgeries.

scholarly journals A retrospective study on the effect of Vitamin C in the management of dengue fever in three different states of India

2019 ◽  
Vol 10 (4) ◽  
pp. 2670-2673 ◽  
Author(s):  
Kothai Ramalingam ◽  
Christina S Varghese ◽  
Chinchu Elias ◽  
Gigi M Mathew ◽  
Arul Balasubramanian
Keyword(s):  
Retrospective Study ◽  
Vitamin C ◽  
Hospital Stay ◽  
Dengue Fever ◽  
Tamil Nadu ◽  
Tertiary Care ◽  
Length Of Hospital Stay ◽  
Madhya Pradesh ◽  
Percentage Increase ◽  
Number Of Patients

The objective of the study was to analyze the effect of vitamin C in the management of Dengue fever in the tertiary care hospitals of selected three states of India (Tamil Nadu, Kerala, and Madhya Pradesh). This retrospective study was carried out for a period of 6 months from November 2017 to April 2018, in which 200 patients were selected by considering the inclusion and exclusion criteria. It included 100 patients who were administered with Vitamin C and another 100 patients who were not given Vitamin C. All data were entered into the prepared PROFORMA. Mainly the increase in platelet counts and the duration of the hospital stay for both categories of patients were studied. Majority of dengue cases were in Tamil Nadu, followed by Kerala and then Madhya Pradesh depending upon the seasonal variations. Occurrence in male patients (58.5%) were more than female patients (41.5%). The most commonly affected age group ranges from 0-15 years (35.5%). Among the various types of dengue fever, a large number of patients had common dengue fever (87.5%). The 100 patients who were treated with vitamin C were mostly administered by oral routes. It was seen that the patients who were administered with Vitamin C had a greater percentage increase in their platelet count and a shorter duration of hospital stay. Study indicates that there exists an association between Vitamin C intake and length of hospital stay.

POST OPERATIVE LESS COMPLICATIONS IN ROBOTIC DONOR NEPHRECTOMY WITH MINIMAL HOSPITAL STAY

2021 ◽  
pp. 74-76
Author(s):  
Vinay Mahendra ◽  
Palash Saha ◽  
J.B. Roy ◽  
Tridibesh Mandal ◽  
Debarshi Jana
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Donor Nephrectomy ◽  
Postoperative Blood Loss ◽  
Minimally Invasive Surgical ◽  
Number Of Patients ◽  
Widespread Acceptance ◽  
Pain Duration ◽  
Group 2

Introduction: Minimally invasive surgical procedures have gained widespread acceptance in the eld of living kidney donation over the last decade. Ratner et al. were the rst to describe laparoscopic donor nephrectomy (LDN). Since then, compared to open donor nephrectomy, LDN has demonstrated several improvements in terms of decreased postoperative pain, decreased length of hospital stay (LOS), rapid patient rehabilitation, reduced postoperative blood loss, and superior cosmetic results. Aims And Objective: The aim of this study is to study less complication in robotic Donor nephrectomy with Respect to clinical outcome which include pordoprade pain, time and minimal stay in hospital. Materials And Methods: This study had been conducted on patients admitted for Robotic Donor Nephrectomy. This study done at Apollo Gleneagles Hospital, Kolkata. Prospective study was carried out in cases performed between which includes number of patients. All patients were older then 20years for this study. Result And Analysis: It was found that 49 (96.1%) patients had under vein group1, and 2(3.9%) patient had under vein group 2. 43 (84.3%) patients had under artery group1, and 8(15.7%) patient had under artery group 2. 1(2.0%) patient had acute graft rejection. 41 (80.4%) patients had Left site, and 10(19.6%) patient had Right site. Conclusion:Robotic donor Nephrotomy performed by the vinei Robot the use 7 Robot allows Minimum blood loss, Minimum OT time in their better result our study proven the ruperiority 7 then method and add then there were less complication. Pastopade pain Duration of hospital stay was less and return to regular life earlier so therefore Robot arrited Donor Nephrotomy is the method I choice for Renal tramplant Surgery.

scholarly journals Laparoscopic Cholecystectomy Performed by Residents: A Retrospective Study on 569 Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Dario Pariani ◽  
Stefano Fontana ◽  
Giorgio Zetti ◽  
Ferdinando Cortese
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Retrospective Study ◽  
Postoperative Complications ◽  
Hospital Stay ◽  
Postoperative Hospital Stay ◽  
Daily Activities ◽  
Safe Procedure ◽  
Duration Of Surgery ◽  
Junior Residents

Introduction. Aim of this study was to evaluate the safety of laparoscopic cholecystectomy performed by residents.Materials and Methods. We retrospectively reviewed 569 elective laparoscopic cholecystectomies.Results. Duration of surgery was84±39min for residentsversus  66±47 min for staff surgeons,P<0.001. Rate of conversion was 3.2% for residentsversus2.7% for staff surgeons,P=0.7. There was no difference in the rates of intraoperative and postoperative complications for residents (1.2% and 3.2%)versusstaff surgeons (1.5% and 3.1%),P=0.7andP=0.9. Postoperative hospital stay was3.3±1.8days for residentsversus  3.4±3.2days for staff surgeons,P=0.6. One death in patients operated by residents (1/246) and one in patients operated by staff surgeons (1/323) were found,P=0.8. No difference in the time to return to normal daily activities between residents (11.3±4.2days) and staff surgeons (10.8±5.6days) was found,P=0.2. Shorter duration of surgery when operating the senior residents (75±31minutes) than the junior residents (87±27minutes),P=0.003.Conclusion. Laparoscopic cholecystectomy performed by residents is a safe procedure with results comparable to those of staff surgeons.

scholarly journals Inguinal hernia repair – TEP or TAPP?? A comparative analysis between both the laparoscopic procedures in a tertiary care center

2020 ◽  
Vol 11 (6) ◽  
pp. 84-88
Author(s):  
Atia Zaka Ur Rab ◽  
Sheikh Saif Alim ◽  
Wasif Mohammad Ali ◽  
Syed Amjad Ali Rizvi
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Prospective Study ◽  
Hospital Stay ◽  
Inguinal Hernia Repair ◽  
Tertiary Care ◽  
Number Of Patients ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Normal Work

Background: Inguinal hernia surgery is one of the most common elective procedures performed by the surgeons and has evolved from open to the laparoscopic technique. Aims and Objectives: This prospective study was conducted to find out intra-operative and post-operative outcomes in patients undergoing TEP and TAPP for inguinal hernia repair. Materials and Methods: A prospective study was conducted on 50 adult patients who underwent laparoscopic inguinal hernia repair between November 2017 to November 2018. It was a randomized study and equal number of patients were allocated to TAPP and TEP group based on the surgeon’s preference. Results: Operative time [p<0.0001], intensity of pain (VAS) was significantly higher in TAPP compared to TEP in the immediate post-operative period (6 hours) and during hospital stay [p=0.0299]. No significant difference observed in VAS between TEP and TAPP during follow up [after 1 week (p=0.2298), 2 weeks (p=0.2337), and 4 weeks (p=0.3944)]. Both TEP and TAPP were comparable in terms of Intra-operative and Post-operative complications {seroma [during hospital stay (p=0.1573), after 1 week (p=0.6375), after 2 weeks (p=0.5513)]; haematoma [during hospital stay (p=0.1492), after 1 week (p=0.3125)]} and Conversion (p=0.3125), and Length of hospital stay (p=0.3960). Time to resume normal work [p<0.0001] was significantly more in TAPP than TEP. Conclusion: TEP has a definite edge over TAPP taking into consideration the lesser intensity of post-operative pain during hospital stay, shorter duration of surgery and relatively early return to normal work associated with the former procedure. TEP should therefore be regarded as the procedure of choice for inguinal hernia repair.

scholarly journals Study comparing the stroke unit outcome and conventional ward treatment: a randomized study in Joinville, Brazil

2003 ◽  
Vol 61 (2A) ◽  
pp. 188-193 ◽  
Author(s):  
Norberto L. Cabral ◽  
Carla Moro ◽  
Giana R. Silva ◽  
Rosana Herminia Scola ◽  
Lineu César Werneck
Keyword(s):  
Hospital Stay ◽  
Stroke Unit ◽  
Survival Curve ◽  
Clinical Status ◽  
Randomized Study ◽  
Length Of Hospital Stay ◽  
General Ward ◽  
Number Of Patients ◽  
Significant Difference ◽  
The Impact

BACKGROUND AND PURPOSE: To assess the impact of a stroke unit (SU) on acute phase treatment when compared to a conventional general ward treatment (GW). METHOD: Seventy-four patients with acute stroke were randomized between a SU and conventional general ward (GW). We compared both groups regarding the length of hospital stay, lethality and functional and clinical status within 6 months, using the Scandinavian scale and Barthel index. RESULTS: Thirty-five and thirty-nine patients were allocated at SU and GW, respectively. Lethality on the 10th day at SU and GW achieved 8.5% and 12.8% respectively (p= 0.41), whereas 30-days mortality rates achieved 14.2% and 28.2% (p= 0.24), 17.4% and 28.7% on the 3rd month (p= 0.39), and 25.7% and 30.7% on the 6th month (p= 0.41). Thirty-day survival curve achieved 1.8 log rank (p= 0.17), with a trend for lower lethality in the SU. In order to save one death in 6 months in SU, NNT (the number need to treat) was 20; to get one more home independent patient NNT was 15. No significant difference was found between the length of hospital stay and morbidity. CONCLUSION: No significant benefit was found in SU patients compared to GW group. However,an evident benefit in absolute numbers was observed in lethality, survival curve and NNT in thirty days period after stroke. Further collaborative studies or incresead number of patients are required to define the role of SU.

scholarly journals A comparative analysis of hysterectomies

Medicina ◽  
2007 ◽  
Vol 43 (2) ◽  
pp. 118 ◽  
Author(s):  
Rosita Aniulienė ◽  
Laima Varžgalienė ◽  
Manvydas Varžgalis
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Complication Rate ◽  
Vaginal Hysterectomy ◽  
Length Of Hospital Stay ◽  
Laparoscopic Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Obstetrics And Gynecology ◽  
Significant Difference ◽  
The Mean

The objective of this study was to evaluate and compare operative and postoperative results and differences among laparoscopic, vaginal, and abdominal hysterectomies performed at the Department of Obstetrics and Gynecology of Kaunas University of Medicine Hospital. Methods. A retrospective review of medical histories was performed for women who had undergone three different types of hysterectomies (laparoscopic, vaginal, and abdominal) at the Department of Obstetrics and Gynecology of Kaunas University of Medicine Hospital during 2004–2005. Results. A total of 602 hysterectomies were performed: 51 (8.5%) laparoscopic, 203 (33.7%) vaginal, and 348 (57.8%) abdominal. The lowest complication rate occurred in patients who underwent laparoscopic hysterectomy (n=5, 9.8%) and the highest – abdominal hysterectomy (n=88, 25.2%) (P<0.05). More complication occurred after abdominal as compared to vaginal hysterectomy (n=88, 25.2% vs. n=20, 9.9%, respectively; P<0.05). There was no statistically significant difference in complication rate comparing laparoscopic and vaginal hysterectomies (P=0.26). The amount of blood loss depended on the type of hysterectomy – less blood was lost during laparoscopic and more during abdominal hysterectomy (123.4 vs. 308.5 mL, respectively; P<0.01). A significantly higher blood loss was observed during abdominal hysterectomy as compared to vaginal (195.3 mL) and vaginal as compared to laparoscopic hysterectomy (P<0.01). The mean length of hospital stay differed comparing all three types of hysterectomies: the shortest stay of 8.6 days was after laparoscopic, the longest of 13.7 days – after abdominal hysterectomy. The mean hospital stay was statistically significant shorter for vaginal hysterectomy compared to abdominal hysterectomy (9.1 vs. 13.7 days, P<0.01). The difference in mean length of hospital stay was insignificant comparing laparoscopic and vaginal hysterectomies (P>0.05). Conclusions. Abdominal hysterectomy was the most common procedure performed. The type of hysterectomy influenced the rate of complications – the lowest complication rate was after laparoscopic and vaginal hysterectomies. The amount of blood loss depended on the type of hysterectomy – the lowest was during laparoscopic hysterectomy. Abdominal hysterectomy required on average a longer hospital stay compared with laparoscopic and vaginal hysterectomies.

scholarly journals Laparoscopic Assisted Vaginal Hysterectomy: A Case Control Comparative Study with Total Abdominal Hysterectomy

2014 ◽  
Vol 8 (2) ◽  
pp. 59-62
Author(s):  
Fahmida Zesmin ◽  
Begum Hosne Ara ◽  
Fatema Begum ◽  
Nusrat Fatima
Keyword(s):  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Length Of Hospital Stay ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Case Control ◽  
Eligibility Criteria ◽  
Laparoscopic Assisted Vaginal Hysterectomy ◽  
Number Of Patients ◽  
Significant Difference

This case control study was conducted in the department of Gynae & Obstetrics, Sir Salimullah Medical College & Mitford Hospital (SSMC & MH), Dhaka, during the period of January 2008 to December 2008 to compare the length of operation, blood loss, length of hospital stay, drug requirements for pain and post-operative pain and activity levels between Laparoscopically Assisted Vaginal Hysterectomy (LAVH) & Total Abdominal Hysterectomy (TAH). A total of 50 patients who met some eligibility criteria were consecutively included in the study and matched in a case control manner for age, weight, diagnosis & uterine size. The procedures were performed by the same surgeon. On average, LAVH operations took significantly longer than TAH operations (P<0.001). Equal number of patients of both groups (40%) needed blood transfusion. No significant difference about haemoglobin level compared to TAH group on 3rd POD (P=0.246). However total amount of analgesics needed was much higher in the TAH group than that of the LAVH group (243.7 ± 40.3VS 182.1 ± 69.6 mg; P= 0.005) and the total cost of operation was significantly less in the TAH group (4500 ± 500 takas) than in the LAVH group (6500 ± 500 taka) (P<0.001). It was observed that LAVH group produced earlier relief from pain in terms of pain VAS on 3rd POD, (P<0.001). LAVH is less painful, has a shorter length of hospital stay and quicker return to work than TAH. Moreover LAVH does not increase intra or postoperative complications. DOI: http://dx.doi.org/10.3329/fmcj.v8i2.20370 Faridpur Med. Coll. J. 2013;8(2): 59-62

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