scholarly journals “Cold” polypectomy for colorectal polyps: prospective randomized trial

2021 ◽  
Vol 20 (2) ◽  
pp. 65-73
Author(s):  
O. S. Toporkova ◽  
V. V. Veselov ◽  
Yu. E. Vaganov ◽  
M. A. Nagudov ◽  
O. A. Majnovskaya ◽  
...  
Keyword(s):  
Risk Factor ◽  
Postoperative Complications ◽  
Randomized Trial ◽  
Intraoperative Complications ◽  
Univariate Analysis ◽  
Operation Time ◽  
Colorectal Polyps ◽  
Prospective Randomized Trial ◽  
Control Group ◽  
Number Of Patients

Background: endoscopic electroexcision is the standard technique for the removal of colorectal polyps. However, it is associated with the postoperative morbidity. In order to reduce the incidence of complications, “cold” excision seems to be an alternative option.Aim: to improve the results of endoscopic treatment for patients with colorectal polyps.Patients and methods: from September 2019 to September 2020, 160 patients ≥ 18 years old (80 in each group), who underwent endoscopic removal of colorectal polyps ≤ 10 mm in size by cold excision (132 lesions) and traditional polypectomy (129 lesions), were included in a prospective randomized trial. All removed specimens were studied histologically with an assessment of the resection margins (R0/R1). The analysis of the postoperative complications after endoscopic polypectomy and the incidence of Rx resection after removal of polyps by both techniques was done.Results: the compared groups were homogenous in the number of patients, gender, age, and comobridities. There were no significant differences in the number of removed polyps, their site and the type according to endoscopic classifications. The operation time was significantly higher in the conventional polypectomy group compared with the “cold” one (p = 0.0001). There were no significant differences in the intraoperative complications rate between the two groups (p = 0.06). There were no postoperative complications in the “cold” group. In the control group postoperative complications occurred after 12 out of 129 polyps removal (p = 0.001). The univariate analysis showed that a risk factor for the development of postoperative complications after conventional polypectomy is the lack of submucosal lifting (OR: 15.3, 95% CI: 1.9-125.6, p = 0.01). Histopathology of the removed specimens showed that in both groups most of the procedures were considered as R0 resections (54% in the main group, 56.4% in the control group, p = 0.8). The polyp size ≤ 4 mm identified as a risk factor for R1, Rx resection (OR: 2.4, 95% CI: 1.3–4.7, p = 0.007).Conclusion: “cold” polypectomy is an effective and safe method and may be recommended as an alternative technique for the removal of non-pedunculated colorectal polyps ≤ 10 mm.

scholarly journals Effect of KAP Intervention Model on Resilience and Cancer-related Fatigue in Patients with Colorectal Cancer Undergoing Chemotherapy

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Hui Zhang
Keyword(s):  
Colorectal Cancer ◽  
Randomized Trial ◽  
Cancer Chemotherapy ◽  
Prospective Randomized Trial ◽  
Control Group ◽  
Observation Group ◽  
Intervention Model ◽  
Cancer Related Fatigue ◽  
Resilience Scale ◽  
The Difference

Objective: To explore the effect of KAP intervention mode on resilience and cancer-related fatigue in patients with colorectal cancer undergoing chemotherapy. Methods: A prospective randomized trial was conducted. 55 patients with colorectal cancer who received routine nursing from February 2018 to February 2019 were included in the control group, and 55 patients who received routine nursing + KAP intervention from March 2019 to March 2020 were included in the observation group. The scores of Resilience Scale and cancer-related fatigue scale (CFS) before and 6 months after intervention were compared between the two groups. Results: After 6 months of intervention, the score of resilience of the two groups was higher than that before intervention, and that of the observation group was higher than that of the control group, the difference was statistically significant (P < 0.05); The CFS score of the two groups was lower than that before intervention, and that of the observation group was lower than that of the control group, the difference was statistically significant (P < 0.05). Conclusion: KAP intervention model can improve the resilience of patients with colorectal cancer chemotherapy, reduce cancer-related fatigue.

scholarly journals Factors Affecting Length of Stay Following 3-Column Spinal Osteotomies in Pediatric Patients

2019 ◽  
pp. 219256821989522
Author(s):  
So Kato ◽  
Taylor Dear ◽  
Stephen J. Lewis
Keyword(s):  
Body Weight ◽  
Postoperative Complications ◽  
Length Of Stay ◽  
Pediatric Patients ◽  
Perioperative Complications ◽  
Intraoperative Complications ◽  
Operation Time ◽  
Fluid Administration ◽  
Prolonged Stay ◽  
Factors Affecting

Study Design: A retrospective analysis. Objectives: Length of stay (LOS) is one of the important indicators for the quality of patient care. Although perioperative complications are known to be associated with longer LOS in general, little has been understood regarding LOS after 3-column spinal osteotomy for the rigid spinal deformity in pediatric population. The main objective of the article is to identify factors affecting the LOS in pediatric patients undergoing 3-column posterior spinal osteotomies. Methods: Following research ethics approval, a retrospective review was performed of 35 consecutive posterior 3-column spinal osteotomies performed on pediatric patients in a single academic institution. Patients’ demographic data, preoperative comorbidities, details of operative procedures, intraoperative complications, and postoperative complications were investigated, and LOS was compared among the groups. Results: The mean LOS was 9.0 days, and the median LOS was 7 days (range = 4-23 days). Low body weight and syndromic deformity were associated with longer LOS. Operation time ≥6 hours and total perioperative fluid administration greater than or equal to twice the estimated blood volume were associated with longer LOS. Among postoperative complications, those with respiratory complication had prolonged stay. Conclusions: Preoperative low body weight and syndromic scoliosis had longer LOS after 3-column osteotomies. Excessive fluid administration and respiratory complications were associated with longer LOS.

scholarly journals Obesity as a risk factor for dengue shock syndrome in children

2013 ◽  
Vol 53 (4) ◽  
pp. 187 ◽  
Author(s):  
Maria Mahdalena Tri Widiyati ◽  
Ida Safitri Laksanawati ◽  
Endy Paryanto Prawirohartono
Keyword(s):  
Risk Factor ◽  
Viral Infections ◽  
Infection Type ◽  
Secondary Infection ◽  
Univariate Analysis ◽  
Fluid Management ◽  
Dengue Shock Syndrome ◽  
Hemorrhagic Fever ◽  
Control Group ◽  
Case Group

Background Dengue hemorrhagic fever (DHF) leads to highmorbidity and mortality if not be treated properly and promptly.Obesity may play a role in the progression ofDHF to dengue shocksyndrome (DSS) and could be a prognostic factor.Objective To evaluate childhood obesity as a prognostic factorfor DSS.Methods We reviewed medical records of patients with DHFand DSS admitted to Department of Child Health, Dr. SardjitoHospital, Yogyakarta between June 2008 and February 2011.Subjects were aged less than 18 years and fulfilled WHO criteria(1997) for DHF or DSS. The exclusion criteria were the denguefever, a milder form of disease, or other viral infections. Riskfactors for DSS were analyzed by logistic regression analysis.Results Of342 patients who met the inclusion criteria, there were116 DSS patients (33 .9%) as the case group and 226 DHF patients(66.1%) as the control group. Univariate analysis revealed thatrisk factors for DSS were obesity (OR= 1.88; 95%CI 1.01 to3.5 l) ,secondary infection type (OR=0.82; 95%CI 0.41 to 1.63), plasmaleakage with hematocrit increase> 25% (OR=3.42; 95%CI 2.06to 5.65), platelet count < 20,000/μL (OR= l.95; 95%CI 1.20 to3 .16), and inadequate fluid management from prior hospitalization(OR=9.ll; 95% CI 1.13 to 73.66). By multivariate analysis,plasma leakage with hematocrit increase > 25% was associatedwith DSS (OR=2.5 l; 95%CI 1.12 to 5.59), while obesity was notassociated with DSS (OR= l.03; 95%CI 0.32 to3.3 1).Conclusion Obesity is not a risk factor for DSS, while plasmaleakage with hematocrit increase > 25% is associated with DSS.

Bismuth subgallate – its role in tonsillectomy

1995 ◽  
Vol 109 (3) ◽  
pp. 203-205 ◽  
Author(s):  
J. E. Fenton ◽  
A. W. Blayney ◽  
T. P. O'Dwyer
Keyword(s):  
Randomized Trial ◽  
Retrospective Studies ◽  
Operating Time ◽  
Prospective Randomized Trial ◽  
Control Group ◽  
Operative Morbidity ◽  
Haemostatic Agent ◽  
Paediatric Patients ◽  
Bismuth Subgallate

AbstractThere have been many attempts at identifying substances and describing methods that would assist the surgeon and be of benefit to the patient undergoing a tonsillectomy. The use of bismuth subgallate as a haemostatic adjunct during tonsillectomy has only been described previously in retrospective studies. A controlled prospective randomized trial of 100 paediatric patients, in which 50 patients had a tonsillectomy performed using bismuth subgallate as a haemostatic agent and in which the remainder did not have any associated haemostatic substance, is presented here.Data on 72 patients was analysed, 39 patients belonging to the bismuth subgallate group and the remaining 33 to the control group. The time for haemostasis was three to 18 (mean 7.8) minutes in the bismuth group. It was four to 16 (mean 9.9) minutes in the non-bismuth group. These figures are statistically significant.The range of ties used in the bismuth group was none to three (mean 1.5) ties and one to seven (mean 3.4) ties in the non-bismuth group. These figures are also statistically significant. The remainder of the recorded parameters did not differ significantly.It was found that bismuth subgallate/adrenaline paste decreases operating time by significantly reducing the haemostasis time and the number of ties required but does not decrease post-operative morbidity.

Adjuvant chemoradiotherapy after radical cystectomy in advanced high risk bladder cancer: A prospective randomized trial

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 4545-4545 ◽  
Author(s):  
M. S. Zaghloul ◽  
H. M. Khaled ◽  
M. Lotayef ◽  
H. William
Keyword(s):  
Bladder Cancer ◽  
Risk Factor ◽  
High Risk ◽  
Randomized Trial ◽  
Radical Cystectomy ◽  
Locally Advanced ◽  
Prospective Randomized Trial ◽  
Adjuvant Chemoradiotherapy ◽  
Nodal Involvement ◽  
Pathological Stage

4545 Background: High risk locally advanced bladder cancer patients experienced low survival rates, high local recurrence and extensive distant metastasis. Postoperative radiotherapy (PORT) though improved the survival through improving local control. Methods: A prospective randomized trial was performed at NCI, Cairo, Egypt including 142 patients in 2 arms. Patients who underwent radical cystectomy and pelvic lymphadenectomy had to have one more of the following: P3b or P4a stage, G3 or involved lymphadenopathy. Arm I (71 patients) received PORT 45 G/30 fractions/3 weeks. Arm II (71 patients) received 2 courses of adjuvant chemotherapy (Gemcitabine 1 gm/m2 D1 and D8 and cisplatin 70 mg/m2 D2), same PORT regimen followed by another 2 courses of Gemcitabine-cisplatin. Results: Chemotherapy was tolerated with grade 1/2 toxicities. Early radiation reactions were also tolerable in both arms, slightly more in arm II. Delayed toxicity was comparable in both arms. The 2-year DFS was 67.6 ± 5.9% in the whole group. This was affected significantly by performance status (p = 0.009), pathological stage (p = 0.001), tumor cell type (p = 0.053), nodal involvement (p = 0.07) and number of risk factors (p = 0.09). Though there was improvement of DFS from 61.5 ± 7.4% in PORT group to 70.9 ± 6.1% in chemoradiotherapy group, yet it was not statistically significant (p = 0.2). Patients having one risk factor, low pathological stage or no nodal involvement in arm II experienced better DFS than those in arm I (p = 0.07, 0.08 and 0.09 respectively). Conclusions: Adjuvant chemoradiotherapy using Gemcitabine-cisplatin and PORT was tolerable with minimal severe toxicities. There was DFS improvement with the addition of chemotherapy to PORT (not statistically significant yet). Patients with one risk factor, lower pathological stage or no nodal involvement seemed to benefit more from added chemotherapy. No significant financial relationships to disclose.

scholarly journals Effects of radiofrequency ablation assisted partial hepatectomy in the treatment of primary liver cancer

2017 ◽  
Vol 1 (3) ◽  
Author(s):  
Yongbo Wang
Keyword(s):  
Radiofrequency Ablation ◽  
Postoperative Complications ◽  
Liver Cancer ◽  
Partial Hepatectomy ◽  
Primary Liver Cancer ◽  
Length Of Hospital Stay ◽  
Operation Time ◽  
Control Group ◽  
Study Group ◽  
Postoperative Length

Objective: To investigate the effects of radiofrequency ablation assisted partial hepatectomy in the treatment of primary liver cancer. Methods: A total of 60 patients with primary liver cancer treated in our hospital from March 2013 to October 2015 were selected as study subjects and were divided into the control group and the study group by the random number table method, 30 cases in each group. The control group were treated with partial hepatectomy. On the basis, the study group were treated with radiofrequency ablation. The operation associated indexes (operation time, the average wound bleeding volume, postoperative length of hospital stay), preoperative and postoperative liver function indexes [alanine aminotransferase (ALT), total bilirubin (TBIL), aspartate aminotransferase (AST)], the incidence of complications and recurrence rates in the two groups were observed. Results: The operation time and postoperative length of hospital stay of the study group were significantly shorter than those of the control group, and the average bleeding volume was significantly less than that of the control group (P < 0.05). There was no significant difference in ALT, TBiL and AST between the two groups before operation(P>0.05). After operation, ALT, TBiL and AST in the two groups were significantly lower than those before operation, and the changes in the study group were greater than those in the control group (P < 0.05). The incidence of postoperative complications and the recurrence rate in 1 year after operation were significantly  lower than those in the control group (P < 0.05). Conclusion: Radiofrequency ablation has obvious positive effect in patients with primary liver cancer undergoing partial hepatectomy. It has advantages of little bleeding, short rehabilitation time, protecting liver function, few postoperative complications and low recurrence rate.

scholarly journals Predictive factors for developing acute cholangitis and cholecystitis in patients undergoing delayed cholecystectomy: a retrospective study

2019 ◽  
Author(s):  
Takashi Miyata ◽  
Daisuke Matsui ◽  
Yuta Fujiwara ◽  
Hiroto Saito ◽  
Yoshinao Ohbatake ◽  
...  
Keyword(s):  
Risk Factor ◽  
Surgical Outcomes ◽  
Intraoperative Complications ◽  
Acute Cholangitis ◽  
Previous History ◽  
Cell Counts ◽  
Number Of Patients ◽  
History Of ◽  
Group A ◽  
Group B

Abstract Background We evaluated the risk of acute cholangitis and cholecystitis while waiting for cholecystectomy for gallstones. Methods We retrospectively enrolled 168 patients who underwent cholecystectomy for gallstones after a waiting period and conservative therapy between April 2014 and March 2018 at our hospital. We compared the clinical data from 20 patients who developed acute cholangitis and cholecystitis while waiting for cholecystectomy (group A) with data from 148 patients who did not develop cholangitis and cholecystitis (group B). The risk factors for developing acute cholangitis and cholecystitis and all patients' surgical outcomes were investigated. Results Preoperatively, significant differences in age (68.6 years vs 60.7 years; p= 0.004) and the number of patients with a previous history of acute grade II or III cholecystitis (55.0% vs 10.8%; p< 0.001) and biliary drainage (20.0% vs 2.0%; p= 0.004) were observed between group A and group B, respectively. Preoperative white blood cell counts (13500/µL vs 8155/µL; p< 0.001) and serum C-reactive protein levels (12.6 mg/dL vs 5.1 mg/dL; p< 0.001) were significantly increased, and serum albumin levels (3.2 g/dL vs 4.0 g/dL; p< 0.001) were significantly decreased in group A vs group B, respectively. Gallbladder wall thickening (≥ 5 mm) (45.0% vs 18.9%; p= 0.018), incarcerated gallbladder neck stones (55.0% vs 22.3%; p= 0.005), and abscess around the gallbladder (20.0% vs 1.4%; p= 0.002) were seen significantly more frequently during imaging in group A vs group B, respectively. Furthermore, investigating patients' surgical outcomes revealed a higher conversion rate to open surgery (20.0% vs 2.0%; p= 0.004), longer operation time (137 min vs 102 min; p< 0.001), and a higher incidence of intraoperative complications (10.0% vs 0%; p= 0.014) in group A vs group B, respectively. Conclusions Our results suggest that a history of severe cholecystitis is a risk factor for developing acute cholangitis and cholecystitis in patients waiting for surgery, and a risk factor for increased surgical difficulty.

Optimal prophylactic method of venous thromboembolism for gastrectomy in Korean patients: A prospective randomized trial.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. TPS229-TPS229
Author(s):  
Kyo Young Song
Keyword(s):  
Venous Thromboembolism ◽  
Randomized Trial ◽  
Intermittent Pneumatic Compression ◽  
Prospective Randomized Trial ◽  
Thromboembolic Prophylaxis ◽  
Optimal Method ◽  
Vein Thrombosis ◽  
Number Of Patients ◽  
Routine Prophylaxis ◽  
Prophylactic Method

TPS229 Background: Whereas routine prophylaxis for venous thromboembolism (VTE) is frequently utilized in the West, Asian physicians employ it much less often, based on its recorded rarity amongst their patients. This trial is to examine the incidence of VTE and to determine the optimal method of thromboembolic prophylaxis following gastrectomy for cancer. Methods: In this prospective randomized trial, patients will be assigned to either an intermittent pneumatic compression (IPC) only or an IPC plus enoxaparin. The primary end point of this study is to determine the VTE incidence rate within 30 days of surgery. A history with physical examinations for VTE and a serum d-dimer test is scheduled on postoperative days (POD) 0, 1, 4, and 7. Duplex ultrasonography (DUS) was performed as an objective test for deep vein thrombosis at POD 4. The number of patients to be randomized was calculated to be 682. Clinical trial information: NCT01448746.

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