scholarly journals Radical surgery for complicated cholelithiasis in elderly patients: three clinical cases

2021 ◽  
Vol 12 (3) ◽  
pp. 76-84
Author(s):  
A. E. Kustov ◽  
V. I. Khrupkin ◽  
I. V. Gorbacheva ◽  
A. S. Vorotyntsev ◽  
A. Y. Emelyanov
Keyword(s):  
Minimally Invasive ◽  
Elderly Patients ◽  
Multidisciplinary Team ◽  
Radical Surgery ◽  
Elective Surgery ◽  
Gallstone Disease ◽  
Multiple Organ ◽  
Complete Relief ◽  
Stone Migration ◽  
Clinical Cases

Management of complicated cholelithiasis (gallstone disease) in elderly patients is often limited to the use of only minimally invasive interventions.Case report. We report three clinical cases of gallstone disease complications in patients over 75 years old who had previously undergone minimally invasive surgery and who was refused radical surgical treatment due to comorbidity. In two patients, this led to the development of purulent cholangitis and multiple organ failure, which required emergency hospitalization. At the first stage, biliary drainage was performed; then the multidisciplinary team managed to stabilize the condition of the patient; at the second stage, biliodigestive anastomoses were formed through laparotomic access on a loop turned off by the Ru. Complete relief of symptoms was achieved and no relapse was observed.In another case, cholecystoduodenal fistula with stone migration and complete obstruction of the small intestine was found during laparotomy in an asymptomatic patient hospitalized for elective surgery.Discussion. Comorbidity should not be considered as an absolute contraindication to radical surgery of complicated cholelithiasis in elderly patients: gallstone disease complications in most cases exceed the risks of surgical intervention. Radical surgery of complicated gallstone disease in patients over 75 years old is possible in condition of patient management by a multidisciplinary team.

scholarly journals Surgical diseases and surgical outcomes in geriatric patients

2020 ◽  
Vol 7 (10) ◽  
pp. 3315
Author(s):  
Amba Prasad Chawan ◽  
Yashwant Singh Rathore ◽  
Sunil Chumber ◽  
Kamal Kataria
Keyword(s):  
Elderly Patients ◽  
Elderly Population ◽  
Elective Surgery ◽  
Gallstone Disease ◽  
Common System ◽  
Co Morbidity ◽  
Increase Risk ◽  
Study Population ◽  
Complications And Mortality ◽  
Morbid Conditions

Background: To study the demography, disease distribution and co morbid conditions, complications and mortality among elderly patients undergoing operation in general surgical wards.Methods: A prospective observational study was conducted among elderly patients of age ≥60 years admitted in General Surgery wards at our institute for a period of a year. Results: A total of 137 patients were recruited in this study. Out of them 62.04% were men and 37.96% were women. Most common system involved was hepatobiliary with a total of 38 cases (27.7%), most common surgical disease in our study was hernias (27%) and gallstone disease (25%). About 55.5% of our study population had co morbid medical conditions. Hypertension was the most common co morbidity (38%) in our study. Out of 137 cases, 115 cases were elective cases and 22 were emergency cases, operated in emergency settings. About 16.7% of the study population had surgical complications. Post-operative seroma formation at the surgical site was the most common complication. About 7 cases were succumbed to death and mortality rate was about 5.1% in our study population.Conclusion: Prevalence of medical co morbidities is higher in elderly population. Out of them, hypertension and diabetes mellitus are the most common co morbid conditions. Most common indications for elective surgery in our study are hernias and gallstone disease. Early elective surgical intervention is preferred in elderly population when presented, as age, co morbidities and emergency settings increase risk of perioperative mortality.

scholarly journals Case reports of patients with chronic disorders of consciousness in obstetric and gynecological practice

2021 ◽  
Vol 69 (6) ◽  
pp. 31-42
Author(s):  
Alina O. Ivanova ◽  
Ekaterina A. Kondratyeva ◽  
Maria I. Yarmolinskaya ◽  
Elena V. Misharina ◽  
Margarita S. Florova ◽  
...  
Keyword(s):  
Elective Surgery ◽  
Case Reports ◽  
Gallstone Disease ◽  
Complete Recovery ◽  
Disorders Of Consciousness ◽  
Surgical Interventions ◽  
Vitamin D Levels ◽  
Chronic Disorders ◽  
Chronic Disorders Of Consciousness ◽  
Clinical Cases

According to the modern classification system, chronic disorders of consciousness are defined as an altered state of consciousness that develops after coma and is accompanied by the restoration of wakefulness without the complete recovery of conscious activity for more than 28 days after traumatic brain injury. Clinical cases of chronic chronic disorders of consciousness development in women after surgical interventions related to various obstetrical and gynecological pathologies, as well as after routine surgical interventions for comorbid somatic pathology, are of particular interest to obstetricians and gynecologists. In the presented chronic chronic disorders of consciousness related clinical cases of operations for ectopic pregnancy, as well as consequences of elective surgery for gallstone disease, the development of hypo- and normogonadotropic ovarian insufficiency associated with chronic disorders of consciousness is described. The characteristics of the thyroid status, adrenocorticotropic function, and vitamin D levels are given. Further in-depth examination and accumulation of data on patients with chronic disorders of consciousness may provide an opportunity to determine informative markers for prognostication of outcomes, as well as to develop new effective approaches to consciousness rehabilitation in this category of patients.

scholarly journals Non-medical risk factors associated with postponing elective surgery: a prospective observational study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Julia Becker ◽  
Gerald Huschak ◽  
Hannes-Caspar Petzold ◽  
Volker Thieme ◽  
Sebastian Stehr ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Low Socioeconomic Status ◽  
Elective Surgery ◽  
Nursing Home Residents ◽  
Hospital Staff ◽  
Data Management System ◽  
Electronic Patient Records ◽  
Specific Patient ◽  
Emergency Procedures ◽  
Patient Groups

Abstract Background Operation room (OR) planning is a complex process, especially in large hospitals with high rates of unplanned emergency procedures. Postponing elective surgery in order to provide capacity for emergency operations is inevitable at times. Elderly patients, residents of nursing homes, women, patients with low socioeconomic status and ethnic minorities are at risk for undertreatment in other contexts, as suggested by reports in the medical literature. We hypothesized that specific patient groups could be at higher risk for having their elective surgery rescheduled for non-medical reasons. Methods In this single center, prospective observational trial, we analysed 2519 patients undergoing elective surgery from October 2018 to May 2019. A 14-item questionnaire was handed out to illicit patient details. Additional characteristics were collected using electronic patient records. Information on the timely performance of the scheduled surgery was obtained using the OR’s patient data management system. 6.45% of all planned procedures analysed were postponed. Association of specific variables with postponement rates were analysed using the Mann–Whitney U test and Fisher's exact test/χ2-test. Results Significantly higher rates of postponing elective surgery were found in elderly patients. No significant differences in postponing rates were found for the variables gender, nationality (Germany, EU, non-EU), native language, professional medical background and level of education. Significantly lower rescheduling rates were found in patients with ties to hospital staff and in patients with a private health insurer. Conclusions Elderly patients, retirees and nursing home residents seem to be at higher risk for having their elective surgery rescheduled. However, owing to the study design, causality could not be proven. Our findings raise concern about possible undertreatment of these patient groups and provide data on short-term postponement of elective surgery. Trial registration DRKS00015836. Retrospectively registered.

Quality of training in cervical cancer radical surgery: a survey from the European Network of Young Gynaecologic Oncologists (ENYGO)

2022 ◽  
pp. ijgc-2021-002812
Author(s):  
Nicolò Bizzarri ◽  
Andrei Pletnev ◽  
Zoia Razumova ◽  
Kamil Zalewski ◽  
Charalampos Theofanakis ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Minimally Invasive ◽  
Radical Surgery ◽  
Gynecologic Oncology ◽  
Laparoscopic Approach ◽  
High Volume ◽  
Lymph Node Biopsy ◽  
European Network ◽  
Before And After ◽  
Level Of Training

BackgroundThe European Society of Gynaecological Oncology (ESGO) and partners are committed to improving the training for gynecologic oncology fellows. The aim of this survey was to assess the type and level of training in cervical cancer surgery and to investigate whether the Laparoscopic Approach to Cervical Cancer (LACC) trial results impacted training in radical surgery for gynecologic oncology fellows.MethodsIn June 2020, a 47-question electronic survey was shared with European Network of Young Gynaecologic Oncologists (ENYGO) members. Specialist fellows in obstetrics and gynecology, and gynecologic oncology, from high- and low-volume centers, who started training between January 1, 2017 and January 1, 2020 or started before January 1, 2017 but finished their training at least 6 months after the LACC trial publication (October 2018), were included.Results81 of 125 (64.8%) respondents were included. The median time from the start of the fellowship to completion of the survey was 28 months (range 6–48). 56 (69.1%) respondents were still fellows-in-training. 6 of 56 (10.7%) and 14 of 25 (56.0%) respondents who were still in training and completed the fellowship, respectively, performed ≥10 radical hysterectomies during their training. Fellows trained in an ESGO accredited center had a higher chance to perform sentinel lymph node biopsy (60.4% vs 30.3%; p=0.027). There was no difference in the mean number of radical hysterectomies performed by fellows during fellowship before and after the LACC trial publication (8±12.0 vs 7±8.4, respectively; p=0.46). A significant reduction in number of minimally invasive radical hysterectomies was noted when comparing the period before and after the LACC trial (38.5% vs 13.8%, respectively; p<0.001).ConclusionExposure to radical surgery for cervical cancer among gynecologic oncology fellows is low. Centralization of cervical cancer cases to high-volume centers may provide an increase in fellows’ exposure to radical procedures. The LACC trial publication was associated with a decrease in minimally invasive radical hysterectomies performed by fellows.

scholarly journals Possibility of oxygen-ozone therapy in the geriatric patient

Ozone Therapy ◽  
2017 ◽  
Vol 1 (3) ◽  
pp. 53
Author(s):  
Marianno Franzini ◽  
Giulia Ionita
Keyword(s):  
Drug Therapy ◽  
Side Effects ◽  
Minimally Invasive ◽  
Elderly Patients ◽  
Geriatric Patient ◽  
Multidisciplinary Care ◽  
Invasive Technique ◽  
Ozone Therapy ◽  
Muscular Pain ◽  
Care Of Elderly

In the context of multidisciplinary care of elderly patients, this work will want to consider the presence of osteo-articular and muscular pain, mostly chronic, of these subjects. The treatment has made use of oxygen-ozone therapy, given the absence of side effects of this minimally invasive technique, and the possibility of its use simultaneously with an already established poly-drug therapy, as typically found in the geriatric patient.

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