Laparoscopic or classic splenectomy?

2021 ◽  
Vol 75 (2) ◽  
pp. 134-137
Author(s):  
Aleš Zatloukal ◽  
Anton Pelikán ◽  
Peter Ihnát
Keyword(s):  
Hospital Stay ◽  
Laparoscopic Splenectomy ◽  
Operative Time ◽  
Operation Time ◽  
University Hospital ◽  
Duration Of Hospital Stay ◽  
Laparoscopic Operation ◽  
Open Operation ◽  
Laparotomy Group ◽  
Invasive Techniques

Introduction: With current development of mini-invasive techniques, laparoscopic splenectomy also gained its place under the sun. The goal of this study is to compare the results of open and laparoscopic splenectomy performed at Clinic of Surgery of University Hospital Ostrava in the period 2010–2019. Materials and Methods: A retrospective cohort study during the period 2010–2019 were counted: an operation time, a need of blood transfusions, weight, complications and duration of hospital stay. A group of patients with laparoscopic operation was compared to a group with an open operation, using the t-test. Results: During the period 2010–2019, we performed 23 laparoscopic splenectomies and 15 classic operations. Unfortunately, the comparison of both groups is difficult. The splenic weight differs in both groups statistically significantly (P = 0.0001). The patients in the classic laparotomy group had much bigger spleens and in four cases, the splenectomy was performed together with metastasectomy of the liver, diaphragmatic resection and resection of the tale of pancreas. Even then the operative time was significantly shorter than the operative time of laparoscopic operation – the operative times differ in both groups statistically significantly (P = 0.0001). The need of blood transfusion and operative complications appear to be comparable in both techniques. The duration of hospital stay was shorter in the patients with laparoscopic operation. Conclusion: Laparoscopic splenectomy off ers all the general benefi ts of mini-invasive operative techniques and is suitable method for patients undergoing elective splenectomy especially for spleens smaller than 20 cm in diameter. We consider portal hypertension and severe comorbidities of the patient to be a contraindication. It seems to us that the main problem of this method lies in a very small number of operated patients and thus in a limited possibility to obtain sufficient surgical erudition, which is probably the case of some complications and insufficient use of this method in practice. It is highly desirable to concentrate these services in the centers.

scholarly journals Laser Hemorrhoidoplasty: Experience at Aga Khan University Hospital

2020 ◽  
Vol 17 (2) ◽  
pp. 76-79
Author(s):  
Abdallah Abdulkarim ◽  
Brian Misoi ◽  
Daniel Gathege
Keyword(s):  
Hospital Stay ◽  
Pain Score ◽  
Operative Time ◽  
Treatment Options ◽  
University Hospital ◽  
Open Group ◽  
Interventional Treatment ◽  
Cross Sectional ◽  
Duration Of Hospital Stay ◽  
Open Hemorrhoidectomy

Background: Hemorrhoidal disease is the commonest benign anal condition diagnosed in the outpatient setup. Interventional treatment options range widely, from office-based procedures to hemorrhoidectomy. Laser technology increasingly is in use in the field of proctology. We present our index clinical outcomes following laser haemorrhoidoplasty (LHP). Methodology: Retrospective cross-sectional study of 21 consecutive patients who underwent LHP between 2015 and 2018 under a single surgeon. Their outcomes were compared with a group of patients who underwent the standard open hemorrhoidectomy over the same period of time. Results: Postoperatively, 85.7% of patients post-LHP had a better pain score (mild) compared with 66.7% in the open hemorrhoidectomy group. The mean operative time in minutes was shorter for LHP, 29.67±17.50 versus 39.20±20.77 in the open group. Duration of hospital stay in days between the two groups were similar; LHP group median=1(1–3), open group median =1(1–3). Rates of infection, recurrence and urinary complications were however higher in the laser group, 4.8%, 9.5% and 9.5% respectively compared with the open hemorrhoidectomy group that were 0%, 6.7% and 6.7 % respectively. Both groups had no reported cases of stool or flatus incontinence. Conclusion: Laser haemorrhoidoplasty is associated with reduced pain scores and shorter operative time than open hemorrhoidectomy. Duration of hospital stay was similar in both groups. The rate of complications was high in the study group. Keywords: Laser haemorrhoidoplasty, Pain score, Complications, Open hemorrhoidectomy

scholarly journals Laparoscopic splenectomy: a personal series of 140 consecutive cases

2010 ◽  
Vol 92 (5) ◽  
pp. 398-402 ◽  
Author(s):  
Clare J Pattenden ◽  
Christopher D Mann ◽  
Matthew S Metcalfe ◽  
Martin Dyer ◽  
David M Lloyd
Keyword(s):  
Laparoscopic Splenectomy ◽  
Operative Time ◽  
Laparoscopic Approach ◽  
University Hospital ◽  
Safe Procedure ◽  
Median Hospital Stay ◽  
Open Procedure ◽  
Open Operation ◽  
Hand Assistance ◽  
Complications And Mortality

Laparoscopic splenectomy has emerged as a safe and effective treatment for a variety of haematological conditions. The objective was to review the results from a large personal series from the perspective of outcomes according to operative time, conversion to open operation, complications and mortality. The application of laparoscopic splenectomy to cases of splenomegaly without hand assistance is examined. A retrospective review of 140 patients undergoing laparoscopic splenectomy at a single university hospital by one surgeon during 1994-2006. Case notes were reviewed and data collected on operative time, conversion to open procedure, morbidity and mortality. Particular reference was made towards the results of cases of splenomegaly. In total 140 laparoscopic splenectomies were performed with a complication rate of 15% and no mortality. The median operative time was 100 min and conversion to open procedure was necessary in 2.1%. Conversion for cases of splenomegaly was only 5.7%. The median hospital stay was 3 days. Laparoscopic splenectomy is a safe procedure with acceptable morbidity. A laparoscopic approach for splenomegaly is feasible.

EVALUATION OF LONGO’S HEMORRHOIDECTOMY AT HUE UNIVERSITY HOSPITAL

2012 ◽  
pp. 79-85
Author(s):  
Van Lieu Nguyen ◽  
Doan Van Phu Nguyen ◽  
Thanh Phuc Nguyen
Keyword(s):  
Hospital Stay ◽  
Perioperative Complications ◽  
University Hospital ◽  
Anal Pain ◽  
Stapled Hemorrhoidectomy ◽  
Fourth Degree ◽  
Duration Of Hospital Stay ◽  
The Mean ◽  
Good For

Introduction: Since Longo First described it in 1998, Stapled Hemorrhoidectomy has been emerging as the procedure of choice for symtomatic hemorrhoid. Several studies have shown it to be a safe, effective and relative complication free procedure. The aim of this study was to determine the suitability of (SH) as a day cas procedure at Hue University Hospital. Methods: From Decembre 2009 to April 2012, 384 patients with third- degree and fourth-degree hemorrhoids who underwent Stapled Hemorrhoidectomy were included in this study. Parameters recorded included postoperative complications, analegic requirements, duration of hospital stay and patient satisfaction. Follow-up was performed at 1 month and 3 months post-operative. Results: Of the 384 patients that underwent a Stapled Hemorrhoidectomy 252 (65,7%) were male and 132 (34,3%) were female. The mean age was 47,5 years (range 17-76 years. Duration of hospital stay: The mean day was 2,82 ± 1,15 days (range 1-6 days). There were no perioperative complications. There was one case postoperative complication: hemorrhage; Follow-up after surgery: 286 (74,4%) patients had less anal pain, 78 (20,3%) patients had moderate anal pain, 3 (0,8%) patients had urinary retention; Follow-up after one month: good for 325 (84,6%) patients, average for 59 (15,4%) patients; Follow-up after three months: good for 362 (94,3%) patients, average for 22 (5,7%) patients. Conclusion: Our present study shows that Stapled Hemorrhoidectomy is a safe, reduced postoperative pain, shorter hospital stay and a faster return to unrestricted daily activity

scholarly journals Effects of the COVID-19 Pandemic on the Epidemiology of Knee and Shoulder Arthroscopy

2021 ◽  
Vol 58 ◽  
pp. 004695802110560
Author(s):  
Krystian Kazubski ◽  
Łukasz Tomczyk ◽  
Piotr Morasiewicz
Keyword(s):  
Hospital Stay ◽  
Shoulder Arthroscopy ◽  
Demographic Data ◽  
Epidemiological Data ◽  
University Hospital ◽  
Female Ratio ◽  
Duration Of Hospital Stay ◽  
The Mean ◽  
Orthopedic Patients ◽  
Male To Female

The purpose of our study was to comprehensively assess the effect of the COVID-19 pandemic on knee and shoulder arthroscopy performed in an orthopedic department of a university hospital in Poland. This study compared the data on all shoulder and knee arthroscopy procedures performed in two different periods: The period of the COVID-19 pandemic in Poland (from March 4, 2020, to October 15, 2020) and the corresponding period prior to the pandemic (March 4, 2019, to October 15, 2019). The study evaluated epidemiological data, demographic data, and hospital stay duration. The total number of arthroscopy procedures conducted in the evaluated period in 2020 was approximately 8.6% higher than that in the corresponding 2019 period. The mean duration of hospital stay for orthopedic patients after their knee or shoulder arthroscopy was 3.1 days in 2020 and 2.8 days in 2019. Our study revealed the mean age of arthroscopy patients during the pandemic to be lower at 48.4 years than the 51.2 years recorded in 2019. The male-to-female ratio was shown to be lower at .85 during the pandemic, having decreased from 1.5 in 2019. The COVID-19 pandemic did not reduce the number of arthroscopy performed at our center, and the mean age of the patients did not change. However, the pandemic had a marked effect on the mean duration of hospital stay and male-to-female ratio.

scholarly journals Erratum to: Duration of Hospital Stay Following Orthognathic Surgery at the Jordan University Hospital

2014 ◽  
Vol 14 (2) ◽  
pp. 518-518
Author(s):  
Fadi Jarab ◽  
Esam Omar ◽  
Ahmed Bhayat ◽  
Samir Mansuri ◽  
Sami Ahmed ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Orthognathic Surgery ◽  
University Hospital ◽  
Duration Of Hospital Stay

scholarly journals Nighttime Appendectomy is Safe and has Similar Outcomes as Daytime Appendectomy: A Study of 1198 Appendectomies

2020 ◽  
pp. 145749692093860
Author(s):  
T. Mönttinen ◽  
H. Kangaspunta ◽  
J. Laukkarinen ◽  
M. Ukkonen
Keyword(s):  
Acute Appendicitis ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Operation Time ◽  
Time Of Day ◽  
University Hospital ◽  
Patient Comfort ◽  
Intraoperative Bleeding ◽  
Significant Difference ◽  
Clinically Significant

Introduction: Although it is controversial whether appendectomy can be safely delayed, it is often unnecessary to postpone operation as a shorter delay may increase patient comfort, enables quicker recovery, and decreases costs. In this study, we sought to study whether the time of day influences the outcomes among patients operated on for acute appendicitis. Materials and Methods: Consecutive patients undergoing appendectomy at Tampere University Hospital between 1 September 2014 and 30 April 2017 for acute appendicitis were included. Primary outcome measures were postoperative morbidity, mortality, length of hospital stay, and amount of intraoperative bleeding. Appendectomies were divided into daytime and nighttime operations. Results: A total of 1198 patients underwent appendectomy, of which 65% were operated during daytime and 35% during nighttime. Patient and disease-related characteristics were similar in both groups. The overall morbidity and mortality rates were 4.8% and 0.2%, respectively. No time categories were associated with risk of complications or complication severity. Neither was there difference in operation time and clinically significant difference in intraoperative bleeding. Patients undergoing surgery during night hours had a shorter hospital stay. In multivariate analysis, only complicated appendicitis was associated with worse outcomes. Discussion: We have shown that nighttime appendectomy is associated with similar outcomes than daytime appendectomy. Subsequently, appendectomy should be planned for the next available slot, minimizing delay whenever possible.

scholarly journals Duration of Hospital Stay Following Orthognathic Surgery at the Jordan University Hospital

2011 ◽  
Vol 11 (3) ◽  
pp. 314-318 ◽  
Author(s):  
Fadi Jarab ◽  
Esam Omar ◽  
Ahmed Bhayat ◽  
Samir Mansuri ◽  
Sami Ahmed
Keyword(s):  
Hospital Stay ◽  
Orthognathic Surgery ◽  
University Hospital ◽  
Duration Of Hospital Stay

scholarly journals A Comparison of Antegrade Percutaneous and Laparoscopic Approaches in the Treatment of Proximal Ureteral Stones

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Hikmet Topaloglu ◽  
Nihat Karakoyunlu ◽  
Sercan Sari ◽  
Hakki Ugur Ozok ◽  
Levent Sagnak ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Operation Time ◽  
Ureteral Stones ◽  
Surgical Equipment ◽  
Duration Of Hospital Stay ◽  
Stone Free Rate ◽  
Surgical Expertise ◽  
Significant Difference ◽  
History Of ◽  
Retroperitoneal Laparoscopic Ureterolithotomy

Purpose. To compare the effectiveness and safety of retroperitoneal laparoscopic ureterolithotomy (RLU) and percutaneous antegrade ureteroscopy (PAU) in which we use semirigid ureteroscopy in the treatment of proximal ureteral stones.Methods. Fifty-eight patients with large, impacted stones who had a history of failed shock wave lithotripsy (SWL) and, retrograde ureterorenoscopy (URS) were included in the study between April 2007 and April 2014. Thirty-seven PAU and twenty-one RLU procedures were applied. Stone-free rates, operation times, duration of hospital stay, and follow-up duration were analyzed.Results. Overall stone-free rate was 100% for both groups. There was no significant difference between both groups with respect to postoperative duration of hospital stay and urinary leakage of more than 2 days. PAU group had a greater amount of blood loss (mean hemoglobin drops for PAU group and RLU group were 1.6 ± 1.1 g/dL versus 0.5 ± 0.3 g/dL, resp.;P=0.022). RLU group had longer operation time (for PAU group and RLU group 80.1 ± 44.6 min versus 102.1 ± 45.5 min, resp.;P=0.039).Conclusions. Both PAU and RLU appear to be comparable in the treatment of proximal ureteral stones when the history is notable for a failed retrograde approach or SWL. The decision should be based on surgical expertise and availability of surgical equipment.

scholarly journals A comparative study of two operative procedures in anterior hypospadias repair: limited urethral mobilization and tubularized incised plate urethroplasty.

2021 ◽  
Vol 28 (11) ◽  
pp. 1578-1584
Author(s):  
Shafiq ur Rehman ◽  
Fareena Ishtiaq ◽  
Zarlish Fazal ◽  
Muhammad Anwar ◽  
Saad Fazal
Keyword(s):  
Hospital Stay ◽  
Functional Outcomes ◽  
Operative Time ◽  
Operation Time ◽  
Cosmetic Appearance ◽  
Tubularized Incised Plate ◽  
Group A ◽  
Tubularized Incised Plate Urethroplasty ◽  
The Mean ◽  
Group B

Objectives: This study is aimed to compare the results of limited urethral mobilization and tubularized incised plate urethroplasty in the management of anterior hypospadias, in terms of cosmetic and functional outcomes, complication rate, operative time, and hospital stay. Study Design: Prospective Randomized Controlled study. Settings: Department of Pediatric Surgery, DHQ Teaching Hospital Sahiwal. Period: January 2019 to December 2020. Material and Methods: A total of 89 patients with anterior hypospadias were included. Patients were divided randomly into two groups. In group A, limited urethral mobilization was performed and in group B, tubularized incised plate urethroplasty was carried out. A self-structured performa was used to collect the data of all patients. Both groups were compared in terms of the operation time, hospital stay, postoperative complications, cosmetic appearance, and functional outcomes. Results: Forty-five patients were included in group A, age ranged from 2.5 to 12 years (mean 4.83years). Forty-four patients were included in group B and their ages ranged from 3.5 to 11years (mean 4.76 years). The operation time was significantly less for group A than for group B. In group A, it ranged from 54 to 69 min with an average time of 60.51 min and in group B from 70 to 88 min, with an average of 79.34 min. The mean hospital stay period in group A was 7.37 days, ranged from 7 to 9 days, and in group B was 11.04 days, ranging from 10 to 13 days. The mean follow-up period in both groups was 7.45 months, ranging from 3 months to 12 months. Meatal stenosis was the most common complication in group A, which developed in 6.66% (n=3) patients. Urethrocutaneous fistula was the most common complication in group B, which developed in 6.81% (n=3) patients. Cosmetic appearance and functional outcome were good and comparable in both groups. Conclusion: Although both techniques, tubularized incised plate and limited urethral mobilization urethroplasty are acceptable modalities for the management of anterior hypospadias. But limited urethral mobilization urethroplasty seems to be a good option due to its simplicity, short hospital stay, significant shorter operative time, low fistula formation rate, and good cosmetic and functional outcomes.

scholarly journals Full-Endoscopic Transforaminal Ventral Decompression for Symptomatic Thoracic Disc Herniation with or without Calcification: Technical Notes and Case Series

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Shangju Gao ◽  
Jingchao Wei ◽  
Wenyi Li ◽  
Long Zhang ◽  
Can Cao ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Clinical Outcomes ◽  
Disc Herniation ◽  
Average Length ◽  
Case Series ◽  
Operation Time ◽  
Leg Pain ◽  
Thoracic Disc Herniation ◽  
Open Operation ◽  
Thoracic Disc

Background. Symptomatic thoracic disc herniation is a challenge in spinal surgery, especially for cases with calcification. Traditional open operation has a high complication rate. The authors introduced a modified full-endoscopic transforaminal ventral decompression technique in this study and evaluated its imaging and clinical outcomes. Materials and Methods. Eleven patients with symptomatic thoracic disc herniation who underwent full-endoscopic transforaminal ventral decompression in a single medical center were enrolled. The surgical technique was performed as described in detail. Dilator sliding punching, endoscope-monitored foraminoplasty, and base cutting through the “safe triangle zone” are the key points of the technique. Clinical outcomes were assessed by the modified Japanese Orthopedic Association (mJOA) score for neurological improvement and the visual analogy score (VAS) for thoracic and leg pain. The operation time, hospital stay, and complications were also analyzed. Results. Postoperative magnetic resonance imaging (MRI) revealed good decompression of the spinal cord. The mJOA improved from 7.4 (range: 5–10) to 10.2 (range: 9–11). Axial thoracic pain improved in 8 of 9 patients. Leg pain and thoracic radicular pain improved in all patients. No complications were observed. The average operation time was 136 minutes (range: 70–180 minutes). The average length of hospital stay was 5.3 days (range: 2–8 days). Conclusion. Minimally invasive full-endoscopic transforaminal ventral decompression for the treatment of symptomatic thoracic disc herniation with or without calcification is feasible and may be another option for this challenging spine disease.

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