Técnicas quirúrgicas en cesárea segmentaria. Revisión de evidencias

Aim: To know which have been the variations of the Pfannenstiel-Kerr technique and how they have influenced maternal morbidity and mortality. Methods: An electronic search was carried out in PubMed, Medline and Cochrane, of works in English and Spanish languages, regardless of the country of origin, preferably randomized and controlled between 2010 and 2020, on variations in the original surgical technique, with emphasis on the differences between the PfannenstielKerr and Miglav-Ladash techniques. Results: The more importants variations regarding morbidity and mortality were: 1. Preferring the transverse skin incision, especially the Joel Cohen type; 2. Lateral blunt dissection of the subcutaneous and cranio-caudal aponeurosis, after its incision; 3. Digital and lateral separation of the rectus abdominis muscles; 4. Digitally and laterally prolong the hysterotomy; 5. Uterine incision closure, without externalizing the uterus, in one or two suture planes, indifferently; 6. Do not suture the visceral and parietal peritoneum or approach the rectus abdominis; 7. Closure of the subcutaneous to separate points, if the thickness is greater than 2 cm. Conclusions: Modifications to the original technique achieved a statistically significant decrease in operative time, the number of sutures, the requirement for analgesics, blood loss, febrile morbidity, as well as operative wound infection and hospital stay. Keywords: Cesarean section, Surgical technique, Pfannenstiel-Kerr, Misgav-Ladach.

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Type 1 Diabetes Mellitus - Risk Factor for Cardiovascular Disease Morbidity and Mortality

Current Diabetes Reviews ◽

10.2174/1573399816666200511004205 ◽

2020 ◽

Vol 17 (1) ◽

pp. 37-54

Author(s):

Tatyana Chalakova ◽

Yoto Yotov ◽

Kaloyan Tzotchev ◽

Sonya Galcheva ◽

Boyan Balev ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Type 1 Diabetes Mellitus ◽

Diabetic Control ◽

Macrovascular Complications ◽

Morbidity And Mortality ◽

Diabetes Mellitus Risk

: Type 1 diabetes mellitus (T1DM) is a chronic disease that starts early in life and often leads to micro- and macrovascular complications. The incidence of the disease is lower than that of type 2 DM and varies in different countries and ethnic groups, and the etiological and pathogenetic factors are different from T2DM. The aim of this overview is to investigate the effect of T1DM on all-cause mortality and CVD morbidity and mortality. During the last decades, the treatment of T1DM has improved the prognosis of the patients. Still, the mortality rates are higher than those of the age- and sex-matched general population. With the prolonged survival, the macrovascular complications and cardiovascular diseases (CVD) appear as major health problems in the management of patients with T1DM. The studies on the CVD morbidity and mortality in this disease group are sparse, but they reveal that T1DM is associated with at least 30% higher mortality. In comparison to healthy people, CVDs are more common in T1DM patients and they occur earlier in life. : Furthermore, they are a major cause for death and impaired quality of life in T1DM patients. The correlation between diabetic control and the duration of T1DM is not always present or is insignificant. Nevertheless, the early detection of the preclinical stages of the diseases and the risk factors for their development is important; similarly, the efforts to improve glycemic and metabolic control are of paramount importance.

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Open and laparoscopic surgeries are associated with comparable 90 day morbidities and mortalities following ERAS protocols- A retrospective Study. (Preprint)

10.2196/preprints.19313 ◽

2020 ◽

Author(s):

BHAVIN VASAVADA ◽

Hardik Patel

Keyword(s):

Multivariate Analysis ◽

Retrospective Study ◽

Mortality Rate ◽

Operative Time ◽

Univariate Analysis ◽

Morbidity And Mortality ◽

Morbidity Rate ◽

Blood Products ◽

Asa Score

UNSTRUCTURED All the gastrointestinal surgeries performed between April 2016 to march 2019 in our institution have been analysed for morbidity and mortality after ERAS protocols and data was collected prospectively. We performed 245 gastrointestinal and hepato-biliary surgeries between April 2016 to march 2019. Mean age of patients was 50.96 years. 135 were open surgeries and 110 were laparoscopic surgeries. Mean ASA score was 2.40, mean operative time was 111 minutes, mean CDC grade of surgery was 2.56. 40 were emergency surgeries and 205 were elective surgeries. Overall 90 days mortality rate was 8.5% and over all morbidity rate was around 9.79% . On univariate analysis morbidity was associated significantly with higher CDC grade of surgeries, higher ASA grade, more operative time, more blood products use, more hospitalstay, open surgeries,HPB surgeries and luminal surgeries(non hpb gastrointestinal surgeries) were associated with higher 90 days morbidity. On multivariate analysis no factors independently predicted morbidity. On univariate analysis 90 days mortality was predicted by grade of surgeries, higher ASA grade, more operative time, more blood products use, open surgeries and emergency surgeries. However on multivariate analysis only more blood products used was independently associated with mortality There is no difference between 90 day mortality and moribidity rates between open and laparoscopic surgeries.

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