scholarly journals AN AUDIT OF HYSTERECTOMIES IN HMC PESHAWAR

1969 ◽  
Vol 4 (1) ◽  
pp. 438-441
Author(s):  
FARZANA NAWAZ
Keyword(s):  
Retrospective Study ◽  
Hospital Stay ◽  
Complication Rate ◽  
Postoperative Hospital Stay ◽  
Vaginal Route

BACKGROUND: An audit of gynecological hysterectomieswas carried out in Gyne C department ofObstetrics & Gynecology Hayatabad Medical Complex Peshawar. Among the patients admitted formajor Gynecological operations, those undergoing hysterectomy were entered in to study programme.This study was carried out to assess the reasons and other related features of patients who underwenthysterectomies in Gyne-C Unit of Hayatabad Medical complex, Peshawar.METHODS: It was retrospective study of hysterectomies at Gyne C unit of Hayatabad MedicalComplex Peshawar, from January 2013 to December 2013. The indications for hysterectomy wereevaluated. Patients were studied and observed preoperatively, during surgery and postoperatively tilltheir stay in hospital. The follow up visit was also recorded with histopathology report after 6 weeksRESULTS: The incidence of hysterectomy among major operations was almost 22%. Ratio ofabdominal to vaginal route was almost 6:1. The complication rate and postoperative hospital stay wasseen more in the former group. Most of the operations were done electively. Majority of indicationswere benign in which surgery could have been avoided reflecting non availability of other effectivemedical treatments.CONCLUSION: There is a need to increase the number of vaginal hysterectomies for better outcomes.But still with all these limitations in our setup hysterectomy proved curative and acceptable form oftherapy to most of the patients.Key Words: Complications, Histopathology, Hysterectomy.

scholarly journals The need for nutritional assessment and interventions based on the prognostic nutritional index for patients with femoral fractures: a retrospective study

2021 ◽  
Author(s):  
Miao He ◽  
Qinghong Fan ◽  
Yuhang Zhu ◽  
Dexing Liu ◽  
Xingxing Liu ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Hospital Stay ◽  
Nutritional Assessment ◽  
Femoral Fractures ◽  
Prognostic Nutritional Index ◽  
Postoperative Hospital Stay ◽  
Adverse Outcomes ◽  
Perioperative Outcomes ◽  
Nutritional Index ◽  
Postoperative Intensive Care

Abstract Background The incidence of adverse perioperative outcomes in surgery for femoral fractures is quite high and is associated with malnutrition. This study aimed to identify independent factors and assess the predictive value of the prognostic nutritional index (PNI) for perioperative adverse outcomes in patients with femoral fractures. Methods This retrospective study included 343 patients who underwent surgery for a single femur fracture. Demographic characteristics, surgery and anaesthesia records, and blood test results at admission, 1 day postoperatively, and before discharge were evaluated using logistic regression analysis. The discriminatory ability of the independent factors was assessed using the receiver operating characteristic curve analysis, and DeLong's test was used to compare the area under the curve (AUC). Results Overall, 159 patients (46.4%) experienced adverse perioperative outcomes. Among these, 123 (35.9%) had lower limb vein thrombus, 68 (19.8%) had hospital-acquired pneumonia, 6 (1.7%) were transferred to the postoperative intensive care unit, 4 (1.2%) had pulmonary embolism, 3 (0.9%) died during hospitalisation, and 9 (2.6%) had other adverse outcomes, including incision disunion, renal and liver function impairment, acute heart failure, acute cerebral infarction, and stress gastroenteritis. The PNI at admission, age, postoperative hospital stay, time to admission, hypertension, combined injures, and surgery type were independent factors for adverse perioperative outcomes. Based on the AUC (PNI at admission: 0.772 (0.723–0.821), P < 0.001; age: 0.678 (0.622–0.734), P < 0.001; postoperative hospital stay: 0.608 (0.548–0.668), P = 0.001; time to admission: 0.585 (0.525–0.646), P = 0.006), the PNI at admission had optimal discrimination ability, indicating its superiority over other independent factors (age vs. PNI at admission, P = 0.002; postoperative hospital stay vs. PNI at admission, P < 0.001; time to admission vs. PNI at admission, P < 0.001). Conclusions Nutritional assessment and appropriate intervention strategies on admission are necessary for patients with femoral fractures, and the PNI at admission may be a good nutritional assessment indicator.

scholarly journals Thirty-Day Postoperative Outcomes Following Sugammadex Use in Colorectal Surgery Patients; Retrospective Study

2019 ◽  
Vol 8 (1) ◽  
pp. 97 ◽  
Author(s):  
Yun Chae ◽  
Han Joe ◽  
Juyeon Oh ◽  
Eunyoung Lee ◽  
In Yi
Keyword(s):  
Retrospective Study ◽  
Colorectal Surgery ◽  
Hospital Stay ◽  
Acetylcholinesterase Inhibitor ◽  
Length Of Hospital Stay ◽  
Postoperative Hospital Stay ◽  
Postoperative Outcomes ◽  
Total Length ◽  
Delayed Discharge ◽  
Postanesthetic Care Unit

Purpose: Sugammadex rapidly reverses muscle relaxation compared to acetylcholinesterase inhibitors. The long-term outcomes of sugammadex, however, are not well known. We compared 30-day postoperative outcomes following sugammadex and acetylcholinesterase inhibitor use in colorectal surgery patients. Patients and methods: Colorectal surgical patients older than 21 were included in this retrospective study, and were dichotomized according to use of reversal agents, sugammadex (group S), and acetylcholinesterase inhibitor (group A). We assessed 30-day postoperative outcomes, including total length of hospital stay, length of postoperative hospital stay, readmission rate, and delayed discharge rate. Additional parameters included postanesthetic care unit stay time, time to first successful oral intake, unforeseen intensive care unit (ICU) admission rate, postoperative pulmonary complications, and mortality. Results: Among a total of 585 patients, 157 patients remained in each group after propensity score matching. Total length of hospital stay, length of postoperative hospital stay, and readmission rates did not differ between the two groups, while the incidence of delayed discharge was significantly lower in group S (23 (15%) vs. 40 (25%), p = 0.017). Other outcomes did not differ between the two groups. Conclusion: We found no difference in 30-day postoperative outcomes following sugammadex and acetylcholinesterase inhibitor use. The only difference between these treatments was the associated incidence of delayed discharge, which was lower in group S.

Endoscopic Carpal Tunnel Release

1997 ◽  
Vol 22 (4) ◽  
pp. 505-507 ◽  
Author(s):  
A. P. ARMSTONG ◽  
J. R. FLYNN ◽  
D. M. DAVIES
Keyword(s):  
Retrospective Study ◽  
Carpal Tunnel ◽  
Complication Rate ◽  
Carpal Tunnel Release ◽  
Endoscopic Release ◽  
Iatrogenic Nerve Injury ◽  
Portal Technique ◽  
Results Of Surgery

We report our experience over a 30 month period of endoscopic release of the carpal tunnel by the Chow two-portal technique. The objective of this retrospective study was to evaluate the long-term subjective results of surgery and to assess if any iatrogenic nerve injury had been caused by the endoscopic procedure. The follow-up period was from 3 to 34 months. Our permanent, iatrogenic, postoperative nerve complication rate was 0.9% (2/208). No other serious complications occurred.

scholarly journals Laparoscopic Radical Antegrade Modular Pancreatosplenectomy: Preliminary Experience with 10 Cases

2021 ◽  
Author(s):  
Renchao Zhang ◽  
Xin-Jun Gan ◽  
Wei Song ◽  
Song-Tao Shi ◽  
Hui-Fang Yu ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Lymph Nodes ◽  
Hospital Stay ◽  
Disease Recurrence ◽  
Postoperative Hospital Stay ◽  
Regional Lymph Nodes ◽  
Patient Demographics ◽  
Radical Antegrade Modular Pancreatosplenectomy ◽  
Distal Pancreas

Abstract BackgroundThe radical antegrade modular pancreatosplenectomy (RAMPS) which is a reasonable surgical approach for left-sided pancreatic cancer is emphasis on the complete resection of regional lymph nodes and tumor-free margin resection. Laparoscopic radical antegrade modular pancreatosplenectomy(LRAMPS) has been rarely performed, with only 49 cases indexed on PubMed. In this study, we present our experience of LRAMPS.Methods: From December 2018 to February 2020, 10 patients underwent LRAMPS for pancreatic cancer at our department. The data of the patient demographics, intraoperative variables , postoperative hospital stay, morbidity, mortality, pathologic findings and follow-up were collected.Results：LRAMPS was performed successfully in all the patients. The median operative time was 235 minutes (range, 212-270min), with an EBL of 120ml(range,100-200ml) . Postoperative complications occurred in 5 (50.0%) patients. Three patients developed a grade B pancreatic fistula. There was no postoperative 30-day mortality and reoperation. The median postoperative hospital stay was 14 days(range,9- 24d).The median count of retrieved lymph nodes was 15 (range, 13–21), and four patients (40%) had malignant-positive lymph nodes. All cases achieved a negative tangential margin and R0 resection.Median follow-up time was 11 months (range, 3–14m). Two patients developed disease recurrence(pancreatic bed recurrence and liver metastasis) 9 months,10 months after surgery,respectively. Others survived without tumor recurrence or metastasis．ConclusionsLRAMPS is technically safe and feasible procedure in well-selected patients with pancreatic cancer in the distal pancreas. The oncologically outcomes need to be further validated based on additional large-volume studies.

scholarly journals Transcatheter and intraoperative device closure of atrial septal defect in infants under three years of age

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Yangyang Han ◽  
Xiquan Zhang ◽  
Fengwei Zhang
Keyword(s):  
Atrial Septal Defect ◽  
Hospital Stay ◽  
Clinical Data ◽  
Septal Defect ◽  
Postoperative Hospital Stay ◽  
Device Closure ◽  
Young Infants ◽  
Group A ◽  
Group B

Abstract Background Transcatheter and intraoperative device closures have been widely used in the treatment of secundum atrial septal defect (ASD). However, for young infants with ASD, device closure remains controversial, and such treatment features limited data. We compared the clinical data and follow-up results of percutaneous and intraoperative device closure for ASD to evaluate the feasibility, safety, and efficacy of both treatments in infants under 3 years of age. Methods From September 2010 to September 2018, 186 children under 3 years of age with significant secundum ASD were included in this study. A total of 88 and 98 patients were divided into groups A (transcatheter device closure) and B (intraoperative device closure), respectively. The clinical data and follow-up results of the two groups were analyzed retrospectively. Result The mean age and weight of patients in group A were significantly higher than those in group B. The proportion of complex ASDs (multiples or rims deficiency) and the device/weight ratio in group B were significantly higher than those in group A. Successful closure was obtained in 86 (97.7%) and 96 (98.0%) infants in groups A and B, respectively, with two failed cases in each group (2.3% vs 2%). The rate of periprocedural complications reached 13.6 and 26.5% for groups A and B (P = 0.058), respectively. The durations of the procedure and postoperative hospital stay in group A were significantly shorter than those in group B (P < 0.05). Excellent follow-up results were observed in both groups. At present, no death nor major complications have occurred. Symptoms either resolved completely or improved significantly for all symptomatic infants. No residual shunts at the 6th month of follow-up evaluation were observed. Patients with failure to thrive gained weight appropriately for age, and the structure and hemodynamic parameters significantly improved during follow-up. Conclusion Transcatheter and intraoperative device closure are feasible, effective, and safe methods for the treatment of ASDs in infants under 3 years of age. Considering improved cosmetic effect and the short duration of the procedure and postoperative hospital stay, transcatheter is preferred for patients with appropriate conditions. Intraoperative device closure can be performed as an alternative to percutaneous closure, particularly for infants with large, complex ASDs, young age, or low-body weight.

Post neoadjuvant chemo-radiation positive anterior circumferential resection margin in carcinoma rectum: Extended resection of rectum versus total pelvic exenteration—Results from a single centre retrospective study.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15156-e15156
Author(s):  
Kamlesh Verma ◽  
Reena Engineer ◽  
Vikas S. Ostwal ◽  
Suman Kumar ◽  
Supreeta Arya ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Hospital Stay ◽  
Circumferential Resection Margin ◽  
Resection Margin ◽  
Pelvic Exenteration ◽  
Total Pelvic Exenteration ◽  
Duration Of Hospital Stay ◽  
Significant Difference ◽  
Carcinoma Rectum

e15156 Background: Positive circumferential resection margin has been shown to be powerful predictor of poor prognosis in rectal CA. Radiologically positive anterior CRM (PACRM) after NACT+RT leads to either resection of involved organ alone ie.Extended resection of rectum (ERR) or Total pelvic exenteration (TPE). Purpose of this study is to compare recurrence rate and survival of patients undergoing ERR or TPE for PACRM after NACT+RT. Methods: Retrospective study of patients operated for rectal CA from January 2013 to December 2014. Results: Out of 237 patients with non-metastatic CA rectum, 51 patients (21.5%) had PACRM. After NACT+RT, 22 patients (43.1%) developed systemic metastases, 7 patients (13.8%) were downsized and underwent extra-mesorectal resection (AR/APR), remaining 22 patients (43.1%) had persistent PACRM. 13 patients with PACRM underwent ERR whereas 9 patients underwent TPE. Median duration of hospital stay in TPE group was 13 days (10 - 26) whereas it was 7 days (5 – 21) in ERR group. Negative pathological CRM was achieved in all TPE and 92.3% of ERR patients. After median follow-up of 31.6 months, 5 patients with TPE (55.6%) and 4 patients with ERR (30.7%) developed systemic recurrence. None of the TPE patient, whereas 3 patients with ERR (23.1%) developed local recurrence. Median D.F.S. was 12.3 months in TPE and 18.9 months in ERR whereas mean O.S. was 36.2 and 32.8 respectively. Conclusions: Due to lack of significant difference in O.S./ D.F.S. and low post-operative complication and duration of hospital stay, ERR can be considered acceptable alternative to TPE.

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 Posterior thoracic corpectomy with cage reconstruction for metastatic spinal tumors: comparing the mini-open approach to the open approach

2015 ◽  
Vol 23 (2) ◽  
pp. 217-227 ◽  
Author(s):  
Darryl Lau ◽  
Dean Chou
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Complication Rate ◽  
Open Surgery ◽  
Operative Time ◽  
Spinal Metastases ◽  
Open Group ◽  
Open Approach ◽  
Mini Open

OBJECT Spinal metastases most commonly affect the vertebral bodies of the spinal column, and spinal cord compression is an indication for surgery. Commonly, an open posterior approach is employed to perform a transpedicular costotransversectomy or lateral extracavitary corpectomy. Because of the short life expectancies in patients with metastatic spinal disease, decreasing the morbidity of surgical treatment and recovery time is critical. One potential approach to decreasing morbidity is utilizing minimally invasive surgery (MIS). Although significant advances have been made in MIS of the spine, data supporting the utility of MIS are still emerging. This study compared outcomes of patients who underwent mini-open versus traditional open transpedicular corpectomy for spinal metastases in the thoracic spine. METHODS A consecutive cohort from 2006 to 2013 of 49 adult patients who underwent thoracic transpedicular corpectomies for spinal metastases was retrospectively identified. Patients were categorized into one of 2 groups: open surgery and mini-open surgery. Mini-open transpedicular corpectomy was performed with a midline facial incision over only the corpectomy level of interest and percutaneous instrumentation above and below that level. The open procedure consisted of a traditional posterior transpedicular corpectomy. Chi-square test, 2-tailed t-test, and ANOVA models were employed to compare perioperative and follow-up outcomes between the 2 groups. RESULTS In the analysis, there were 21 patients who had mini-open surgery and 28 patients who had open surgery. The mean age was 57.9 years, and 59.2% were male. The tumor types encountered were lung (18.3%), renal/bladder (16.3%), breast (14.3%), hematological (14.3%), gastrointestinal tract (10.2%), prostate (8.2%), melanoma (4.1%), and other/unknown (14.3%). There were no significant intergroup differences in demographics, comorbidities, neurological status (American Spinal Injury Association [ASIA] grade), number of corpectomies performed, and number of levels instrumented. The open group had a mean operative time of 413.6 minutes, and the mini-open group had a mean operative time of 452.4 minutes (p = 0.329). Compared with the open group, the mini-open group had significantly less blood loss (917.7 ml vs 1697.3 ml, p = 0.019) and a significantly shorter hospital stay (7.4 days vs 11.4 days, p = 0.001). There was a trend toward a lower perioperative complication rate in the mini-open group (9.5%) compared with the open group (21.4%), but this was not statistically significant (p = 0.265). At follow-up, there were no significant differences in ASIA grade (p = 0.342), complication rate after the 30-day postoperative period (p = 0.999), or need for surgical revision (p = 0.803). The open approach had a higher overall infection rate of 17.9% compared with that in the mini-open approach of 9.5%, but this was not statistically significant (p = 0.409). CONCLUSIONS The mini-open transpedicular corpectomy is associated with less blood loss and shorter hospital stay compared with open transpedicular corpectomy. The mini-open corpectomy also trended toward lower infection and complication rates, but these did not reach statistical significance.

scholarly journals The need for nutritional assessment and interventions based on the prognostic nutritional index for patients with femoral fractures: a retrospective study

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Miao He ◽  
Qinghong Fan ◽  
Yuhang Zhu ◽  
Dexing Liu ◽  
Xingxing Liu ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Hospital Stay ◽  
Nutritional Assessment ◽  
Femoral Fractures ◽  
Prognostic Nutritional Index ◽  
Postoperative Hospital Stay ◽  
Adverse Outcomes ◽  
Perioperative Outcomes ◽  
Nutritional Index ◽  
Postoperative Intensive Care

Abstract Background The incidence of adverse perioperative outcomes in surgery for femoral fractures is high and associated with malnutrition. Here, we identified independent factors and assessed the predictive value of the prognostic nutritional index (PNI) for perioperative adverse outcomes in patients with femoral fractures. Methods This retrospective study included 343 patients who underwent surgery for a single femur fracture. Demographic characteristics, surgery and anaesthesia records and blood test results at admission, 1 day postoperatively and before discharge were evaluated using logistic regression analysis. The discriminatory ability of the independent factors was assessed using the receiver operating characteristic curve analysis, and DeLong’s test was used to compare the area under the curve (AUC). Results Overall, 159 patients (46.4%) experienced adverse perioperative outcomes. Amongst these, 123 (35.9%) had lower limb vein thrombus, 68 (19.8%) had hospital-acquired pneumonia, 6 (1.7%) were transferred to the postoperative intensive care unit, 4 (1.2%) had pulmonary embolism, 3 (0.9%) died during hospitalisation and 9 (2.6%) had other adverse outcomes, including incision disunion, renal and liver function impairment, acute heart failure, acute cerebral infarction and stress gastroenteritis. The PNI at admission, age, postoperative hospital stay, time to admission, hypertension, combined injures and surgery type were independent factors for adverse perioperative outcomes. Based on the AUC (PNI at admission: 0.772 [0.723–0.821], P < 0.001; age: 0.678 [0.622–0.734], P < 0.001; postoperative hospital stay: 0.608 [0.548–0.668], P = 0.001; time to admission: 0.585 [0.525–0.646], P = 0.006), the PNI at admission had optimal discrimination ability, indicating its superiority over other independent factors (age vs. PNI at admission, P = 0.002; postoperative hospital stay vs. PNI at admission, P < 0.001; time to admission vs. PNI at admission, P < 0.001). Conclusions Patients with femoral fractures require a nutritional assessment and appropriate nutritional intervention at admission, and that the PNI value at admission may be a good nutritional assessment indicator.

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