scholarly journals Experience of Maharaj Nakorn Chiang Mai Hospital in extravesical ureteral reimplantation for vesicoureteral reflux in pediatric patients

2021 ◽  
Vol 42 (2) ◽  
pp. 90-96
Author(s):  
Wittawat Rawiyotai ◽  
◽  
Phitsanu Mahawong ◽  
Wilaiwan Chongruksut ◽  
◽  
...  
Keyword(s):  
Hospital Stay ◽  
Urinary Retention ◽  
Vesicoureteral Reflux ◽  
Pediatric Patients ◽  
Operative Time ◽  
Postoperative Hospital Stay ◽  
Ureteral Reimplantation ◽  
Chiang Mai ◽  
Time Duration ◽  
Estimated Blood Loss

Objective: The most commonly used technique for vesicoureteral reflux (VUR) treatment in pediatric patients in Maharaj Nakorn Chiang Mai Hospital is extravesical ureteral reimplantation (EUR). This report describes our experience of clinical outcomes of this technique. Materials and Methods: A total of 30 children underwent EUR for unilateral and bilateral VUR between July 2007 and June 2015. We retrospectively reviewed their medical records. Patient characteristics, operative time, duration of catheter drainage, length of postoperative hospital stay, and perioperative complications were evaluated. Results: Twenty-two boys and 8 girls with a mean age of 4.4 years (range, 0.5-14.6) were included in the study. Reflux was graded 1 to 5. Fourteen unilateral and 16 bilateral procedures were performed. A Pfannenstiel incision was implemented in the first 20 cases and inguinal incision in the last 10 cases. Mean operative time was 115.5 minutes. Mean duration of catheter insertion was 5.7 days. Mean length of postoperative hospital stay was 6.1 days and mean estimated blood loss was 28.7 ml. Overall success rate was 90%. One patient (3.3%), developed a post- operative urinary tract infection, while 3 cases had persistent VUR after surgery. Acute urinary retention occurred in 1 patient (3.3%) on postoperative day 4 but following catheterization the patient was able to urinate by day 7. Conclusion: EUR for the treatment of VUR is a simple, safe, and effective procedure. The prevalence of postoperative urinary retention in bilateral reimplantation is low and transient. The inguinal approach is a viable option and as effective as classical procedures.

scholarly journals Surgical strategy of empyema thoracis in children: open thoracotomy v/s video assisted thoracoscopy

2018 ◽  
Vol 5 (12) ◽  
pp. 3823
Author(s):  
Pranav Jadhav ◽  
Sanjay Raut ◽  
Manish Kumar Kashyap ◽  
Riddhi Ajay Bora
Keyword(s):  
Hospital Stay ◽  
Operative Time ◽  
Statistical Significance ◽  
Postoperative Hospital Stay ◽  
Empyema Thoracis ◽  
Open Thoracotomy ◽  
Appropriate Treatment ◽  
Estimated Blood Loss ◽  
Number Of Patients ◽  
Prolonged Air Leak

Background: Empyema is the suppuration within the pleural cavity, most commonly a complication of acute bacterial pneumonia. It is one of the most common diseases in children in India. Prognosis is excellent, provided appropriate treatment is administered early in the course of the disease.Methods: This study examines treatment of complex empyema thoracis between June 1, 2016, and April 30, 2018. Total number of patients were 30 cases in open thoracotomy and 30 in VATS in treatment of their disease. Effusion etiology was distributed as follows: infectious, neoplastic-associated, traumatic.Results: A total of 30 patients underwent VATS debridement and open thoracotomy for treatment of empyema thoracis. The median postoperative hospital stay was 10.31±3.751 days in case of VATS and 4.41±1.593 days in case of open thoracotomy. Median estimated blood loss in case of VATS was 78±15.634 ml and in case of open thoracotomy was 15.97±5.871 ml. Mean operative time was 82.86±17.293 minutes in case VATS and 77.59±13.38 minutes in case of open thoracotomy.Conclusions: VATS might be comparable or even better than open thoracotomy in terms of operative time, postoperative hospital stay, chest tube duration, prolonged air leak rate, morbidity and mortality. But referring to the relapse rate, there was no statistical significance.

scholarly journals Comparison of Cohen and Lich-Gregoir ureteral reimplantation in the surgical management of primary unilateral vesicoureteral reflux in children

2020 ◽  
Vol 66 (4) ◽  
pp. 424-429
Author(s):  
Cemil Aydin ◽  
Ali Akkoc ◽  
Ramazan Topaktas ◽  
Aykut Bugra Senturk ◽  
Zeynep Banu Aydin ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Vesicoureteral Reflux ◽  
Operative Time ◽  
Significant Risk ◽  
Operation Time ◽  
Ureteral Reimplantation ◽  
Macroscopic Hematuria ◽  
Group A ◽  
The Mean ◽  
Group B

SUMMARY OBJECTIVE Vesicoureteral reflux (VUR) represents one of the most significant risk factors for acute pyelonephritis in children. Various intravesical and extravesical techniques have been described for the surgical correction of VUR. The aim of our study was to compare the results of open intravesical and extravesical procedures for unilateral primary VUR in children. METHODS Between January 2012 and August 2018, 38 children with primary VUR who underwent open ureteral reimplantation surgery were retrospectively reviewed. The Cohen (intravesical) and the Lich-Gregoir (extravesical) approach were grouped as groups A and B, respectively. The groups were compared for age, gender, preoperative reflux grade, presence of lower urinary tract symptoms, operation time, discomfort and pain, analgesic requirements, duration of hematuria, postoperative complications, and hospital stay. All the parameters were statistically compared. RESULTS There were 38 patients in this study. Group A had 18 patients, and group B had 20 patients. The mean operative time was significantly shorter in group B than in group A. The mean hospital stay was also shorter in group B. The urethral foley stay period was 4.7±0.9 days 2±0 days (p = 0.000*), respectively, for group A and B. Macroscopic hematuria was seen in group A. The objective pain scale was worse after intravesical surgery. Analgesic requirements were higher in group A (p =0.131). CONCLUSION Intravesical and extravesical ureteroneocystostomy methods are equally successful and feasible in the treatment of primary unilateral VUR. The Cohen technique is associated with a longer and more painful hospital stay, gross hematuria, and longer operative time, compared to the Lich-Gregoir technique.

Hand-assisted Laparoscopic Spleen-preserving Total Gastrectomy for Gastric Cancer: Technical Feasibility and Early Results

2013 ◽  
Vol 79 (4) ◽  
pp. 407-413
Author(s):  
Guang-Tan Zhang ◽  
Xue-Dong Zhang
Keyword(s):  
Gastric Cancer ◽  
Blood Loss ◽  
Lymph Nodes ◽  
Hospital Stay ◽  
Operative Time ◽  
Postoperative Hospital Stay ◽  
Injection Time ◽  
Spleen Preserving ◽  
Estimated Blood Loss ◽  
Method Group

To evaluate the feasibility and safety of hand-assisted laparoscopic spleen-preserving total gas-trectomy for gastric cancer, we compared the operative outcomes between two methods for dissection of lymph nodes along the distal splenic artery (No. 11d) and at the splenic hilum (No. 10). Sixty-four patients with proximal or total gastric cancer operated on in our department from October 2009 to February 2012 were divided into two groups: the extracorporeal method group (EMG) and the intracorporeal method group (IMG). Operative time, estimated blood loss, number of lymph node retrieval, times of analgesic injection, time to the first flatus, and postoperative hospital stay were compared between the two groups. Estimated blood loss, times of analgesic injection, time to the first flatus, and postoperative hospital stay were equivalent between the two groups. The operative time was significantly shorter in the IMG than the EMG. There were no significant differences in tumor size, retrieved lymph nodes, American Joint Committee on Cancer/Union for International Cancer Control staging, or resection margins between the two groups. Hand-assisted laparoscopic spleen-preserving total gastrectomy is technically feasible and safe and allows for adequate lymphadenectomy.

scholarly journals Comparison of single-layered continuous and interrupted gastrointestinal anastomosis in pediatric patients

2019 ◽  
Author(s):  
Qianyang Liu ◽  
Ping Li ◽  
Chunbao Guo
Keyword(s):  
Hospital Stay ◽  
Pediatric Patients ◽  
Operative Time ◽  
Intestinal Anastomosis ◽  
Single Layer ◽  
Postoperative Recovery ◽  
Postoperative Hospital Stay ◽  
C Reactive Protein ◽  
Beneficial Effects ◽  
Reactive Protein

Abstract Background Optimal gastrointestinal construction in pediatric patients still exist controversy as to the technique for the anastomosis. The study was to investigate the advantage of single-layered continuous anastomosis for pediatric patients who underwent intestinal anastomosis on emergency or electively laparotomy. Methods The medical records of 252 patients with single-layered continuous anastomosis and 196 patients with two-layered interrupted anastomosis, served as control, were reviewed retrospectively. Clinical outcomes, including postoperative complications, overall expenditure, postoperative hospital stay and anastomotic leakage, were compared according to the single-layered or two-layered anastomosis. Results Single-layered continuous anastomosis was associated with advantageous postoperative outcomes, including anastomotic time (p<0.001), operative time (p=0.041) and overall expenditure (p=0.009). A reduction trend for postoperative hospital stay was indicated in patients receiving single-layer anastomoses (p= 0.09). There was also an decreased of inflammation variables, C-reactive protein [CRP]) at postoperative days (POD) 5 ( p = 0.032) in the single-layer anastomoses patients. There were no differences for the other main complications. Conclusions Beneficial effects of single-layered continuous anastomosis in terms of anastomotic time, faster postoperative recovery and cost incurred in pediatric patients were demonstrated.

A comparative study between continuous and interrupted sutures in open pyeloplasty

2021 ◽  
pp. 039156032110151
Author(s):  
Sandeep Gupta ◽  
Ankit Verma ◽  
Dilip Kumar Pal
Keyword(s):  
Comparative Study ◽  
Hospital Stay ◽  
Operative Time ◽  
Postoperative Hospital Stay ◽  
Continuous Group ◽  
Care Hospital ◽  
Time Duration ◽  
Group A ◽  
Group B ◽  
Operative Drainage

Background: Pelvi-ureteric junction obstruction (PUJO) is one of the common causes of obstructive uropathy dealt by urologists around the globe. The management of PUJO requires surgical intervention and pelvi-ureteral anastomosis is most time-consuming step in surgery and suturing plays a critical role for the good outcome of the surgery. Objective: To assess the outcomes of continuous or interrupted suturing in open pyeloplasties done for PUJ obstruction. Materials and methods: This comparative study was conducted in the department of Urology in a tertiary care hospital of eastern India. A total of 60 patients with pelviureteric junction obstruction were included as per inclusion and exclusion criteria and divided into two groups depending upon whether continuous (Group A) or interrupted (Group B) suturing was done. Both groups were compared for mean operative time, mean suturing time, duration of post-operative drainage, mean drain output, post-operative hospital stay, postoperative GFR and improvement in GFR. Results: Out of 60 patients continuous and interrupted suturing was done in 30 patients in both arms. Out of 60 cases there were 46 (76.66%) males and 14 (23.33%) females with a M:F ratio of 1:0.30. The mean age in group A and group B was found to be 30.06 ± 8.28 and 27.63 ± 6.07, respectively. Mean operative time, mean suturing time, duration of post-operative drainage, mean drain output and postoperative hospital stay were found to be higher in interrupted suture group and the difference was found to be statistically highly significant ( p < 0.0001). The complication rates and recurrence rates were found comparable in both the cases with no statistically significant difference ( p > 0.05). Conclusion: Continuous suturing technique for pyeloplasty is preferable as it is found to have a lower mean operative time, mean suturing time, duration of post-operative drainage, mean drain output and postoperative hospital stay.

scholarly journals Laparoscopic repair of umbilical and paraumbilical hernias: a prospective and interventional study in government hospital

2019 ◽  
Vol 6 (9) ◽  
pp. 3283
Author(s):  
Kiren B. Patel ◽  
Mithun V. Barot
Keyword(s):  
Surgical Site Infection ◽  
Hospital Stay ◽  
Wound Infection ◽  
Ventral Hernia ◽  
Laparoscopic Repair ◽  
Umbilical Hernia ◽  
Operative Time ◽  
Postoperative Hospital Stay ◽  
Site Infection ◽  
Drain Removal

Background: Umbilical and ventral hernia occurs as a result of weakness in musculofascial layer of anterior abdominal wall. The most important causes are congenital, acquired, incisional and traumatic. UH and VH can be repair by open surgical procedure. A successful series of laparoscopic repair of umbilical hernia and VH was done by Le blanc in 1993. The cost can be optimised by selection of mesh and optimal uses of transabdominal suture and various fixation devices. This original article reveals methods, techniques, indication, contraindication, post-op pain, operative time, surgical site infection recurrence and outcome of laparoscopic umbilical hernia and paraumbilical hernia repair.Methods: A total of 21 patients of ventral hernia (umbilical, paraumbilical and incisional), who underwent laparoscopic hernia repair from October 2014 to October 2016, were selected have taken part in study with valid consent, in B.J. Medical College Ahmedabad Gujarat. All patient study regarding operative time, postoperative pain, postoperative hospital stay, surgical site infection like wound infection, seroma, hernia defect size, mean drain removal and recurrence.Results: Out of 21 patients male are 33% and female are 67%. Mean age of patients is 45 yrs with range being 18-65 yrs. 28%, 33.33%, and 38.1% of patient had umbilical, paraumbilical and incisional hernia respectively. Mean size defect was 7.8 cm2. Mean operative time in this study is 98.6 minute. Mean drain removal is 2.80 day. Mean postoperative hospital stay was 3.3 days. 4.7% had wound infection, 9.5% had seroma formation. There is 0% recurrence in present study.Conclusions: The laparoscopic approach appears to be safe, effective and acceptable. It is also effective in those who are obese, with co morbidities (complex) and who have recurrence from prior open repair and having ascites.

scholarly journals Inappropriate manipulation and drainage exacerbate post-operative pain and prolong the hospital stay after laparoscopic appendectomy for pediatric complicated appendicitis

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yi-Wen Tsai ◽  
Shin-Yi Lee ◽  
Jyun-Hong Jiang ◽  
Jiin-Haur Chuang
Keyword(s):  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Pediatric Patients ◽  
Complicated Appendicitis ◽  
Postoperative Hospital Stay ◽  
Postoperative Outcomes ◽  
Chang Gung Memorial Hospital ◽  
Abdominal Abscess ◽  
Penrose Drain ◽  
Drain Group

Abstract Background This study examined whether drain placement or not is associated with the postoperative outcomes of pediatric patients following trans-umbilical single-port laparoscopic appendectomy (TUSPLA) for complicated appendicitis. Methods The medical records of pediatric patients undergoing TUSPLA for acute complicated appendicitis from January 2012 to September 2018 in Kaohsiung Chang Gung Memorial Hospital were reviewed retrospectively. They were classified according to whether they received passive drainage with a Penrose drain (Penrose group) (19), active drainage with a Jackson-Pratt drain with a vacuum bulb (JP group) (16), or no drain (non-drain group) (86). The postoperative outcomes of the three groups were compared. Results Postoperative visual analog scale pain score was significantly higher in the non-drain group than in either the JP group or Penrose group. Patients in the Penrose group had a significantly longer postoperative hospital stay than those in the non-drain group and a higher rate of intra-abdominal abscess, while patients in the JP group had a significantly shorter postoperative hospital stay; moreover, no patient in JP group developed a postoperative intra-abdominal abscess. Conclusions Compared to passive drainage with a Penrose drain or no drain, active drainage with a JP drain shorter the postoperative hospital stay and decreased the risk of postoperative intra-abdominal abscess.

The Self-Retaining Barbed Suture for Parenchymal Repair in Laparoscopic Partial Nephrectomy: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 26 (6) ◽  
pp. 744-752
Author(s):  
Hailun Zhan ◽  
Chunping Huang ◽  
Tengcheng Li ◽  
Fei Yang ◽  
Jiarong Cai ◽  
...  
Keyword(s):  
Renal Function ◽  
Blood Loss ◽  
Hospital Stay ◽  
Partial Nephrectomy ◽  
Operative Time ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
The Self ◽  
Barbed Suture ◽  
Estimated Blood Loss

Objectives. The warm ischemia time (WIT) is key to successful laparoscopic partial nephrectomy (LPN). The aim of this study was to perform a meta-analysis comparing the self-retaining barbed suture (SRBS) with a non-SRBS for parenchymal repair during LPN. Methods. A systematic search of PubMed, Scopus, and the Cochrane Library was performed up to March 2018. Inclusion criteria for this study were randomized controlled trials (RCTs) and observational comparative studies assessing the SRBS and non-SRBS for parenchymal repair during LPN. Outcomes of interest included WIT, complications, overall operative time, estimated blood loss, length of hospital stay, and change of renal function. Results. One RCT and 7 retrospective studies were identified, which included a total of 461 cases. Compared with the non-SRBS, use of the SRBS for parenchymal repair during LPN was associated with shorter WIT ( P < .00001), shorter overall operative time ( P < .00001), lower estimated blood loss ( P = .02), and better renal function preservation ( P = .001). There was no significant difference between the SRBS and non-SRBS with regard to complications ( P = .08) and length of hospital stay ( P = .25). Conclusions. The SRBS for parenchymal repair during LPN can significantly shorten the WIT and overall operative time, decrease blood loss, and preserve renal function.

scholarly journals Robot-Assisted Laparoscopic Radical Prostatectomy in the Morbidly Obese Patient

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Jennifer Yates ◽  
Ravi Munver ◽  
Ihor Sawczuk
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Operative Time ◽  
The United States ◽  
Morbidly Obese ◽  
Health Issues ◽  
Morbidly Obese Patient ◽  
Estimated Blood Loss ◽  
Clavien Grade ◽  
Grade Ii

Introduction. Obesity and prostate cancer are among the more common health issues affecting men in the United States.Methods. We retrospectively reviewed morbidly obese (BMI ≥ 40 kg/m2) patients undergoing RALP between 2004–2009 at our institution. Parameters including operative time, estimated blood loss, hospital stay, pathology, and complication rate were examined.Results. A total of 15 patients were included, with a mean BMI of 43 kg/m2. Mean preoperative PSA was 5.78 ng/dL, and Gleason score was 6.6. Mean operative time was 163 minutes, and mean estimated blood loss was 210 mL. The mean hospital stay was 1.3 days. Positive margins were noted in 2 (13%) patients, each with pT3 disease. There were no blood transfusions, open conversions, or Clavien Grade II or higher complications.Conclusions. In our experience, RALP is feasible in morbidly obese patients. We noted several challenges in this patient population which were overcome with modification of technique and experience.

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