scholarly journals To Study the Outcome of Posterior Sagittal Anorectoplasty in Anorectal Malformations

2021 ◽  
Vol 15 (9) ◽  
pp. 2245-2247
Author(s):  
Shafiq-Ur- Rehman ◽  
Muhammad Anwar
Keyword(s):  
Postoperative Complications ◽  
Complication Rate ◽  
Functional Outcomes ◽  
Spinal Dysraphism ◽  
Operation Time ◽  
Anorectal Malformations ◽  
Posterior Sagittal Anorectoplasty ◽  
Operative Complication ◽  
Bowel Habits ◽  
Urethral Fistula

Aim: To assess the effectiveness of posterior sagittal anorectplasty for the repair of anorectal malformations in terms of postoperative complications and functional outcomes. Study design: Descriptive prospective study. Place and duration of study: Sahiwal Teaching Hospital, Sahiwal. From 1st January 2016 to 31st December 2019. Methodology: Forty-two children with high/intermediate anorectal malformations, who underwent posterior sagittal anorectoplasty, were included in the study. Patients with low variety anorectal malformations, recto vestibular/ano vestibular fistula, persistent cloaca and patients with sacral dysraphism, spinal dysraphism, myelomeningocele spina bifida occulta and menifesta were excluded. Demographic information included age, gender, weight, type of anorectal malformation, type of surgery performed, operation time and hospital stay. Immediate post-operative complications were also noted. Bowel habits, constipation and faecal incontinence were evaluated in all patients during the follow up period. Results: Thirty-one (73.80%) were males and 11(26.19%) were females and mean age was 1.72 years. The mean weight at the time of operation was 11.00 kg. High variety anorectal malformations were 14(33.33%) and intermediate were 28(66.66%). Rectourethral fistula 25(59.52%) was most common variety seen in males. Recto bulber urethral fistula in 17(40.47%) and recto prostatic urethral fistula in 8(19.04%) patients were seen. Anal agenesis without fistula 7(16.66%) was most common anomaly in females. Overall complication rate was 15(35.71%). Constipation 11(26.19%) was most common post-operative complication. True fecal incontinence was seen in 3(7.14%) patients. Strong and effective squeeze of anal sphincter was seen in 39 (92.85%) patients and satisfactory bowel habits were present in 37 (88.08%) patients. Conclusion: Posterior sagittal anorectplasty is a useful procedure in the management of high/intermediate anorectal malformations, precise identification and reconstruction of muscle complex result in good anatomical and functional outcome. Immediate post-operative complication rate is also low. Keywords: Anorectal malformations, Posterior Sagittal Anorectoplasty, Postoperative complications, Functional outcomes

scholarly journals A study of efficacy and feasibility of laparoscopic surgery in a tertiary care center, Pokhara, Nepal

2021 ◽  
Vol 14 (2) ◽  
pp. 141-145
Author(s):  
Anuj Shrestha ◽  
Sunil Man Bijukchhe ◽  
Anand Bhattarai ◽  
Bhojraj Neupane ◽  
Ketki Kaushal
Keyword(s):  
Developing Countries ◽  
Laparoscopic Surgery ◽  
Complication Rate ◽  
Conversion Rate ◽  
Care Center ◽  
Tertiary Care ◽  
Operation Time ◽  
Developed Countries ◽  
Cross Sectional ◽  
Operative Complication

Introduction: Laparoscopic surgery is the gold standard technique for most of the gastrointestinal surgeries in developed countries. However, challenges in developing countries, apart from cost of instrumentation, include lack of awareness. Therefore, the aim of this study is to determine the efficacy and feasibility of laparoscopic surgeries in our part of the world. Methods: Retrospective, cross-sectional study was carried out from January 1, 2018 to June 30, 2019. Patient’s information on demographic details, type of laparoscopic surgery, operation time, length of hospital stay, reasons for conversion to open surgery, and intra-operative and post-operative complication details were retrieved from the operation log book and patient’s chart. Results: A total of 380 patients that underwent laparoscopic surgeries were included in the study. Out of 193 patients that underwent laparoscopic cholecystectomy, there were 144 (74.61%) females and 49 (25.38%) males with conversion rate of 4.66% and post-operative complication rate of 8.80%. Similarly, among 136 patients that underwent laparoscopic appendectomy, there were 68 (50%) females and 68 (50%) males with conversion rate of 4.41% and post-operative complication rate of 14.70%. Finally, amid 51 patients who underwent trans-abdominal pre-peritoneal approach, post-operative seroma collection was seen in three cases and port site hematoma formation was seen in two cases only. Conclusions: Our results were comparable with various literature demonstrating that laparoscopic surgeries are safe and effective. However, evolution of laparoscopic surgery in developing countries is still slow. Therefore, effective training and availability of required instruments is needed.  

scholarly journals Single Incision Laparoscopic Cholecystectomy by Using a 2 mm Atraumatic Grasper without Trocar

HPB Surgery ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Kamil Gulpinar ◽  
Suleyman Ozdemir ◽  
S. Erpulat Ozis ◽  
Turgut Aydin ◽  
Atila Korkmaz
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Complications ◽  
Abdominal Wall ◽  
Single Incision ◽  
Single Port ◽  
Operation Time ◽  
Scar Formation ◽  
Single Incision Laparoscopic Cholecystectomy ◽  
Skin Scar

Purpose. We present our experience in single incision laparoscopic cholecystectomy by using a grasper directly without using a trocar in five patients. Methods and Results. The technique involves the use of Karl Storz 27290F grasper in order to perform gallbladder retraction in single port cholecystectomy. The grasper was introduced directly into the skin through abdominal wall without using any trocar and used to mobilize gallbladder whenever needed during surgery without causing any perforation or leakage of the gallbladder. There were no intraoperative and postoperative complications in 5 patients with the advantages of shorter operation time and almost invisible postoperative skin scar formation. Conclusion. We claim that the use of this instrument in SILS surgery might be advantageous than the conventional placement of sutures for the gallbladder mobilization.

scholarly journals The Assessment of Early Complications and Risk Factors Affecting Their Occurrence in Breast Reconstructive Procedures

2021 ◽  
Author(s):  
Justyna Jończyk ◽  
Jerzy Jankau
Keyword(s):  
Risk Factors ◽  
Postoperative Complications ◽  
Breast Reconstruction ◽  
Complication Rate ◽  
Clinical Factors ◽  
Early Complications ◽  
Reconstructive Procedures ◽  
Factors Affecting ◽  
Rehospitalization Rate ◽  
Early Postoperative Complications

AbstractThe presence of postoperative complications may have a significant impact on the outcome of the breast reconstruction. The aim of this study was to investigate early postoperative complications and the risk factors for their occurrence. A prospective analysis was carried out to evaluate surgical outcomes after breast reconstructive surgeries performed over a 2-year period. Procedures included expander/implant (TE/IMP), pedicle transverse rectus abdominis musculocutaneous (pTRAM), and latissimus dorsi (LD) techniques. All adverse events which occurred within 6 weeks of surgery were ranked according to severity based on the contracted Accordion grading system. Outcomes were assessed for their association with surgical, demographic, and clinical variables. Sixty-one consecutive breast reconstruction procedures were analyzed. The overall complication rate was 60.7% (n = 37), and 8 patients (13.1%) required reoperation. The lowest complication rate was observed in implant-based reconstructions (TE/IMP, 18.8%; pTRAM, 72.7%; LD, 78.3%; p = 0.008). Mild complications occurred significantly more often after LD reconstructions (LD, 60.9%; pTRAM, 22.7%; TE/IMP, 12.5%; p = 0.031), while severe complications were significantly more frequent after the pTRAM procedures (pTRAM, 27.3%; TE/IMP, 6.2%; LD, 8.7%; p = 0.047). Severe complications were associated with higher rehospitalization rate (p = 0.010) and longer hospital stay. Study revealed a significant impact of the operative method on the incidence and severity of early complications after breast reconstruction procedures with little effect from other demographic and clinical factors.

scholarly journals Hybrid ileal pouch with concomitant anti-refluxing and refluxing ureteroileal anastomosis

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Se Young Choi ◽  
Bumjin Lim ◽  
Byung Hoon Chi ◽  
Jung Hoon Kim ◽  
Wonchul Lee ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Renal Function ◽  
Postoperative Complications ◽  
Functional Outcomes ◽  
Ileal Pouch ◽  
Oncologic Outcomes ◽  
Voiding Function ◽  
Short Bowel ◽  
Left And Right ◽  
Grade 3

Abstract Purpose We report our preliminary experience of using a hybrid ileal pouch, assessing oncologic outcomes, complications, voiding, and renal function. Methods The study included 25 patients with bladder cancer treated with radical cystectomy with a hybrid ileal pouch with concomitant anti-refluxing and refluxing anastomosis, performed by a single surgeon. The patients were divided into two groups (first and last cases) according to the surgery date. Postoperative complications, separate renal function by renal scan, voiding function by uroflowmetry with residual urine, and oncologic outcomes were assessed. Results The surgery duration was shorter in the last cases than the first cases. The voiding volume increased with time. There were 23 cases of grade 3 complication in 12 patients and one case of grade 4 complication (sepsis). In the first cases, ureterovesical stenosis occurred in five cases, whereas in the last cases, there were no cases of stenosis. In separate renal function, there was no difference between the left and right side or between the first and last cases. Conclusions The hybrid ileal pouch showed acceptable oncologic and functional outcomes and complications; therefore, it can be used according to the appropriate surgical situation with a relatively short bowel segment during neobladder construction.

Lymphocyte C-reactive protein ratio: A new biomarker to predict early complications after gastrointestinal oncologic surgery

2021 ◽  
pp. 1-9
Author(s):  
Murat Yildirim ◽  
Bulent Koca
Keyword(s):  
Colorectal Cancer ◽  
Postoperative Complications ◽  
Inflammatory Markers ◽  
Operation Time ◽  
C Reactive Protein ◽  
Oncologic Surgery ◽  
Protein Ratio ◽  
Colorectal Cancer Surgery ◽  
Neutrophil Lymphocyte Ratio ◽  
Reactive Protein

BACKGROUND: Lymphocyte-to-C-reactive protein ratio (LCR) has been used as a post-surgical prognostic biomarker in patients with gastric and colorectal cancer. However, its relationship with early postoperative complications in these patients is unknown. In this study, we aimed to reveal the relationship between LCR and postoperative complications. METHODS: Eighty-one patients operated for stomach and colorectal cancer between January 2020 and August 2020 were prospectively analyzed. On preoperative and postoperative days 1, 3 and 5, other inflammatory parameters, mainly LCR, neutrophil lymphocyte ratio (NLR), were recorded. The patients were divided into two groups according to Clavien-Dindo classification as stage III and higher complications major, stage I-II/non-complication minor. RESULTS: Fifty seven patients were operated for colorectal cancer, 24 patients for gastric cancer. The mean age of the patients was 65.6 ± 12.6, 34.6% of them was women. Age, operation time and hospital stay were significantly different between the groups (p= 0.004, p= 0.002, p< 0.001). Major complications developed in 18 patients. On postoperative day 5, LCR found superior diagnostic accuracy in predicting major postoperative complications compared to other inflammatory markers. On the postoperative 5th day, the cut-off value of LCR was 0.0034, 88.8% (71.9–94.8) sensitivity, and 85.7% (73.6–95.4) selectivity. CONCLUSION: Among different inflammatory markers, postoperative LCR is a safe and effective predictor of postoperative complications, especially after gastric and colorectal cancer surgery on day 5.

scholarly journals Relationship between Oral Bacterial Count and Postoperative Complications among Patients with Cardiovascular Disease Treated by Surgery: A Retrospective Cohort Study

Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 850
Author(s):  
Rie Osako ◽  
Yuhei Matsuda ◽  
Chieko Itohara ◽  
Yuka Sukegawa-Takahashi ◽  
Shintaro Sukegawa ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Postoperative Complications ◽  
Operation Time ◽  
Bacterial Count ◽  
Cardiovascular Complications ◽  
Pericardial Fluid ◽  
Bacterial Counts ◽  
Lung Torsion ◽  
Propensity Score Adjustment ◽  
The Relationship

In this retrospective observational study, we evaluated the relationship between perioperative oral bacterial counts and postoperative complications in cardiovascular disease (CVD) patients. From April 2012 to December 2018, all patients scheduled for surgery received perioperative oral management (POM) by oral specialists at a single center. Tongue dorsum bacterial counts were measured on the pre-hospitalization day, preoperatively, and postoperatively. Background data were collected retrospectively. Among the 470 consecutive patients, the postoperative complication incidence rate was 10.4% (pericardial fluid storage, n = 21; postoperative pneumonia, n = 13; surgical site infection, n = 9; mediastinitis, n = 2; and seroma, postoperative infective endocarditis, lung torsion, and pericardial effusion, n = 1 each). Oral bacterial counts were significantly higher in the pre-hospitalization than in the pre- and postoperative samples (p < 0.05). Sex, cerebrovascular disease, and operation time differed significantly between complications and no-complications groups (p < 0.05). Multivariate analysis with propensity score adjustment showed a significant association between postoperative oral bacterial count and postoperative complications (odds ratio 1.26; 95% confidence interval, 1.00–1.60; p = 0.05). Since the development of cardiovascular complications is a multifactorial process, the present study cannot show that POM reduces complications but indicates POM may prevent complications in CVD patients.

1239 Postoperative Complication Rate of Facial Injury Repairs Treated by Maxillofacial On-Call Team: Surgical Audit

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
G Dhanjal ◽  
M Ghouri ◽  
S Crank
Keyword(s):  
Soft Tissue ◽  
Postoperative Complications ◽  
Postoperative Complication ◽  
Complication Rate ◽  
Maxillofacial Surgery ◽  
General Anaesthetic ◽  
Facial Injury ◽  
Postoperative Complication Rate ◽  
Female Ratio ◽  
Facial Injuries

Abstract Introduction A significant aspect of Oral and Maxillofacial Surgery workload relates to trauma, particularly soft-tissue injuries. Contingent on the aetiology of injury, facial wounds require debridement and rapid closure to reduce risk of infection and degree of scarring. The aim was to identify possible risks and frequency of postoperative complications, including problems identified by patients following treatment of facial injuries by the Maxillofacial on-call team. Method Data was retrospectively collected from patients who sustained soft-tissue facial injuries treated by the Maxillofacial team and provided with follow-up appointments from January to August 2020. Computerised clinical notes were accessed to determine patient demographics, mechanism and site of injury, location and time of repair, operator grade and postoperative complications (if any). Results 153 patients required debridement and suturing of a facial injury under local or general anaesthetic. Among these, the male to female ratio was 65:35. 47% of facial injuries resulted from mechanical fall. Lips were found to be the most common site (31%) of injury. Postoperative complication rate was 8% within the 8-month period, with reports of infection, wound dehiscence and haematoma requiring further treatment. 58% of complications resulted from treatment carried out between 5pm-5am with a sole operator (DCT/SHO). 83% of complications followed treatment carried out within the Emergency Department rather than Maxillofacial clinical setting. Conclusion Following facial injury repair, just less than 8% of patients experienced complications, which required corrective treatment. Although facial injuries require immediate care, careful planning and performing treatment in a specialised setup may improve perioperative care, thus clinical outcomes.

scholarly journals Revision of 116 orthognathic surgery patients operated on with the high-oblique sagittal osteotomy (HOSO): a retrospective case series (PROCESS-compliant article)

2020 ◽  
Author(s):  
C. Herrera-Vizcaino ◽  
L. Seifert ◽  
M. Berdan ◽  
S. Ghanaati ◽  
M. Klos ◽  
...  
Keyword(s):  
Complication Rate ◽  
Orthognathic Surgery ◽  
Mouth Opening ◽  
Case Series ◽  
Operation Time ◽  
University Hospital ◽  
Material Failure ◽  
Retrospective Case ◽  
Non Union ◽  
Facial Plastic

Abstract Background The high-oblique sagittal osteotomy (HOSO) is an alternative to a bilateral sagittal split osteotomy (BSSO). Due to its novelty, there are no long-term studies which have focused on describing the incidence and type of complications encountered in the post-operative follow-up. The aim of this retrospective study is to analyze patients operated on with this surgical technique and the post-operative complications encountered. Patient and methods The electronic medical records of all patients treated with orthognathic surgery at the Department of Oral, Maxillofacial and Facial Plastic Surgery, University Hospital Frankfurt, Goethe University, Frankfurt, Germany, between the years 2009 and 2016 were retrospectively reviewed. Results A total of 116 patients fulfilled the inclusion criteria. The cases operated on with the standard osteosynthesis (X, Y, and straight) showed a complication rate of 36.37% (n = 4/11). The cases operated on with the HOSO-dedicated plates (HOSO-DP) showed, in total, a complication rate of 6.67% (n = 7/105). The most common post-operative complication resulting from both fixation methods was a reduction in mouth opening and TMJ pain for 4.3%. During the first years of performing the surgery (2009–211), a variety of standard plates had material failure causing non-union or pseudarthrosis. No cases of material failure were observed in the cases operated on with the HOSO-DP. The statistical results showed a highly significant dependence of a reduction in OP-time over the years, when the HOSO was performed without additional procedures (R2 > 0.83, P < 0.0015). Conclusion The rate of complications in the HOSO were shown to be comparable to the rate of complications from the BSSO reported in the literature. Moreover, the use of the ramus dedicated plate appears to provide enough stability to the bone segments, making the surgery safer. Clinical relevance The HOSO needs to be considered by surgeons as an alternative to BSSO. Once the use of the HOSO-DP was established, the rate of complications and the operation time reduced considerably.

scholarly journals A 10-Year Follow-Up of Two-Incision and Modified Watson-Jones Total Hip Arthroplasty in Patients with Osteonecrosis of the Femoral Head

2017 ◽  
Vol 2017 ◽  
pp. 1-7
Author(s):  
Shih-Jie Lin ◽  
Tsan-Wen Huang ◽  
Po-Chun Lin ◽  
Feng-Chih Kuo ◽  
Kuo-Ti Peng ◽  
...  
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Functional Outcomes ◽  
Large Scale ◽  
Operation Time ◽  
Harris Hip Score ◽  
Total Hip ◽  
Radiographic Parameters

Long-term data and information indicating whether minimally invasive surgery (MIS) approaches are safe and effective with total hip arthroplasty (THA) are lacking. Between 2004 and 2006, 75 patients with alcohol-related osteonecrosis of the femoral head (ONFH) who underwent 75 THAs with the two-incision approach were studied. The medical records, radiographic parameters, and functional outcomes were collected prospectively. All data were compared with those for matched patients who underwent a modified Watson-Jones (WJ) approach. THA using the two-incision approach was associated with longer operation time, more blood loss, more lateral femoral cutaneous nerve injury, and more periprosthetic femoral fractures (p<0.05for all four) than the modified WJ approach. The Harris Hip Score (HHS) and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) increased significantly from the period preoperatively to 6 weeks postoperatively and thereafter up to the last follow-up in both groups. However, there were no significant differences in terms of radiographic parameters and functional outcomes between the two groups throughout the study period. Both the two-incision and the modified WJ approach provided satisfactory results and survival rates at a mean follow-up of 10.8 years. A prospective, randomized, large-scale cohort study is still warranted for evidence-based recommendations.

scholarly journals Unligature method of laparoscopic appendectomy in children

2020 ◽  
Vol 10 (1) ◽  
pp. 53-58
Author(s):  
Vyacheslav G. Svarich ◽  
Evgeniy G. Perevozchikov ◽  
Ilya M. Kagantsov
Keyword(s):  
Postoperative Complications ◽  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Operation Time ◽  
High Energy ◽  
Inflammatory Infiltration ◽  
Surgical Department ◽  
Clinical Hospital ◽  
Digital Assessment

Aim. On the basis of the accumulated clinical material to show the possibility of a ligature-free method of laparoscopic appendectomy in children. Materials and methods. From 2000 to 2019, 2044 children with acute appendicitis were treated in the surgical department of the Republican childrens clinical hospital in Syktyvkar. Of these, 651 patients had an open appendectomy with treatment of the stump of the vermiform process by the submersible method, 1363 children had a laparoscopic appendectomy with ligature treatment of the stump of the process, and 32 patients had their first non-ligature laparoscopic appendectomy with the intersection of the vermiform process with the Ligasure device. Results. On average, surgery for ligature-free laparoscopic appendectomy lasted 7 3 minutes less than for laparoscopic appendectomy using the ligature method for treating the stump of the worm-like process. Experimentally, it was found that this method of appendectomy should not be used when the thickness of the worm-like process is more than 1.5 cm, with pronounced inflammatory infiltration of the caecum dome and perforation at the base of the process. With ligature-free appendectomy, the operation time was reduced. In the period from 1 to 6 months, there were no intra-abdominal postoperative complications associated with the new method of surgery. Conclusion. Ligar-free laparoscopic appendectomy in children using modern high-energy platforms with a digital assessment of the degree of tissue coagulation readiness made it possible to avoid intraoperative and postoperative complications, simplify the technique of its implementation, and reduce the time of surgery.

Sign in / Sign up

Export Citation Format

Share Document