scholarly journals Treatment of Cavitary Bone Defects in Chronic Osteomyelitis: Bioactive glass S53P4 vs. Calcium Sulphate Antibiotic Beads

2017 ◽  
Vol 2 (4) ◽  
pp. 194-201 ◽  
Author(s):  
Albert Ferrando ◽  
Joan Part ◽  
Jose Baeza
Keyword(s):  
Postoperative Complications ◽  
Hospital Stay ◽  
Chronic Osteomyelitis ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Calcium Sulphate ◽  
Bone Defects ◽  
Group 2 ◽  
Group 1

Abstract. Aim: To evaluate the efficacy of bioglass (BAG-S53P4) in the treatment of patients with chronic osteomyelitis and compare the results with calcium sulphate antibiotic beads in one medical centre.Methods: Retrospective analysis of 25 cases. Inclusion criteria: patients diagnosed clinically and radiographically of osteomyelitis and treated surgically (Group 1: cavitary bone defects treated with bioglass and Group 2: cavitary bone defects treated with calcium sulphate antibiotic beads) during the period of 2014 and 2015 in one medical centre.Results: Patients in group 1 (bioglass treatment): total of 12 patients (11 males and 1 female) with mean age: 50 years (30-86). Average length of hospital stay was 22 days and mean follow-up time: 23 months (16-33). Mean erythrocyte sedimentation rate (ESR) and mean c-reactive protein (CRP) before surgery: 55mm/hr and 54 mg/L, respectively. Mean ESR and mean CRP in last blood exam: 18 mm/hr and 8 mg/L, respectively. There were 2 postoperative complications: seroma formation and delayed wound healing. Only 1 patient had recurrence of infection.Patients in group 2 (calcium sulphate antibiotic beads treatment): total of 13 patients (9 males and 4 females) with mean age: 48 years (17-67). Average length of hospital stay was 21 days and mean follow-up time 22 months (16-29). Mean ESR and mean CRP before surgery: 51mm/hr and 41 mg/L, respectively. Mean ESR and mean CRP in last blood test: 15 mm/hr and 11 mg/L. 2 postoperative complications were registered: chronic expanding hematoma of the muscle flap donor site and seroma formation. 1 patient had recurrence of infection. Overall, there were no differences in recurrence of infection, p=0.740 and in complication rate, p=0.672. 11 (91,7%) patients in group 1 and 12 (92,3%) patients in group 2 showed no signs of recurrence of infection both clinically and radiologically at final follow-up.The most frequent cause of osteomyelitis in group 1 was post traumatic while a postsurgical aetiology was more frequent in group 2. The distal tibia was the most common location. The most frequent pathogen isolated in both groups was methicillin sensible staphylococcus aureus.Conclusions: An advance in treatment of patients with cavitary bone defects in chronic osteomyelitis is the use of synthetic bone substitutes although current evidence is low. In this study, we demonstrate how bioglass without local antibiotics and calcium sulphate antibiotic beads are both equally effective treatment options. Overall, there were no differences between groups in mean hospital stay, complication rates and recurrence of infection.

scholarly journals Comparison of Laparoscopic and Conventional Cystotomy/Partial Cystectomy in Treatment of Liver Hydatidosis

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Huseyin Kazim Bektasoglu ◽  
Mustafa Hasbahceci ◽  
Yunus Tasci ◽  
Ibrahim Aydogdu ◽  
Fatma Umit Malya ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Operative Time ◽  
Length Of Hospital Stay ◽  
Partial Cystectomy ◽  
Complication Rates ◽  
First Choice ◽  
Group 2 ◽  
Liver Hydatidosis ◽  
Group 1

Introduction. Hydatidosis is a zoonotic infection and treatment is mandatory to avoid complications. Surgery remains the first choice in the treatment especially for CE2-CE3b cysts. Open or laparoscopic approaches are available. However, comparative studies are limited. Materials and Methods. Data of patients who underwent cystotomy/partial cystectomy for liver hydatidosis between January 2012 and September 2016 (n=77) were evaluated retrospectively. Recurrent cases and the patients with previous hepatobiliary surgery were excluded. 23 patients were operated upon laparoscopically and named as Group 1. 48 patients operated conventionally named as Group 2. Demographics, cyst characteristics, operative time, length of hospital stay, recurrences, and surgery related complications were evaluated. Results. Groups were similar in terms of demographics, cyst characteristics, and operative time. The length of hospital stay was 3.4 days in Group 1 and 4.7 days in Group 2 (p=0,007). The mean follow-up period was 17.8 months and 21.7 months, respectively (p=0.170). Overall complication rates were similar in two groups (p=0.764). Three conversion cases occurred (13%). One mortality was seen in Group 2. Four recurrences occurred in each group (17% versus 8.3%, respectively) (p=0.258). Conclusions. Laparoscopy is a safe and feasible approach for surgical treatment of liver hydatidosis. Recurrence may be prevented by selection of appropriate cases in which exposure of cysts does not pose an intraoperative difficulty.

Pilonidal Sinus: How to Choose Between Excision and Open Granulation Versus Excision and Primary Closure?

Swiss Surgery ◽  
2002 ◽  
Vol 8 (6) ◽  
pp. 255-258 ◽  
Author(s):  
Perruchoud ◽  
Vuilleumier ◽  
Givel
Keyword(s):  
Hospital Stay ◽  
Pilonidal Sinus ◽  
Primary Closure ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Healing Time ◽  
Incision And Drainage ◽  
The Mean ◽  
Primary Healing

Aims: The purpose of this study was to evaluate excision and open granulation versus excision and primary closure as treatments for pilonidal sinus. Subjects and methods: We evaluated a group of 141 patients operated on for a pilonidal sinus between 1991 and 1995. Ninety patients were treated by excision and open granulation, 34 patients by excision and primary closure and 17 patients by incision and drainage, as a unique treatment of an infected pilonidal sinus. Results: The first group, receiving treatment of excision and open granulation, experienced the following outcomes: average length of hospital stay, four days; average healing time; 72 days; average number of post-operative ambulatory visits, 40; average off-work delay, 38 days; and average follow-up time, 43 months. There were five recurrences (6%) in this group during the follow-up period. For the second group treated by excision and primary closure, the corresponding outcome measurements were as follows: average length of hospital stay, four days; average healing time, 23 days; primary healing failure rate, 9%; average number of post-operative ambulatory visits, 6; average off-work delay, 21 days. The average follow-up time was 34 months, and two recurrences (6%) were observed during the follow-up period. In the third group, seventeen patients benefited from an incision and drainage as unique treatment. The mean follow-up was 37 months. Five recurrences (29%) were noticed, requiring a new operation in all the cases. Discussion and conclusion: This series of 141 patients is too limited to permit final conclusions to be drawn concerning significant advantages of one form of treatment compared to the other. Nevertheless, primary closure offers the advantages of quicker healing time, fewer post-operative visits and shorter time off work. When a primary closure can be carried out, it should be routinely considered for socio-economical and comfort reasons.

Impact of Length of Stay on Functional Outcomes of TBI Patients

2005 ◽  
Vol 71 (11) ◽  
pp. 920-930 ◽  
Author(s):  
M.L. Hawkins ◽  
F.D. Lewis ◽  
R.S. Medeiros
Keyword(s):  
Length Of Stay ◽  
Functional Outcomes ◽  
Inpatient Care ◽  
Average Length ◽  
Functional Independence ◽  
Average Length Of Stay ◽  
Group 2 ◽  
The Impact ◽  
Group 1

The purpose of this study was to compare the functional outcomes of two groups of patients with traumatic brain injury (TBI) with attention to the impact of reduced length of stay (LOS) in the trauma center (TC) and rehabilitation hospital (RH). From 1991 to 1994, 55 patients, Group 1, with serious TBI (Abbreviated Injury Scale score ≥3) were admitted to a level 1 TC and subsequently transferred to a comprehensive inpatient RH. These results have been previously published. From 1996 to 2002, 64 similarly injured patients, Group 2, received inpatient care at the same TC and RH. These patients had a marked decrease in length of stay. Functional Independence Measures (FIM) were obtained at admission (Adm), discharge (D/C), and at 1 year follow-up for both groups. The average length of stay at the TC dropped from 36 days in Group 1 to 26 days in Group 2. In addition, the average length of stay at the RH dropped from 46 days (Group 1) to 25 days (Group 2); overall, an average reduction of 31 days of inpatient care. Group 2 had significantly lower FIM scores at the time of RH discharge for self-care, locomotion, and mobility compared to Group 1. At the 1 year follow-up, however, there were no significant differences between Groups 1 and 2 in these FIM scores. FIM scores at 1 year were higher in Group 2 for communication (90% vs 71%) and social cognition (77% vs 49%) compared to Group 1. Over one-fourth of each group returned to work by the 1 year follow-up. Socially disruptive behavior occurred at least weekly in 28 per cent (Group 1) and 23 per cent (Group 2) of patients. The outcome for serious TBI is better than generally perceived. Reduction of inpatient LOS did not adversely affect the ultimate functional outcome. The decreased LOS placed a greater demand on outpatient rehabilitative services as well as a greater burden on the family of the brain-injured patient

PS01.218: MORBIDITY AND MORTALITY IN ELDERLY PATIENTS AFTER MINIMALLY INVASIVE ESOPHAGECTOMY

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 112-112
Author(s):  
Jeroen Hol ◽  
Joos Heisterkamp ◽  
Barbara Langenhoff
Keyword(s):  
Minimally Invasive ◽  
Elderly Patients ◽  
Hospital Stay ◽  
Minimally Invasive Esophagectomy ◽  
Length Of Hospital Stay ◽  
Morbidity And Mortality ◽  
Tumor Type ◽  
Invasive Esophagectomy ◽  
Group 2 ◽  
Group 1

Abstract Background Elderly patients undergoing gastrointestinal surgery are at higher risk for postoperative complications and mortality. Currently available literature on elderly patients undergoing an esophagectomy is inconclusive and dates back from the time before minimally invasive techniques were implemented. Methods Length of hospital stay, 90-day morbidity and mortality were analyzed from patients undergoing minimally invasive esophagectomy (MIE) between 2014 and 2017 in a single center. Data from patients aged 76 years or older was compared to the cohort of patients aged 71 to 75 years old. Results From a consecutive series of in total 187 patients two cohorts were retrieved: 19 patients 76 years or older (group 1) were compared to 41 patients 71 to 75 years old (group 2). Median age was 77 years (76–83) in group 1 and 72 years (71–75) in group 2 (P < 0.05). There were no significant differences in sex, Charlson comorbidity score, number of patients undergoing neoadjuvant chemoradiaton, histological tumor type, tumor stage, number of lymph nodes harvested and type of anastomosis. There were no significant differences in length of hospital stay, 90-day morbidity and mortality. The percentage of anastomotic leakage was 21.2% in group 1 and 14.6% in group 2. Mortality was 10.5% and 4.9% respectively. Conclusion No difference was seen in morbidity and mortality after MIE comparing the eldest old to younger old patients. Therefore, patient selection should not be based on calendar age alone. Disclosure All authors have declared no conflicts of interest.

A clinical pathway for patients undergoing primary cytoreductive surgery with rectosigmoid colectomy for advanced ovarian or primary peritoneal cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 5569-5569
Author(s):  
M. A. Gerardi ◽  
A. Santillan ◽  
B. Meisner ◽  
T. P. Diaz-Montes ◽  
G. J. Gardner ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Median Time ◽  
Cytoreductive Surgery ◽  
Clinical Pathway ◽  
Length Of Hospital Stay ◽  
Hospital Charges ◽  
Primary Peritoneal Cancer ◽  
Peritoneal Cancer ◽  
Group 2 ◽  
Group 1

5569 Background: To evaluate the safety, feasibility, and economic impact of a clinical pathway including rapid diet advancement for patients undergoing rectosigmoid colectomy as part of cytoreductive surgery for advanced ovarian or primary peritoneal cancer. Methods: Post-operative management was dictated by surgeon preference in 45 consecutive patients (Group 1) and according to the prescribed clinical pathway in 19 consecutive patients (Group 2). Critical elements of the clinical pathway included: rapid diet advancement, early discontinuance of nasogastric suction, criteria-based utilization of parenteral nutrition, selective laboratory testing, and deferring initiation of chemotherapy until after discharge. Results: The median age was 58 years for Group 1 patients and 67 years for Group 2 patients. Median time to flatus was 6 days for both groups; however, the median time to tolerating diet was 6 days for Group 1, and 4 days for Group 2. Patients in Group 1 had a median length of hospital stay of 12 days (range=5–30 days), a median total 30-day post-operative hospital charge of $42,868 (range=$19,960-$130,252), and a 30-day readmission rate of 33%, compared to 8 days (range=4–28 days) (p=0.020), $32,840 (range=$18,353-$140,283) (p=0.016), and 21% (p=0.379) for Group 2, respectively. Clinical pathway-directed management was associated with a median reduction in hospital charges of $10,027 per patient. Conclusions: A critical pathway incorporating rapid diet advancement for patients undergoing primary cytoreductive surgery with rectosigmoid colectomy for ovarian or primary peritoneal cancer is feasible, safe, and associated with a significant reduction in length of hospital stay and hospital-related charges and did not increase morbidity. No significant financial relationships to disclose.

Independent and Interdependent Influence of Number of CD34+ Cells and Use of G-CSF on Outcomes in Autologous PBSCT Patients

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 4319-4319
Author(s):  
Meghana Trivedi ◽  
Sue Corringham ◽  
Sam Martinez ◽  
Katherine Medley ◽  
Edward D Ball
Keyword(s):  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Post Transplant ◽  
Cd34 Cells ◽  
Significant Difference ◽  
Autologous Pbsct ◽  
Group 3 ◽  
Group 2 ◽  
Neutrophil Engraftment ◽  
Group 1

Abstract Background: Recovery of neutrophilic granulocytes after autologous peripheral blood stem cell transplantation (PBSCT), and thus overall outcome, depends on 2 main factors: the quality and quantity of mobilized peripheral blood progenitor cell products (CD34+ cells) and the use of myeloid growth factors, such as granulocyte colony stimulating factor (G-CSF). Methods: We performed a 5-year (from February 2003 to January 2008) retrospective analysis of data to evaluate independent and interdependent influence of number of CD34+ cells and use of G-CSF on outcomes in autologous PBSCT patients. At the time of analysis, the practice at our institution was as follows: Autologous PBSCT patients receiving infusion of &lt; 5×106 CD34+ cells/kg were treated with daily subcutaneous injection of G-CSF (filgrastim 300 mg for &lt; 80 kg; 480 mg for ≥ 80 kg). In these patients, G-CSF was started on Day +5 and was continued until the ANC was &gt; 500/μl. On the other hand, autologous transplant patients who received ≥ 5×106 CD34+ cells/kg did not typically receive G-CSF. If engraftment did not occur after an “expected” length of time, G-CSF treatment was initiated at the discretion of the treating physician. The definition of “expected” length of time, however, varied from practitioner to practitioner. For the analysis, patients were divided in 3 groups: patients who collected &lt; 5×106 CD34+ cells/kg and received G-CSF (group 1, n=103), patients who were infused with ≥ 5×106 CD34+ cells/kg and did not receive G-CSF (group 2, n=155), and patients who received ≥ 5×106 CD34+ cells/kg and were given G-CSF (group 3, n=47). Time to neutrophil engraftment (ANC &gt;500/ml), time to platelet engraftment (platelets &gt; 20,000/ml), and post-transplant length of hospital stay were compared. Results: Median time to neutrophil engraftment was significantly shorter in patients who were treated with G-CSF (11 days) in groups 1 and 3, compared to those who were not (13 days) in group 2 (table 1). Similarly, median post-transplantation hospital stay was significantly longer in patients who did not receive G-CSF (14 days) in group 2 compared to patients who were treated with G-CSF (13 days) in groups 1 and 3. There was no significant difference in time to neutrophil engraftment and post-transplant hospital stay between groups 1 and 3, suggesting that these outcome parameters did not significantly depend on number of CD34+ cells infused in our patients if G-CSF was used. Median time to platelet engraftment was significantly longer in patients receiving &lt; 5×106 CD34+ cells/kg (12 days) in group 1 compared to patients infused with ≥ 5×106 CD34+ cells/kg (10 days) in groups 2 and 3. There was no significant difference in time to platelet engraftment between groups 2 and 3, indicating that G-CSF use did not influence platelet engraftment. Summary: These results suggest that a higher number of CD34+ cells helps accelerate platelet engraftment, but does not influence neutrophil engraftment and post-transplant length of hospital stay, as long as G-CSF treatment is instituted. The use of G-CSF accelerates neutrophil recovery, regardless of the number of CD34+ cells infused, without affecting platelet engraftment in patients undergoing autologous PBSCT. Based on this analysis, the practice at our institution has been revised to use G-CSF in all autologous transplant patients, regardless of the number of CD34+ cells, since this practice reduces the length of hospital stay. Table 1. A retrospective data analysis for patients treated at the UCSD BMT unit with autologous PBPCT from February 2003 to January 2008. The data is represented as a median value with a range indicated in parenthesis. * indicates significant difference from group 1, † indicates significant difference from group 2, and ‡ indicates significant difference from group 3 (p &lt; 0.001, Mann Whitney U test; Graph Pad Prism, version 3.02 (Graph Pad Software, San Diego, CA)). Abbreviations: ANC-absolute neutrophil count, LOS-length of hospital stay. Group 1 &lt; 5×106/kg (G) (N = 103) Group 2 ≥5×106/kg (no G) (N = 155) Group 3 ≥5×106/kg (G) (N = 47) CD34+ cells (×106/kg) 3.2 †,‡ (1.4–4.98) 6.8 * (5.0–16.7) 7.0 * (5.0–12.3) Initiation of G-CSF Day +5 N/A Day +5 (day 0–day +16) Time to ANC &gt; 500/ml (days) 11 † (9–28) 13 *,‡ (9–21) 11 † (8–17) Time to Platelet &gt; 20,000/ml (days) 12 †,‡ (6–42) 10 * (0–29) 10 * (0–27) Post-Transplant LOS (days) 13 † (10–38) 14 *,‡ (1–43) 13 † (10–18)

Postoperative Complications After Distal Pancreatectomy Performed During Cytoreductive Surgery for Gynecologic Malignancies

2015 ◽  
Vol 25 (6) ◽  
pp. 1128-1133 ◽  
Author(s):  
Haider Mahdi ◽  
Peter G. Rose ◽  
Samantha Gonzalez ◽  
Robert DeBernardo ◽  
Jason Knight ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Hospital Stay ◽  
Distal Pancreatectomy ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Gynecologic Malignancies ◽  
Pancreatic Leak ◽  
Debulking Surgery ◽  
Perioperative Mortality ◽  
Time To Initiation

ObjectivesTo investigate the incidence of pancreatic leak and other postoperative complications after distal pancreatectomy performed during debulking surgery for gynecologic malignancies.MethodsAll patients who underwent distal pancreatectomy during their debulking surgery from 2010 to 2014 were identified. Postoperative complications within 30 days and pancreatic leak within 120 days after surgery were included.ResultsEighteen patients met the inclusion criteria. The median age was 62 years (36–78 years). Four patients (22%) were admitted to the intensive care unit, and the average length of hospital stay was 10 days. Nine patients developed postoperative complications within 30 days after surgery (50%) with no perioperative mortality up to 90 days after surgery. No patients required reexploration. The median time from surgery to initiation of chemotherapy was 39.5 days. Two patients developed pancreatic leak (11%). Among the patients who developed pancreatic leak, the average length of hospital stay was 11.5 days and time to initiation of chemotherapy was 75 days. Conservative management was successful in both cases.ConclusionIn this series, the rate of pancreatic leak was lower than previously reported with no perioperative mortality or surgical reexploration. However, the time to initiation of chemotherapy was delayed in those who developed pancreatic leak. These data are important in patient counseling and decision making at the time of debulking surgery. Gynecologic oncologists considering distal pancreatectomy should be familiar with perioperative management of these patients.

scholarly journals Comparison of Different IOL Types in the Flanged IOL Fixation Technique

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Yusaku Miura ◽  
Yosuke Harada ◽  
Yoshiaki Kiuchi
Keyword(s):  
Postoperative Complications ◽  
Case Series ◽  
Operation Time ◽  
University Hospital ◽  
Fixation Technique ◽  
The Mean ◽  
Group 2 ◽  
Iol Fixation ◽  
Group 1

Purpose. To compare short-term clinical outcomes between two different intraocular lens (IOL) types in the flanged IOL fixation technique. Methods. This study was a retrospective case series and included the patients who underwent flanged IOL fixation between June 2017 and July 2018 at the Hiroshima University Hospital. Two different 3-piece IOLs (NX-70 and PN6A) were used. Recipients of NX-70 and PN6A IOLs were classed into groups 1 (15 eyes) and 2 (25 eyes), respectively. Patient characteristics, surgical results, and postoperative complications were analyzed. We excluded patients with a postoperative follow-up of <1 month. Results. The mean follow-up period was 13.3 ± 11.7 weeks. The postoperative best corrected visual acuity, in logarithm of the minimum angle of resolution (logMAR), was 0.10 ± 0.33 in group 1 and 0.26 ± 0.42 in group 2. The mean operation times for groups 1 and 2 were 11.2 ± 4.54 minutes and 7.00 ± 2.20 minutes, respectively (p=0.0024). Detachment of the IOL haptic from the optic during surgery occurred in four eyes in group 2 (16%), but did not occur in group 1. Iris capture of the optic was observed in 3 of the 13 eyes (23%) without a peripheral iridotomy in group 2. No peripheral iridotomies were performed on group-1 eyes, but iris capture did not occur in that group. Conclusions. There was a trend to fewer intraoperative and postoperative complications when using NX-70 IOLs. On the other hand, PN6A IOLs was easy to maneuver within the anterior chamber, and the operation time was shorter when using PN6A IOLs. Selection of optimal IOLs for flanged IOL fixation necessitates an understanding of their characteristics in terms of intraoperative and postoperative complications.

scholarly journals Medial buttressing of the quadrilateral surface in acetabular and periprosthetic acetabular fractures

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243592
Author(s):  
Pol Maria Rommens ◽  
Michiel Herteleer ◽  
Kristin Handrich ◽  
Mehdi Boudissa ◽  
Daniel Wagner ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hospital Stay ◽  
Activity Level ◽  
Acetabular Fractures ◽  
Life Activity ◽  
Quadrilateral Plate ◽  
Group 2 ◽  
Group 1

Background In geriatric acetabular fractures, the quadrilateral plate is often involved in the fracture pattern and medially displaced. Open reduction and internal fixation (ORIF) includes reduction of the quadrilateral plate and securing its position. In this study, the concept of medial buttressing in acute and periprosthetic acetabular fractures is evaluated. Materials and methods Patients, who sustained an acetabular fracture between 2012 and 2018, in whom ORIF with a specific implant for medial buttressing was performed, were included in the study. Patients were divided in two groups; acute acetabular fractures (group 1) and periprosthetic acetabular fractures (group 2). Demographics, type of fracture, surgical approach, type of implant for medial buttressing, comorbidities, general and surgical in-hospital complications and length of hospital stay were recorded retrospectively. The following data were collected from the surviving patients by telephone interview: EQ-5D-5L, SF-8 physical and SF-8 mental before trauma and at follow-up, UCLA activity scale, Parker Mobility Score and Numeric Rating Scale. Results Forty-six patients were included in this study, 30 males (65.2%) and 16 females (34.8%). Forty patients were included group 1 and six patients in group 2. The median age of patients of group 1 was 78 years. Among them, 82.5% presented with comorbidities. Their median length of in-hospital stay was 20.5 days. 57.5% of patients suffered from in-hospital complications. The concept of medial buttressing was successful in all but one patient. ORIF together with primary total hip arthroplasty (THA) was carried out as a single stage procedure in 3 patients. Secondary THA was performed in 5 additional patients (5/37 = 13.5%) within the observation period. Among surviving patients, 79.2% were evaluated after 3 years of follow-up. Quality of life, activity level and mobility dropped importantly and were lower than the values of a German reference population. SF-8 mental did not change. The median age of patients of group 2 was 79.5 years, all of them presented with one or several comorbidities. The median length of in-hospital stay was 18.5 days. 50% of patients suffered from in-hospital complications. The concept of medial buttressing was successful in all patients. 5 of 6 patients (83.3%) could be evaluated after a median of 136 weeks. In none of these patients, secondary surgery was necessary. Quality of life, activity level and mobility importantly dropped as well in this group. SF-8 mental remained unchanged. Conclusion In geriatric acetabular fractures with involvement and medial displacement of the quadrilateral plate, medial buttressing as part of ORIF proved to be reliable. Only 13.5% of patients of group 1 needed a secondary THA within 3 years of follow-up, which is lower than in comparable studies. Despite successful surgery, quality of life, activity level and mobility dropped importantly in all patients. The loss of independence did however not influence SF-8 mental values.

Results of minimally invasive treatment of liver echinococcosis in comparison with traditional surgical methods

2021 ◽  
Vol 26 (4) ◽  
pp. 61-68
Author(s):  
M. S. Nagasbekov ◽  
Zh. B. Baimakhanov ◽  
Sh. A. Kaniyev ◽  
E. K. Nurlanbayev ◽  
A. T. Chormanov ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Disease Recurrence ◽  
Invasive Treatment ◽  
Early Recovery ◽  
Surgical Methods ◽  
Group 3 ◽  
Group 2 ◽  
Hepatic Echinococcosis ◽  
Group 1

Aim. To analyze the effectiveness of PAIR in comparison with traditional surgical methods.Materials and methods. A retrospective analysis of 199 patients who underwent surgical treatment of hepatic echinococcosis was carried out. Pericystectomy was performed on 95 (47.7%) patients (1st group), traditional echinococcectomy – 55 (27.6%; 2nd group), PAIR – 49 (24.6%; 3rd group). All patients received antihelmintic therapy for 2 months in the postoperative period.Results. Patients of the group 3 had significantly more CE1 cysts compared with the groups 2 and 1 – 38 (77.5%) versus 19 (34.5%) and 44 (46.3%; p < 0.05) respectively. In group 2, CE2 and CE3 cysts were predominant. The duration of the operation in group 3 was significantly shorter than in group 1 and 2 – 58.2 (25–170), 194.8 (85–440) and 217 (75–540) minutes (p < 0.05). In group 1, intraoperative blood loss was higher than in group 2 – 165.4 ml (10–1000) and 106.7 ml (10–500; p < 0.05). There were no statistically significant differences between the groups in postoperative complications according to Clavien–Dindo. The duration of postoperational hospital stay of patients from the group 3 was shorter than for 1 and 2 groups – 4.3 (2–11) days, 8.03 (5–16) days and 8.08 (4–20) days (p < 0.05) respectively. There was no disease recurrence during the follow-up period.Conclusion. The optimal treatment should be based on the stage of the disease. In CE1, the most effective method is PAIR, which is characterized by a shorter postoperational hospital stay and early recovery. In multivesicular cysts (CE2-CE3b), traditional methods of treatment are effective.

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