TO EVALUATE COMPLICATION OF LAPAROSCOPIC TRANSPERITONEAL PYELOLITHOTOMY FOR MANAGEMENT OF RENAL PELVIC STONES

Background: To evaluate complication of laparoscopic transperitoneal pyelolithotomy for management of renal pelvic stones Methods: This study has been conducted in the Department of General surgery, Indira Gandhi Medical College, Shimla on selected patients of Renal pelvis stones admitted in institution Results: There were no major postoperative complications. Two patient developed mild low grade fever which subsided on oral antipyretic medication. One patient had a cough and one patient had ileus. Conclusion: We concluded that there were no major intraoperative or postoperative complications were seen in our study. Keywords: Laparoscopic Transperitoneal Pyelolithotomy, Pelvic stone, Complication

Patient Handoff Among General Surgery Residents in Saudi Arabia: A Cross-Sectional Study

Background Communication failure is a common cause of adverse events. An essential element of communication among healthcare providers is patient handoffs. To explore this practice, we assessed patient handoffs among general surgery residents in Saudi Arabia. Methods A cross-sectional survey was conducted with individuals in accredited general surgery residency programs in Saudi Arabia between 2020 to 2021. Results Participants comprised 118 general surgery residents—66 (57.3%) were females; 67 (72.8%) did not receive any formal training on patient handoff; 35 (38.8%) reported that they were sometimes interrupted during the patient handoff process. The most common reason for such interruptions was medical personnel paging. Further, 60 (68.1%) general surgery residents stated that such interruptions led to a decreased quality of effective communication, 39 (44.3%) believed it led to decreased quality of patient care, 63(71.5%) believed it led to the loss of some information related to patient handoff, and 16 (18.1%) believed it led to patient harm. Finally, 31 (34.4%) general surgery residents believed that the existing handoff system at their institutions neither adequately protected the patient’s safety nor allowed for continuity of care; and 51 (68%) reported that they did not have a standardized protocol for patients’ verbal handoff process at their institution. There were higher proportion of patients with minor harm in residents who did not, rare or some time received verbal or written hand off (67% vs 33%). Conclusion The patient handoff process among general surgery residents in Saudi Arabia is subjective, not standardized, and can contribute to patient harm. Standardizing it is paramount to improve patient safety.

Fatores de Risco Associados à Recusa de Notas de Transferência e Vales Cirurgia: O Caso da Região Centro em Portugal

Introduction: In Portugal, the rate of refusals regarding transfer between hospitals through surgery vouchers is high, which makes it difficult to meet maximum waiting times for elective surgeries. The objectives of this study are to examine how many vouchers were issued and refused between the third quarter of 2016 and the fourth quarter of 2019 and the risk factors associated with their refusal, in Central PortugalMaterial and Methods: Data was obtained in the database of cancelled vouchers and the waiting list for surgery on the 31st December 2019. Multiple logistic regression was used to investigate risk factors.Results: The number of issued vouchers increased after 2018 and the rate of refusals has been above 55% since the 3rd quarter of 2018. Refusal was more likely for individuals aged 55 years or above (OR = 1.136; CI = 1.041 – 1.240; OR = 1.095; CI = 1.005 – 1.194; OR = 1.098; CI = 1.002 – 1.203, for the age bands 55 - 64, 65 - 74 and 75 - 84, respectively), for inpatient surgery when compared to ambulatory (OR = 2.498; CI = 2.343 – 2.663) and for Orthopaedics when compared to General Surgery (OR = 1.123; CI = 1.037 – 1.217). The odds of refusal also varied across hospitals (for example OR = 3.853; CI = 3.610 – 4.113; OR = 3.600; CI = 3.171 – 4.087; OR = 2.751; CI =3.383 – 3.175 e OR = 1.337; CI = 1.092 – 1.637, for hospitals identified as HO_2, HO_7, HO_4 and HO_6, respectively).Conclusion: In this study, we have confirmed that the number of issued surgery vouchers increased after the administrative reduction of maximum waiting times in 2018 and that the rate of transfer refusals has been increasing since 2016 and has remained above 55% from the third trimester of 2018 onwards. Some of the factors for which we obtained a positive association with refusal are age, inpatient surgery (compared to ambulatory) and Orthopaedics (compared to General Surgery).