Risk Factors for Early and Late Complications after Laparoscopic Sleeve Gastrectomy in One-Year Observation

Background: Although laparoscopic sleeve gastrectomy (LSG) is considered a safe bariatric procedure in the treatment of obesity, it still involves a risk of developing postoperative complications. Knowledge of risk factors for possible complications would allow appropriate preoperative planning, optimization of postoperative care, as well as early diagnosis and treatment. The aim of this study was to evaluate risk factors for complications after laparoscopic sleeve gastrectomy. Methods: A retrospective study of 610 patients who underwent LSG at a tertiary institution were included in the study through retrospective analysis of the medical data. Complications were categorized as early (<30 days) and late (≥30 days) and evaluated according to the Clavien–Dindo Classification. Results: Early complications were observed in 35 patients (5.74%) and late complications occurred in 10 patients (1.64%). Independent risk factors of early complications after laparoscopic sleeve gastrectomy included hypercholesterolemia (OR 3.73; p-value = 0.023) and smoking (OR = 274.66, p-value < 0.001). Other factors that may influence the postoperative course are length of hospital stay and operation time. Smoking, peptic ulcer diseases and co-existence of hiatal hernia were found to be an independent predictors of late complications. Conclusions: Smoking is associated with the higher risk of both, early and late complications, while hypercholesterolemia with only <30 days complications after laparoscopic sleeve gastrectomy.

COMPARISON OF ILEAL CONDUIT AND TUUC: A 4 YEARS STUDY

Objective: This study aims to compare 4 years of experience of IC and TUUC in the same period and among similar experienced surgeons. Material & Methods: Between January 2016 and August 2019, 44 radical cystectomies were performed, but 4 patients were excluded due to incomplete data or who underwent neo-bladder procedures. The primary endpoint was 30 days of complication rate and intraoperative complications. Bowel movement, ambulation, and length of stay (LOS) postoperatively were followed-up over a period of 30-day postoperatively. Results: 12 male patients underwent TUUC and 24 male patients IC, while only 4 female patients underwent IC. The mean of LOS of IC was 12.72 8.6 and 10.08 3.5 for TUUC; there were no significant differences between arms. However, TUUC had lower intra-operatively bleeding (779.17 441.15 ml) compared to IC (1328.57 810.40 ml). There was no difference in early complications between arms. Conclusion: Our results suggest that TUU with UC diversion may be used as a viable option of urinary diversion in radical cystectomy. This technique provides similar safety both surgically and oncologically.

The Development of a Nationwide, Multicenter Electronic Database for Spinal Instrumentation Surgery in Japan: Japanese Spinal Instrumentation Society Database (JSIS-DB)

(1) Background: Despite the number of complicated and expensive spine surgery procedures maintained by the national health insurance system in Japan, until now there has been no large-scale multicenter clinical database for this field to understand and improve healthcare expenditure and treatment outcomes. The purpose of this report is to announce the establishment and methodology of a nationwide registry system for spinal instrumentation surgeries by the Japanese Spinal Instrumentation Society (JSIS), and to report the progress over the first 1.5 years of this database’s operation. (2) Methods: The JSIS recently produced an online database with an electronic server. The collected information included patient background, surgery information, and early complications of primary and revision cases. Analysis included data from February 2018, when registration began, to August 2019. (3) Results: As of August 2019, 73 facilities have completed the required paperwork to start, and 55 facilities have registered cases. Of the total 5456 registered cases, 4852 were valid and 2511 were completed. (4) Conclusions: JSIS-DB, the nationwide web-based registry system for spinal instrumentation surgery in Japan, was launched for the purpose of research, healthcare policy regulation, and improved patient care, and its methodology and progress in the first 1.5 years are reported in this study.

Evaluation of early results of patients with permanent peacemakers implantation at Bai Chay Hospital from 2016 to 2020

Objectives: Review the results of pacing and some early complications of patients Who implanted pacemaker at Bai Chay Hospital from 2016 to 2020. Subjects and research methods: A descriptively prospective study longitudinal follow-up study on 31 bradyarrhythmia patients who were permanently paced at Bai Chay Hospital from 2016 to October 2020. Results: After implantation of pacemaker, the rate of symptoms improved markedly, the change was statistically significant with p = 0.0001. Medium heart rate before and after implantation (47.84 ± 7.712 with 65.61 ± 4.425, 95%CI: 17.77 ± 7.173, p = 0.000). Change in QRS width after implantation (153.52 ± 11,963ms vs 91.81 ± 10,882ms, 95%CI 61.71 ± 12,947, p = 0.000). Pacing threshold changed after 6 months (0.68 ± 0.146V; 0.73 ± 0.149; p=0.001). Received R wave and electrode wire impedance did not changing after 6 months of follow-up. The rate of complications right after the procedure accounted for a total of 6.45%. The rate of complications after 6 months of follow-up accounted for 6.45%. Complications were all minor complications and were well managed. The successful rate of the procedure reached 100%, the pacing parameter was assessed as good, accounting for 70.97%. Conclusion: The method is considered effectively in the symptom improvement, safety, low complication rate and should be applied and deployed for patients with bradyarrhythmias with indications for permanent pacemaker implantation.

Pulp hyperemia: analysis of treatment based on the results of a survey of dentists

The purpose of the study: to analyze the methods of treatment of deep caries by dentists of the Samara region.Materials and methods. In 2021, 220 specialists of the Samara region were surveyed on the treatment of deep dental caries on the bases of budgetary and extra-budgetary organizations. The questionnaires contained 20 questions that provided information about the level of professional training of specialists, the degree of their awareness of quality criteria and standards, the use of modern technologies and the implementation of each stage of deep caries treatment. The statistical significance of the obtained results (p) was calculated using the Student’s criterion (t) and its interpretation based on the standard table of critical values of the Student’s coefficient. Spearman’s rank correlation method was used to determine the strength and direction of the correlation.Results. The majority of dentists – 89.9% use a medical pad in the treatment of deep caries, of which 38.7% of respondents use this pad only when accidentally opening the tooth cavity. Based on the answers to the questionnaire, 77.0% of respondents prefer calcium-containing self-hardening medical pads and only 4.6% use MTA-based pads. A comparative analysis of doctors with rare early complications and doctors with frequent early complications showed that doctors of the second group apply a medical pad when opening the tooth cavity 25% more often than doctors of the first group when performing necrectomy in full volume in both groups. A comparative analysis of doctors with rare late complications and frequent late complications did not reveal a statistical significance between the imposition of a medical pad and the opening of the tooth cavity during a complete necrectomy in doctors of the first and second groups. Complications after the treatment of deep caries may be due to an incorrect interpretation of reversible and irreversible changes in the pulp, and in this regard – incorrectly chosen treatment tactics.Conclusion. The success of the treatment of deep carisea largely depends on the correct determination of reversible and irreversible changes in the pulp of the tooth.

The frequency of early stomal, peristomal and skin complications

Background: The incidence of early complications after stoma formation (within 30 days of surgery) is difficult to determine and has been reported to be in a range of 3%–82%. Aim: The aim of this study was to analyse the onset of stomal, peristomal and skin complications one month (30 days) after ostomy creation. Method: This review analysed enteral stoma therapy nurse reports on patients who had an ostomy created between January 2016 and December 2020. Findings: Complications were analysed according to ostomy type: colostomy, ileostomy and urostomy. There were 1292 incidences of complications: skin complications were the most common (26%), and abscess the least common (0%). Conclusion: A majority (63%) of patients experienced at least one or more complications within 30 days of surgery. Haemorrhage was reported as a complication (2%) but the authors found no data on its incidence in the literature. In addition to early complications, late complications were detected.

A multicenter cohort study of early complications after cranioplasty: results of the German Cranial Reconstruction Registry

OBJECTIVE Cranioplasty (CP) is a crucial procedure after decompressive craniectomy and has a significant impact on neurological improvement. Although CP is considered a standard neurosurgical procedure, inconsistent data on surgery-related complications after CP are available. To address this topic, the authors analyzed 502 patients in a prospective multicenter database (German Cranial Reconstruction Registry) with regard to early surgery-related complications. METHODS Early complications within 30 days, medical history, mortality rates, and neurological outcome at discharge according to the modified Rankin Scale (mRS) were evaluated. The primary endpoint was death or surgical revision within the first 30 days after CP. Independent factors for the occurrence of complications with or without surgical revision were identified using a logistic regression model. RESULTS Traumatic brain injury (TBI) and ischemic stroke were the most common underlying diagnoses that required CP. In 230 patients (45.8%), an autologous bone flap was utilized for CP; the most common engineered materials were titanium (80 patients [15.9%]), polyetheretherketone (57 [11.4%]), and polymethylmethacrylate (57 [11.4%]). Surgical revision was necessary in 45 patients (9.0%), and the overall mortality rate was 0.8% (4 patients). The cause of death was related to ischemia in 2 patients, diffuse intraparenchymal hemorrhage in 1 patient, and cardiac complications in 1 patient. The most frequent causes of surgical revision were epidural hematoma (40.0% of all revisions), new hydrocephalus (22.0%), and subdural hematoma (13.3%). Preoperatively increased mRS score (OR 1.46, 95% CI 1.08–1.97, p = 0.014) and American Society of Anesthesiologists Physical Status Classification System score (OR 2.89, 95% CI 1.42–5.89, p = 0.003) were independent predictors of surgical revision. Ischemic stroke, as the underlying diagnosis, was associated with a minor rate of revisions compared with TBI (OR 0.18, 95% CI 0.06–0.57, p = 0.004). CONCLUSIONS The authors have presented class II evidence–based data on surgery-related complications after CP and have identified specific preexisting risk factors. These results may provide additional guidance for optimized treatment of these patients.