P557 Long-term outcomes following laparoscopic ileocecal resection without any residual lesion for Crohn’s disease: a single-center observational study

Background To describe the characteristic of Crohn’s disease (CD) patients undergoing ileocecal resection, and to analyze the long-term outcomes following surgery. Methods A retrospective study on patients undergoing ileocecal resection without any from residual disease in the remnant intestine from July 2011 to March 2020 was conducted. The clinical data and the following outcomes were evaluated. Results Among 86 CD patients, the mean disease duration was 33.4 months, 40 patients had perianal fistula. 53 patients underwent surgery due to stricture, 26 was perforation, and 7 was failure of medical therapy. 27 (31.4%) patients suffered postoperative complications. Mean follow-up was 44.4 months, 47 (54.7%) patients had an endoscopic recurrence with 9 were non-anastomotic recurrence, 20 were anastomotic recurrence, and 18 were both anastomotic and non-anastomotic recurrence, and 4 patients had a surgical recurrence. Furthermore, 41 (47.7%) had postoperative prophylaxis with 22 (25.6%) azathioprine and 17 (19.8%) infliximab. 45 (52.3%) patients were without postoperative prophylaxis, 19 (42.2%) had an endoscopic recurrence, and 26 (57.8%) had none endoscopic recurrence. The penetrating disease and lower skeletal muscle index were independent risk factors for endoscopic recurrence. Conclusion CD patients with penetrating disease or lower skeletal muscle index were suggested to have earlier postoperative prophylaxis after ileocecal resection without any from residual disease in the remnant intestine.

A Review of Nasal Polyps

Nasal polyps (NP) are one of the most common inflammatory lesions of the nose, affecting up to 4% of the population. Their etiology remains unclear, but they are known to have associations with allergy, asthma, infection, cystic fibrosis, and aspirin sensitivity. However, the underlying mechanisms interlinking these pathologic conditions to NP formation remain unclear. Also strong genetic factors are implicated in the pathogenesis of NP, but genetic and molecular alterations required for its development and progression are still unclear. They present with nasal obstruction, anosmia, rhinorrhea, post nasal drip, and less commonly facial pain. Management of polyposis involves a combination of medical therapy and surgery. There is good evidence for the use of corticosteroids (systemic and topical) both as primary treatment and as postoperative prophylaxis against recurrence. Surgical treatment has been refined significantly over the past twenty years with the advent of endoscopic sinus surgery and, in general, is reserved for cases refractory to medical treatment. Recurrence of the polyposis is common with severe disease recurring in up to ten percent of patients. In this talk I will present the newer treatment options available for better control and possibly cure of the disease.

Аnalysis of dynamics of clinical changes in cicatricially-changed tissues after surgical treatment of branchiogenic cysts in chronological aspect

Objective. Studying of processes of the cicatrices development after surgical treatment of the neck cysts of embryonal origin in chronological aspect. Маterials and methods. Experience of surgical treatment of 60 patients, suffering branchiogenic cysts, was analyzed. Retrospective analysis of the treatment results, including those performed in accordance to own elaborated procedures, was conducted. Results. Clinical changes in cicatricially-changed tissues depends upon the kind of intra- and postoperative prophylaxis of the cutaneous pathological cicatrices in surgical treatment of the neck cysts of embryological origin. Intraoperative application of the fibrin clot, enhanced by thrombocytes (PRF - clot), аnd postoperatively - of biocerrulin preparation, promotes a mostly expressed lowering of the course intensity for the free-radical oxidation in cicatricially-changed tissues of postoperative wound and prognosis for the pathological cutaneous cicatrices development, comparing with solely application of PRF-clot, аnd with operative intervention in accordance to classical method as well. Conclusion. Application of PRF-clot and biocerullin preparation improves significantly the healing processes in postoperative wound after surgical treatment of the neck cysts of embryonal origin, and this lead to lowering of possibility for development of pathological cutaneous cicatrices.

Prescription analysis of drug prescribed in post-operative period in a teaching hospital in Bhilai, Chhattisgarh, India

Background: Surgical site infections are associated with prolonged hospital stays and increased cost of therapy. Prophylactic use of antimicrobials is to prevent the incidence of postoperative wound infection. To generate data on postoperative use of antimicrobials this study was planned.Methods: The information was collected in semi-structured questionnaire format from the patient’s case paper. Information regarding the antimicrobials prescribed by surgeon, including drug combinations, duration of therapy, frequency of drug administration, and diagnosis for the surgery was collected. Surgical wounds were classified based on National Research Council (NRC) criteria.Results: Mean duration of antibiotic use was 3.71 days for clean surgeries (70%) and ranging from 2.67 days to 6 days for clean contaminated, contaminated and dirty types of surgeries. average number of antimicrobials prescribed for surgical antimicrobial prophylaxis was 3 per patients. Ceftriaxone, cefixime, ofloxacin, levofloxacin, amikacin, amoxycillin + clavulanic acid, ampicillin, metronidazole were used for postoperative prophylaxis.Conclusions: As per guidelines, the usage of antibiotics was found to be inappropriate in some conditions. Third generation cephalosporin was the preferred or most prescribed choice of drug for postoperative prophylaxis. The average number of antimicrobials prescribed for postoperative prophylaxis was 3 per patients.

Chronic Kidney Dysfunction Can Increase the Risk of Deep Vein Thrombosis after Total Hip and Knee Arthroplasty

Background. Deep vein thrombosis (DVT) is one of the major complications of total joint arthroplasty (TJA). Chronic kidney dysfunction (CKD) has proven to promote a proinflammatory and prothrombotic state and is prevalent among patients undergoing TJA. The purpose of this study is to identify whether CKD increase the risk of DVT following TJA. Methods. In a retrospective study, 1274 patients who underwent primary TJA were studied. CKD is graded in 5 stages. Univariate and multivariate analysis were used to identify the association of CKD and its severity with postoperative DVT. Results. There were 1139 (89.4%) participants with normal kidney function, 103 (8.1%) with mildly decreased kidney function, and 32 (2.5%) with stage 3 and 4 CKD. A total of 244 patients (19.2%) were diagnosed with DVT. Sixty-four patients (5.0%) developed symptomatic DVT. Advanced age, female gender, malignancy, and eGFR showed significant association with total DVT. BMI, thrombosis history, malignancy, and eGFR were associated with symptomatic DVT. After adjusting for age, gender, BMI, and malignancy, eGFR was found to be related to both total and symptomatic DVT. Conclusions. CKD is an important risk factor for both total and symptomatic DVT following TJA. Postoperative prophylaxis should be made a priority in this population.