Periadrenal Volume is a Better Predictor of Prolonged Operative Time in Laparoscopic Retroperitoneal Adrenalectomy than BMI

2019 ◽  
Vol 44 (2) ◽  
pp. 578-584 ◽  
Author(s):  
Sarah S. Pearlstein ◽  
Jennifer H. Kuo ◽  
John A. Chabot ◽  
James A. Lee
Keyword(s):  
Operative Time ◽  
Retroperitoneal Adrenalectomy ◽  
Prolonged Operative Time

Prolonged Operative Time Associated with Increased Healthcare Utilization after Open Reduction and Internal Fixation of Intra-Articular and Extra-Articular Distal Radial Fractures: An Analysis of 17,482 Cases

2021 ◽  
Author(s):  
Joseph P. Scollan ◽  
Erin Ohliger ◽  
Ahmed K. Emara ◽  
Daniel Grits ◽  
Kara McConaghy ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Open Reduction ◽  
Operative Time ◽  
Adverse Outcomes ◽  
Care Utilization ◽  
Wound Complications ◽  
Spline Regression ◽  
Distal Radial Fractures ◽  
Prolonged Operative Time

Abstract Background The current literature does not contain a quantitative description of the associations between operative time and adverse outcomes after open reduction and internal fixation (ORIF) of distal radial fractures (DRF). Questions/Purpose We aimed to quantify associations between DRF ORIF operative time and 1) 30-day postoperative health care utilization and 2) the incidence of local wound complications. Methods The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for DRF ORIF cases (January 2012–December 2018). A total of 17,482 cases were identified. Primary outcomes included health care utilization (length of stay [LOS], discharge dispositions, 30-day readmissions, and reoperations) per operative-time category. Secondary outcome was incidence of wound complications per operative-time category. Multivariate regression was conducted to determine operative-time categories associated with increased risk while adjusting for demographics, comorbidities, and fracture type. Spline regression models were constructed to visualize associations. Results The 121 to 140-minute category was associated with significantly higher risk of a LOS > 2 days (odds ration [OR]: 1.64; 95% confidence interval [CI]:1.1–2.45; p = 0.014) and nonhome discharge (OR: 1.72; 95% CI:1.09–2.72; p = 0.02) versus 41 to 60-minute category. The ≥ 180-minute category exhibited highest odds of LOS > 2 days (OR: 2.08; 95%CI: 1.33–3.26; p = 0.001), nonhome discharge disposition (OR: 1.87; 95% CI: 1.05–3.33; p = 0.035), and 30-day reoperation occurrence (OR: 3.52; 95% CI: 1.59–7.79; p = 0.002). There was no association between operative time and 30-day readmission (p > 0.05 each). Higher odds of any-wound complication was first detected at 81 to 100-minute category (OR: 3.02; 95% CI: 1.08–8.4; p = 0.035) and peaked ≥ 181 minutes (OR: 9.62; 95% CI: 2.57–36.0; p = 0.001). Spline regression demonstrated no increase in risk of adverse outcomes if operative times were 50 minutes or less. Conclusion Our findings demonstrate that prolonged operative time is correlated with increased odds of health care utilization and wound complications after DRF ORIF. Operative times greater than 60 minutes seem to carry higher odds of postoperative complications.

scholarly journals Long-Term Clinical Efficacy and Perioperative Safety of Endoscopic Submucosal Dissection versus Endoscopic Mucosal Resection for Early Gastric Cancer: An Updated Meta-Analysis

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Yajie Zhao ◽  
Chengfeng Wang
Keyword(s):  
Gastric Cancer ◽  
Local Recurrence Rate ◽  
Operative Time ◽  
Postoperative Bleeding ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Complete Resection ◽  
Resection Rate ◽  
En Bloc ◽  
Prolonged Operative Time

Background. To systematically evaluate the safety and efficacy of endoscopic submucosal dissection (ESD) versus endoscopic mucosal resection (EMR) for early gastric cancer (EGC). Methods. We searched the databases of PubMed, Web of Science, EMBASE, and the Cochrane Library from January 2000 to April 2017 and included studies that compared the outcomes of ESD with EMR for EGC. These eligible studies that met the inclusion criteria were screened out and were assessed by two independent investigators. Result. In total, 18 retrospective cohort studies were eligible for analysis. Our results indicated that ESD is more beneficial than EMR in increasing the complete resection rate and en bloc resection rate and decreasing the local recurrence rate. However, ESD prolonged operative time and increased incidence of gastric perforation than EMR. No differences were found in postoperative bleeding rate between the two approaches. Conclusion. Compared with EMR, ESD offers higher complete resection rate, higher en bloc resection rate, and lower local recurrence rate but has prolonged operative time and increased incidence of gastric perfusion. There is no statistical difference in the rate of postoperative bleeding between the two groups. However, the above conclusion needs further verification by well-designed, randomized trials with larger samples and long follow-up periods.

scholarly journals Prolonged operative time increases infection rate in tibial plateau fractures

Injury ◽  
2013 ◽  
Vol 44 (2) ◽  
pp. 249-252 ◽  
Author(s):  
Matthew Colman ◽  
Adam Wright ◽  
Gary Gruen ◽  
Peter Siska ◽  
Hans-Christoph Pape ◽  
...  
Keyword(s):  
Infection Rate ◽  
Tibial Plateau ◽  
Operative Time ◽  
Tibial Plateau Fractures ◽  
Prolonged Operative Time

Independent predictors of prolonged operative time during robotic-assisted radical prostatectomy

2015 ◽  
Vol 9 (2) ◽  
pp. 117-123 ◽  
Author(s):  
Philippe D. Violette ◽  
David Mikhail ◽  
Gregory R. Pond ◽  
Stephen E. Pautler
Keyword(s):  
Radical Prostatectomy ◽  
Operative Time ◽  
Robotic Assisted ◽  
Robotic Assisted Radical Prostatectomy ◽  
Prolonged Operative Time

scholarly journals Rhabdomyolysis Following Bariatric Surgery: a Retrospective Analysis

2013 ◽  
Vol 5 (1) ◽  
pp. 51-59
Author(s):  
Francesco Forfori ◽  
Anna Sidoti ◽  
Riccardo Taddei ◽  
Nora Terrasini ◽  
Erik Arbeid ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Operative Time ◽  
Creatine Phosphokinase ◽  
Circulatory System ◽  
Kidney Injury ◽  
University Hospital ◽  
Bivariate Analysis ◽  
Muscle Necrosis ◽  
The University ◽  
Prolonged Operative Time

Background: Rhabdomyolysis (RML) indicates a skeletal muscle necrosis which results in an emission of intracellular contents from myocytes into the circulatory system. It has been recognized to be a complication of bariatric surgery. A high BMI and a prolonged operative time are the main risk factors associated to the development of RML. The aim of this study is to define the incidence and the main features of RML in a cohort of obese patients undergoing bariatric surgery. Materials and Methods: a retrospective observational analysis was carried out on 100 patients undergone bariatric surgery. The bariatric operations were open or laparoscopic Roux-en-Y gastric bypass (RYGB) and laparoscopic sleeve gastrectomy (SG); they were performed at the university hospital Nuovo S. Chiara in 2011. Results: 6 of 100 patients enrolled developed RML. Three of these also showed acute kidney injury due to RML (50%). A significant correlation between post-operative increased creatine phosphokinase (CPK) levels and BMI was found (r=0.369; r2=0,137; p=0.005) as well as a significant correlation between the increased levels of creatine phosphokinase, myoglobin and operative time (increased operative time - highest CPK: r=0.550; r2=0.302; p<0.0001; increased operative time - highest myoglobin: r=0.553; r2=0.305; p<0.0001). Moreover, hypertension and prolonged operative time were found to be variables associated with RML in bivariate analysis. Conclusions: The incidence of RML following bariatric surgery was 6%. Since rhabdomyolysis is the most important complication of bariatric surgery, appropriate precautions should be taken during surgery. Post-operative monitoring of CPK and myoglobin levels is essential for an early diagnosis of RML.

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