Frequency and risk factors of surgical complications in patients with locally advanced cervical esophageal cancer

2022 ◽  
pp. 37-40
Author(s):  
Z. A-G. Radzhabova ◽  
M. A. Kotov ◽  
E. V. Levchenko
Keyword(s):  
Esophageal Cancer ◽  
Surgical Treatment ◽  
Blood Loss ◽  
Locally Advanced ◽  
Fistula Formation ◽  
Intraoperative Blood Loss ◽  
Cervical Esophageal Cancer ◽  
Simultaneous Reconstruction ◽  
Increased Risk ◽  
Duration Of Surgery

Objective. Analyze the frequency and prognostic factors of complications in patients with locally advanced cervical esophageal cancer after pharyngolaryngoesophagectomy with simultaneous reconstruction of the defect.Material and methods. The retrospective study included patients with a verified locally advanced cervical esophageal cancer who were treated at the N. N. Petrov National Research Institute of Oncology in the period from 2009 to 2018, who underwent surgical treatment followed by chemoradiotherapy. The end point of the study was the frequency of postoperative complications.Results. Forty-eight patients were included in the study. All patients underwent laryngopharyngoesophagectomy with simultaneous reconstruction of the digestive tract. Forty-one patients (85.4 %) underwent the reconstructive stage using a narrow gastric stalk, and a wide gastric stalk and a small intestine graft were used in 5 (10.4 %) and 2 (4.2 %) patients, respectively. The average duration of the operation was 390 (337.5–525.0) minutes, the volume of blood loss was 300 (200–500) ml, and the average time of hospitalization and the patient’s stay in the intensive care unit was 21.5 (16.00–36.00) and 3 (1.000–6.75) days, respectively. Complications within 30 days after surgical treatment were observed in 54.1 % of patients, while anastomosis failure, fistula formation and pneumonia were observed in 22.9 %, 12.5 % and 18.8 % of cases, respectively. Factors slightly increasing the likelihood of pneumonia in the early postoperative period were: duration of surgery [OR = 1.0 (95 % CI: 1.00–1.01), p = 0.0131] and intraoperative blood loss [OR = 1.0 (95 % CI: 1.00–1.01), p = 0.0017].Conclusion. The overall complication rate after pharyngolaryngoesophagectomy with simultaneous repair of the defect by bioengineered graft was 54.1 %. Intraoperative blood loss and duration of surgery were associated with an increased risk of complications.

scholarly journals A clinico-surgical outcome of vaginal hysterectomy with or without hydro dissection: a Quasi experimental study

2018 ◽  
Vol 7 (9) ◽  
pp. 3668
Author(s):  
Kirti M. Hurakadli ◽  
L. L. Pujari ◽  
Prashant G.
Keyword(s):  
Blood Loss ◽  
Vaginal Hysterectomy ◽  
Minimal Invasive Surgery ◽  
Minimal Invasive ◽  
Intraoperative Blood Loss ◽  
Duration Of Surgery ◽  
Quasi Experimental ◽  
Abdominal Route ◽  
The Mean ◽  
Lower Morbidity

Background: Vaginal hysterectomy -the signature operation of gynecologic profession, is a hallmark of gynecological extirpative hysterectomy surgery and surgical excellance1. In the era of minimal invasive surgery, Nondescent vaginal hysterectomy has evolved over the years and is opted over abdominal route. It is because of lower morbidity, less postoperative pain, more rapid   return to normal activities and lesser hospital stay associated with this route of surgery. Practice of hydrodissection with diluted adrenalin has been noticed by few surgeons.Methods: We did a retrospective analysis of 267 cases of vaginal hysterectomies in our hospital over a period of three years, regarding the benefit of hydro dissection in reducing the blood loss and time of surgery, so as to incorporate this technique on routine basis.Results: Of 267 cases, NDVH was done in 107 (40.1%) cases, and 160 (59.9%) patients underwent vaginal hysterectomy with PFR. Of 267 cases, 121 (45.3%) cases had hydro dissection. In 146 (54.7%) cases hydro dissection was not done. The mean blood loss was significantly reduced in cases with hydro dissection to a mean of 1.07 mops when compared to cases with no hydro dissection-mean of 1.71 mops. Duration of surgery was also significantly reduced to a mean of 39.9 minutes in cases with hydro dissection when compared to cases with no hydro dissection with a mean of 46.3 minutes. There was no significant change in duration of hospital stay.Conclusions: Hydro dissection with diluted adrenaline should be routinely practice by all vaginal surgeons to reduce the duration of surgery and intraoperative blood loss.

scholarly journals Intraoperative Blood Loss during Induced Abortion: A Comparison of Anesthetics

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Camille A. Clare ◽  
Gabrielle E. Hatton ◽  
Neela Shrestha ◽  
Michael Girshin ◽  
Andre Broumas ◽  
...  
Keyword(s):  
Blood Loss ◽  
Retrospective Chart Review ◽  
First Trimester ◽  
Induced Abortion ◽  
Anesthetic Technique ◽  
Anesthetic Techniques ◽  
Intraoperative Blood Loss ◽  
Anesthetic Agents ◽  
Dilatation And Curettage ◽  
Increased Risk

Objective. To determine whether there is a difference in intraoperative bleeding with inhalational versus noninhalational anesthetic agents for patients undergoing suction dilatation and curettage for first-trimester induced abortion.Methods. This is an IRB-approved retrospective chart review of the electronic medical records of patients undergoing induced abortion at gestational ages between 5 0/7 and 14 0/7 weeks of pregnancy at the New York City Health + Hospitals/Metropolitan. The records of 138 patients who underwent suction dilatation and curettage for induced abortion between June 2012 and June 2014 were reviewed for an association between anesthetic technique and intraoperative hemorrhage. Twenty patients received inhalational anesthetic agents, while 118 received intravenous anesthetics. Blood loss was estimated by the operating gynecologists.Results. The mean intraoperative blood loss for inhalational anesthetics (113.6 ml) was significantly higher than with noninhalational agents (40.2 ml) (p=0.007). Age, body mass index, and gestational age were not statistically different between the groups; the number of methylergonovine doses at induced abortion trended higher with inhalation anesthetics.Conclusions. The difference in blood loss between the two types of anesthetic techniques was statistically significant. These findings may be important for patients with significant anemia or at an increased risk of bleeding, such as those with unrecognized coagulopathies.

scholarly journals Effect of anaesthesia on the perioperative outcomes of pelvi-acetabular fracture surgeries in the apex trauma centre of a developing country–a retrospective analysis

2015 ◽  
Vol 3 ◽  
pp. 1-6
Author(s):  
Naveen Yadav ◽  
Suma Rabab Ahmad ◽  
Nisha Saini ◽  
Babita Gupta ◽  
Chhavi Sawhney ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Blood Loss ◽  
Hospital Stay ◽  
General Anaesthesia ◽  
Acetabular Fracture ◽  
Regional Anaesthesia ◽  
Trauma Centre ◽  
Intraoperative Blood Loss ◽  
Duration Of Hospital Stay ◽  
Duration Of Surgery

Abstract Background Regional anaesthesia has been proposed to reduce intraoperative blood loss, duration of hospital stay and in-hospital complications with improved postoperative pain control. General anaesthesia is advantageous for prolonged surgeries. We hypothesized that combined regional and general anaesthesia would offer advantages of both in pelvi-acetabular fracture surgeries. Methods We identified 71 patients who underwent open reduction and internal fixation of pelvi-acetabular fractures from May 2012 to 2013 in our trauma centre. We excluded patients with incomplete records (n = 4) and other injuries operated along (n = 8). Hence, 59 patients were divided into three groups: G group (general anaesthesia), R group (regional anaesthesia) and GR group (combined regional and general anaesthesia). Main outcome measurements studied were intraoperative blood loss, duration of hospital stay, duration of surgery and intraoperative and postoperative complications. Results No differences were obtained in between the groups in terms of age, gender, Injury Severity Score, number of comorbidities, or duration from injury to surgery. No significant differences were found between the three groups for intraoperative blood loss, days of hospital stay and duration of surgery. Intraoperative and postoperative complications were also comparable between the groups (p > 0.05). Conclusions There is no specific significant advantage of the technique of anaesthesia on the observed perioperative complications in pelvi-acetabular fracture surgeries.

Open cystectomy is still alive and well: Outcomes from a single-centre 6-year review

2018 ◽  
Vol 12 (3) ◽  
pp. 239-245
Author(s):  
Alexios Dosis ◽  
Blessing Dhliwayo ◽  
Patrick Jones ◽  
Iva Kovacevic ◽  
Jonathan Yee ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Radical Cystectomy ◽  
Length Of Hospital Stay ◽  
Categorical Variables ◽  
Complication Rates ◽  
Intraoperative Blood Loss ◽  
Single Centre ◽  
Significant Difference ◽  
Duration Of Surgery

Objectives: To compare perioperative and oncological outcomes between open and laparoscopic radical cystectomy in a single-centre setting. Materials and methods: This study was a retrospective cohort (level 2b evidence) non-randomised review of 228 radical cystectomies that were performed between January 2010 and February 2016. Primary outcome measures were operative time, complications, blood loss and length of hospital stay. Statistical analysis was performed using the SPSS v21.0. Quantitative values were compared with Student’s t-test; categorical variables with the chi-square test. Statistical significance was considered a result of an alpha value less than 0.05. A Kaplan–Meier survival analysis was also conducted. Results: Intraoperative blood loss was lower in laparoscopic surgery (855±673 vs. 716±570 mL, P=0.15), which had a significant impact on transfusion rates ( P=0.02). Operative times were lower in open surgery (339±52.9 vs. 353.1±67.1 minutes, P=0.10), while hospital stay was lower in the laparoscopic group (14.2±11.2 vs. 16.0±13.6 days, P=0.28). Five-year survival rates were superior for patients who underwent an open procedure but were not statistically significant ( P=0.10). Conclusion: This is, so far, the largest cohort to compare laparoscopic and open radical cystectomy. The laparoscopic approach can reduce the need for transfusion; however, there was no statistically significant difference in complication rates, duration of surgery, length of hospital stay or intraoperative blood loss, survival and margin positivity. Level of evidence: Not applicable for this multicentre audit.

scholarly journals Comparative analysis of safety and effect of minimally invasive esophageal cancer radical resection and conventional thoracotomy for esophageal cancer

2018 ◽  
Vol 2 (6) ◽  
Author(s):  
Ke Du ◽  
Zhenxing Wang
Keyword(s):  
Esophageal Cancer ◽  
Blood Loss ◽  
Minimally Invasive ◽  
Lymph Nodes ◽  
Radical Surgery ◽  
Radical Resection ◽  
Control Group ◽  
Clinical Effects ◽  
Intraoperative Blood Loss ◽  
Experimental Group

【Abstract】Objective: To compare the clinical effects of minimally invasive esophageal cancer radical resection and traditional esophageal cancer radical resection.Methods: 200 cases of esophageal cancer radical resection were performed from July 2014 to July 2017 in our hospital.The cases were divided into experimental group and control group, 82 cases in the experimental group and 118 cases in the control group.The experimental group was treated with minimally invasive esophageal cancer radical surgery, and the control group was treated with conventional thoracotomy.Record the comparison between the two groups (1) surgical conditions, including the time of surgery, intraoperative blood loss, hospitalization time; (2) the number of lymph nodes cleaned; (3) the postoperative control group used conventional thoracotomy, including lung lesions, anastomotic fistula / narrow.RESULTS: The parameters of operation time, intraoperative blood loss, hospitalization time, and number of lymph nodes cleaned in the experimental group were lower than those in the control group, and the difference was statistically significant (p<0.05). In addition to pulmonary infection (p<0.05), There was no significant difference in the incidence of other complications between the experimental group and the control group (p>0.05).Conclusion: Minimally invasive esophageal cancer radical resection and conventional thoracotomy have good clinical effects in the treatment of esophageal cancer. Minimally invasive esophageal cancer radical surgery can effectively reduce intraoperative trauma and postoperative reaction, which is worthy of popularization and application.

scholarly journals Surgical Treatment of Tensile Effusion in Postoperative Cavity after Glioma Resection

2020 ◽  
pp. 1-7
Author(s):  
Sheng-Qing Lv ◽  
Guo-Hao Huang ◽  
Lin Yang ◽  
Sheng-Qing Lv ◽  
Xun Qin ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Subdural Hematoma ◽  
Burr Hole ◽  
Intraoperative Blood Loss ◽  
Gcs Score ◽  
Glioma Resection ◽  
Time Of Operation ◽  
Better Than

Objectives: To explore the clinical surgical methods for the treatment of tensile effusion in postoperative cavity after glioma resection. Methods: Clinical data of 26 cases of tensile effusion in postoperative cavity after glioma resection were analyzed retrospectively. All 26 patients underwent surgical treatment, including 16 cases who underwent puncture and drainage (P&D), and 10 cases who underwent craniotomy decompression (CD). Among the cases of P&D, postoperative cavity in 7 cases were punctured through the burr hole for creating the skull flap for intraoperative resection of glioma, and postoperative cavities in 9 cases were punctured through a burr hole for the dura mater suspended under the skull flap. Glasgow Coma Scale (GCS) was used to evaluate the consciousness status of the two groups of patients before and after surgery. Moreover, time of operation, intraoperative blood loss, postoperative hospital duration, and postoperative complications were also adopted for evaluation of the merits of the two methods for treatment of tensile effusion in postoperative cavity after glioma resection. Results: The consciousness of the patients in both groups improved within 24 hours after the operation, and there were no death cases. In the P&D group, the GCS score within 24 hours after surgery was (14.38±0.20), the time of operation time was (7.81±0.64) mins, intraoperative blood loss was (6.25±0.56) ml, and postoperative hospital duration was (6.69±0.54) days. There were 3 cases with postoperative complications (1 case of puncture tract hemorrhage, 1 case of subdural hematoma and 1 case of intracranial infection) in the P&D group. All of the puncture tract hemorrhage and subdural hematoma did not require surgical treatment, and the intracranial infection was cured after antibiotic treatment and lumbar puncture for cerebrospinal fluid replacement. In the CD group, the GCS score within 24 hours after surgery was (13.70±0.21), the time of operation was (124.10±8.96) mins, intraoperative blood loss was (260±30.55) ml, and postoperative hospital duration was (11.30±0.60) days. There were 2 cases with postoperative complications (both of them were with subdural hematoma), none of which required surgical treatment. The GCS score, time of operation, intraoperative blood loss and postoperative hospital duration in the P&D group were better than those in the CD group (P < 0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P >0.05). Conclusion: The P&D and CD for tensile effusion in postoperative cavity after glioma resection can both achieve ideal results, but P&D in line with the concept of micro-invasive neurosurgery was better than CD in terms of postoperative GCS score within 24 hours, duration of operative, intraoperative blood loss, and postoperative hospital duration.

scholarly journals Single- and multistage surgical treatment of patients with degenerative sagittal imbalance

2021 ◽  
Vol 18 (2) ◽  
pp. 44-53
Author(s):  
E. S. Baikov ◽  
A. V. Peleganchuk ◽  
A. J. Sanginov ◽  
O. N. Leonova ◽  
A. V. Krutko
Keyword(s):  
Surgical Treatment ◽  
Blood Loss ◽  
Charlson Comorbidity Index ◽  
Sagittal Imbalance ◽  
Group I ◽  
Duration Of Surgery ◽  
Comorbidity Index ◽  
Group Ii ◽  
Clinical And Radiological Results ◽  
High Charlson Comorbidity Index

Objective. To analyze the nearest clinical and radiological results of simultaneous and staged surgical treatment of patients with degenerative sagittal imbalance.Material and Methods. Retrospective monocentric cohort study included analysis of data from 54 patients who underwent simultaneous combination of surgical methods with obligatory corrective anterior fusion at the L4–L5 or at L4–L5 and L5–S1 levels (Group I, n = 27) or similar surgical intervention though divided into stages with an interval of 5 days or more (Group II, n = 27). A comparison of clinical, radiological, and operational data during inpatient treatment was carried out.Results. The duration of surgery was 410.93 ± 76.34 minutes in Group I and 594.63 ± 102.61 minutes in Group II (p = 0.000001); the  blood loss was 926.67 ± 378.63 ml versus 1345.19 ± 522.97 ml, respectively (p = 0.001575). Postoperative clinical and radiological parameters did not differ between groups: VAS back (p = 0.248647), VAS leg (p = 0.196140), PT (p = 0.115965), SVA (p = 0.208449), LL (p = 0.023654), LDI (p = 0.931646), PI-LL (p = 0.693045), GAP (p = 0.823504), and restoration of the ideal Russoly type (p = 0.111476). The incidence of perioperative complications in groups was comparable: 17 (62.96 %) in Group I and 15 (55.56 %) in Group II (p = 0.583171). Patients with a high Charlson comorbidity index had a significantly higher incidence of complications (p = 0.023471). The index of surgical invasiveness in Group I had a significant correlation with the total number of complications (r = 0.421332).Conclusion. Clinical and radiological results and the incidence of complications are comparable between single- and multistage approaches to correct sagittal balance disorders. In staged treatment, the total duration of surgery and the volume of blood loss are significantly higher. With a high Charlson comorbidity index and Mirza surgical invasiveness index, a multistage approach to the treatment of patients with sagittal imbalance is preferred.

scholarly journals Anesthesia for surgery in a patient with Knist's dysplasia for severe scoliotic deformity

2020 ◽  
Vol 10 (3) ◽  
pp. 299-308
Author(s):  
Igor V. Smirnov ◽  
Grigorij E. Rojtberg ◽  
Leonid E. Tsypin ◽  
Vladimir V. Lazarev
Keyword(s):  
Surgical Treatment ◽  
Tracheal Intubation ◽  
Blood Loss ◽  
Spinal Deformity ◽  
Abdominal Cavity ◽  
Sensorineural Deafness ◽  
Intraoperative Blood Loss ◽  
Airway Patency ◽  
Scoliotic Deformity ◽  
Kniest Dysplasia

Kniest dysplasia is a disease that is inherited in an autosomal dominant manner. It manifests itself as dwarfism, scoliotic deformity of the spine, impaired joint mobility, muscle weakness, visual impairment, and sensorineural deafness. As a result of disproportionate trunk shortening, lumbar hyperlordosis and kyphoscoliosis develop, leading to internal organs (respiratory, cardiovascular system) disorders, disability, and reduced life expectancy. A case of surgical treatment of a patient with Kniest dysplasia for severe kyphoscoliotic spinal deformity is described. Posterior corrective cross-rod transpediculocorporal screw spondylodesis T3-L5 with bone autoplasty was performed. While planning anesthesia, difficult tracheal intubation was evaluated on the LEMON scale of 7 points high-risk. While performing tracheal intubation, endoscopic techniques were used: videolaryngoscope, intubation bronchoscope, enabling success. Management of intraoperative blood loss was conducted by a complex of measures: laying the patient in the prone position with the release of the abdominal cavity, normothermia, intraoperative hemodilution of azlactone-balanced polyionic solutions to achieve the target hematocrit in the range of 24%26%, and controlled hypotension with blood pressure decreased by 30% from the original hardware blood reinfusion during surgery. Also, on the first postoperative day, fusing tranexamic acid, correcting anemia and deficiency of blood coagulation factors donor components contributed to the success. Discussion. When planning surgery and anesthesia, it is necessary to consider the risk of developing malignant hyperthermia, predicting difficult intubation, and complying with the algorithm to ensure airway patency and prevent massive intraoperative blood loss. With a comprehensive approach to patient management, it is possible to achieve rapid rehabilitation and discharge for outpatient treatment. Surgical treatment for rapidly progressing severe kyphoscoliathical spinal deformity can change the quality and duration of life in patients with Kniest syndrome.

Three-Dimensional vs Two-Dimensional Completely Minimally Invasive 2-Stage Esophagectomy With Intrathoracic Hand-Sewn Anastomosis for Esophageal Cancer: Comparison of Intra-and Postoperative Outcomes

2020 ◽  
pp. 155335062097254
Author(s):  
Omar Abbassi ◽  
Krashna Patel ◽  
Naga Venkatesh Jayanthi
Keyword(s):  
Esophageal Cancer ◽  
Blood Loss ◽  
Minimally Invasive ◽  
Three Dimensional ◽  
Two Dimensional ◽  
Lymph Node Yield ◽  
Invasive Esophagectomy ◽  
Open Esophagectomy ◽  
Duration Of Surgery ◽  
2D And 3D

Background. Completely minimally invasive esophagectomy (CMIE) has been associated with reduced morbidity compared to open esophagectomy in the treatment of esophageal cancer. Three-dimensional (3D) vision can enhance depth perception during minimally invasive surgery when compared to two-dimensional (2D) vision. We aimed to compare outcomes from 2-stage CMIEs when performed in 2D vs 3D. Method. All consecutive 2-stage CMIEs performed for esophageal or gastroesophageal junctional cancer at a single-centre between 2016 and 2018 were identified from a prospectively maintained database. All operations were completed in either 2D or 3D. All esophagogastric anastomoses were hand-sewn thoracoscopically. Intraoperative and postoperative clinical parameters were compared between 2D and 3D CMIE. Results. Overall, 98 patients underwent a 2-stage CMIE, of which 59 (60.2%) were in 2D and 39 (39.8%) in 3D. Median operative blood loss was less in the 3D group compared to the 2D group (283 mls vs 409 mls, P = .016). A higher number of lymph nodes were retrieved from 3D CMIE (30 vs 25, P = .010). The median duration of surgery was 407 minutes (interquartile ranges (IQR): 358-472 minutes) and 426 minutes (IQR: 369-509 minutes) when performed in 2D and 3D, respectively ( P = .162). There were no significant intergroup differences in 30-day postoperative complications, short-term mortality, and hospital stay. Conclusion. We report reduced blood loss and higher lymph node yield when performing 3D CMIE than 2D CMIE. Other intraoperative and postoperative clinical outcomes were similar in both groups. A randomized controlled trial is needed to validate these findings of superior outcomes from CMIE performed in 3D over 2D.

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