scholarly journals Impact of Having a Planned Additional Operation at Time of Liver Transplant on Graft and Patient Outcomes

2020 ◽  
Vol 9 (2) ◽  
pp. 608
Author(s):  
Shirin Salimi ◽  
Keval Pandya ◽  
Vinay Sastry ◽  
Claire West ◽  
Susan Virtue ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Operating Time ◽  
Length Of Hospital Stay ◽  
Liver Graft ◽  
Short Term ◽  
Additional Operation ◽  
Additional Surgery ◽  
Surgical Complexity ◽  
Abdominal Operations ◽  
Baseline Characteristics

Advances in liver transplantation (LT) have allowed for expanded indications and increased surgical complexity. In select cases, additional surgery may be performed at time of LT rather than prior to LT due to the significant risks associated with advanced liver disease. We retrospectively studied the characteristics and outcomes of patients who underwent an additional planned abdominal or cardiac operation at time of LT between 2011–2019. An additional operation (LT+) was defined as a planned operation performed under the same anesthetic as the LT but not directly related to the LT. In total, 547 patients were included in the study, of which 20 underwent LT+ (4%). Additional operations included 10 gastrointestinal, 5 splenic, 3 cardiac, and 2 other abdominal operations. Baseline characteristics between LT and LT+ groups were similar. The median total operating time was significantly longer in LT+ compared to LT only (451 vs. 355 min, p = 0.002). Graft and patient survival, intraoperative blood loss, transfusion of blood products, length of hospital stay, and post-operative complications were not significantly different between groups. In carefully selected patients undergoing LT, certain additional operations performed at the same time appear to be safe with equivalent short-term outcomes and liver graft survival as those undergoing LT alone

Three-Port, Two Located on the Pfannenstiel Line, Laparoscopic Cholecystectomy Comparison with Traditional Laparoscopic Cholecystectomy

2017 ◽  
Vol 83 (3) ◽  
pp. 260-264
Author(s):  
Musa Akoglu ◽  
Erdal Birol Bostanci ◽  
Muhammet Kadri Colakoglu ◽  
Erol Aksoy
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Operating Time ◽  
Length Of Hospital Stay ◽  
Postoperative Results ◽  
Conversion To Open Surgery ◽  
Included Patient ◽  
History Of ◽  
Abdominal Operations ◽  
American Society ◽  
American Society Of Anesthesiologists

Laparoscopic cholecystectomy (LC) is seen as a gateway to minimally invasive surgery. We defined a new three-port technique with different port sites and compared the postoperative results with traditional four-port LC procedure in a case-match study. Between June 2012 and May 2013, 104 consecutive patients underwent three-port LC by same experienced surgeon. In the same center, 2963 consecutive patients underwent four-port LC, and of these 2963 patients, a matched group of 104 patients was selected. Data included patient age, gender, body mass index, American Society of Anesthesiologists score, history of abdominal operations, intraoperative data about operating time and conversion to open surgery, and postoperative data about length of hospital stay and postoperative complications were recorded prospectively. We concluded that our new three-port technique with different port sites is as feasible and safe as traditional four-port technique.

scholarly journals Short-Term Postoperative Outcome of Laparoscopic Total Mesorectal Excision in Rectal Carcinoma

2017 ◽  
Vol 28 (2) ◽  
pp. 75-78
Author(s):  
Sharmistha Roy ◽  
Samiron Kumar Mondal
Keyword(s):  
Total Mesorectal Excision ◽  
Anterior Resection ◽  
Operating Time ◽  
Length Of Hospital Stay ◽  
Postoperative Outcome ◽  
Laparoscopic Total Mesorectal Excision ◽  
Mesorectal Excision ◽  
Short Term ◽  
Central Vascular Ligation ◽  
Mean Time

Despite the proven benefits, laparoscopic colorectal surgery is still under utilized among surgeons. Aim of this study is to determine the feasibility and morbidity after laparoscopic Total Mesorectal Excision(TME), implementing a standardized operative technique and recovery protocol. The first 30 patients treated laparoscopically were included. Standardized oncological clearance ensured by early central vascular ligation, medial to lateral approach, and complete mesorectalexcision. Recovery parameters, short-term outcomes, morbidity and mortality have been assessed.Total number of patient was 30. In 26 patients anterior resection was done, in 4 patients Abdominoperineal resection was done.Overall mean operating time was 224( 242-137) minutes. In anterior resection Mean operating time was 187( 236-137) minutes, whereas in lap APR operating time was 210(242-178) minutes. In total 4 patients(13%) were converted to open procedure. Average bleeding in anterior resection group was 120 ml( 50-200ml), in Lap APR 210 ml(115-350ml). Mean number of lymphnodes removed in AR 16. In APR1, Mean time to flatus was 1.5 days. Mean time to stool 4.2 days, mean length of hospital stay in AR 8.6 days, in APR 11.5 days. Overall morbidity 23%(7), major morbidity 10%(3). There is no mortality, no anastomotic leak, and no 30 days readmission.laparoscopic Total Mesorectal Excision is safe and leads to excellent results in terms of recovery and short term outcomes. Key factors for better outcomes is adoption of a standardized technique and training model.Medicine Today 2016 Vol.28(2): 75-78

Short Term Radiographic and Patient Outcomes of a Biplanar Plating System for Triplanar Hallux Valgus Correction

2020 ◽  
Author(s):  
Kshitij Manchanda ◽  
Alice Chang ◽  
Blake Wallace ◽  
Junho Ahn ◽  
Yin Xi ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Patient Outcomes ◽  
Short Term

A Clinical Study and Management of Inguino-scrotal Swellings In Children

2018 ◽  
Vol 2 (S1) ◽  
pp. e000125
Author(s):  
Khyati Vaja ◽  
Mukesh Suvera
Keyword(s):  
Inguinal Hernia ◽  
Pediatric Surgery ◽  
Pediatric Patients ◽  
Undescended Testis ◽  
Length Of Hospital Stay ◽  
Indirect Inguinal Hernia ◽  
Short Term ◽  
One Year ◽  
Groin Hernias ◽  
Inguinal Hernia In Children

Aims and Objectives: To know the most common surgical problems in pediatric patients presented with inguino-scrotal swellings and management done routinely. Methodology: This study was carried out in the department of general surgery, Sharadaben hospital and pediatric surgery of VS hospital, Ahmedabad. The cases were studied for a period of about one year (January, 2017 to Dec, 2017) and all children below 12 years of age, presenting to us with inguinoscrotal swellings were included in this study. The information was analysed in terms of age, diagnosis, procedure carried out and outcome. Results: Amongst the 150 children under the age of 12 years, 143 patients were males and 7 were females. Among these 150, 52 cases were of hydrocoele, 70 cases of hernia (of which 63 were males and 7 were females), 25 cases of undescended testis and 3 cases of epididymo orchitis were documented. All cases underwent simple herniotomy for hernia and hydrocoele, orchidopexy for undescended testis. The length of hospital stay ranged from 2-4 days with mean of 2.46 days. 11 children in the study were documented to have short term complications, all of which were recognised in the hospital and managed with good results. Conclusion: Hernia and Hydrocoele in children are often congenital and diagnosed clinically (history and examination). Indirect inguinal hernia are more common than other groin hernias. Open herniotomy is the operation of choice for inguinal hernia in children.

scholarly journals ECMO in COVID-19—prolonged therapy needed? A retrospective analysis of outcome and prognostic factors

Perfusion ◽  
2021 ◽  
pp. 026765912199599
Author(s):  
Esther Dreier ◽  
Maximilian Valentin Malfertheiner ◽  
Thomas Dienemann ◽  
Christoph Fisser ◽  
Maik Foltan ◽  
...  
Keyword(s):  
Lung Compliance ◽  
Ecmo Support ◽  
Short Term ◽  
Single Center Study ◽  
Venovenous Extracorporeal Membrane Oxygenation ◽  
Baseline Characteristics ◽  
Ecmo Therapy ◽  
Vv Ecmo

Background: The role of venovenous extracorporeal membrane oxygenation (VV ECMO) in patients with COVID-19-induced acute respiratory distress syndrome (ARDS) still remains unclear. Our aim was to investigate the clinical course and outcome of those patients and to identify factors associated with the need for prolonged ECMO therapy. Methods: A retrospective single-center study on patients with VV ECMO for COVID-19-associated ARDS was performed. Baseline characteristics, ventilatory and ECMO parameters, and laboratory and virological results were evaluated over time. Six months follow-up was assessed. Results: Eleven of 16 patients (68.8%) survived to 6 months follow-up with four patients requiring short-term (<28 days) and seven requiring prolonged (⩾28 days) ECMO support. Lung compliance before ECMO was higher in the prolonged than in the short-term group (28.1 (28.8–32.1) ml/cmH2O vs 18.7 (17.7–25.0) ml/cmH2O, p = 0.030). Mechanical ventilation before ECMO was longer (19 (16–23) days vs 5 (5–9) days, p = 0.002) and SOFA score was higher (12.0 (10.5–17.0) vs 10.0 (9.0–10.0), p = 0.002) in non-survivors compared to survivors. Low viral load during the first days on ECMO tended to indicate worse outcomes. Seroconversion against SARS-CoV-2 occurred in all patients, but did not affect outcome. Conclusions: VV ECMO support for COVID-19-induced ARDS is justified if initiated early and at an experienced ECMO center. Prolonged ECMO therapy might be required in those patients. Although no relevant predictive factors for the duration of ECMO support were found, the decision to stop therapy should not be made dependent of the length of ECMO treatment.

scholarly journals Comparative study between minimally invasive supraorbital craniotomy and pterional craniotomy for treating anterior circulation cerebral aneurysms in a low-resource setting

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ricardo Brandão Fonseca ◽  
Alyne Oliveira Correia ◽  
Raysa Siqueira Vieira ◽  
José Erivaldo Fonseca dos Santos ◽  
Heverty Rocha Alves-Neto ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Operative Time ◽  
Operating Time ◽  
Cerebral Aneurysms ◽  
Length Of Hospital Stay ◽  
Neurological Status ◽  
Aneurysm Rupture ◽  
Anterior Circulation ◽  
Pterional Craniotomy ◽  
Resource Setting

AbstractThe challenges encountered in performing minimally invasive approaches, such as supraorbital minicraniotomy (SOMC), in services without adequate equipment are rarely reported in the literature. This study analyzes the viability of SOMC in the treatment of cerebral aneurysms, using exactly the same resources as pterional craniotomy (PC). The results of these two techniques are compared. 35 patients underwent SOMC, compared to 50 patients underwent CP (100 aneurysms in total), using the same microsurgical instruments. The following variables were compared: operative time, angiographic cure, length of intensive care unit stay during the post-operative period, surgical complications, length of hospital stay after surgery until hospital discharge, intraoperative aneurysm rupture, aesthetic satisfaction with the scar, and neurological status at discharge. SOMC had a significantly shorter operative time in relation to PC (213.9 ± 11.09 min and 268.6 ± 15.44 min, respectively) (p = 0.0081).With respect to the cosmetic parameters assessed by the Visual Analog Scale, the average for SOMC was 94.12 ± 1.92 points, and the average for PC was 83.57 ± 4.75 points (p = 0.036). SOMC was as effective as PC in relation to successful aneurysm clipping (p = 0.77). The SOMC technique did not show advantages over PC in any other variable. Even in a general neurosurgery service lacking a specific structure for minimally invasive surgeries, SOMC was feasible and effective for treating intracranial aneurysms, using the same set of microsurgical instruments used for PC, obtaining better results in operating time and cosmetic satisfaction.

Haemostatic devices in parotid surgery: a systematic review

2021 ◽  
pp. 1-7
Author(s):  
L Allen ◽  
C MacKay ◽  
M H Rigby ◽  
J Trites ◽  
S M Taylor
Keyword(s):  
Systematic Review ◽  
Blood Loss ◽  
Facial Nerve ◽  
Hospital Stay ◽  
Outcome Measures ◽  
Meta Analysis ◽  
Operating Time ◽  
Length Of Hospital Stay ◽  
Operative Blood Loss ◽  
Parotid Surgery

Abstract Objective The Harmonic Scalpel and Ligasure (Covidien) devices are commonly used in head and neck surgery. Parotidectomy is a complex and intricate surgery that requires careful dissection of the facial nerve. This study aimed to compare surgical outcomes in parotidectomy using these haemostatic devices with traditional scalpel and cautery. Method A systematic review of the literature was performed with subsequent meta-analysis of seven studies that compared the use of haemostatic devices to traditional scalpel and cautery in parotidectomy. Outcome measures included: temporary facial paresis, operating time, intra-operative blood loss, post-operative drain output and length of hospital stay. Results A total of 7 studies representing 675 patients were identified: 372 patients were treated with haemostatic devices, and 303 patients were treated with scalpel and cautery. Statistically significant outcomes favouring the use of haemostatic devices included operating time, intra-operative blood loss and post-operative drain output. Outcome measures that did not favour either treatment included facial nerve paresis and length of hospital stay. Conclusion Overall, haemostatic devices were found to reduce operating time, intra-operative blood loss and post-operative drain output.

The learning curve following adoption of a novel short-stem prosthesis in total hip arthroplasty: implications on short-term patient outcomes

2018 ◽  
Vol 29 (4) ◽  
pp. 819-825 ◽  
Author(s):  
Jorge A. Padilla ◽  
Afshin A. Anoushiravani ◽  
James E. Feng ◽  
Ran Schwarzkopf ◽  
James Slover ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Learning Curve ◽  
Patient Outcomes ◽  
Hip Arthroplasty ◽  
Short Stem ◽  
Short Term ◽  
Total Hip

Detention of In-Patients under Section 5(2) of the Mental Health Act 1983

1998 ◽  
Vol 38 (1) ◽  
pp. 10-16 ◽  
Author(s):  
Emad Salib ◽  
Boni Iparragirre
Keyword(s):  
Mental Health ◽  
Hospital Stay ◽  
Clinical Diagnosis ◽  
Length Of Hospital Stay ◽  
The Other ◽  
Short Term ◽  
Time Of Application ◽  
Mental Health Act ◽  
Equal Chance

All applications of s.5(2) of the Mental Health Act 1983, allowing the emergency detention of voluntary in-patients in North Cheshire between 1985 and 1995, were reviewed to examine general trends in its use and to assess variables likely to influence its outcome. Of the 877 applications implemented (4% of all admissions), 500 (57%) were converted to longer-term detention under the Act, 396 (45%) were converted to s.2 and 104 (12%) to s.3. The other 377 (43%) detained patients under s.5(2) regained informal status. The review found that time of application of section, length of hospital stay prior to application, medical officer's grade, use of s.5(4) and clinical diagnosis are best predictors of s.5(2) outcome. The results are similar to other published studies and seem to reflect a national pattern, possibly implying that patients detained under this short-term detention order have an almost equal chance of either regaining their voluntary status or being detained under another section by the end of the 72 hours. This may raise questions about the purpose of s.5(2) as expressed by the Mental Health Act Commission.

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