Comparative Study Of Postoperative Complications Research Articles

Correction: Jeong et al. A Comparative Study of Postoperative Complications Associated with Distal Gastrectomy and Pylorus-Preserving Gastrectomy among Gastric Cancer Patients Based on Nationwide Survey Data and Propensity Score Weighting. Cancers 2024, 16, 2203

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A Comparative Study of Postoperative Complications Associated with Distal Gastrectomy and Pylorus-Preserving Gastrectomy among Gastric Cancer Patients Based on Nationwide Survey Data and Propensity Score Weighting.

This study aimed to compare complication rates between pylorus-preserving gastrectomy (PPG) and distal gastrectomy (DG) using Korean nationwide survey data and propensity score weighting (PSW). PPG preserves gastric function but may lead to more postoperative complications than DG. We analyzed 9424 gastric cancer patients who underwent either DG (n = 9183) or PPG (n = 241). PSW balanced variables such as age, sex, TNM stage, comorbidities, ASA score, and surgical approach. Before PSW, 87.8% of DG patients and 87.1% of PPG patients had no complications (p = 0.053). Severe complications (Clavien-Dindo IIIa or higher) were more frequent in PPG (6.6%) than in DG (3.8%) (p = 0.039). After PSW, overall complication rates (p = 0.960) and severe complication rates (p = 0.574) were similar between groups. Incidence rates of anastomotic stricture and leakage were higher in PPG (2.9% and 1.7%) compared to DG (0.6% and 0.5%) (p = 0.001 and 0.036) before PSW, but these differences were not significant after PSW (p = 0.999 and 0.123). The PSW-adjusted analysis indicates no significant difference in overall and severe complication rates between PPG and DG in gastric cancer patients.

Comparative study of postoperative complications after open and laparoscopic surgery of the perforated peptic ulcer: Advantages of the laparoscopic approach

BackgroundDespite the acceptance of the laparoscopic approach for the treatment of perforated peptic ulcers, its definitive implantation is still a matter of discussion. We performed a comparative study between the open and laparoscopic approach focused on postoperative surgical complications. MethodsRetrospective observational study in which patients operated on for perforated peptic ulcus in our center between 2001 and 2017 were analyzed. Only those in whom suture and/or omentoplasty had been performed were selected, either for open or laparoscopic approach. Demographic, clinical, and intraoperative variables, complications, mortality and length of stay were collected. Both groups, open and laparoscopic surgery patients, were compared. ResultsThe final study sample was 250 patients, 190 (76%) men and 60 (24%) women, mean age 54 years (SD ± 16.7). In 129 cases (52%), the surgical approach was open, and in 121 (48%) it was laparoscopic. Grades III-V complications of the Clavien-Dindo Classification occurred in 23 cases (9%). Operative mortality was 1.2% (3 patients). Laparoscopically operated patients had significantly fewer complications (p = 0.001) and shorter hospital stay (p < 0.001). In multivariate analysis, laparoscopic approach (p = 0.025; OR:0.45–95%CI: 0.22–0.91), age (p = 0.003; OR:1.03–95%CI: 1.01–1.06), and Boey score (p = 0.024 – OR:1.71 – CI95%: 1.07–2.72), were independent prognostic factors for postoperative surgical complications. ConclusionLaparoscopic surgery should be considered the first-choice approach for patients with perforated peptic ulcer. It is significantly associated with fewer postoperative complications and a shorter hospital stay than the open approach.

A prospective comparative study of post-operative complications of hand sewn versus stapled anastomosis in elective GI surgeries

Background: Anastomotic leak and wound infection are the two feared complications of any bowel anastomosis. In this study a comparison between hand suturing and surgical stapling in patients undergoing elective gastrointestinal surgerieswith regard to post-operative complications namely anastomotic leak and wound infection. Methods: A prospective study was conducted in 40 patients undergoing elective resection and anastomosis over a period of 1 year. Post-operatively patients were followed up for post-operative complications namely anastomotic leak and wound infection. Follow up for 30 days post-operative was done. Results: In total forty patients were studied out of which twenty patients underwent hand sewn and twenty patients underwent stapler anastomosis. There was anastomotic leak in 1 case of gastrojejunostomy in hand sewn group. No leak was observed in stapled anastomosis group. Wound infection was observed in 5 cases. 4 cases were in hand sewn group and 1 in stapled group. There was no mortality in either group post-operatively. A sub-group analysis was also done. Conclusion: There was no significant difference in the incidence of post-operative complications namely anastomotic leak and wound infection with respect to hand sewn and staples techniques. Therefore both hand sewn and stapled anastomosis technique can be safely practiced.

Comparative study of postoperative complications in elective versus emergency laparotomy at JSS hospital

Background: Laparotomy is a commonly performed procedure in any surgical unit. The incidence of postoperative complications are higher after laparotomy particularly in emergency. In surgical language, “the word laparotomy explains exploration of the abdomen and proceed further according to the cause identified”. Postoperative complications directly affect the outcome of the disease.Aims & Objectives:• To document the postoperative complications of laparotomy and its comparison between elective versus emergency laparotomy done at JSS hospital.• To study the incidence of morbidity and mortality encountered after emergency and elective laparotomy.Methodology: This is a prospective studies conducted at Department of General Surgery of JSS Hospital mysore, Karnataka during period of December 2017 to June 2019. All patients who underwent laparotomy (elective or emergency) were included in this study. Demographic data about patients were noted in performa, all the complications were compared according to nature of laparotomy and patients were followed for 30 days postoperatively.Result: A total of 100 patients were undertaken, 50 patients in each group who underwent emergency and elective laparotomy respectively. Postoperative complications following emergency laparotomy included postoperative pain (72%), fever (50%), and postoperative nausea and vomiting (46%) followed by surgical site infection (38%), wound dehiscence (10%), respiratory tract infection (28%), cardiac complications (10%), renal complications (16%), gastrointestinal complications (16%), septicaemia (14%) and mortality (10%). Postoperative complications in elective were minimum as compared to emergency laparotomy i.e postoperative fever (40%), postoperative nausea and vomiting (34%), surgical site infection (18%), respiratory complications (14%).Conclusion: In comparison to elective laparotomy postoperative complications are more common in emergency laparotomy

Comparative Study of Postoperative Complications after Rubber Band Ligation (RBL) and RBL Combined with Sclerotherapy in Treatment of Second- and Third-Degree Internal Hemorrhoids

Hemorrhoid is a very common disease in surgical departments. Internal hemorrhoids of second degree or above often require surgical treatment due to the persistent bleeding and prolapse symptoms. Rubber band ligation (RBL) is the most common procedure available for hemorrhoids because of its safety, efficacy, and effectiveness. The study evaluates comparative results of postoperative complications after RBL and RBL combined with sclerotherapy. It included 300 patients having second- or third-degree internal hemorrhoids who attended the colorectal surgical department in Beilun People’s Hospital of Ningbo, China, over a period of 1 year from July 2015 to June 2016. These 300 patients were selected randomly and divided into two groups, with 150 for RBL group and 150 for RBL combined with sclerotherapy group. All the patients were asked to return to an out-patient clinic for follow-up at 1 day, 3 days, 7 days, 14 days, 2 months, and 6 months and through a telephone call every 6 months for 2 years. The data of all the patients including gender, age, postoperative pain, postoperative bleeding, the days of rubber band slippage, and postoperative recurrence were recorded. The statistical analysis of the study was done using SPSS statistical package in which we used descriptive statistics and chi-square test for the final evaluation. There was no significant difference between the two groups in postoperative pain. However, RBL combined with sclerotherapy achieves better results than RBL, less postoperative bleeding, less unexpected rubber band slippage, and less postoperative recurrence.

A comparative study of postoperative complications in emergency versus elective laparotomy at a tertiary care centre

Background: The incidences of post-operative complications are higher after laparotomy particularly in emergency. This study was aimed to evaluate and compare postoperative complications after emergency versus elective laparotomy performed at Bundelkhand Medical College, Sagar.Methods: This comparative study was carried out at Department of General Surgery in Bundelkhand Medical College, Sagar, Madhya Pradesh during period of January 2015 to February 2016. All the patients who underwent laparotomy (elective or emergency) were included in the study. Demographic data about patients was collected and noted in pro forma. Patients were followed in postoperative period and any complication developed recorded. Complications compared according to nature of laparotomy whether elective or emergency.Results: A total of 350 patients underwent emergency laparotomy and 50 patients underwent elective laparotomy. 128 (36.57%) patients developed complications following emergency laparotomy while 11 (22%) patients developed complication after elective laparotomy. Postoperative complications following emergency laparotomy included pyrexia (18.2%) followed by nausea and vomiting (12%), wound infection (11.4%), respiratory tract infection (6.85%), urinary tract infection (2.28%), gastrointestinal complications (3.71%), toxemia and septicaemia (8%). After elective laparotomy 20% patients showed postoperative fever, 10% patients suffered from postoperative nausea and vomiting and wound infection was noted in 4% patients.Conclusions: In comparison to elective laparotomy postoperative complications are more common in emergency laparotomy.

Comparative study of postoperative complications of Lichtenstein Tension Free Repair and Pure Tissue Repairs like Modified Bassini or Shouldice at Nishtar Hospital Multan

The objective of this study is to compare the postoperative complications of Lichtenstein tension free repair and pure tissue repairs like modified Bassini or Shouldice. This was an interventional (quasi experimental) study. This study was carried out on 100 patients having primary inguinal hernia. After taking detail history, examination and necessary investigations, only tit patients were included in the study and rest were excluded. A separate file was maintained for each patient to note the complication rate of different hernia`s repairs. Patients in group I underwent modified Bassini (35%) and Shouldice repair (15%). Patients in group II underwent Lichtenstein repair (50%).30 (30%) complications were observed. Out of these 23(23%) were in group I and 7(7%) were in group II. All were managed conservatively. The main complications were wound hematoma (9%), Wound infection (3%), scrotal edema (1%), postoperative neuralgia (6%), retention of urine (8%) and recurrence (3%). Wound infection, wound hematoma and recurrence were seen more in group I. Post operative neuralgia was more common in group II. Although follow up was for a shorter period of time and complications like recurrence and post operative neuralgia could not be assessed accurately. It was concluded that Lichtenstein tension free repair is simple and effective method of repairing inguinal hernia, with low complication rates and low recurrence rate. The method is much easier and should be considered in majority of patients with inguinal hernia.

Comparative study of postoperative complications in patients with and without an obstruction who had left-sided colorectal cancer and underwent a single-stage operation after mechanical bowel preparation.

PurposeThe purpose of this study is to compare postoperative complications for single-stage surgery after mechanical bowel preparation in patients who experienced obstruction and those who did not.MethodsFrom 2000 to 2011, 1,224 patients underwent a single-stage operation for left colorectal cancer after bowel preparation. Nonobstruction (NOB) and obstruction (OB) colorectal cancer patients were 1,053 (86.0%) and 171 (14.0%), respectively. Postoperative morbidity and mortality were compared between groups.ResultsThe OB group had poor preoperative conditions (age, white blood cell, hemoglobin, albumin level, and advanced tumor stage) compared with the NOB group (P < 0.05). Mean on-table lavage time for the OB group was 17.5 minutes (range, 14-60 minutes). Mean operation time for the OB group was statistically longer than that of the NOB group (OB: 210 minutes; range, 120-480 minutes vs. NOB: 180 minutes; range, 60-420 minutes; P < 0.001). Overall morbidity was similar between groups (NOB: 19.7% vs. OB: 23.4%, P = 0.259). Major morbidity was more common in the OB group than in the NOB group, but the difference was without significance (OB: 11.7% vs. NOB: 7.6%, P = 0.070). Postoperative death occurred in 16 patients (1.3%), and death in the OB group (n = 7) was significantly higher than it was in the NOB group (n = 9) (4.1% vs. 0.9%, P = 0.001). Twelve patients had surgical complications, which were the leading cause of postoperative death: postoperative bleeding in five patients and leakage in seven patients.ConclusionPostoperative morbidity for a single-stage operation for obstructive left colorectal cancer is comparable to that for NOB, regardless of poor conditions of the patient.

A comparative study of postoperative complications after hepatectomy in patients with and without chronic liver disease

Background: Although hepatic resection is the most reliable treatment for hepatocellular carcinoma, impaired liver function because of cirrhosis or chronic hepatitis contributes to relatively high rates of postoperative complications. We have reviewed a series of hepatectomies at our institution and investigated risk factors for complications after hepatectomy in patients with impaired liver compared with patients with normal liver. Methods: From October 1994 to March 1998, 277 hepatectomies for hepatocellular carcinoma, cholangiocellular carcinoma, metastatic liver tumors, and other hepatic diseases were performed. In an attempt to clarify the safety of hepatectomy for the impaired liver at our institution, we did a comparative study of postoperative complications after hepatectomy in 2 groups: patients with impaired livers (187 hepatectomies) and patients with normal livers (90 hepatectomies). Results: Of the 277 hepatectomies, bile leakage occurred in 25 patients (16 in impaired livers vs 9 in normal livers), abdominal infection in 45 patients (30 vs 15 patients), wound infection in 13 patients (9 vs 4 patients), pleural effusion in 52 patients (35 vs 17 patients), atelectasis in 26 patients (17 vs 9 patients), pneumonia in 4 patients (3 vs 1 patients), ileus in 6 patients (3 vs 3 patients), intra-abdominal hemorrhage in 3 patients (0 vs 3 patients), and hyperbilirubinemia in 5 patients (4 vs 1 patients). Hepatic insufficiency and hospital death were not experienced in this series. The mean postoperative hospital stay was 22.9 days (23.5 vs 23.1 days), and except for intra-abdominal hemorrhage there was no statistically significant difference between the 2 groups. Conclusions: Hepatectomy for the impaired liver is now as safe a procedure as for the normal liver, provided the overall guidelines outlined in our algorithm are followed. (Surgery 1999:126:484-91.)

A comparative study of postoperative complications after hepatectomy in patients with and without chronic liver disease

A comparative study of postoperative complications after hepatectomy in patients with and without chronic liver disease

Comparative Study of Postoperative Complications Associated With Modified Indiana Pouch in Elderly Versus Younger Patients

Purpose We defined the nature and risk of complications associated with the modified Indiana pouch in patients older than 75 years. Materials and Methods We analyzed the clinical course of 25 elderly patients and a control group of 25 selected randomly from the cohort of those younger than 75 years. All patients underwent the modified Indiana pouch procedure. Charts were reviewed for type of operation, mean patient age, length of hospital stay, medical conditions, and early and late morbidity and mortality. Comparisons were made between the 2 groups. Results Simultaneous cystectomy or anterior exenteration was performed in 84 percent and 95 percent of patents in the elderly and younger groups, respectively. Mean age was 78.5 years in the elderly and 59.3 years in the younger group. Medical illnesses and early postoperative complication rates did not differ significantly between the 2 groups. Mean hospital stay was increased but not significantly in the elderly group (12.4 versus 11.1 days). There were 2 perioperative deaths in the elderly group (8 percent) and 1 in the control group (4 percent). Mean followup was 24.5 months (range 4 to 64) in the elderly versus 29.5 months (range 6 to 69) in the younger group. Late complications with the pouch were also similar (16 percent in the elderly and 12 percent in the control group). Of the elderly patients 9 died (intercurrent medical disease in 1 and cancer progression in 8) compared to 4 in the younger group (intercurrent medical disease in 1 and cancer progression in 3). Of the elderly patients 13 are alive (mean age 81 years) with a well functioning continent diversion. Conclusions The modified Indiana pouch can be created with acceptable postoperative morbidity and mortality in elderly patients, and it provides an excellent functional result.

Comparative Study of Postoperative Complications Associated With Modified Indiana Pouch in Elderly Versus Younger Patients

Comparative Study of Postoperative Complications Associated With Modified Indiana Pouch in Elderly Versus Younger Patients

Unilateral and bilateral hernia: Comparative study of postoperative complications and factors concerned

T HIS study was undertaken primarily for the purpose of determining whether there was any increased risk to the patient in the performance of bilateral over uniIatera1 inguinal herniotomy. It resolved into an analysis of the postoperative complications and an attempt to ascertain the etiologic factors concerned. It was felt that information might be obtained which would aid in determining the value of thyroid extract as a prophylactic agent against embolism. The total number of cases studied was 1066, comprising a consecutive series of 522 bilateral and 544 unilateral herniotomies. Of the total number of patients, only 71, or 6.6 per cent, were females. Although various types of surgical procedures are employed in the treatment of inguinaI hernias they are sufficiently standardized to give a reasonable basis for comparison, and it can be said that there is approximately twice as much surgical trauma, and the duration of operation and anesthesia is approximately twice as long in bilateral herniotomy as in unilateral herniotomy. Right inguinal hernia occurs more frequently than left inguinal hernia, but there is no significant difference between the two in the risk of operative treatment, as far as comphcations are concerned. An interesting point was noted that, regardless of the side on which operation had been performed, phIebitis occurred much more frequently in the left Ieg. We shaI1 first concern ourseIves with those compIications that couId be of FeIIow in Surgery, The Mayo Foundation