Evaluation Of Postoperative Complications Research Articles

Internal Fixation With Cannulated Screws for Stable Femoral Neck Fractures in High-Risk Patients: Good Clinical Outcomes and Evaluation of Postoperative Complications

Internal Fixation With Cannulated Screws for Stable Femoral Neck Fractures in High-Risk Patients: Good Clinical Outcomes and Evaluation of Postoperative Complications

Outcomes of Resection Anastomosis versus Hartmann’s Procedure in Sigmoid Volvulus

AIM: This study seeks to ascertain the comparative efficacy between the Hartmann procedure (HP) and resection anastomosis (RA), with or without concurrent fecal diversion, as surgical interventions for Sigmoid Volvulus (SV). The primary objective is to discern the procedure associated with a more favorable clinical outcome. MATERIAL AND METHOD: The study cohort comprised individuals who underwent surgical intervention for SV within the timeframe of 2010 to 2022 at our clinical facility. Demographic particulars encompassing gender and age, as well as comorbid conditions, ASA scores, procedural modalities, postoperative untoward events, and duration of inpatient care, were sourced from the patient database. Evaluation of postoperative complications, occurring within the 30-day window post-surgery, was undertaken in conformity with the Clavien Dindo (CD) classification schema. Statistical analyses encompassing the Mann Whitney U test and chi-square test were applied for data interpretation. Variables with p-values below 0.05 were deemed to possess statistical significance. RESULTS: The study encompassed a total of 125 patients, of whom 99 (79.2%) were male. Among these, 51 (40.8%) patients were allocated to the HP group, while 74 (59.2%) were assigned to the RA group. Concerning hospitalization duration, the median period was 8 (2-30) days in the HP group and 10 (3-35) days in the RA group (p=0.013). In accordance with the CD Classification, 68 (54.4%) patients encountered complications linked to the surgical procedure, with 11 (8.8%) patients experiencing procedure-associated mortality. Despite the observed statistically significant inter-group variance, it was discerned that HP exhibited a superior performance in terms of complications when compared to RA (p=0.048). CONCLUSION: Significantly reduced durations of hospitalization and fewer occurrences of postoperative complications were observed within the cohort undergoing the Hartmann's procedure. As a result, we advocate that clinicians consider prioritizing the implementation of Hartmann's procedure for patients undergoing surgical intervention for SV.

Evaluation of post-operative complications and adjuvant treatments following immediate prepectoral versus subpectoral direct-to-implant breast reconstruction without acellular dermal matrix

BackgroundIn immediate breast reconstruction (IBR), it is unclear whether there is any difference in the complication rates between prepectoral versus subpectoral implant placement without acellular dermal matrix (ADM). AimTo compare the rates of early post-operative complications and time to initiation of adjuvant treatment in patients undergoing IBR between prepectoral and subpectoral implant placement without ADM for the two surgical procedure. MethodsWe retrospectively retrieved data of patients who underwent IBR with prepectoral versus subpectoral implant placement between January 1, 2020 and December 31, 2022 in a large cancer center in France. ResultsWe included 192 patients: 119 in the prepectoral and 73 in the subpectoral group. Their clinical characteristics were similar. Thirty patients (15.6%) received adjuvant chemotherapy, among them 27 (14.1%) received it within 12 weeks, and there was no difference between the groups (p = 0.12). In the prepectoral group, 39 patients (32.8%) received adjuvant radiotherapy versus 5 (6.8%) in the subpectoral group (p < 0.001), but there was no significant difference in time to treatment commencement. Overall, 35 patients (29.4%) in the prepectoral group and 17 (23.3%) in the subpectoral group experienced post-operative complications (p = 0.44). Using multivariable analysis, the only factor associated with post-operative complications was determined to be mastectomy weight (odds ratio 1.98 (1.10–3.59) for weight ≥500 g; p = 0.02). ConclusionPrepectoral implant placement without ADM can be proposed to patients undergoing IBR with an indication for adjuvant treatment. However, in our study, the reoperation rate with this technique was slightly higher (p = 0.008). This is partly due to the learning curve for surgeons using this new technique.

Evaluation of Postoperative Complications Following Modified Coronally Advanced Flap as Root Coverage Procedure - A Prospective Clinical Study.

Root coverage procedures are very technique sensitive and require patients' compliance for successful treatment outcomes. Post operative complications can influence patients' acceptance of treatment and compromise further periodontal maintenance. The aim of this study was to evaluate the frequency and severity of complications after a modified coronally advanced flap procedure. A total of 78 modified coronally advanced flap procedures were performed in 42 patients for root coverage. Duration of surgical procedure, history of smoking, gender, and age were recorded for each patient. A questionnaire was given to every patient to fill in at first post operative week regarding their experience of postoperative pain, swelling, and bleeding. Pain and duration of surgery had a correlation (OR: 1.05, P < 0.05). Post operative bleeding was significantly correlated with duration of surgery (OR: 1.03, P < 0.05). Current smokers experienced post operative swelling (P < 0.05). However, post operative pain in current smokers was not significantly different (P > 0.05) as compared to nonsmokers. Descriptive statistics were expressed as mean and standard deviations. Odd's ratio was obtained to evaluate risk indicators for moderate to severe types of complications. P < 0.05 was considered as significant. The duration of the surgery, long duration, and the presence of smoking can increase the frequency and severity of post operative complications.

Evaluation of postoperative complications after removal of mandibular third molar by conventional bur technique and lingual split technique

ABSTRACT Aim: The objective of this study was to evaluate the effect and safety including postoperative outcomes in the extraction of impacted mandibular third molar by conventional bur technique and lingual split technique. Methods, Selection Criteria, and Search Strategy: A total of 40 healthy individuals, both male and female, aged from 18 to 40 years, underwent surgical removal of impacted mandibular third molars under local anesthesia in a single session. An intensive electronic search was conducted on Google, PubMed, Scopus, Embase, Directory of Open Access Journals, Ovid Medline, and Cochrane Central online databases from their respective inception dates to November 2020. Initially, the search criteria included the terms: ((mandibular OR lower) AND (third molar OR wisdom) AND lingual split). The following outcomes were investigated: pain, swelling, trismus, and dry socket on the first day before surgery, the second (post 24 h), and on the seventh day. Results and Observations: The present retrospective comparative study evaluates the postoperative complications after the removal of the third molar. A total of 40 subjects of either sex were randomized to be treated either with the conventional bur technique (Group A) or the lingual split technique (Group B). The ages of Groups A and B ranged from 19 to 40 years and from 19 to 42 years, respectively, with a mean ± SD of 26.20 ± 6.01 and 27.15 ± 6.21 years, respectively. The mean age of Group B was slightly higher than Group A. Comparing the mean age of the two groups, t-test revealed similar (P &gt; 0.05) age between the two groups (26.20 ± 6.01 vs. 27.15 ± 6.21, t = 0.49; P = 0.626). The subjects in both groups were age-matched, suggesting that age may have had minimal influence on the outcome measures (swelling, trismus, and pain). Conclusion: In the realm of mandibular third molar (M3) extraction, it is acknowledged that this surgical procedure can present challenges, and there exists a diversity of professional approaches between dentists and oral surgeons. Prior to determining a treatment course for each M3, it is imperative to possess a comprehensive understanding of the pertinent anatomical structures, including the inferior dental and lingual nerves. Additionally, a thorough clinical assessment and the utilization of radiographic imaging are essential for carefully evaluating each case and balancing the advantages and disadvantages of various treatment plans. Timely removal of the third molar (tooth M3) can significantly reduce the adverse complications associated with delayed extraction.

The Evaluation of Postoperative Complications and Oral Health-Related Quality of Life Following Dental General Anesthesia for Early Childhood Caries.

Aim The study aims toevaluate the postoperative complications and oral health-related quality of life (OHRQoL) following dental general anesthesia for early childhood caries (ECC). Materials and methods Two hundred children aged between three and six requiring full-mouth rehabilitation for general anesthesia were recruited for the study. Demographic data and oral health-related quality of life using the Early Childhood Oral Health Impact Scale (ECOHIS) were collected before the surgery. Postoperative complications and oral health-related quality of life were evaluated after 24hours and at a one-week follow-up appointment. Results All 200 children returned for the follow-up appointment after one week. Pain was found to be the most common postoperative complication after 24 hours (52%) and one week (6%). The oral health-related quality of life showed a significant improvement after one week (P < 0.001) Conclusion Children may experience a postoperative complication after full-mouth rehabilitation, which resolves within a week. Dental pain was the most common operative complication in the present study. Oral health-related quality of life showed significant improvement after full-mouth rehabilitation.

Inside-out anal sacculectomy in small dog breeds and cats.

This report describes a new, simple and rapid surgical technique for the removal of anal sac in small dogs and cats. The anal sacs were simply everted using mosquito hemostatic forceps and excised with the aid of an electrocautery surgical unit. On the evaluation of postoperative complications, only one dog of 28 animals experienced short-term minor complications of mild fecal incontinence and scooting. Thus, we suggest that this new surgical technique is easy, inexpensive and time-saving and some of the complications with previously reported methods used for small dog breeds and cats may be avoided by using this technique.

Pre and postoperative nurse-guided incentive spirometry versus physiotherapist-guided pre and postoperative breathing exercises in patients undergoing cardiac surgery: An evaluation of postoperative complications and length of hospital stay

Atelectasis is the most occurring postoperative complication after cardiac surgeries. Postoperative respiratory exercises and incentive spirometry led to decrease in postoperative complications, especially atelectasis and hospital stay. The objectives of the study were to evaluate postoperative complications and length of hospital stay of patients who received pre and postoperative nurse-guided incentive spirometry against those of patients who received pre and postoperative breathing exercises by the physiotherapist in patients who underwent cardiac surgery. Data of patients who received 2 days preoperative and 2 days postoperative nurse-guided incentive spirometry with a spirometer (PPN cohort, n = 102) or received 2 days preoperative and 2 days postoperative breathing exercises by physiotherapist without spirometer (PPP cohort, n = 105), or 2 days postoperative physiotherapist-guided breathing exercises only without spirometer (PPB cohort, n = 114) were collected and analyzed. The acute or chronic collapse of part or entire lung was defined as atelectasis. The length of stay in the hospital was from the day of admission to discharge. Patients of the PPN cohort had fewer numbers of incidences of atelectasis, dyspnea, and sweating >1 day after operations compared to those of the PPB and the PPP cohorts (P < .05 for all). The partial pressure of oxygen and oxygen saturation of arterial blood ≥6 hours after operations reported higher, the duration of ventilation was shorter, and numbers of re-intubation processes reported fewer for patients of the PPN cohort than those of the PPB and the PPP cohorts (P < .05 for all). The hospital length of the stay of patients in the PPN cohort was fewer than those of the PPB and the PPP (P < .0001 for both) cohorts. Pre and postoperative nurse-guided incentive spirometry with a spirometer following cardiac surgeries would have better postoperative pulmonary outcomes and fewer hospital stays than those of postoperative-only or pre and postoperative physiotherapist-guided breathing exercises (level of evidence: IV; technical efficacy stage: 5).

Evaluation of postoperative complications in the older population

Evaluation of the frequency and severity of postoperative complications is an integral part of establishing the clinical utility of a specific treatment. They define the possible consequences resulting from the chosen method of treatment, and thus the potential risks associated with this choice. Thanks to the analysis of complications, it is possible to evaluate patients’ safety, identify a problem in the course of surgery within a given hospital and surgical team or carry a financial analysis. Not only is the frequency of occurrence important, but so is the severity of complications. Therefore, in recent years we have seen the development of several new tools for assessing postoperative complications such as the Cla­vien-Dindo scale, the Accordion Severity Grading System, the Postoperative Morbidity Index or the Comprehensive Complication Index. Analysis of the above-mentioned scales may contribute to the development of clear algorithms for the management of older patients at increased risk of severe complications and higher mortality, which subsequently may lead to increased efficacy and safer treatment in this population.

Ultrasound-Guided Gastrostomy Tube Placement: An Evaluation of Postoperative Complications in the Pediatric Population.

Background: Using ultrasound guidance has been demonstrated as a feasible alternative method for gastrostomy tube placement in the pediatric population. The aim of this study is to evaluate short- and long-term postoperative complications after ultrasound-guided gastrostomy tube placement (USGTP) and to compare them with complications after laparoscopic gastrostomy tube placement (LGTP). Methods: A retrospective chart review evaluated patients who underwent USGTP (n = 41) and LGTP (n = 120) at the same institution. Comparisons were made between the two groups in the context of demographics as well as 30-day and 6-month postoperative complications. A phone survey (n = 26) further identified USGTP complications potentially not captured in the electronic medical records. Results: There were no significant differences in age, gender, and indication for procedure between the two groups. Chart review revealed that USGTP and LGTP had statistically comparable rates of emergency department (ED) visits for postoperative complications. Among USGTP patients, 8% had a recorded ED visit within 30 days of the operation and 13% presented to the ED within 6 months, compared with 6% and 11%, respectively, in the LGTP group (P = .65, P = .69). The USGTP phone survey reported total complications over an average postoperative follow-up time of 34.6 months (range 8-87) and revealed a total ED visit rate of 35%, which is comparable with rates reported in the literature for minimally invasive feeding tube placement. Conclusion: USGTP is a safe and feasible alternative option for gastrostomy tube placement in the pediatric population and it has postoperative complication rates that are comparable with LGTP.

Evaluation of postoperative complications following management of mandibular fractures with open reduction &amp; internal fixation under regional anaesthesia

Aim: To assess the rate of postoperative complications and its association with respect to aetiology, gender, age, time lapse between injury and commencement of treatment, history of substance abuse, number and location of the fractures in mandibular fracture patients treated with open reduction and internal fixation (ORIF) under regional anaesthesia. Materials and method: All patients fulfilling the selection criteria with mandible fracture reporting to our institution, from March 2017 to August 2021, were included in the study and were divided into three groups based on anatomic site involved. Patient’s records were analysed for deriving complications that occurred during the postoperative period of ORIF andassociation with different variables. The values were subjected to Chi-square tests. Results: Out of 160 study population, patients with combined Para symphysis involving angle (Group C) were reported with the highest number of complications such as minor occlusal discrepancies (20.4%), surgical site infection (4.1%), wound dehiscence and paraesthesia (4.1%) as compared to fractures involving symphysis &amp; para symphysis region (Group A and Group B respectively). Conclusion: The most common postoperative complication in this study was surgical site infection which can be managed effectively with local wound care, antibiotics and can be prevented with aseptic technique.

Research Updates: Standardized Reporting and Evaluation Instruments for Postoperative Complications

Postoperative complications are important indicators for evaluating surgical outcomes, and mortality and the incidence of various specific complications are often used to measure the efficacy of surgical and perioperative management strategies. With the progress of medical technology, there has been a dramatic decline in mortality and the incidence of complications. As a result, reporting and evaluation in the traditional methods no longer meets the actual needs of the world. There has arisen an urgent need for an instrument of standardized reporting and evaluation. The instrument should be aligned with the actual circumstances and should represent the patient's overall burden of postoperative complications. We herein reviewed the latest research findings on Clavien-Dindo Classification (CDC) system and comprehensive complication index (CCI), two instruments of standardized reporting and evaluation of postoperative complications, and discussed the space for improvement and prospects of application of CDC and CCI.

Imaging Manifestations and Evaluation of Postoperative Complications of Bone and Joint Infections under Deep Learning.

To explore and evaluate the imaging manifestations of postoperative complications of bone and joint infections based on deep learning, a retrospective study was performed on 40 patients with bone and joint infections in the Department of Orthopedics of Orthopedics Hospital of Henan Province of Luoyang City. Sensitivity and Dice similarity coefficient (DSC) were used to evaluate the image results by convolutional neural network (CNN) algorithm. Imaging features of postoperative complications in 40 patients were analyzed. Then, three imaging methods were used to diagnose the features. Sensitivity and specificity were used to evaluate the diagnostic performance of three imaging methods for imaging features. Compared with professional doctors and biomarker algorithms, the sensitivity of CNN algorithm proposed was 90.6%, and DSC was 84.1%. Compared with traditional methods, the CNN algorithm has higher image resolution and wider and more accurate lesion area recognition and division. The three manifestations of soft tissue abscess, periosteum swelling, and bone damage were postoperative imaging features of bone and joint infections. In addition, compared with X-ray, CT examination and MRI examination were better for the examination of imaging characteristics. CT and MRI had higher sensitivity and specificity than X-ray. The experimental results show that CNN algorithm can effectively identify and divide pathological images and assist doctors to diagnose the images more efficiently in clinic.

Evaluation of post-operative complications after Milligan- Morgan haemorrhoidectomy versus Stapled Haemorrhoidopexy techniques

Abstract Background Haemorrhoidal disease is one of the oldest illnesses known to mankind. It leads to significant pain, discomfort and poor quality of life. It is one of the common diseases which affect mankind but it is difficult to give an accurate figure of the prevalence because although many patients present with symptoms, many do not and some never bring it to notice of clinicians. The word hemorrhoids means flow of blood, the word pile means a ball, indicating two cardinal symptoms of this disease; bleeding per rectum and mass per anus. Aim of the work Aim of the work is to detect and compare the post-operative complications (Pain, Bleeding and anal stenosis) after 2 of the most commonly used techniques for management of the clinically diagnosed third and fourth stage hemorrhoids: Milligan-Morgan hemorrhoidectomy and stapler hemorrhoidopexy. Patient and Methods After obtaining approval from The College Ethical Committee, the study entitled "Evaluation of Postoperative Complications after Open MM Hemorrhidectomy versus Stapled Hemorrhoidopexy" was conducted on a total of 30 patients with hemorrhoids undergoing either conventional hemorrhoidectomy by Milligan Morgan (MM) technique or stapler hemorrhoidopexy. The patients were selected randomly after fulfilling the inclusion criteria in the department of general surgery, Ain Shams University hospitals over a period of 4 months starting from 1 August 2019 to 1 December 2019. Patients were admitted via surgical outpatient clinic. Patients were randomly distributed to 2 groups (A &amp; B), each group containing 15 patients. Results A total of 30 patients who underwent either conventional hemorrhoidectomy (CH) or stapler hemorrhoidopexy (SH) in The Department of Surgery, Faculty of Medicine, Ain Shams University included in this study for 4 months started from 1/8/2019 and ended in 1/12/2019 and the following results are obtained. Conclusion Haemorrhoidal disease is considered as one of the commonest ano-rectal diseases. Non-surgical measures whatever drug therapy or office procedures, can be presented to the patients with stage 1 and stage 2 haemorrhoids. However, when these measures fail, surgical intervention must be thought for the patients with stage 3 and stage 4 haemorrhoids. Surgical intervention should be tailored to each patient in accordance to the seriousness of symptoms, the magnitude of the external anorectal element and the presence of any concurrent ano-rectal morbidity. At present, there are many surgical interventions obtainable for treatment of prolapsing piles disease and most of them yielding acceptable success rates. Conventional Haemorrhoidectomy (CH) whatever open (Milligan Morgan) or closed (Ferguson) is considered the gold standard for surgical intervention of piles but due to the severe associated post-operative pain, especially with defecation, Stapled Haemorrhoidopexy (SH) seems to present shorter operative time, less post-operative pain, less bleeding and anal stricture and also less time off work in comparison with CH. Although rare but horrible complications have been noted with SH, which dictate that SH should be performed only by experienced surgeons. Eventually we strongly recommend the use of stapler devices for haemorrhoidectomy when and where possible especially for high grade and prolapsing haemorrhoids although more research and study should be made in this concern for more confirmation of our results due to decreased specimen size and short post-operative follow up period in our study.

Evaluation of Postoperative Complications after Laparoscopic Sleeve Gastrectomy with Omentopexy versus Conventional Laparoscopic Sleeve Gastrectomy

Abstract Background: Laparoscopic sleeve gastrecomy is the most popular bariatric procedure with good outcome and acceptable complications (bleeding, leakage, stenosis or twist). Aim of Study: To evaluate the role of omentopexy rein-forcement of staple line in reducing postoperative leakage, bleeding and gastric twist. Patients and Methods: This is a prospective cohort study conducted at Ain-Shams University Hospitals, in the period From May 2017 to November 2020. Four hundred morbid obese patients were recruited for this study. Ethical approval was obtained from the Ethical Committee of Ain Shams University Hospitals, and informed written consents were obtained from all patients. Results: Our study included 200 patients who underwent Laparoscopic sleeve gastrectomy, one hundred patients un-derwent LSG without omentopexty (group A) and the other one hundred patients underwent LSG with omentopexy (group B). As regards the age, group A (control group) mean age of 35.74±7.88 while group B (omentopexy group) mean age of 35.6±7.85. The mean BMI 40.95±5.25 in group A while 40.94±5.02 in group B. Three cases of group A (1.5%) while group B had no cases of postoperative leakage with p-value is 0.24. Two cases of group A had postoperative bleeding (1%) while it did not happen in group B with P value is 0.499. Gastric twist had happened in only 1 case of group A (0.5%) while did not happen in any cases of group B, P value is 1. The mean operative time in group A 46.08±10.95 minutes, while 67.49±9.19 minutes in group B with p-value 0.00. Conclusion: LSG with omentopexy reduce rate of post-operative complications (bleeding, leakage and gastric twist) but need longer time than conventional LSG.

Evaluation of post-operative complications after mastectomy performed without perioperative antimicrobial prophylaxis in dogs

BackgroundMastectomy is the most common procedure for treatment of mammary tumours. Dogs undergoing mastectomy have a risk of developing surgical site infections (SSI) and other postoperative complications. However, potential risk factors associated with such complications have been sparsely investigated. Thus, the objective of this retrospective study was to determine the incidence of, and identify risk factors for, SSI and non-SSI postoperative complications after mastectomy performed without perioperative antimicrobial prophylaxis in privately owned otherwise clinically healthy dogs.ResultsMedical records were reviewed retrospectively for 135 client-owned female dogs, 10–35 kg in weight and three to 10 years of age, which had undergone mastectomy due to mammary tumours at three referral animal hospitals in Sweden over a 3-year period. Twelve (8.9%) dogs developed SSI, and 21 dogs (17.1%) dogs suffered a non-SSI postoperative complication. The incidence of SSI and all complications (SSI and non-SSI) were higher in dogs that had two to three (SSI: P = 0.036 and all complications: P = 0.0039) and four to five (SSI and all complications: P = 0.038) mammary glands excised, compared to dogs that had one mammary gland excised. The incidence of SSI was 1.7% (n = 1/60) in dogs that had one gland removed. The incidence of non-SSI postoperative complications was higher in dogs with a higher body weight (P = 0.02).ConclusionsThe incidence of SSI was lower than or similar to previously reported incidences of SSI in dog populations that have undergone tumour excisional surgery, despite the fact that dogs in the present study had not received perioperative antibiotics. Dogs that had two or more glands excised had an increased risk of developing SSI and non-SSI complications compared to dogs that had one gland excised. Furthermore, higher BW was associated with an increased risk of non-SSI complications. Results from the study indicate that routine use of perioperative antibiotics in tumour excisional surgery can be questioned, at least in single gland mastectomy in otherwise clinically healthy dogs.

Evaluation of Postoperative Complications after Mandibular Third Molar Extraction without Suture and its Association with Age and Gender

Evaluation of Postoperative Complications after Mandibular Third Molar Extraction without Suture and its Association with Age and Gender

Evaluation of post-operative complications, outcome, and long-term owner satisfaction of elbow arthrodesis (EA) in 22 dogs.

The objective of this study was to report post-operative complications and outcomes in canines undergoing elbow arthrodesis (EA) with fixation techniques including bone plate fixation with a non-locking dynamic compression plate (DCP), bone plate fixation with a locking plate (LCP), and external skeletal fixator (ESF). Medical records of twenty-two cases that underwent EA between January 2009-December 2019 from 8 referral hospitals including both private practice and academic institutions were reviewed. Post-operative complications were classified as either minor or major, surgical evaluations were performed 8 weeks post operatively, and a follow-up questionnaire was sent to owners. Of the total 22 cases that met inclusion criteria, a total of 19/22 cases had complications, 12 major and 7 minor. Complications reported in 8/9, 7/9, and 4/4, for the DCP, LCP, and ESF fixation groups, respectively. Mild to moderate mechanical lameness was identified at surgical evaluation in 16/22 cases. Complete radiographic bone healing was achieved after 9 weeks in 19/22 cases. Long term owner follow up was available in 14/22 cases. Owners reported a good to normal quality of life in 13/14 cases and poor in one case. The majority of owners (11/14) reported good to excellent satisfaction with the outcome irrespective of persistent lameness. This study demonstrates that successful EA can be achieved using a variety of fixation methods, but persistent lameness is expected and complication rate is high.

Pre-auricular Transparotid Approach for the Management of Mandibular Condylar Fracture: An Experience of 82 Cases.

This paper retrospectively analyses the functional outcomes and complications associated with pre-auricular transparotid approach for the management of mandibular condylar fractures. The retrospective data of 82 condylar fractures were analysing in 73 patients who underwent open reduction and internal fixation with pre-auricular transparotid approach. Evaluation of post-operative complications and the post-operative occlusion status, maximal inter-incise opening, adequacy of reduction and stability of fixation were assessed clinically and radiographically. The exposure of fracture segment was adequate in all the cases, and fixation was easy with 2mm delta miniplate. Transient facial nerve palsy occurred in 2 patients (2.43%). 1 patient developed sialocele which was managed conservatively. There were slight occlusal discrepancies in 10 patients at the end of 1-week follow-up which was corrected with guiding elastics at the end of 1-month follow-up. The reduction was adequate, and fixation was stable. The functional outcomes were satisfactory in term of mouth-opening and range of motion. The pre-auricular transparotid approach provides direct access to the fracture site resulting in less retraction of the tissue containing facial nerve and also less amount of periosteal stripping is required, thus it maintains good vascularity to the fracture segments. It provides direct visualization of the fracture without much retraction of the tissue containing facial nerve branches. It allows better fixation of the fracture with very less complication which results in good functional outcomes.

Prediction value of EuroSCORE II in total arterial revascularization and its usage in the evaluation of postoperative complications: Single-center experience

Total arterial revascularization is the most durable and technically the most demanding type of coronary artery bypass grafting procedure. It has proven long-term supremacy in comparison to conventional coronary artery bypass grafting. In our study, we investigated the reliability of EuroSCORE II as a predictor of intrahospital death. We showed its impact on adverse perioperative events. In this nonrandomized prospective study, we analyzed 116 consecutive patients who underwent the total arterial revascularization procedure at our Institute from January 2011 until the present. For myocardial revascularization, the most suitable combinations with left internal mammary artery, right internal mammary artery, and radial artery grafts were used. Main fact in this research was intrahospital mortality value in comparison with the value predicted. There were 104 (89.7%) males and 12 (10.3%) females. Mean preoperative EuroSCORE II prediction value was 1.98% and postoperative we obtained 1.72%. Postoperative redo for bleeding was 6%. Positive correlation was proven between the EuoroSCORE II value and intensive care unit stay (0.452; p < 0.001). Among patients who received two internal mammary arteries, the highest EuroSCORE II was among those with presternal wound infection (p = 0.005). Patients with bilateral internal mammary arteries and diabetes showed that they have the highest values of EuroSCORE II and, at the same time, that they are extremely prone to wound problems. We achieved a lower intrahospital mortality level than it was predicted with preoperative EuroSCORE II value. This tool is a reliable method for preoperative death risk calculation in this group of patients.