Frequency Of Early Postoperative Complications Research Articles

Rationale for early rehabilitation of patients with uterine corpus cancer

To study the dynamics of hemorheologic changes and the frequency of early complications of laparoscopic radical hysterectomy in patients with uterine corpus cancer depending on conducting rehabilitation activities in the early postoperative period. The number of patients with uterine corpus cancer equal 49 (mean age 54.8±2.2 years), divided into 2 comparable groups, was examined: experimental group - 23 patients, who received local magnetotherapy since the first day after surgery for 5-6 days, and control group - 26 patients without physiotherapy. Comparative group included 24 healthy women. The basic rheological parameters, namely blood viscosity at high and low shear rate, hematocrit, erythrocytes' aggregation and deformability, erythrocytes and platelets electrophoretic mobility, were evaluated in all patients initially, on the 1st and 5th days after surgery and in comparison group. There were changes in the rheological properties of the blood before surgery in patients of both groups: increase of blood viscosity, enhancement of aggregation activity of its formed elements, decrease of erythrocytes' deformability properties. The laparoscopic radical hysterectomy was accompanied by the exacerbation of these disorders. The early magnetotherapy in patients reduced hemorheological abnormalities up to the preoperative parameters (p<0.05) for 5 days, as well as reduced the incidence of early postoperative complications by 2.4 times compared to the control group. The application of local low-frequency low-intensity magnetotherapy since the first postoperative day allows to reduce the level of postoperative hemorheological abnormalities up to the level of preoperative parameters, as well as the frequency of early postoperative complications.

Oncological standards in the treatment of diffuse inflammatory diseases of the colon

Aim. To improve the effectiveness of cancer prevention and the results of surgical treatment in diffuse inflammatory diseases of the colon by identifying and using risk factors for malignancy, improving diagnostic methods, surgical strategy and tactics. Materials and methods. Using generally accepted oncological standards, 36 patients with diffuse inflammatory diseases of the colon were operated on. There were 20 (55.6 %) patients with ulcerative colitis and 16 (44.4 %) with Crohn’s disease of the colon. There were 19 (52.7 %) men and 17 (47.3 %) women. The patients’ age ranged from 21 to 56 years. When performing surgical interventions, we were guided by the studied risk factors for malignancy, the provisions of the surgical strategy and tactics, that included the indication choice, the surgical intervention extent, and the ensuring of oncoprevention. Results. The use of oncological standards, provisions of surgical strategy and tactics prevented the occurrence of postoperative mortality, malignancy of precancerous conditions, contributed to a decrease in the incidence of early postoperative complications to 5 (13.9 %), locoregional recurrence to 1 (2.8 %). Conclusions. Determination of risk factors for malignancy, improvement of diagnostic methods, surgical strategy and tactics in diffuse inflammatory diseases of the colon contribute to the timely detection of precancerous conditions, malignancy and colon cancer, justification for the feasibility of performing surgical interventions using generally accepted oncological standards. Performing surgical interventions with the use of generally accepted oncological standards, proven provisions of strategy and tactics have made it possible to prevent the occurrence of malignization of precancerous conditions, cases of postoperative mortality, reduce the frequency of early postoperative complications to 5 (13.9 %) and locoregional recurrences to 1 (2.8 %).

Comparison of complications and results of early vs. delayed surgery for pediatric supracondylar humeral fractures.

Pediatric supracondylar humerus fracture (SCHF) is one of the most common elbow fractures in children aged 5-7 years. There is a continuous discussion regarding the optimal timing for conducting surgery for fractures of this nature. Therefore, we aimed to determine whether the timing of surgery in pediatric SCHFs has an impact on the frequency of early postoperative complications. Between January 2018 and March 2020, pediatric SCHF patients who underwent surgery at our hospital were retrospectively reviewed. Patients operated on within 12 hours after the fracture and those operated on later were respectively included in the early and late groups. Early postoperative complications, including neurological deficits, iatrogenic ulnar nerve injury, vascular injury, compartment syndrome, K-wire migration, and unexpected returns to the operating room, were compared between the two groups. We investigated surgical duration, reduction, and perioperative radiographic data. For modified Gartland type II or type III fractures, there was no significant difference in the incidence of early complications between the early and delayed groups. Additionally, there were no noticeable differences between the two groups in terms of perioperative radiographic data, reduction procedure, or surgical duration. Delayed surgery in type II or type III supracondylar humerus fractures was not associated with an increased incidence of early postoperative complications. The difficulty or effectiveness of reduction is not influenced by the timing of surgery.

Analysis of the risk of early postoperative complications after Bentall procedure

The aim – to investigate the frequency of early postoperative complications and to analyze possible predictors of the prolonged stay of patients in the intensive care unit (ICU) after Bentall procedure.Materials and methods. In the study, the medical histories of adult patients (from 18 to 75 years old) who underwent Bentall procedure for ascending aortic aneurysm at the State Institution «Heart Institute of the Ministry of Health of Ukraine» between 2012 and 2021 were analyzed. Univariate and multivariate analysis (logistic regression) was used to determine prognostic risk factors.Results. Patients with prolonged stay in intensive care unit were characterized by significantly older age (p = 0.005), more frequent presence of comorbidities of arterial hypertension (p = 0.044) and significantly lower initial values of glomerular filtration rate (p = 0.045). In addition, these patients were 3.6 times more likely (p = 0.0005) to use an autohemotransfusion device and almost 6 times more likely (p = 0.0037) to require rethoracotomy due to bleeding. Acute renal failure was recorded 4.3 times (p = 0.0002) and acute respiratory failure was recorded 3.3 times more often (p = 0.0004). The duration of mechanical ventilation (OR 1.204 (CI 1.053–1.377), p = 0.007) and the development of acute renal failure (OR 4.069 (CI 1.040–15.923), p = 0.044) were two independent predictors of prolonged stay of patients in ICU.Conclusions. For patients with risk factors for a prolonged ICU stay after surgery, more active treatment strategies before and after surgery are recommended to avoid possible complications and shorten hospital stay.

EFFECTIVENESS OF SYNTHETIC IMPLANTS FOR GENITAL PROLAPSE SURGERY

The aim of the study is to evaluate the effectiveness of synthetic implants for genital prolapse surgery in women of different age groups.&#x0D; Materials and Methods. 139 patients underwent genital prolapse surgery, vaginal approach, with synthetic mesh and biologic grafts. For the anterior, posterior and complete reconstruction of the vaginal walls, two mesh implants were used: Pelvix (Lintex, Russia) and Prolift (Ethicon Women´s Health and Urology, Johnson and Johnson Company, USA). The size of mesh implant was adapted to each particular case.&#x0D; Results. The most common intraoperative complication was intraoperative blood loss. During pelvic floor reconstruction with mesh implants, it was 1.8 times and 1.5 times higher in reproductive age and perimenopause respectively, compared with grafts. In postmenopause, there was a tendency to greater blood loss in surgeries with biological grafts. In reproductive age, the frequency of early postoperative complications was the same for mesh and non-mesh repair. In perimenopause, complications were three times more often for mesh repair, and in postmenopause, complications were observed in every third examined patient, regardless of the repair used. Late postoperative complications (pelvic pain and dyspareunia) occurred more often for biological graft: in reproductive age – twice, in perimenopause – 1.5 times, and in postmenopause – 5 times as frequently as for mesh.&#x0D; Conclusion. Prolapse surgery with synthetic implants is effective, safe and justified in terms of pathogenesis.

The Significance of Local Intraoperative Hemostasis and Laser Influence in the Prevention and Treatment of Complications During Thyroid Surgery

The article presents the results of clinical studies on the development of a method for local intraoperative hemostasis and improvement of reparative processes during operations on the thyroid gland. For clinical evaluation of the effectiveness of the proposed method, two study groups were formed for 237 patients with mixed, nodular and diffuse toxic goiter. The main group consisted of 98 patients, and the comparison group - 139. In the main group of operated patients, hemostasis was carried out according to the method developed by us, and in the comparison group, by traditional methods. Surgery included thyroidectomy, hemithyroidectomy, and subtotal thyroidectomy. In the main group of patients, for the purpose of hemostasis, Hemoben powder crystals with a size of 25-50 microns were used at the rate of 200 mg per area of 8-9 cm2, which was applied over the wound with a thin layer until a thin translucent film was formed, followed by irradiation of the wound with low-energy laser radiation (Sogdiana apparatus) with a wavelength of 0.89 microns, a frequency of 500 Hz for 2 minutes at a distance of 5 cm from the wound; then, for 5-7 days, percutaneous irradiation sessions with the same laser at a frequency of 80 Hz were performed daily in the projection of the surgical wound. The study showed that the use of the domestic hemostatic agent Hemoben provides complete hemostasis, and the addition of the technique by treating the surgical field with low-intensity laser radiation enhances the reparative properties of the drug. The proposed method for local hemostasis and improvement of reparative processes during thyroid surgery is characterized by a quick, effective and stable stop of bleeding, prevents the development of lymphohemorrhagic complications, and also reduces the frequency of early postoperative complications due to intra- and postoperative laser exposure.

Retrospective Cohort Trial of the Effectiveness of Plasma Surgery for Benign Prostatic Hyperplasia of Large and Giant Sizes

Background. Over the past 10 years, the incidence of benign prostatic hyperplasia (BPH) over 80 cm3 has increased 34 times. With indications for surgical treatment, transurethral methods are increasingly used today with the use of laser or plasma techniques for resection and enucleation of the prostate. The article presents a comparative analysis of the results of plasma transurethral enucleation of the prostate (P-TUEP) and open prostatectomy, methods of surgical and drug prevention of dysuric complications, which indicates the primacy of the choice of P-TUEP in large and giant BPH surgery. Aims to prove the effectiveness of the use of plasma surgical methods and the scheme of complex medical postoperative prevention of late dysuric and cicatricial complications in the treatment of benign prostatic hyperplasia of large and giant sizes. Methods. The design of a retrospective cohort trial included several stages conducted at the urological center of the clinical hospital RZD-Medicine, Nizhny Novgorod in 20082019. The object of the study were patients with a confirmed diagnosis of large BPH (over 80 cm3) and giant (over 250 cm3) size, divided into the main and control groups according to the methods of surgical intervention and postoperative prevention of dysuric complications. The selection of patients was carried out by the method of paired design with an equal number of observations and maximum comparability of the initial parameters. Data analysis was carried out using the methods of parametric and nonparametric statistics, multivariate statistical analysis. Results. Comparison of the results of P-TUEP (n = 122) and open prostatectomy (n = 122) in groups of patients with large and giant BPH showed the possibility of reducing intraoperative blood loss by 1.5 times, the duration of bladder catheterization by 3.8 times, the frequency of early postoperative complications by 1.7 times and the duration of hospitalization by 2.9 times, which significantly saves hospital costs. Modification of the initial stage of P-TUEP, which consists in creating access to the prostate using new anatomical landmarks to maximize the preservation of the anterior fibrostromal complex, reduces the risk of trauma to the external urethral sphincter, which was proven by a three-fold decrease in the frequency of stress incontinence after surgery. In order to prevent late dysuric and cicatricial complications of P-TUEP, a scheme of complex medical postoperative prophylaxis with the use of a hyaluronic acid preparation was developed. It has been histologically and clinically confirmed that instillations of a hyaluronic acid solution into the bladder in combination with standard postoperative therapy make it possible to accelerate reparative processes by 24 times and get rid of irritative symptoms at 612 postoperative weeks, depending on the volume of removed BPH. Conclusion. The validity of the use, clinical and economic efficiency, high safety profile and the primacy of the choice of P-TUEP in surgery of large and giant BPH, including its modified technique and a comprehensive scheme of drug prevention of late complications, have been proven.

Острый коронарный синдром у пациентов со стенозом клапана аорты

The purpose — to assess the acute coronary syndrome (ACS) clinical aspects in patients with aortic stenosis. Material and methods. This is a retrospective single-center study that included comparison of hospital and midterm outcomes of ACS and aortic stenosis (n = 95, divided into the following groups: group 1 — severe aortic stenosis + ACS (n = 39); group 2 — moderate aortic stenosis + ACS (n = 28); group 3 — ACS without aortic stenosis (the control group selected using «Propensity matching» method) (n = 28)). Results. Hospital mortality did not differ statistically between the groups. In group 1, there was a tendency to worse survival within 1 year. In groups with aortic malformation, ACS with ST segment elevation was less common — p = 0.0002 and p = 0.001, respectively. In group 1, 23.1% of patients had intact coronary arteries. Conclusions. Severe aortic valve stenosis in some cases «mimics» acute coronary syndrome, which is indicated by significantly more frequent detection of intact coronary arteries in this cohort. Aortic stenosis of varying degrees does not lead to an increase in the frequency of early postoperative complications and 30-day mortality after PCI.

Early Complications of Modified Tension-Band Wiring (MTBW) in the Treatment of Close Patellar Fractures

Introduction: Patella fracture account for 1 Percent of all skeletal fracture, Patella fractures are problematic because the loss of the extensor mechanism of the knee, loss of articular congruity and stiffness of the knee joint. The surgical goals are anatomic reconstruction of the articular surface and stable fixation to allow early motion. Modified tension band wiring MTBW (MTBW) is the procedure of choice for patellar fracture these days because of the dramatic decrease in post-operative complications with this procedure.The complications noted in the early post-operative period are infection,loss of reduction, prominence of hardware, and knee stiffness. Objective: To determine the frequency of early post-operative complications following modified tension band wiring MTBW for closed patellar fractures. Methods: This study was conducted in the department of orthopedic surgery, Lady Reading Hospital, Peshawar from June 2010-september 2011. Through a descriptive cross sectional study, a total of hundred patients of closed patellar fractures were selected in a consecutive manner from the OPD and ER department. All patients were subjected to modified tension band wiring MTBW under G/A by an expert orthopedic surgeon and data was also collected at 1st week, 1st month, 3 months and 6 months regarding early post-operative complications like loss of reduction, infection, prominence of hardware and stiffness. Results: Total patients were hundred. There were 60 (60 Percent) males and 40 (40 Percent) were females. Mean age of the patients was 43.82 years + 14.3SD years (range 20-85 years). 74 (74 Percent) were presented with history of road traffic accident. Overall complication rate by the end of 6 months was a total of 25 Percent with of 21 Percent patients with infection, 11 Percent had developed stiffness, 6 Percent with hardware prominence and only 4 Percent with loss of reduction. Conclusion: The frequency of early post-operative complication following modified tension band wiring MTBW for closed patellar fractures was higher than previously reported and further research work should be carried out to identify the factors responsible for it. Keywords: Developed Stiffness, Closed Fracture Patella, Modified Tension Band Wiring MTBW, Early Post-Operative Complications, Hardware Prominence,

SAFETY OF SIMULTANEOUS LAPAROSCOPIC APPENDECTOMY IN COMBINATION WITH LAPAROSCOPIC HERNIA REPAIR (TAPP). A SERIES OF CLINICAL CASES

Aim: To evaluate the technical feasibility and safety of a simultaneous surgery: laparoscopic appendectomy in combination with transabdominal preperitoneal hernia repair.Methods: The study was a retrospective analytical one. The medical histories were studied and postoperative monitoring of eleven patients hospitalized with acute appendicitis who underwent simultaneous surgery: laparoscopic appendectomy with simultaneous laparoscopic plastic surgery of clinically significant inguinal hernia was carried out. During the statistical analysis, the following parameters were evaluated: the timing of postoperative recovery, the frequency of early postoperative complications and the frequency of recurrence of inguinal hernia a year after surgery.Results: The surgery was successfully performed in all 11 patients. There were no cases of infectious complications of the surgical intervention area. Acute urinary retention was registered in one patient in the early postoperative period. In one case, an early adhesive intestinal obstruction was diagnosed, which was resolved with conservative treatment. There were no cases of recurrent inguinal hernia during the year.Conclusion: laparoscopic appendectomy in combination with transabdominal preperitoneal hernia repair can be used in the treatment of acute appendicitis in combination with inguinal hernia in the absence of signs of gangrenous appendicitis with purulent peritonitis. The low statistical power of the study does not allow us to draw conclusions about the safety of this approach for patients of the older age group with a high comorbidity index.

EFFECTIVE USE OF EXTRACORPOREAL MEMBRANE OXYGENATION IN SURGICAL TREATMENT OF KIDNEY CANCER PATIENT WITH TUMOR THROMBOSIS

The presented clinical case demonstrates the potential of medical technologies with organ replacement in the treatment for kidney cancer (KC) with a tumor thrombus located in the retrohepatic inferior vena cava (IVC) complicated by thromboembolism of the medium and small branches of the pulmonary artery (PATE). The treatment outcomes in such patients are usually poor due to a great number of complications and high mortality. The literature data estimates operative mortality rate of 13 %, and the frequency of early postoperative complications reaches 60 %. Standard approaches to anesthesia in case of thromboembolism and the threat of massive PATE are ineffective. In this clinical case, we chose the therapeutic tactics with extracorporeal membrane oxygenation (ECMO) in the intra- and early postoperative period in order to avoid or minimize life-threatening complications in the KC patient with a tumor thrombus in IVC and PATE. The effective use of ECMO minimized the risk of fatal complications during nephrectomy with thrombectomy for a malignant kidney tumor in the patient with pulmonary embolism and subcompensated disorders of the oxygen transport function of the lungs. The main objective of medical care for this patient involved both the radical treatment of kidney cancer and the elimination of a potential cause of thromboembolism of the pulmonary artery branches, fragments of hematogenous and tumor microthrombi. The total duration of ECMO was 30 hours. No significant complications in organs and systems were recorded during the surgery and in the early postoperative period. The development and implementation of new technologies, including devices for oxygen blood saturation and carbon dioxide elimination, undoubtedly gives a chance for a cure for cancer patients with decompensated organ and functional capabilities.

Sex-related differences in postoperative complications following elective craniotomy for intracranial lesions: An observational study.

Introduction:The integration of sex-related differences in neurosurgery is crucial for new, possible sex-specific, therapeutic approaches. In neurosurgical emergencies, such as traumatic brain injury and aneurysmal subarachnoid hemorrhage, these differences have been investigated. So far, little is known concerning the impact of sex on frequency of postoperative complications after elective craniotomy. This study investigates whether sex-related differences exist in frequency of postoperative complications in patients who underwent elective craniotomy for intracranial lesion.Material and Methods:All consecutive patients who underwent an elective intracranial procedure over a 2-year period at our center were eligible for inclusion in this retrospective study. Demographic data, comorbidities, frequency of postoperative complications at 24 hours following surgery and at discharge, and hospital length of stay were compared among females and males.Results:Overall, 664 patients were considered for the analysis. Of those, 339 (50.2%) were females. Demographic data were comparable among females and males. More females than males suffered from allergic, muscular, and rheumatic disorders. No differences in frequency of postoperative complications at 24 hours after surgery and at discharge were observed among females and males. Similarly, the hospital length of stay was comparable.Conclusions:In the present study, no sex-related differences in frequency of early postoperative complications and at discharge following elective craniotomy for intracranial lesions were observed.

Impact of Age on Surgical Outcomes Following Mandible Fracture Repair.

Open repair of mandibular fractures are frequently performed surgical procedures. Increasing rates of such fractures are seen in older adults following falls. This study assesses the impact of older age on early complications following mandible fracture repair. Retrospective analysis of national registry. The 2013-2018 National Surgical Quality Improvement Program database was queried for all cases of open mandible fracture repair and cases were categorized into younger (18-40), middle (41-65), and older (>65) age cohorts. Demographics and comorbidities were compared between the age groups. Rates of surgical, medical, and wound complications within 30-days of surgery were determined. Multivariable logistic analyses were performed to assess the relationship between age and complications. Altogether, 1818 cases were included for analysis, of which 1269 (69.8%) were younger, 459 (25.2%) were middle, and 90 (5.0%) were older age. Increased rates of complications were seen in the older groups, including unplanned reoperation, unplanned readmission, wound disruption, and medical complications (p < 0.01). On unadjusted analysis, the older (>65) age group had an increased odds of experiencing a complication compared to the younger (18-40) group (OR: 4.19, p < 0.001). The older age group continued to have a significantly increased odds of medical complications after multivariable adjustment (adjusted OR: 8.64, p < 0.001). On this analysis of a national database, advanced age was associated with an increased frequency of early postoperative complications following open mandibular fracture repair. Following multivariable adjustment, advanced age continued to be associated with increased odds of postoperative medical complications within 30 days of surgery. 3 Laryngoscope, 133:287-293, 2023.

Outcome of Laparoscopic Cholecystectomy in Acute Calculous Choleycystitis – Analysis of 100 cases

Introduction: Gallbladder disease is one of the most common surgical problems worldwide. About 10-15% of the adult western population has gallstone diseases . More than half a million cholecystectomies are performed per year in United States alone. Laparoscopic cholecystectomy (LC) is currently the most widely used surgical procedure for the treatment of gallstones. Aims and Objectives: To observe the cause of difficulties, the sequele , identify and find out the nature &amp; rate of per operative complications and find out the type &amp; frequency of early post-operative complications following laparoscopic cholecystectomy in acute calculous cholecystitis. Materials and Methods: This is a prospective interventional study which was conducted at Jashore Medical College Hospital &amp; some clinics of the city from Sept 2019 to Feb 2020. A total of 100 patients underwent Laparoscopic cholecystectomy for acute calculous cholecystitis within 7 days of admission. Results:Among 100 patients, 80 females &amp; 20 males with maximum age group were in the fourth decade, Laparoscopic cholecystectomy was done in 97 (97%) cases &amp; in 3(3%) cases conversion were needed, none of the patients were developed major Per &amp; postoperative complications. Peroperative complication rate was 22 (22%) with conversion was 03(3%) cases. All of the above complications were managed accordingly &amp; successfully. Conclusion: Laparoscopic Cholecystectomy is a safe, effective procedure for the early management of patients with acute calculus cholecystitis. Meticulous dissection &amp; good exposure of callot’s triangle, posterior clearance may prevent bile duct injuries. Medicine Today 2022 Vol.34(1): 39-43

Early Postoperative Complications and Surgical Anatomy After Ileostomy Reversal Among the Population of Khyber Pakhtunkhwa, Pakistan.

ObjectiveTo assess the frequency of early postoperative complications and surgical anatomy after ileostomy reversal among the population of Khyber Pakhtunkhwa, Pakistan.Materials and methodsIn the current study, a total of 241 patients were assessed. Sufficient urine output, usual serum electrolytes and urea were indicators of a sufficient recovery. All patients remained in the ward for a minimum of seven days after surgery to detect early postoperative complications like surgical site infection (SSI), wound dehiscence, small bowel obstruction, and anastomotic leak.ResultsIn the present study, 113 (47%) were in age 18-40 years, while 128 (53%) patients were in age 41-60 years. The mean age was 40±10.05. One hundred twenty-three (51%) were male, and 118 (49%) patients were female. One hundred seventy-one (71%) had ileostomy closure in ≤3 months, 70 (29%) had ileostomy closure in >3 months. The mean duration of closure was 03±3.70 months. One hundred and six (44%) had enteric perforation, 87 (36%) had blunt trauma, 48 (20%) had tuberculous abdomen. Moreover, the frequency of early complications of ileostomy closure was analyzed as 19 (8%) had surgical site infection, 14 (6%) patients had wound dehiscence, 12 (5%) patients had small bowel obstruction, and three (1%) patients had anastomotic leakage.ConclusionsOur study concluded that early postoperative complications and surgical anatomy after ileostomy reversal among the population of Khyber Pakhtunkhwa, Pakistan were surgical site infection (8%), wound dehiscence (6%), small bowel obstruction (5%), and anastomotic leak was (1%).

COMPARATIVE CHARACTERISTICS OF DIFFERENT METHODS OF TREATMENT OF CHRONIC COMPLICATED HEMORRHOIDS

Abstract. Introduction. In recent years, a method of surgical treatment of hemorrhoids by the method of ligation of hemorrhoidal arteries under Doppler control (THD technique), as well as with additional rectoanal reconstruction (HAL-RAR) has been developed and widely used.&#x0D; The aim of the study. The aim of our study was to compare methods of treatment of chronic complicated hemorrhoids stage II-III: classical Milligan-Morgan surgery, staple mucopexy according to Longo, as well as a combined technique: Doppler desarterization by HAL-RAR with additional removal of the external anodermal component.&#x0D; Materials and methods. In the clinic of coloproctology of Military medical: Clinical Center of the Southern Region of Odessa performed an analysis of three groups of patients for the period from 2011 to 2021, who underwent hemorrhoidectomy for complicated forms of hemorrhoids (bleeding, nodular prolapse, mucosal prolapse, anal fissure). All patients suffered from chronic complications of stage II or III hemorrhoids, with one or more of the above complications. Selected cases are divided into three groups: Group I (control) operations on Milligan-Morgan — 240 patients, including -64 women and 176 men; Distribution by age from 18 to 75 years; Group II staple hemorrhoidopexy for Longo — 276 patients, including 89 women and 115 men. Distribution by age from 18 to 72 years; Combined interventions using the wireless Doppler surgical complex Wi-3 HAL-RAR and additional removal of excess anoderm (from January 2019 to May 2021) operated on 53 patients, including 31 (58%) men and 22 (42%) women . Distribution by age from 28 to 62 years.&#x0D; Results and discussion. According to our data: bed day ranged from 1 to 8 days, mostly it was lower in group III — 1.3 (± 0.4) bed per day compared to 3.1 (± 0.8) in group II and 4.8 (± 1,7) in group III resorptive fever was not observed; the highest pain syndrome for VASH (average 7 points) in the group of patients of group I — compared with patients from group II (average 4 points) and patients of group III (average 2 points); the highest number of early postoperative complications was found in the group of patients operated on Milligan- Morgan: 1) acute urinary retention was observed in 43 cases (18%) of group I, compared with 38 cases (14%) of group II. The lowest number of cases of urinary retention was observed in group III — 2 cases (4%) (p &lt;0.05). 2) postoperative bleeding from the wound was significantly more common in group I — 9 cases (3.75%), compared with group II — 6 cases (2.5%). No postoperative bleeding was observed in group III. 3) resorptive fever was most common in group I — 43 cases (18%) compared with group II - 33 cases (12%). Resorptive fever did not occur in group III (p&lt;0.05).&#x0D; In all patients using the combined intervention HAL-RAR + excision of the external component of the anoderm, the pain was acquired by taking nonspecific anti-inflammatory drugs without the use of narcotic analgesics. No complications were observed. All patients noted no reduction in quality of life in the postoperative period.&#x0D; Conclusions. 1. Surgical treatment of hemorrhoids by the combined method of HAL-RAR + excision of the external component is a simple and effective method that in the postoperative period reduces the patient’s stay in the hospital, relatively lower in pain and the frequency of early postoperative complications. 2. HAL-RAR technology with excision of the outer component of the anoderm can be the operation of choice in the surgical treatment of chronic complicated hemorrhoids stage II-III.

Complications and adverse effects related to surgical and medical treatment in patients with inflammatory bowel disease in a prospectively recruited population-based cohort

Background Medical adverse effects and surgical complications have been reported during treatment of patients with inflammatory bowel diseases (IBDs). There is however a shortage of studies describing these in the same cohort of patients. Aim To describe medical adverse effects and surgical complications in a prospectively followed population-based cohort of patients followed for at least 10 years. Methods All newly diagnosed patients with ulcerative colitis (UC) and Crohn’s disease (CD) in the county of Uppsala between 2005 and 2009 were prospectively followed. At the end of 2019, the medical notes were scrutinised and all medical adverse effects and postoperative surgical complications were registered. Results A total of 330 patients with UC and 153 patients with CD in all age groups were included in the cohort. Four hundred and forty-two of these (91.5%) could be followed for 10 years or until death. One hundred and twenty-two patients (26.9%) experienced one or more adverse effects during the pharmacological treatment, and 25 of these could be classified as serious. Fifty-seven malignancies were diagnosed during the observation time. Surgery was performed in 16/330 UC and 33/153 CD patients. Frequency of early postoperative complications was 31% for UC patients and 36% for CD patients. Most complications were minor but two patients were re-operated, two needed intensive care and one patient died postoperatively. Conclusions Adverse effects related to medical therapy were experienced by approximately every fourth patient, and by every third patient that was operated.

Comparison of Outcomes between Elective Tracheostomy versus Emergency Tracheostomy

Aim: To compare the frequency of early postoperative complications of elective tracheostomy and emergency tracheostomy. Study design: Comparative/observational study Place and duration of study: Department of ENT/Head &amp; Neck Surgery, Mayo Hospital Lahore from 1st July 2012 to 31st December 2012. Methodology: One hundred patients of both genders undergoing tracheostomy were enrolled. All the patients were divided equally in two groups; Group A (elective) comprised 50 patients and group B (emergency) tracheostomies also comprised 50 patients. Early postoperative complications were examined and compare between both groups. Results: There were 28 (56%) and 22 (44%) males and females in group A with mean age 42.45±10.55 years while in group B 30 (60%) and 20 (40%) patients were male and females with mean age 43.06±9.84 years. Patients received emergency tracheostomy had high rate of postoperative complications as compared to elective tracheostomy (36% vs 16%). The difference was statistically significant(P&lt;0.05). Conclusion: Early postoperative complications were high in patients underwent emergency tracheostomy as compared to elective tracheostomy. Keywords: Early complications, Elective tracheostomy, Emergency tracheostomy

Frequency of Early Post-Operative Complications following Modified Radical Mastectomy (MRM) in patients with Breast Carcinoma

Objective: Breast carcinoma is the commonest cancer affecting female gender and is the second major cause of mortality in females globally. Among different surgical options, modified radical mastectomy (MRM) with or without neoadjuvant therapy is the most frequent surgery carried out globally for breast carcinoma. In this study we aimed to determine the frequency of early post-operative complications following modified radical mastectomy (MRM) in patients with breast carcinoma. Material and methods: This dual setting retrospective descriptive study was conducted at General surgery departments of Kuwait Teaching Hospital and MTI-Lady Reading Hospital Peshawar between January, 2018 and June, 2019. A total of 60 patients aged &gt;18 years with biopsy proven stage-I to stage-III breast carcinoma who underwent modified radical mastectomy were included.All patients were followed on weekly basis for six weeks at the out-patient department (OPD) and evaluated for the development of early complications such as seroma/hematoma, flap necrosis and wound infections. Results: Seroma formation found in 9 patients (15%) and wound infection seen in 5 patients (8.3%) were the commonest complications. Conclusion: In our study seroma formation was the most common complication followed by wound infection. Skin flap necrosis, wound dehiscence, hematoma formation and development of early lymphoedema were less common. None of our patients presented with muscle paralysis secondary to nerves injury. Keywords: Breast carcinoma, modified radical mastectomy, complications, seroma, wound infection.

Early post-operative complications in abdominal surgery at the university clinics of Lubumbashi: Frequency, diagnosis and prognosis

Introduction: Postoperative complications in abdominal surgery have a high incidence in developing countries’ hospitals, thus increasing the rate of their morbimortality. The aim of this work was to determine the frequency of early postoperative complications in abdominal surgery, their indications for operation, the types of postoperative complications, and their prognosis at University Clinics of Lubumbashi. Patients and Methods: This is a descriptive cross-sectional observational study with retrospective data collection from January 1, 2018 to December 31, 2019 including all patients operated on in the abdominal surgery department of the University Clinics of Lubumbashi and having presented complications within 30 postoperative days.Results: The frequency of early postoperative complicationsin abdominal surgery was 32.2%. The sex ratio M / F was 2.5 and the mean age was 31.5 ± 0.6. Emergency was the mode of admission in 80% of cases with a mean admission time of 17.2 ± 0.5. In this study, 71.42% of patients were classified ASA III. The mean time to surgical management was 36.5 ± 1.7 hours.Asthenia (62.9%) and abdominal pain (80%) were the most dominant functional signs. Suppuration of the wound (30.5%), abdominal distension (26.6%) and flow of stercoral fluid through the wall (23.8%) were the most dominant physical signs. The antibiogram on wound secretion (19%), imaging combining the chest x-ray (20%), the abdomen without preparation (27.6%) and the abdominal ultrasound (65.7%) are additional examinations which were more practiced. The post-operative complications were grade III in 95.24% of cases (n = 100) according to the Clavien-Dindo classification. The initial indications for surgery were more dominated by acute peritonitis (60%), followed by mechanical intestinal obstruction (16%). The duration of surgery was> 2 hours in 81% of cases and in 58.09% of cases the initial intervention was performed by a specialist. The mean time to resumption of oral feeding was 3.4 ± 0.6 days (Extreme: 12 hours and 192 hours). POC occurred within 5 days of surgery (59.04%).Surgical complications were more dominant (80%), made up of postoperative peritonitis (33.33%), digestive fistulas (19.5%), surgical site infection (16.7%), post-operative intestinal obstruction (13.1%) and evisceration in 6%% of cases. The majority of post-operative complications (52.4%) had undergone relaparotomy, and the outcome was good in 69.5% of cases (n = 73/105), with a mortality rate of 30.4% of cases (n = 32/105). The mean length of hospital stay was 27.4 ± 0.5 days.Conclusion: Postoperative complications are frequent at University Clinics of Lubumbashi and dominated by infection, postoperative peritonitis and digestive fistulas. The implementation of well-coded management algorithms could reduce this incidence.