Frequency Of Surgery Research Articles

Patient safety in palliative surgery

Palliative surgery aims to improve the quality of life for patients with incurable diseases. This patient group is vulnerable due to the underlying illness, prior treatment and comorbidities, which increase the risk of complications that can negatively impact the course of the disease and quality of life. Palliative surgical interventions often provide effective long-term symptom control but are more invasive than conservative, interventional endoscopic or interventional radiological alternatives. This article exemplary discusses frequent palliative visceral surgical procedures and less invasive alternatives. In practice, a close interdisciplinary collaboration, open and realistic communication, optimized perioperative care and in particular the minimization of cumulative invasiveness are crucial to maximize the quality of life and safety for oncological patients.

Outcome of Vaginal Hysterectomy versus Abdominal Hysterectomy for Benign Non-Prolapsed Uterus

Introduction: Hysterectomy is a very frequent pregnancy-unrelated surgical procedure performed in women, which may be accomplished either by abdominal or vaginal route. This study aims to assess the advantages of vaginal hysterectomy compared to abdominal hysterectomy in women with benign gynecological disorders other than prolapse. Aim of the study: The aim of this study was to compare the outcomes of vaginal hysterectomy and abdominal hysterectomy in treating benign non-prolapsed uterus. Methods: This cross-sectional comparative study was conducted among 60 patients at the Department of Obstetrics and Gynaecology, Institute of Child and Mother Health (ICMH), Dhaka, from May 2015 to October 2015. The study included 30 patients who underwent vaginal hysterectomy and 30 patients who underwent abdominal hysterectomy. Data collection involved recording patient history, conducting clinical examinations, and documenting information in a pre-designed data collection sheet. Data were analyzed using SPSS version 22.0. Result: This study included a total of 60 patients, with 30 undergoing abdominal hysterectomy (AH) and 30 undergoing vaginal hysterectomy (VH). Baseline characteristics were similar between the two groups. There were no intraoperative complications in either group. The operation time, intraoperative blood loss, time to out-of-bed activity, mean maximum postoperative body temperature, and duration of fever were all significantly shorter and less severe in the VH group compared with the AH group. Additionally, vaginal length in the VH group was significantly shorter than in the AH group. Conclusion: Vaginal hysterectomy offers advantages over abdominal hysterectomy in treating benign gynecological diseases, providing greater efficacy and safety with less invasiveness.

Analysis of emergency resuscitative thoracotomy in the combat setting

IntroductionEmergency resuscitative thoracotomy (ERT) is a resource-intensive procedure that can deplete a combat surgical team’s supply and divert attention from casualties with more survivable injuries. An understanding of survival after...

Strategical Ways for Dental Anxiety Management Prior to Third Molar Extraction.

A patient experiencing moderate to severe anxiety often skips regular check-ups, choosing to visit only when necessary. As a result, their oral health worsens. Various variables can affect anxiety such as age, gender, culture, and previous experiences. One of the most frequent oral surgical procedures is extracting the third molar, which is accompanied by severe pain, tension, and anxiety, the use of invasive equipment, and local anesthetic. A combined effect was found of four factors, including the patient, dental employees, setting, and dental procedure, which can trigger and affect dental anxiety. Both pharmacological and non-pharmacological approaches were explored; as a non-drug approach, anxiety was managed by music therapy. Acupuncture, music, audio-visual aids, and lavender oil showed an effect that helped in reducing anxiety. Patients' dental anxiety can be reduced through behavioral management such as educating the patients before the surgical procedure, relaxation strategies, biofeedback, and exposure therapy. Medicationsinclude benzodiazepines, nitrous oxide (N2O), and midazolam. Effective treatment relies on collaboration between the patients anddentists; calm patients not only provide a manageable environment for the dental team but can also result in better treatment outcomes.

Opioid use after surgical treatment in the Danish population-Protocol for a register-based cohort study.

Over the past 25 years, global opioid consumption has increased. Denmark ranks fifth in opioid use globally, exceeding other Scandinavian countries. Postsurgical pain is a common reason for opioid prescriptions, but opioid use patterns after patient discharge from the hospital are unclear. This study examines trends in opioid prescription among Danish surgical patients over a year. This register-based cohort study will use data from Danish governmental databases related to patients undergoing the 10 most frequent surgical procedures in 2018, excluding cancer-related and minor procedures. The primary outcome will be the dispensed postoperative opioid prescriptions at retail pharmacies over four quarters. Secondary analyses will include associations with sex, age, education attainment, and oral morphine equivalent quotient. Surgical treatments and diagnoses will be identified using NOMESCO procedure codes and ICD-10 codes. Opioids will be identified by ATC codes N02A and R05DA04. Subjects will be classified as preoperative opioid consumers or non-opioid consumers based on opioid prescriptions redeemed in the 6 months before surgery. The study will use extensive national register-based data, ensuring consistent data collection and enhancing the generalizability of the findings to similar healthcare systems. The study may identify high-risk populations for long-term opioids and provide information to support opioid prescribing guidelines and public health policies.

Post Caesarean Surgical Site Infection: Incidence, Prevalence, Risk Factors and Microbiological Profile of Tertiary Care Hospital, Jaipur

Background: In the past few decades, the prevalence of cesarean sections (CS) has continuously increased worldwide making it one of the most frequent surgical procedures. CS can often save a patient's life, but there are chances of postoperative consequences such as surgical site infections (SSI). During this study we have determine the occurrence and risk factors associated surgical site infections in women undergoing CS. Methodology: This is a prospective study conducted in a tertiary care hospital. Total 280 women were selected whose undergoes elective or emergency CS during May 2023 – July 2023. Each woman was properly examined and followed for 7 days to developed SSI. Bacterial profile and antibiotics pattern were examined to relate other factors associated with SSI. Results: Among 280 candidate 59 candidate suspected for SSI which are 4.74%. after microbiological analysis 5 samples were failed to produce culture, 54 (5.18%) samples were identified as SSI. Among 54 samples 77. 78% (n=42) observed as Single bacterial infection and 22.22 (n=12) observed as Mixed bacterial infection. Among all Coagulase negative staphylococci spp (CoNS) showed the highest infection 22.23% followed by Staphylococcus aureus 16.95% highest infection was observed in higher age candidate (>30) 37.04%, rural candidate 59.26%, obese candidate 31.48% and Lower-class candidate 53.70%. Conclusion: This study showed the high incidence of SSI after CS which highlighted the urgent need of prevent and surveillance of SSI. Considering patients demographic and medical history incidences of SSI can be reduced.

Hernia Correction After Liver Transplantation Using Nonvascularized Fascia.

Liver transplantation is an increasingly frequent surgical procedure, with elevated rates of postoperative incisional hernias ranging from 5% to 46%. There are numerous known risk factors for incisional hernia, including the type of incision, patient sex, and presence of comorbidities such as diabetes, ascites, older age, and the use of steroids. Most studies on the treatment of incisional hernias in patients who have undergone liver transplantation have shown consistently high rates of complications. Consequently, we propose the use of nonvascular fascia for the symptomatic treatment of incisional hernias in patients with concomitant liver transplantation. We performed our new technique on 8 patients, who had previously undergone liver transplantation, between January 2019 and January 2023. The patients were examined using imaging techniques during the follow-up period. Of the 8 patients, 7 were liver transplant recipients and 1 was a combined liver-kidney transplant patient. The median donor age was 57 y (5-66 y), whereas the mean recipient age was 58 y (31-66 y). The median patient height and weight were 163 cm (117-185 cm) and 76 kg (17-104 kg), respectively. Immunosuppression did not change in fascia recipients. The median time between transplantation and hernia repair surgery was 41 mo (5-116 mo). The sizes of the aponeurotic defects varied from 6 × 6 to 25 × 20 cm. Two patients experienced complications: one experienced bulging that required reintervention and the other experienced surgical site seroma. There was no mortality related to the use of the technique, and none were reported during follow-up. With its promising results, nonvascularized fascial transplantation can be a successful treatment for incisional hernias in patients who had previously received a liver transplant.

A surgical activity model of laparoscopic cholecystectomy for co-operation with collaborative robots

BackgroundLaparoscopic cholecystectomy is a very frequent surgical procedure. However, in an ageing society, less surgical staff will need to perform surgery on patients. Collaborative surgical robots (cobots) could address surgical staff shortages and workload. To achieve context-awareness for surgeon-robot collaboration, the intraoperative action workflow recognition is a key challenge.MethodsA surgical process model was developed for intraoperative surgical activities including actor, instrument, action and target in laparoscopic cholecystectomy (excluding camera guidance). These activities, as well as instrument presence and surgical phases were annotated in videos of laparoscopic cholecystectomy performed on human patients (n = 10) and on explanted porcine livers (n = 10). The machine learning algorithm Distilled-Swin was trained on our own annotated dataset and the CholecT45 dataset. The validation of the model was conducted using a fivefold cross-validation approach.ResultsIn total, 22,351 activities were annotated with a cumulative duration of 24.9 h of video segments. The machine learning algorithm trained and validated on our own dataset scored a mean average precision (mAP) of 25.7% and a top K = 5 accuracy of 85.3%. With training and validation on our dataset and CholecT45, the algorithm scored a mAP of 37.9%.ConclusionsAn activity model was developed and applied for the fine-granular annotation of laparoscopic cholecystectomies in two surgical settings. A machine recognition algorithm trained on our own annotated dataset and CholecT45 achieved a higher performance than training only on CholecT45 and can recognize frequently occurring activities well, but not infrequent activities.The analysis of an annotated dataset allowed for the quantification of the potential of collaborative surgical robots to address the workload of surgical staff. If collaborative surgical robots could grasp and hold tissue, up to 83.5% of the assistant’s tissue interacting tasks (i.e. excluding camera guidance) could be performed by robots.

Is Incentive Spirometry Superior to Standard Care in Postoperative Cardiac Surgery on Clinical Outcomes and Length of Hospital and Intensive Care Unit Stay? A Systematic Review with Meta-Analysis.

Cardiac surgery is a frequent surgical procedure and may present a high risk of complications. Among the prophylactic strategies studied to decrease the rates of negative outcomes, respiratory care seems to reduce pulmonary complications. Incentive spirometry (IS) is a low-cost, respiratory exercise technique, used for the prevention and treatment of postoperative pulmonary complications (PPC). The aim of this review was to evaluate whether IS is superior to respiratory care, mobilization exercises, and noninvasive ventilation on PPC, and clinical outcomes. Systematic review. Medical Literature Analysis and Retrieval System Online (or MEDLINE®), Embase®, Cochrane Central Register of Controlled Trials (or CENTRAL), Physiotherapy Evidence Database (or PEDro), Cumulative Index of Nursing and Allied Health (or CINAHL®), Latin American and Caribbean Health Sciences Literature (or LILACS), Scientific Electronic Library Online (or SciELO), Allied, Scopus®, and OpenGrey databases, clinical trial registration sites, conferences, congresses, and symposiums were searched. Twenty-one randomized trials and one quasi-randomized trial (1,677 participants) were included. For partial pressure of oxygen (PaO2), IS was inferior to respiratory care (mean difference [MD] -4.48; 95% confidence interval [CI] -8.32 to -0.63). Flow-oriented IS was inferior to respiratory care on PaO2 (MD -4.53; 95% CI -8.88 to -0.18). However, compared to respiratory care, flow-oriented IS was superior on recovery vital capacity. This meta-analysis revealed that IS was not superior to standard respiratory care for PPCs and clinical outcomes, therefore its use should not be widely recommended until further studies with high quality be performed to ensure this clinical guidance.

The economic and resource burden of e-scooter-related orthopaedic injuries: A district general hospital's experience

PurposeElectric scooters (e-scooters) are an increasingly popular method of transportation worldwide. However, there are concerns regarding their safety, specifically with regards to orthopaedic injuries. We aimed to investigate the overall burden and financial impact on orthopaedic services as a result of e-scooter-related orthopaedic injuries. MethodsWe retrospectively identified all e-scooter-related injuries requiring orthopaedic admission or surgical intervention in a large District General Hospital in England over a 16-month period between September 2020 and December 2021. Injuries sustained, surgical management, inpatient stay and resources used were calculated. ResultsSeventy-nine patients presented with orthopaedic injuries as a result of e-scooter transportation with a mean age of 30.1 years (SD 11.6), of which 62 were males and 17 were females. A total of 86 individual orthopaedic injuries were sustained, with fractures being the most common type of injury. Of these, 23 patients required 28 individual surgical procedures. The combined theatre and recovery time of these procedures was 5500 min, while isolated operating time was 2088 min. The total cost of theatre running time for these patients was estimated at £77,000. A total of 17 patients required hospital admission under Trauma and Orthopaedics, which accounted for total combined stay of 99 days with a mean length of stay of 5.8 days. ConclusionWhile there are potential environmental benefits to e-scooters, we demonstrate the risks of injury associated with their use and the associated increased burden to the healthcare system through additional emergency attendances, frequent outpatient clinic appointments, surgical procedures, and hospital inpatient admissions.

Trends in spinal cancers: Primary & metastatic. An Irish epidemiological perspective

BackgroundThe incidence and histological type of spinal cancer is diverse. It is our role as physicians to explore the epidemiology of spinal cancers so that several projections can be made. Resource allocation, cost analyses, and the requirement of rehabilitation facilities all need to be considered.The objective of this paper is to provide an account of the acute spinal oncological admissions to the National Spinal Injuries Unit (NSIU) in both 2010 and 2020 with the hypothesis that upward trends will be noted. Only by exemplifying this trend, will it highlight the need to give spinal cancer the attention it deserves in the Republic of Ireland. MethodsAll patients who were to undergo spinal surgery for primary or metastatic spinal cancer in the Mater Misericordiae University Hospital (MMUH) in 2010 and 2020 were included in this retrospective cohort study. A list of medical record numbers (MRNs) for all patients who underwent spinal surgery in the MMUH were included. Data pertaining to patient demographics were noted. Results90 patients were included in this retrospective cohort study. 37 patients in 2010, had increased to 53 by 2020. Metastatic disease to the spine was still the most prominent reason for referral. The most common spinal region affected was the thoracic spine. Breast cancer was the most prevalent metastatic cancer to the spine in 2010. Lung cancer became the most prevalent by 2020. Posterior spinal fusion was the most frequent surgical procedure performed. The length of stay in higher care facilities decreased from 5.4 days in 2010, to 4 days in 2020. Decreased were also seen in the mean length of hospital stay, plummeting from 23.6 days in 2010, to 7.6 days in 2020. The same could not be said for the 30-day mortality rate, increasing from 5.4% in 2010, to 9.4% in 2020. ConclusionThe results of this study show a substantial rise in the incidence and prevalence of both primary and metastatic spinal disease here in Ireland. One can see clear improvements in operative technique, with less patients proceeding to higher levels of post-operative care, and earlier discharge times. This data can be used for future planning. The paper highlights the economic cost of spinal oncological care, but it also identifies key areas where preventative campaigns can be targeted.

No Reason to Use Mesh in Groin Hernia Repair in Adolescents.

Groin hernias are common and hernia repair is one of the most frequent surgical procedures performed worldwide. Despite this, there is no international guideline on the management of groin hernias in adolescents. Mesh reinforcement is used for repair in adults but not in young children. Adolescents, positioned between these age groups, pose unique challenges for surgeons due to their varying growth patterns. Placing a synthetic mesh in growing patients is a concern, particularly in relation to chronic pain. Traditionally, the hernia literature has defined adults as individuals aged 18years and above. Considering that growth can continue until age 19, this review proposes a revised definition of adolescence for patients with groin hernias encompassing ages 10 to 19. Symptomatic groin hernias in adolescents should be repaired with an open non-mesh technique because of acceptable recurrence rates and the desire to avoid introducing synthetic foreign materials into young patients with ongoing growth potential. Watchful waiting is suggested for asymptomatic groin hernias, postponing repair until the adolescent has become a fully grown adult and symptoms from the hernia develop. Most groin hernias in adolescents are lateral hernias, but before pursuing a watchful waiting strategy in females, an ultrasound or magnetic resonance imaging scan is suggested to rule out the presence of a femoral hernia that may need repair.

The effectiveness of intravenous ibuprofen versus intravenous ketorolac for postoperative pain relief after caesarean section

Background Caesarean deliveries are currently the most frequent surgical procedure performed worldwide. Nonsteroidal anti-inflammatory drugs are frequently used to control postoperative pain as a part of the multimodal analgesia technique. We studied the efficacy of intravenous ibuprofen versus intravenous ketorolac to relieve postoperative pain following caesarean delivery under general anaesthesia. Patients and methods Fifty adult parturients aged 20–30 were studied and classified to the American Society of Anaesthesiologists (ASA) class II scheduled for elective caesarean delivery under general anaesthesia. Patients were divided into groups: group A (n=25), 30 mg ketorolac in 200 ml normal saline every 6 h, and group B (n=25), 800 mg ibuprofen in 200 ml normal saline every 6 h. They were evaluated for haemodynamic stability, visual analog score (VAS) score, 24-h opioid requirement, time to ambulate, and time to first analgesic dose. Results Group B (ibuprofen group) showed a lower VAS score through all the 24 h postoperatively at rest and during movement with allover VAS at rest (3.17±1.08) versus (4.32±1.3) P=0.008 and allover VAS during movement (3.21±1.11) versus (4.56±1.92) P=0.001. Also, lower 24-h opioid requirement in group B (ibuprofen group) with a mean value of (42.0 ±21.31) mg versus (110.0±17.68) mg in group A (ketorolac group) P=0.0021 and longer time to first analgesic dose in group B (ibuprofen group) with a mean value of (328.0±89.63) min versus (158.40 ±57.13) min in group A (ketorolac group) P=0.001 with more haemodynamic stability. Group B also showed lower ambulation time and less nocturnal awakening due to pain. Conclusions Intravenous ibuprofen is more effective than intravenous ketorolac in reducing postoperative pain following caesarean delivery. It reduces the 24-h opioid requirement and VAS at rest and during movement.

Modified Endoscopic Vacuum Assisted Closure (E-VAC) is a novel minimally invasive technique for treating esophageal pleural fistulas

BackgroundSurgical pathologies of the esophagus in the pediatric age are not unusual. However, when they appear, they are not complications-free. These include anastomotic dehiscence or pleural fistulas. Classically they are treated clinically, and this treatment is associated with complications such as mediastinitis, pleural effusion, sepsis, and death. We propose treating esophageal dehiscence using a negative pressure system placed endoscopically. This minimally invasive procedure can be used as definitive treatment or bridging therapy for surgical correction. MethodsThis is a retrospective longitudinal multicenter study from January 2018 to January 2022 in five medical centers, three located in Colombia and two in Mexico. The patients had esophageal dehiscence or pleural fistula diagnosed by contrast leakage in postoperative esophagogram or endoscopy and treated with an endoscopic negative pressure system, with a 30-day follow-up after the diagnosis. We analyze the time of placement, pressure and E-VAC (Endoscopic- Vacuum Assisted Closure) replacements, as well as the efficacy and inherent complications. ResultsWe present nine patients diagnosed with esophageal dehiscence or pleural fistula treated with endoscopic VAC. The oldest was 14-years old and the youngest was 2-day-old. Six patients were diagnosed with esophageal atresia, either type III or type I. The other three patients had gastric volvulus, short esophagus, and embryonic esophageal remnants. The most frequent initial surgical procedures were the correction of esophageal atresia and esophageal-jejunal anastomosis. The esophageal dehiscence or pleural fistula was diagnosed by esophagogram with hydrosoluble contrast. Four patients had E-VAC as initial therapy; the remaining five used it after expectant management failed. Fistula closure took an average of 13 days, with fewer than three VAC changes required. Two of the nine patients presented with subsequent anastomotic stenosis, which was treated with endoscopic dilation using a balloon dilation. ConclusionsUsing the E-VAC system in esophageal and pleural fistulas is effective in all our patients. It also shortens hospitalization and treatment time when performed as the first management line. We recommend using E-VAC at a pressure of 50 - 125 mmHg and preferably of the continuous type. System changes are indicated when there are suction problems, system clogging, or E-VAC migration when relocation is impossible. The other methods described do not use the transparent dressing, so it must be completely changed at each control. Level evidenceIV

1161 The Financial Impact of Electric Scooter Orthopaedic Injuries at a Large District General Hospital in England

Abstract Aim Electric scooters are becoming an increasingly popular method of transportation in major urban cities worldwide. As their popularity gains, there are concerns about safety and injuries sustained, of which significant proportion are orthopaedic injuries. The aim of this study was to see the financial impact of e-scooter related orthopaedic injuries. Method In a retrospective study, we investigated the overall burden and the financial impact of the orthopaedic injuries as a result of the use of e-scooter transportation in a large District General Hospital in England over a 16-month period between September 2020 and December 2021. Results Seventy-nine patients were identified with a mean age of 30.1 years (SD 11.6). Sixty-two of these patients were males and seventeen were females. There were eighty-six orthopaedic injuries, with fractures being the most occurring type of injury. Twenty-three patients required twenty-eight different surgical procedures. The combined theatre and recovery time was 5500 minutes, while the surgical procedures operating time was 2088 minutes. The cost total cost of theatre running time for these patients was £77,000. Seventeen patients required hospital admission under Trauma and Orthopaedics, which accounted for total stay of ninety-nine days with a mean length of stay of 5.8 days per patient. Conclusions We have demonstrated that although there are environmental benefits to e-scooters; there have been a significant increase in healthcare system burden as demonstrated by additional emergency attendances, frequent outpatient clinic appointments, surgical procedures, and hospital inpatient admissions.

Impact of COVID-19 Vaccination on General Surgical Emergencies in Al-Qassim Region, Saudi Arabia: A Single-Center Retrospective Chart Review.

Background This study sought to determine the COVID-19 pandemic and vaccination's effects on the number of patients presenting with emergent surgical illnesses or requiring emergency general surgical procedures. We compared the number of presenting cases and surgical emergencies before the pandemic, in 2019, and during the pandemic, before and after the COVID-19 vaccination's introduction. Method This observational retrospective chart review was conducted at a tertiary hospital in Al-Qassim, Saudi Arabia. The data were retrospectively collected for three periods (July 1 to September 30) in 2019, 2020, and 2021 using a data collection sheet for demographic data, visit date, comorbidities, emergency procedure type, COVID-19 test result, length of hospitalization, ICU admission status, and surgical case mortality. Results The study included 152 participants with a mean age of 36.1 (SD: 16) years, and 69.7% of them were male. Common surgical conditions were identified as acute appendicitis (49.3%), skin abscesses and pilonidal sinus (21.7%), and diabetic foot (9.2%) across all three years. The most frequent (48.7%) surgical procedure was appendectomy. A decrease in surgical emergencies rate was observed during the year 2020, as compared to 2019 and 2021. The general surgery emergency rate was highest in 2021 among patients admitted for procedures post-vaccination (38.8%). Conclusion Common surgical emergencies were most frequent in 2021, after the COVID-19 vaccine's introduction. Future research areas include the impact of the pandemic on delays or the severity and complication of surgical or medical cases.

Multimodal Haptic Simulation for Ventriculostomy Training.

Freehand ventriculostomy is a frequent surgical procedure and is among the first ones that junior neurosurgery residents learn. Although training simulators exist, none has been adopted in the clinical routine to train junior residents. This paper focuses on a novel multimodal haptic training simulator that will lift the limitations of current simulators. We thus propose an architecture that integrates (1) visual feedback through augmented MRIs, and (2) a physical mock-up of the patient's skull to (3) active haptic feedback.

Randomized Clinical Trial to Evaluate the Efficacy and Tolerability of Nebulized Hyaluronic Acid and Xylitol Based Solution after Septoturbinoplasty.

Septoplasty and turbinate surgery are among the most frequent surgical procedures to improve nasal obstruction and quality of life. These procedures usually imply the presence of congestion, secretions, and crusting related to the movement of the instruments during surgery. However, the use of nasal lavage may reduce this situation. The addition of Hyaluronic acid or Xylitol offers advantages in these washes. This study was a randomized, double-blind, controlled trial. All patients underwent endoscopic septoplasty with inferior turbinate submucosal resection without posterior nasal packing. SNOT-22, main VAS, NOSE, Modified Lund-Kennedy endoscopic scale, number of crusts and adhesions were quantified before and on the day of the surgery, visit three (seven days), visit four (fourteen days), and visit five (twenty-eight days). Forty-seven patients completed the study, divided into a standard saline arm (group 1, 22 patients) and normal saline plus HA and Xylitol arm (group 2, 27 patients). Both treatment groups improved their quality of life and objective parameters during the four weeks of the study. All patients tolerated the nasal irrigations well, and none discontinued the treatments. The study concludes that nasal washes of Aluneb Isotónico® offer several benefits to patients as a protective and preventative agent.

Analysis of cardiac surgeries and operative mortality at the National Cardiovascular Institute during 2022

To describe cardiac surgeries, their approaches, and determine operative mortality according to the type of surgery and the main complications recorded within 30 days postoperatively, performed at the National Cardiovascular Institute of Peru. A descriptive study was conducted on all patients over 18 years of age who underwent cardiovascular surgery at the National Cardiovascular Institute "Carlos Alberto Peschiera Carrillo". During the year 2022, a total of 503 cardiac surgeries were performed. Of the patients undergoing surgery, 63.6% (320) were males. Isolated valvular surgery, primarily aortic or mitral valve replacement, was the most frequent surgical procedure, with 136 surgeries (27.0%). This was followed by myocardial revascularization surgery with 110 procedures (21.9%). Throughout the year, there were 23 deaths, resulting in an overall mortality rate of 4.5%. The mortality rate for elective surgeries was 2.8%, while for emergency surgeries, it was 14.3%. The most common complication was paroxysmal atrial fibrillation (14.0%), followed by surgical site infection with 52 cases (10.3%). Valvular surgery, whether isolated or combined with other procedures, was the most frequently performed. The obtained mortality rate is considered acceptable for a reference center.

Evaluation of Post-Tonsillectomy Complications between the Traditional Cold-Steel Dissection and Electrocautery Methods. A Controlled Randomized Trial

Background: One of the most frequent ENT surgical procedures is the tonsillectomy. Comparing electrocautery to the conventional cold-steel dissection technique, it has been indicated that the latter will cause fewer post-tonsillectomy problems. However, there needs to be more randomized controlled studies to compare the two methods. Objectives: This Study's primary goal is to compare the post-tonsillectomy problems caused by the electrocautery technique versus the conventional cold-steel dissection approach. Methods: Between January 2022 and January 2023, this Study was carried out by the department of Ent hmc Peshawar. A prospective randomized controlled trial will include 125 participants in total. Patients will get a tonsillectomy and be randomly allocated to either the electrocautery technique or the conventional cold-steel dissection approach. Pain, bleeding, and infection related to post-tonsillectomy sequelae will be assessed and compared between the two groups. Results: The Study's findings will be utilized to compare the effectiveness and safety of the electrocautery approach versus the conventional cold-steel dissection method for tonsillectomy. Conclusion: This Study will provide otolaryngologists with evidence-based advice on a tonsillectomy procedure. Keywords: tonsillectomy, electrocautery, cold-steel, post-tonsillectomy complications, randomized controlled trial