Incidence Of Injury Research Articles

The Addition of a Non-Steroidal Anti-Inflammatory Drug (NSAID) in Local Infiltration Analgesia During Total Knee Arthroplasty Increases the Risk of Acute Kidney Injury in Patients Who Have Renal Impairment: A Propensity-Matched Retrospective Cohort Study

BackgroundLocal infiltration analgesia (LIA) is a crucial component of pain management during total knee arthroplasty (TKA). Various formulations of the LIA drug cocktail have been described, with non-steroidal anti-inflammatory drugs (NSAIDs) commonly included. Although NSAIDs are highly effective in improving postoperative pain, they are associated with adverse renal, gastrointestinal, and cardiovascular effects. This study aimed to investigate whether the addition of an NSAID in LIA affects the incidence of acute kidney injury (AKI) in TKA patients, especially those who have pre-existing renal impairment. The secondary aim was to determine overall AKI incidence. MethodsA retrospective cohort study was conducted on elective, primary TKA patients in a single tertiary institution between January 2020 and April 2024. Data was obtained from a prospectively collected institutional knee arthroplasty registry. Patients were administered LIA intraoperatively, with or without an NSAID (30 mg of ketorolac). The study population was divided into two subpopulations, patients who did or did not have chronic kidney disease (CKD), and analyzed separately. Propensity matching was performed on the CKD group, correcting for age, sex, BMI, ASA score, and presence of diabetes mellitus/hypertension. The outcome of interest was the incidence of AKI. A t-test or Chi-square test was used, where appropriate, to determine the statistical significance of the results. ResultsIn patients who had CKD (n = 114), the presence of ketorolac in LIA was associated with a higher AKI incidence (12.7 versus 2.0%, P = 0.041). In patients who did not have CKD (n = 870), the presence of ketorolac in LIA was not associated with a higher AKI incidence (2.0 versus 1.9%, P = 1.0). Overall AKI incidence was 2.6%. ConclusionIn patients who have CKD, orthopaedic surgeons should be highly cautious of administering ketorolac in LIA during TKA, as it is associated with a higher risk of AKI. Patients who have normal renal function can be safely given ketorolac in LIA without an elevated risk of AKI. Further studies are needed to examine AKI incidence when other NSAIDs are used in LIA.

Comparison of three-dimensional vs. two-dimensional assisted thoracoscopy for recurrent laryngeal nerve lymph nodes dissection in esophagectomy: a retrospective study

BackgroundThis study aimed to explore the clinical value of 3D video-assisted thoracoscopic surgery in dissecting recurrent laryngeal nerve lymph nodes in patients undergoing minimally invasive esophagectomy.MethodsA retrospective cohort study was conducted on 205 patients, including 120 males, who underwent esophagectomy from May 2018 to May 2020 in the Department of Thoracic Surgery at the Affiliated Huai’an No.1 People’s Hospital of Nanjing Medical University. Perioperative parameters, including intraoperative blood loss, operation time, the number of dissected recurrent laryngeal nerve lymph nodes, the incidence and degree of postoperative recurrent laryngeal nerve injury, the volume of postoperative thoracic drainage, and postoperative complications, were compared between the 3D and 2D groups.ResultsThere were no significant differences in the preoperative baseline data between these two groups (P > 0.05). The number of dissected recurrent laryngeal nerve lymph nodes in the 3D group was significantly higher than in the 2D group (P < 0.05). The operation times were significantly shorter in the 3D group than in the 2D group (P < 0.05). The volume of thoracic drainage in the first 2 days was significantly less in the 3D group than in the 2D group (P < 0.05).ConclusionsCompared to the 2D system, the application of 3D video-assisted thoracoscopic surgery in minimally invasive esophagectomy can increase the number of dissected recurrent laryngeal nerve lymph nodes and ensure safety. Additionally, it can reduce the duration of the operation, decrease early postoperative thoracic drainage volume, and promote patient recovery.

The gender and sex data gap in anterior cruciate ligament injuries in paediatric patients.

Anterior cruciate ligament (ACL) injury is a concerning problem in the paediatric population, impacting joint health and longevity. Moreover, ACL injury hampers physical activity, which is important for children's social network and general well-being. Recent data demonstrates a rise in paediatric ACL reconstructions, affecting both girls and boys. However, it is unclear whether this rise reflects a higher injury rate or a more proactive approach towards surgery, as information on nonoperated patients is lacking. Regarding gender differences, increasing evidence implies that girls engaged in pivoting sports experience a higher incidence of ACL injuries and reinjuries compared to boys. Furthermore, data suggestthat girls have inferior outcomes and lower return-to-sport rates than boys. The social context in which girls compete in sports is likely a significant contributing factor to the risk of serious knee injuries. Lack of attention and insufficient data on gender-based differences in ACL injuries, outcomesand evidence-based treatment guidelines highlight the need for further research on this topic. LEVEL OF EVIDENCE: Level IV.

Occupational exposure to Blood and Body Fluids among Healthcare Professionals in a military hospital in Greece: A retrospective single-center study

BackgroundHealthcare Professionel (HCP) worldwide are subjected to various occupational hazards, including exposure to Blood and Body Fluids (BBF). However, with systematic training and supervision, the impact of such incidents can be significantly mitigated. ObjectiveThis study aims to assess the incidence of occupational exposure to BBF among HCPs reported to a military hospital over a five-year period. Additionally, it seeks to explore the characteristics of the affected HCP and the conditions of exposure, and to evaluate HCP’ overall compliance with the hospital's guidelines. MethodsThis is a retrospective, single-center study that includes all self-reported forms submitted from January 1, 2019, to December 31, 2023. ResultsThe overall incidence of BBF exposure was 3.05 per 100 full-time employment-years (FTEYs) or 3.01 per 100 HCP per year, whereas the incidence of needlesticks and sharps injuries (NSSIs) was 2.73 per 100 FTEYs or 2.54 per 100 HCPs per year. Overall HCP’ compliance was 34.1%, with an increase from 1.6% in 2019 to 45.9% in 2023. ConclusionsThere is a need for a unified process for the collection of nationwide, longitudinal data on exposure to BBF, as well as for the development of targeted training programs on occupational health and safety for HCP.

Age, Running Biomechanics, And The Incidence Of Running-related Injuries: A 1-year Prospective Cohort Study

Age, Running Biomechanics, And The Incidence Of Running-related Injuries: A 1-year Prospective Cohort Study

The global, regional, and national burden of burns: An analysis of injury by fire, heat, and hot substances in the global burden of disease study 2019

BackgroundBurn caused by exposure to hot substances is a common occurrence but there is little data on prevalence trends and disease burden. This research report the burden of burn injuries globally, regionally, and nationally from 1990 to 2019, identify hotspots, and analyze factors affecting disease burden with data from Global Burden of Disease 2019 survey. MethodsThe Global Burden of Disease 2019 estimated the incidence, death rate, and disease-adjusted life years (DALY) for injuries due to exposure to fire, heat, and hot substances from 1990 to 2019. For comparison, all rates were age standardized. And the estimated annual percentage change (EAPC) was used to reflect the degree of change of the annual rate. ResultsGlobally, there were an estimated 8,378,122 (95 % uncertainty interval [UI]: 6,531,887–10,363,109) burn injuries in 2019, with age-standardized incidence, death, and DALY rates of 118 (95 % UI: 89–147), 1.44 (95 % UI: 1.14–1.72), and 96.6 (95 % UI: 75.03–123.05) per 100,000 people, which were 22 %, 43 %, and 43 % lower than those in 1990, respectively. Regionally, age-standardized incidence rate showed a positive association with Socio-demographic Index (SDI) from 1990 to 2019, whereas age-standardized death and DALY rates were negatively associated with SDI. The variation in the age-standardized incidence rate was intrinsic, and the variation in the age-standardized death rate was related to the human development index in the country. The global burn incidence population was skewed, with peaks mainly in the 5 to 19 years age group, but age-specific death rates and disease burden were higher in the under-5 and older age groups. ConclusionsThe results of this study indicate the need to consider regional differences in burns when allocating health resources. Despite the reduced global burden of burns, incidence and deaths remain high. Moreover, there are significant differences between regions which are associated with the SDI and the human development index. Additionally, differences exist in the age and sex of the affected populations. Although the exact causes require further study, there is no doubt that the prevention of burns requires serious attention.

Low incidence of acute kidney injury with combined intravenous and topical antibiotic infusions in periprosthetic joint infection after total knee arthroplasty.

This study aimed to assess the risk of acute kidney injury (AKI) associated with combined intravenous (IV) and topical antibiotic therapy in patients undergoing treatment for periprosthetic joint infections (PJIs) following total knee arthroplasty (TKA), utilizing the Kidney Disease: Improving Global Outcomes (KDIGO) criteria for classification. We conducted a retrospective analysis of 162 knees (162 patients) that received treatment for PJI post-TKA with combined IV and topical antibiotic infusions at a single academic hospital from 1 January 2010 to 31 December 2022. The incidence of AKI was evaluated using the KDIGO criteria, focussing on the identification of significant predictors and the temporal pattern of AKI development. AKI was identified in 9.26% (15/162) of the cohort, predominantly presenting as stage 1 AKI, which was transient in nature and resolved prior to discharge. The analysis highlighted moderate anaemia and lower baseline serum creatinine levels as significant predictors for the development of AKI. Notably, the study found no instances of severe complications such as wound dehiscence, skin erosion, or the need for haemodialysis following treatment. The findings suggest that the combined use of IV and topical antibiotic therapy in the management of PJIs post-TKA is associated with a low incidence of primarily transient stage 1 AKI. This indicates a potentially favourable renal safety profile, advocating for further research to confirm these outcomes and potentially influence treatment protocols in PJI management.

Schatzker IV tibial plateau fractures involving the posterolateral column: Higher incidence of lateral meniscus and anterior cruciate ligament injuries with suboptimal postoperative outcomes

BackgroundCurrent literature offers scant insights into Schatzker IV tibial plateau fractures (TPFs) that affect the posterolateral (PL) column. This study seeks to elucidate the prevalence of meniscal and ligamentous injuries in the knee, as well as the clinical outcomes, in Schatzker IV TPF cases, both with and without PL column involvement. MethodsWe conducted a retrospective analysis of clinical and imaging data from patients with Schatzker IV TPFs who received surgical treatment at our institution between January 2018 and January 2022. Patient demographics and surgical details were meticulously documented. The study participants were categorized into two groups based on the involvement of the PL column in the Schatzker IV TPF. Group A comprised patients without PL column fractures, whereas Group B included those with such fractures. We compared soft tissue injuries affecting knee stability, namely meniscal and ligamentous injuries, between two groups using Magnetic Resonance Imaging (MRI) and surgical records. Further, Group B was divided into subgroups based on the presence or absence of knee subluxation. Within Group B, we measured the lateral plateau depression (LPD) and lateral plateau widening (LPW). Additionally, we investigated the frequency of meniscus entrapment in patients with PL column fractures. Clinical outcomes were assessed using The American Hospital for Special Surgery (HSS) and Rasmussen scores. ResultsThe study comprised 66 patients with Schatzker IV TPFs. Of these, 12 patients had no PL column fracture, while 54 had a PL column fracture. Group B demonstrated a 57.4 % and 64.8 % incidence of lateral meniscus (LM) and anterior cruciate ligament (ACL) injuries, respectively, significantly higher than that in Group A (25 %, 8.3 %) (p = 0.044, p < 0.001). Within Group B, those with knee subluxation showed a marked increase in LPD (14.5 ± 5.3 mm) and LPW (9.3 ± 4.9 mm), correlating with a higher rate of meniscus entrapment (76.0 %) (p < 0.001). Patients in Group B had lower HSS and Rasmussen scores compared to Group A (p = 0.048, p = 0.006). ConclusionThis investigation reveals that Schatzker IV TPFs involving the PL column are highly associated with increased rates of LM and ACL injuries. Additionally, these fractures correlate with a greater likelihood of knee subluxation and meniscus entrapment, ultimately leading to poorer prognostic outcomes.

Injury Incidence Fluctuates Across The Menstrual Cycle In Female Athletes

Injury Incidence Fluctuates Across The Menstrual Cycle In Female Athletes

Significant reduction in full-thickness pressure injuries through the quality improvement project that implements alternating pressure air mattresses.

To assess a quality improvement project using alternating pressure air mattresses' impact on reducing full-thickness pressure injuries by enhancing setting accuracy and device utilization. We retrospectively evaluated adult acute care unit patients with inclusion criteria (Braden scores ≤12 or existing full-thickness pressure injuries) between May 2020 and August 2023. A wound team attempted to enhance the accuracy, utilization and effectiveness of alternating pressure air mattress implementation. The implementation outcomes were setting accuracy and accurate utilization rates. The clinical outcome was the full-thickness pressure injury proportion. Utilization and allocation gaps were also calculated. The setting accuracy and accurate utilization rates increased (0.59 to 0.88 and 0.15 to 0.37, respectively). The full-thickness pressure injury proportion decreased (0.17 to 0.06), with a strong negative correlation coefficient (-0.789) (p < 0.001) with accurate utilization rates. The full-thickness pressure injury proportion declined faster during the project's complete phase than the partial phase (-0.0046 vs. -0.0016; p < 0.05). The utilization gap narrowed (99 to 60); however, the allocation gap increased (1 to 13), suggesting increased alternating pressure air mattress usage among ineligible patients. Targeting high-risk patients for alternating pressure air mattress utilization and ensuring correct settings, both performed by a dedicated team, substantially reduces the full-thickness pressure injury incidence.

Eye Injury Incidence in Germany from 2008 to 2022: An Analysis of Hospital Quality Reports.

Eye injuries range from minor to severe and may lead to permanent visual impairment. There is still little in the way of epidemiological data on eye injuries in Germany. The aim of this study was to obtain an objective record of minor and severe eye injuries in Germany by evaluating hospital quality reports. We also investigated the relevance of injuries from fireworks in relation to the total number of eye injuries and the general population. This retrospective routine data study entailed analysing hospital quality reports from 2008 to 2022 in XML format. The R programming language was used for data processing and statistical analysis. The number of ICD-coded eye injuries was exported and analysed together with location data. We also included data from a prospective survey study on fireworks-related eye injuries from 2016 to 2023. Eyeball and/or orbital contusions are the most common eye injuries treated in Germany at up to 2,500 cases per year. The most severe injuries comprise traumatic globe rupture with loss of intraocular tissue at up to 990 cases per year. Numbers of eye injuries of any type have been declining since 2020. As a percentage of population, Mecklenburg-Western Pomerania treats the most eye injuries at up to 0.017%; in absolute numbers, North Rhine-Westphalia leads the country at up to 1,600 injuries. Private firework displays are probably responsible for 1.4% of annual globe ruptures and 8.3% of eyeball contusions. Our analysis of hospital quality reports has provided the first comprehensive epidemiological record on eye injuries in Germany. Firework-related injuries account for a relevant proportion of total injuries. These results could serve as a basis for preventive measures and health policy decisions.

ASSOCIATION OF RADIAL ARTERY ACCESS WITH REDUCED INCIDENCE OF ACUTE KIDNEY INJURY

Acute kidney injury (AKI) is a serious complication following cardiac procedures, leading to increased morbidity and mortality. The choice of vascular access site may influence the incidence of AKI, with radial artery access potentially offering protective benefits compared to femoral artery access. Objective: To evaluate the association between radial artery access during cardiac procedures and the incidence of acute kidney injury among patients. Methods: This retrospective cohort study was conducted at the National Institute of Cardiovascular Disease from January 2023 to January 2024. A total of 370 patients who underwent cardiac procedures were included, comprising 200 patients in the radial artery access group and 170 in the femoral artery access group. Data were collected retrospectively from medical records, including demographic information, baseline renal function, procedural details, and serum creatinine levels before and after the procedure. The incidence of AKI was determined based on established criteria for changes in serum creatinine. Statistical analyses were performed using appropriate tests, with a significance level set at p &lt; 0.05. Results: Patients in the radial artery access group had a shorter average hospital stay (2.5 ± 1.2 days) compared to the femoral group (3.8 ± 1.5 days, p = 0.001). The mortality rate was lower in the radial group (1.5%) versus the femoral group (4.1%), although this difference was not statistically significant (p = 0.09). The incidence of major adverse cardiovascular events (MACE) was 2.5% in the radial group compared to 5.9% in the femoral group (p = 0.07). Acute kidney injury occurred in 10.0% of patients in the radial artery access group (20 out of 200) versus 17.6% in the femoral artery access group (30 out of 170), indicating a significant reduction in AKI incidence with radial access. Conclusion: Using radial artery access during cardiac procedures significantly reduces the incidence of acute kidney injury compared to femoral artery access. These findings support the preference for radial artery access to minimize the risk of AKI and improve patient outcomes.

Effect of standardized hypnotic bundles on insomnia during hospitalization and reducing fall rate: A single-center retrospective cohort study.

Although the use of benzodiazepine receptor agonists is a risk factor for falls and fractures, whether benzodiazepine-avoiding hypnotic bundles are beneficial in clinical settings remains unclear. A new hospital-wide standardized hypnotic bundle for insomnia, with suvorexant as the first choice, was created for clinical purposes. This single-center retrospective cohort study involved a pre-post design and adult inpatients who had had falls. The primary outcome was the total fall rate in the pre-post groups. Additionally, the level change in the fall-rate trend for each month at standardization of the new hypnotic bundle was analyzed. The numbers of hypnotic-related falls and injuries requiring treatment were evaluated. There were no differences in baseline characteristics between the two groups, except for patients with COVID-19. Overall, 31 736 patients were included in this study. The total number of falls was 924 (3.42‰) in the pre-standardization group and 837 (3.31‰) in the post-standardization group, with no significant difference. An interrupted time-series analysis of the level change in the fall rate revealed that the gap in trend at standardization was -11%, with no significance. Hypnotic-related falls were 300 (1.11‰) versus 213 (0.84‰), and the injury incidences were 251 (0.93‰) versus 181 (0.71‰) in the pre and post groups, respectively, showing a significant reduction. The standardization of the new hypnotic bundle for insomnia did not help achieve a significant reduction in total falls. However, our findings suggest that this bundle has the potential to reduce hypnotic-related falls and injuries in inpatients who have had falls. Geriatr Gerontol Int 2024; ••: ••-••.

Insights into Advances and Applications of Biomaterials for Nerve Tissue Injuries and Neurodegenerative Disorders.

The incidence of nerve tissue injuries, such as peripheral nerve injury, spinal cord injury, traumatic brain injury, and various neurodegenerative diseases (NDs), is continuously increasing because of stress, physical and chemical trauma, and the aging population worldwide. Restoration of the damaged nervous system is challenging because of its structural and functional complexity and limited regenerative ability. Additionally, there is no cure available for NDs except for medications that provide symptomatic relief. Stem cells offer an alternative approach for promoting damage repair, but their efficacy is limited by a compromised survival rate and neurogenesis process. To address these challenges, neural tissue engineering has emerged as a promising strategy in which stem cells are seeded or encapsulated within a suitable biomaterial construct, increasing cell survival and neurogenesis. Numerous biomaterials are utilized to create different types of constructs for this purpose. Researchers are trying to develop ideal scaffolds that combine biomaterials, cells, and molecules that exactly mimic the biological and mechanical properties of the tissue to achieve functional recovery associated with neurological dysfunction. This review focuses on exploring the development and applications of different biomaterials for their potential use in the diagnosis, therapy, nerve tissue regeneration, and treatment of neurological disorders.

The effectiveness of a novel modified retracting arm for transaxillary endoscopic thyroid surgery to minimize complications: A randomized controlled study

Objective: To evaluate the safety of a novel modified retracting arm for endoscopic thyroidectomy by gasless unilateral axillary approach (ETGUA) and its effectiveness in minimizing complications. Methods: A novel retracting arm, which comprises a suspension part, a retracting arm, and a suction tube, was designed for ETGUA. The thyroid pull hook used in this study is an approved medical device: Su Xu, 20210063 (https://scjgj.xz.gov.cn/). The cohort of this randomized controlled study included 84 patients with unilateral thyroid cancer who underwent ETGUA at Xuzhou Central Hospital from February 2021 to March 2023. The patients (n = 42/group) were randomly assigned to a control group (conventional endoscopic retracting arm) or an experimental group (modified endoscopic thyroid retracting arm). Clinical indicators, complication rates, neck pain scores, and cosmetic scores were compared between the two groups. Results: There were no significant differences in hospitalization time, surgical duration, intraoperative blood loss, postoperative drainage volume, hypoparathyroidism, or postoperative hematoma between the groups. However, there were significant differences in the incidences of transient recurrent laryngeal nerve injury (x2 = 6.65, p = 0.02) and transient superior laryngeal nerve injury (x2 = 4.49, p = 0.03), as well as visual analog scale scores on postoperative day (POD) 1 and 7 (tPOD1 = 12.66; tPOD7 = 10.54; both, p ＜ 0.001), and cosmetic scores (t = -15.27, p ＜ 0.05). Conclusion: The modified retracting arm was safe and effective for ETGUA.

Linking Data on Nonfatal Firearm Injuries in Youths to Assess Disease Burden

This cross-sectional study estimates the incidence of nonfatal firearm injuries among children and young adults after linking patient-level police and trauma registry data.

Analyzing the Burden of Midface Fractures Due to Road Traffic Accidents in Vietnam: An Epidemiological Approach.

Road traffic accidents have significantly impacted public health in Vietnam. This study investigated the patterns of midface fractures in Vietnam and their correlation with road traffic accidents in the country. This retrospective cross-sectional study reviewed 2187 medical records of patients with midface fractures in Ho Chi Minh City. After applying exclusion criteria, the fractures were categorized. Statistical analyses, including chi-squared and logistic regression, were conducted to identify associations and relationships among the types and causes of fractures. The study found that 89.3% of midface fractures stemmed from road traffic accidents, with 55.2% and 14.4% zygomatic complex fractures and Le Fort type II fractures, respectively. Adults aged 19-39 accounted for 65.1% of patients, with males at 80.5%. Traffic accidents were significantly associated with an 18.7 times higher risk of concomitant mandibular fractures and a 10.5 times higher risk of Le Fort type II fractures, irrespective of age and gender. This study underscores the need for targeted prevention strategies to decrease the incidence of maxillofacial injuries resulting from road traffic accidents in Vietnam, particularly among high-risk groups such as males and young adults.

Incidence, risk factors and outcomes of traumatic head injury among trauma patients visited at the Yanet Trauma and Surgery Specialized Centre, Sidama region, Hawassa, Ethiopia: cohort study.

Traumatic brain injuries are a major public health concern that contributes to youth morbidity and mortality in developing nations, including Ethiopia. Despite of this, little is known about head injury in the study area. The goal of the study was to identify the incidence, risk factors and outcomes for traumatic head injury among trauma patients who visited at the Yanet Trauma and Surgery Specialized Centre. This was a 5 year an institutional-based retrospective cohort study conducted among 1,029 patients who experienced trauma and admitted at the Yanet Trauma and Surgical Specialized Centre. The research was carried out between September 01/2023 to October 15/2023. The study units were selected by using simple random sampling techniques through computer-generated random numbers. The data were collected via a checklist designed on the Kobo toolbox with a smart smartphone. The collected data were exported to a statistical package for Social Science version 27. Then, descriptive statistical analysis was conducted to determine the mean, standard deviation, and median. Bivariate and multivariate logistic regression was subsequently conducted to determine the associations between head injury and the independent variables. A total of 1,029 injured patients were followed for 2,302 person-days. Over all, incidence density rate of 14.03/100 person-days (323, 31.4%) [95% CI: 29.5-34%]. The third year of follow-up showed the greatest incidence compared to other years. The most common type of head injury observed during following up were brain contusion (38.1%), followed by epidural hematoma (33.1%), skull fracture (15.8%), and intracerebral hematoma (13.0%). In multivariate logistic model, rural residence [AOR = 1.6; 95% CI: 1.18-2.16], mechanism of injury namely road traffic accident [AOR = 5.5; 95% CI: 2.27-13.34], assault [AOR = 3.4; 95% CI: 1.35-8.37] and comorbidity of chronic disease [AOR = 2.2; 95% CI: 1.13-4.18] were the risk factors significantly associated with head injury. The incidence density rate of 14.03/100 person-days. As the result, more has to be done by health professionals, traffic police officers and local government raise awareness and enforce the implementation of driving rules and regulations.

Incidence and Risk Factors for Lumbar Sympathetic Chain Injury After Oblique Lumbar Interbody Fusion.

Oblique lumbar interbody fusion (OLIF), performed using a retroperitoneal approach, can lead to complications related to the approach, such as lumbar sympathetic chain injury (LSCI). Although LSCI is a common complication of OLIF, its reported incidence varies across studies due to an absence of specific diagnostic criteria. Moreover, research on the risk factors of postoperative sympathetic chain injuries after OLIF remains limited. Therefore, this study aimed to describe the incidence, and identify independent risk factors for LSCI, in patients with degenerative lumbar spinal diseases who underwent OLIF. Between October 2020 and August 2023, a retrospective review was conducted at our institute on 200 patients who underwent OLIF at 1 to 4 consecutive spinal levels (L1-5) for degenerative spinal diseases including spinal stenosis, spondylolisthesis, degenerative scoliosis. We excluded those with infections, trauma, tumors, and lower extremity edema/warmth due to other causes. The patients were categorized into 2 groups: those with and without LSCI symptoms. Demographic data, operative data, and pre- and postoperative parameters were evaluated for their association with LSCI using a univariate logistic regression model. Variables with a p-value <0.1 in the univariate analysis were included in a multivariate model to identify the independent risk factors. Thirty-five of 200 patients (17.5%) developed LSCI symptoms after OLIF. Multivariate logistic regression analysis indicated that prolonged retraction time, particularly exceeding 31.5 miniutes, remained an independent risk factor (adjusted odds ratio, 12.59; p<0.001). This study demonstrated that prolonged retraction time was an independent risk factor for LSCI following OLIF, particularly when it exceeded 31.5 minutes. Protecting the lumbar sympathetic chain during surgery and minimizing retraction time are crucial to avoiding LSCI following OLIF.

Application of indocyanine green during laparoscopic cholecystectomy in elderly and senile patients

Aim. To evaluate an effect of fluorescence cholangiography for intraoperative identification of extrahepatic bile ducts on the treatment outcomes of patients with cholelithiasis.Materials and methods. The study included 71 cholelithiasis patients who underwent laparoscopic cholecystectomy with fluorescence cholangiography and 69 cholelithiasis patients who underwent standard laparoscopic cholecystectomy. The study analyzed intraoperative damage of extrahepatic bile ducts and arteries, duration of surgery, conversion rate, need for colleague assistance, incidence of postoperative complications, hospital length of stay, and outcomes.Results. Fluorescence of the vesicular duct was achieved in 100% of patients, of the common bile duct – in 91%, and of the common hepatic duct – in 64%. A correlation between the number/type of complications and the application of ICG-diagnostics was found statistically significant (p &lt;0.001, p = 0.012), thereby indicating the advantages of the method. The colleague-surgeon assistance was required in the ICG group 35 times less than in the standard surgery group (OR = 0.029; 95% CI = 0.003–0.319). A 34-minute reduction in surgery duration (linear regression) can be expected when performing ICG-guided surgery.Conclusion. The application of fluorescence cholangiography reduces the probability of postoperative complications, in particular, biliary leakage with the necessity of reoperation. Due to the method, a surgeon appears able to complete the operation independently without colleague assistance. Treatment outcomes, incidence of bile duct injuries, and conversion rate are yet to be investigated.