Surgical approach is associated with complication rate in sinonasal malignancy: A multicenter study

2021 ◽  
Author(s):  
Daniel M. Beswick ◽  
Peter H. Hwang ◽  
Nithin D. Adappa ◽  
Christopher H. Le ◽  
Ian M. Humphreys DO ◽  
...  
Keyword(s):  
Multicenter Study ◽  
Surgical Approach ◽  
Complication Rate ◽  
Sinonasal Malignancy

scholarly journals A Multicenter Study Analyzing the different Indications of Hysteroscopy in General Population and the Complication Rate: An Experience of 11 Years

2015 ◽  
Vol 7 (1) ◽  
pp. 37-43
Author(s):  
Rahul Manchanda ◽  
Soma Ghoshal ◽  
BC Manjula
Keyword(s):  
General Population ◽  
Multicenter Study ◽  
Complication Rate ◽  
Air Embolism ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Indian Region ◽  
Uterine Perforation ◽  
Common Indication ◽  
The Common

ABSTRACT Study objectives An assessment of the common indications for hysteroscopy (either diagnostic or therapeutic), in multiple hospitals especially in the North Indian region, over the period of past 11 years. To do an analysis of the common intraoperative diagnosis and the different types of surgeries performed therefore. To estimate the incidence of complications in the same patient population over the same time period and describe their nature. Data collection Records were collected from twelve hospitals spread mainly over North Indian region, pertaining to all those patients who underwent hysteroscopy during the period from July 2003 to October 2014. Total cases analyzed was 1834. Design Retrospective analytic study. Patients All those patients who underwent hysteroscopy of all ages referring to the above mentioned hospitals during the period from July 2003 to October 2014. Results Of the 1834 hysteroscopic procedures, 588 (32.06%) were diagnostic hysteroscopies and 1246 (67.93%) were therapeutic hysteroscopies. The most common indication for hysteroscopy was abnormal uterine bleeding (28.14%) closely followed by the second most common indication, which was for infertility check-up (26.67%). The most common hysteroscopic intervention was endometrial biopsy. The second most common intervention and the most common therapeutic hysteroscopic procedure was polypectomy; and the third most common Hysteroscopic procedure was intrauterine adhesiolysis. The main complication as found in our present study was found to be uterine perforation (0.21%), followed by false passage. Air embolism also occurred in one patient. How to cite this article Ghoshal S, Manchanda R, Manjula BC. A Multicenter Study Analyzing the different Indications of Hysteroscopy in General Population and the Complication Rate: An Experience of 11 Years. J South Asian Feder Obst Gynae 2015;7(1):37-43.

scholarly journals Transperitoneal versus extraperitoneal laparoscopic radical prostatectomy during the learning curve: does the surgical approach affect the complication rate?

2010 ◽  
Vol 36 (4) ◽  
pp. 450-457 ◽  
Author(s):  
Tiberio M. Siqueira Jr. ◽  
Anuar I. Mitre ◽  
Ricardo J. Duarte ◽  
Humberto Nascimento ◽  
Francualdo Barreto ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Learning Curve ◽  
Surgical Approach ◽  
Complication Rate ◽  
Laparoscopic Radical Prostatectomy

scholarly journals Surgical Approach to Orbital Floor Fractures: Comparing Complication Rates Between Subciliary and Subconjunctival Approaches

2020 ◽  
Vol 13 (1) ◽  
pp. 45-48
Author(s):  
Joel A. Bronstein ◽  
William J. Bruce ◽  
Fadi Bakhos ◽  
Dalia Ishaq ◽  
Cara J. Joyce ◽  
...  
Keyword(s):  
Surgical Approach ◽  
Complication Rate ◽  
Patient Characteristics ◽  
Orbital Floor ◽  
Study Patient ◽  
Complication Rates ◽  
Postoperative Complication Rate ◽  
Corneal Injury ◽  
Orbital Floor Fractures ◽  
Orbital Floor Reconstruction

Background: There are multiple approaches to repairing orbital floor fractures. This study compares the postoperative complications of the subciliary and transconjunctival approaches. Methods: The electronic medical records from 2 hospitals were screened for CPT codes associated with orbital floor reconstruction. A total of 184 patients were identified and included in the study. Patient characteristics and complications were compared by surgical approach. Results: Of the 184 patients, 82 (44.6%) were in the subciliary group and 102 (55.4%) were in the transconjunctival group. The overall postoperative complication rate was 25.5%. The most common of these were diplopia (11.4%), corneal injury (7.1%), proptosis (5.4%), and enopthalmos (4.9%). The complication rate was not statistically significant between the 2 groups. Conclusion: Subciliary and transconjunctival approaches to orbital floor repair are equally safe. This study is limited by a smaller sample size, and a larger study will likely be necessary to fully address this question.

Comparative Outcomes by Surgical Approach in Patients with Malignant Sinonasal Disease

2021 ◽  
Author(s):  
Nicholas R. Lenze ◽  
Carolyn Quinsey ◽  
Deanna Sasaki-Adams ◽  
Matthew G. Ewend ◽  
Brian D. Thorp ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Surgical Approach ◽  
Complication Rate ◽  
Perioperative Complications ◽  
Intraoperative Complications ◽  
Care Center ◽  
Tertiary Care ◽  
Undifferentiated Carcinoma ◽  
Open Approach ◽  
Sinonasal Disease

Abstract Objective There is a paucity of data on comparative outcomes for open versus endoscopic surgery for patients with malignant sinonasal pathology. Most of the available studies are limited by a sample size <100 patients. Design This is a retrospective cohort study. Setting The findings of this study come from a single-institution tertiary care center from 2008 to 2019. Participants In total, 199 patients who underwent surgery for malignant sinonasal disease participated in this study. Main Outcome Measures The main outcome measures were perioperative complications and reoperation. Results Patients in our sample had a mean age of 59.7 years (SD, 20.4). In total, 62% were male and 72% were white. An endoscopic-only approach was used in 41% of patients and an open or combined approach in 59% of patients. Squamous cell carcinoma was the most common pathology (43.0%), followed by sarcoma (9.5%), skin cancer (6.5%), sinonasal undifferentiated carcinoma (6.5%), and adenocarcinoma (5.5%). The all-cause complication rate was 14.6%. Patients with an open resection had a higher rate of intraoperative complications (5.9 vs. 0%; p = 0.043), postoperative complications (19.5 vs. 3.7%; p = 0.001), and all-cause complications (21.0 vs. 3.7%; p < 0.001). The likelihood of early reoperation (<6 months) or late reoperation (>6 months) did not significantly differ by surgical approach (p = 1.000 and 0.741, respectively). Conclusion The endoscopic approach for resection of malignant sinonasal disease is viable for select patients and may be associated with a favorable complication rate compared with the open approach.

scholarly journals Surgical management of spinal meningiomas: focus on unilateral posterior approach and anterior localization

2019 ◽  
Vol 30 (3) ◽  
pp. 308-313 ◽  
Author(s):  
Julia Onken ◽  
Kathrin Obermüller ◽  
Franziska Staub-Bartelt ◽  
Bernhard Meyer ◽  
Peter Vajkoczy ◽  
...  
Keyword(s):  
Surgical Approach ◽  
Complication Rate ◽  
Posterior Approach ◽  
Surgical Complication ◽  
Extent Of Resection ◽  
Surgical Approaches ◽  
Special Focus ◽  
Complication Rates ◽  
Duration Of Surgery ◽  
Spinal Meningiomas

OBJECTIVESpinal meningiomas (sMNGs) are relatively rare in comparison to intracranial MNGs. sMNGs localized anterior to the denticulate ligament (aMNGs) represent a surgically challenging subgroup. A high perioperative complication rate due to the need for complex surgical approaches has been described. In the present study, the authors report on their surgical experience that involves two institutions in which 207 patients underwent surgery for sMNGs. Special focus was placed on patients with aMNGs that were treated via a unilateral posterior approach (ULPA).METHODSBetween 2005 and 2017, 207 patients underwent resection of sMNGs at one of two institutions. The following characteristics were assessed: tumor size and localization, surgical approach, duration of surgery, grade of resection, peri- and postoperative complication rates, and neurological outcome. Data were compared between the subgroups of patients according to the lesion’s relationship to the denticulate ligament and to surgical approach.RESULTSThe authors identified 48 patients with aMNGs, 86 patients with lateral MNGs, and 76 patients with posterior MNGs (pMNGs). Overall, 66.6% of aMNGs and 64% of pMNGs were reached via a ULPA. aMNGs that were approached via a ULPA showed reduced duration of surgery (131 vs 224 minutes, p < 0.0001) and had surgical complication rates and neurological outcomes comparable to those of lesions that were approached via a bilateral approach. No significant differences in complication rate, outcomes, and extent of resection were seen between aMNGs and pMNGs.CONCLUSIONSThe duration of surgery, extent of resection, and outcomes are comparable between aMNGs and pMNGs when removed via a ULPA. Thus, ULPA represents a safe route to achieve a gross-total resection, even in cases of aMNG.

scholarly journals P076 DIFFERENT SURGICAL APPROACH IN DIASTASIS RECTI REPAIR: IMPORTANCE OF AN OVERALL VIEW OF THE DISEASE

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Federico Fiori ◽  
Francesco Ferrara ◽  
Daniele Gentile ◽  
Caterina Baldi ◽  
Laura Benuzzi ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Surgical Approach ◽  
Complication Rate ◽  
Surgical Complications ◽  
Umbilical Hernia ◽  
Surgical Approaches ◽  
Anterior Repair ◽  
Linea Alba ◽  
Diastasis Recti ◽  
Critical Issues

Abstract Aim Diastasis Recti (DR) is characterized by a defect of the linea alba sometimes associated with midline hernias, and frequent lipocutaneous excess. We present our experience in the treatment of diastasis recti with Inter Recti Distance (IRD) &gt; 50mm -with or without umbilical hernia- by 3 different approaches. Material and Methods From January 2018 to February 2020, 104 patients were referred to our unit for clinical and radiological diagnosis of DR with IRD &gt; 50 mm. Three different surgical approaches were used, based on presence of lipocoutaneous excess: laparoabdominoplasty, laparominiabdominoplasty and minimally-invasive/endoscopic with Totally Sublay Anterior Repair (TESAR) approach. Results We performed 28 TESAR (29.8%), 44 laparoabdominoplasties (42.3%) and 32 laparominiabdominoplasties (30.8%). Overall complication rate was 26% (27 patients). In 3 (2.9%) cases major surgical complications (Clavien-Dindo 3-4) occurred, all for open operations. Minor complications (Clavien-Dindo 1-2) included: 13 cutaneous ischemia, 10 small muscular hematomas and 1 subcutaneous seroma. The overall median post-operative stay was 3 days (range 2 – 14 days), and 3, 4 and 3 days for TESAR, laparoabdominoplasty and laparominiabdominoplasty groups, respectively. No recurrence registered to date. Conclusions Our experience shows the importance of an overall view of the functional and cosmetic impairment created by the DR. The surgeon must obtain an optimal functional outcome also aiming for the best cosmetic result. Therefore different approaches have to be considered, tailored to the clinical, instrumental and psychological aspects of the disease. The complication rate, while in line with the literature, emphasize how in this type of operation the critical issues of functional as well as morphological surgery coexist.

scholarly journals Pipeline embolization of posterior circulation aneurysms: a multicenter study of 131 aneurysms

2019 ◽  
Vol 130 (3) ◽  
pp. 923-935 ◽  
Author(s):  
Christoph J. Griessenauer ◽  
Christopher S. Ogilvy ◽  
Nimer Adeeb ◽  
Adam A. Dmytriw ◽  
Paul M. Foreman ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Multicenter Study ◽  
Complication Rate ◽  
Posterior Circulation ◽  
Major Complications ◽  
Lower Complication ◽  
Posterior Circulation Aneurysms ◽  
Occlusion Rate ◽  
Dissecting Aneurysms ◽  
Saccular Aneurysms

OBJECTIVEFlow diversion for posterior circulation aneurysms performed using the Pipeline embolization device (PED) constitutes an increasingly common off-label use for otherwise untreatable aneurysms. The safety and efficacy of this treatment modality has not been assessed in a multicenter study.METHODSA retrospective review of prospectively maintained databases at 8 academic institutions was performed for the years 2009 to 2016 to identify patients with posterior circulation aneurysms treated with PED placement.RESULTSA total of 129 consecutive patients underwent 129 procedures to treat 131 aneurysms; 29 dissecting, 53 fusiform, and 49 saccular lesions were included. At a median follow-up of 11 months, complete and near-complete occlusion was recorded in 78.1%. Dissecting aneurysms had the highest occlusion rate and fusiform the lowest. Major complications were most frequent in fusiform aneurysms, whereas minor complications occurred most commonly in saccular aneurysms. In patients with saccular aneurysms, clopidogrel responders had a lower complication rate than did clopidogrel nonresponders. The majority of dissecting aneurysms were treated in the immediate or acute phase following subarachnoid hemorrhage, a circumstance that contributed to the highest mortality rate in those aneurysms.CONCLUSIONSIn the largest series to date, fusiform aneurysms were found to have the lowest occlusion rate and the highest frequency of major complications. Dissecting aneurysms, frequently treated in the setting of subarachnoid hemorrhage, occluded most often and had a low complication rate. Saccular aneurysms were associated with predominantly minor complications, particularly in clopidogrel nonresponders.

Adrenalectomy for malignant disease: Utilization and outcomes by surgeon specialty and surgical approach.

2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 489-489
Author(s):  
Izak Faiena ◽  
Alexandra Tabakin ◽  
Jeffrey Leow ◽  
Neal Patel ◽  
Parth K Modi ◽  
...  
Keyword(s):  
Surgical Approach ◽  
Complication Rate ◽  
Malignant Disease ◽  
National Level ◽  
Major Complication ◽  
Geographic Region ◽  
Adrenal Tumors ◽  
Open Approach ◽  
Adrenal Cancer ◽  
Significant Difference

489 Background: Adrenal cancers have traditionally been treated using an open surgical approach. With advances in minimally invasive surgery (MIS), adrenal tumors have become more amenable to MIS resection. We report a study on the utilization and outcomes of surgery for adrenal cancers on a national level. Methods: Data on patients who underwent open, laparoscopic, or robotic adrenalectomy for adrenal cancer (ICD-9 code 194.0) from 2003-2013 were extracted from the nationally representative Premier Hospital Database. Surgeon specialty, patient demographics, hospital characteristics, intraoperative and perioperative data, and complications were compared. Data were analyzed using univariate and multivariate logistic regression analyses. Results: 4,781 adrenalectomies were performed for malignant disease. Surgery was more commonly performed in patients >50 years of age (83%), men (64%), and white race (80%). There was no significant difference in rate of adrenalectomy with regards to comorbidities, insurance status, teaching vs. non-teaching hospital, hospital bed size, or geographic region. Adrenalectomy for malignant disease was more commonly performed by non-urologists (66 vs. 34%; p=0.011). Among non-urologists, open surgery was most common followed by laparoscopic and robotic approaches (56.3% vs. 37.4% vs. 6.4%, respectively) as compared to urologists (48.8% vs. 38.4% vs. 12.9%, respectively). There was no difference in complication rate or operative time between surgeon types. On multivariate regression analysis, the best predictor of major complication was a Charlson Comorbidity Index (CCI) >2 (OR 6.1, 95% CI 2.9-12.5; p<0.0001). Surgical approach and surgeon specialty were not predictors of complications. Conclusions: Adrenalectomy for malignant disease was more commonly performed by non-urologists via an open approach. Patient CCI >2 was associated with a higher rate of post-op complications, while surgical approach did not influence complication rate. These findings indicate that MIS can be performed safely for adrenal cancers. Prospective study of MIS for adrenal cancer is needed to evaluate its oncologic efficacy.

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