scholarly journals A nationwide analysis of 30-day adverse events, unplanned readmission, and length of hospital stay after peripheral nerve surgery in extremities and the brachial plexus

Microsurgery ◽  
2018 ◽  
Vol 39 (2) ◽  
pp. 115-123 ◽  
Author(s):  
Enrico Martin ◽  
Ivo S. Muskens ◽  
Joeky T. Senders ◽  
David J. Cote ◽  
Timothy R. Smith ◽  
...  
Keyword(s):  
Adverse Events ◽  
Peripheral Nerve ◽  
Hospital Stay ◽  
Brachial Plexus ◽  
Length Of Hospital Stay ◽  
Unplanned Readmission ◽  
Peripheral Nerve Surgery ◽  
Nerve Surgery

scholarly journals Current Concept in Adult Peripheral Nerve and Brachial Plexus Surgery

2017 ◽  
Vol 12 (01) ◽  
pp. e7-e14 ◽  
Author(s):  
Lukas Rasulic
Keyword(s):  
Minimally Invasive ◽  
Peripheral Nerve ◽  
Brachial Plexus ◽  
Soft Tissue Injuries ◽  
Minimal Invasive ◽  
Peripheral Nerve Surgery ◽  
Nerve Conduits ◽  
Nerve Surgery ◽  
Brachial Plexus Surgery ◽  
New Generation

AbstractPeripheral nerve injuries and brachial plexus injuries are relatively frequent. Significance of these injuries lies in the fact that the majority of patients with these types of injuries constitute working population. Since these injuries may create disability, they present substantial socioeconomic problem nowadays. This article will present current state-of-the-art achievements of minimal invasive brachial plexus and peripheral nerve surgery. It is considered that the age of the patient, the mechanism of the injury, and the associated vascular and soft-tissue injuries are factors that primarily influence the extent of recovery of the injured nerve. The majority of patients are treated using classical open surgical approach. However, new minimally invasive open and endoscopic approaches are being developed in recent years—endoscopic carpal and cubital tunnel release, targeted minimally invasive approaches in brachial plexus surgery, endoscopic single-incision sural nerve harvesting, and there were even attempts to perform endoscopic brachial plexus surgery. The use of the commercially available nerve conduits for bridging short nerve gap has shown promising results. Multidisciplinary approach individually designed for every patient is of the utmost importance for the successful treatment of these injuries. In the future, integration of biology and nanotechnology may fabricate a new generation of nerve conduits that will allow nerve regeneration over longer nerve gaps and start new chapter in peripheral nerve surgery.

Complication Avoidance in Peripheral Nerve Surgery: Preoperative Evaluation of Nerve Injuries and Brachial Plexus Exploration—part 1

2006 ◽  
Vol 59 (suppl_4) ◽  
pp. ONS-441-ONS-448 ◽  
Author(s):  
Stephen M. Russell ◽  
David G. Kline
Keyword(s):  
Peripheral Nerve ◽  
Brachial Plexus ◽  
Preoperative Evaluation ◽  
Nerve Injuries ◽  
Peripheral Nerve Surgery ◽  
Intraoperative Assessment ◽  
Nerve Surgery

Abstract Complication avoidance during peripheral nerve surgery has received little attention in the neurosurgical literature. The goal of our two-part review is to discuss these possible complications, with this initial article highlighting the pitfalls associated with pre- and intraoperative assessment of nerve injuries, as well as the operative nuances used during brachial plexus exploration to minimize complications.

Peripheral Nerve Surgery - View through Multidiciplinary Approch Window

2014 ◽  
Vol 75 (S 01) ◽  
Author(s):  
L. Rasulic ◽  
M. Samardzic ◽  
V. Bascarevic ◽  
M. Micovic ◽  
I. Cvrkota ◽  
...  
Keyword(s):  
Peripheral Nerve ◽  
Peripheral Nerve Surgery ◽  
Nerve Surgery

scholarly journals Palliative treatment for malignant gastrointestinal obstruction with peritoneal carcinomatosis: enteral stenting versus surgery

2020 ◽  
Vol 08 (10) ◽  
pp. E1487-E1494
Author(s):  
Veeravich Jaruvongvanich ◽  
FNU Chesta ◽  
Anushka Baruah ◽  
Meher Oberoi ◽  
Daniel Adamo ◽  
...  
Keyword(s):  
Adverse Events ◽  
Hospital Stay ◽  
Peritoneal Carcinomatosis ◽  
Large Scale ◽  
Clinical Success ◽  
Eastern Cooperative Oncology Group ◽  
Length Of Hospital Stay ◽  
Palliative Surgery ◽  
Gastrointestinal Obstruction ◽  
Malignant Gastrointestinal Obstruction

Abstract Background and study aims Management of malignant gastrointestinal obstruction (MGIO) is more challenging in the presence of peritoneal carcinomatosis (PC). Outcomes data to guide the management of MGIO with PC are lacking. We aimed to compare the clinical outcomes and adverse events between endoscopic and surgical palliation and identify predictors of stent success in patients with MGIO with PC. Patients and methods Consecutive inpatients with MGIO with PC between 2000 and 2018 who underwent palliative surgery or enteral stenting were included. Clinical success was defined as relief of obstructive symptoms. Results Fifty-seven patients with enteral stenting and 40 with palliative surgery were compared. The two groups did not differ in rates of technical success, 30-day mortality, or recurrence. Clinical success from a single intervention (63.2 % versus 95 %), luminal patency duration (27 days vs. 145 days), and survival length (148 days vs. 336 days) favored palliative surgery (all P < 0.05) but the patients in the surgery group had a trend toward better Eastern Cooperative Oncology Group (ECOG) status. The rate of adverse events (AEs) (10.5 % vs. 50 %), the severity of AEs, and length of hospital stay (4.5 days vs. 9 days) favored enteral stenting (P < 0.05). The need for more than one stent was associated with a higher likelihood of stent failure. Conclusions Our study suggests that enteral stenting is safer and associated with a shorter hospital stay than palliative surgery, although unlike other MGIOs, clinical success is lower in MGIO with PC. Identification of the right candidates and potential predictors of clinical success in ECOG-matched large-scale studies is needed to validate these results.

Clinical evaluation of two adult oxygenator systems in terms of mortality and major adverse events

Perfusion ◽  
2021 ◽  
pp. 026765912110638
Author(s):  
Hüsnü Kamil Limandal ◽  
Mehmet Ali Kayğın ◽  
Servet Ergün ◽  
Taha Özkara ◽  
Mevriye Serpil Diler ◽  
...  
Keyword(s):  
Adverse Events ◽  
Hospital Stay ◽  
Artery Bypass ◽  
Length Of Hospital Stay ◽  
Fresh Frozen Plasma ◽  
Wound Complications ◽  
Significant Difference ◽  
Delayed Sternal Closure ◽  
Fresh Frozen ◽  
Major Adverse Events

Purpose The primary aim of this study was to examine the effects of two oxygenator systems on major adverse events and mortality. Methods A total of 181 consecutive patients undergoing coronary artery bypass grafting in our clinic were retrospectively analyzed. The patients were divided into two groups according to the oxygenator used: Group M, in which a Medtronic Affinity (Medtronic Operational Headquarters, Minneapolis, MN, USA) oxygenator was used, and Group S, in which a Sorin Inspire (Sorin Group Italia, Mirandola, Italy) oxygenator was used. Results Group S consisted of 89 patients, whereas Group M included 92 patients. No statistically significant differences were found between the two groups in terms of age ( p = .112), weight ( p = .465), body surface area ( p = .956), or gender ( p = .484). There was no statistically significant difference in hemorrhage on the first or second postoperative day ( p = .318 and p = .455, respectively). No statistically significant differences were observed in terms of red blood cell ( p = .468), fresh frozen plasma ( p = .116), or platelet concentrate transfusion ( p = .212). Infections, wound complications, and delayed sternal closure were significantly more common in Group M ( p = .006, p = .023, and p = .019, respectively). Extracorporeal membrane oxygenators and intra-aortic balloon pumps were required significantly more frequently in Group S ( p = .025 and p = .013, respectively). Major adverse events occurred in 16 (18%) patients in Group S and 14 (15.2%) patients in Group M ( p = .382). Mortality was observed in six (6.7%) patients in Group S and three (3.3%) patients in Group M ( p = .232). No statistically significant difference was found between the two groups in terms of length of hospital stay ( p = .451). Conclusion The clinical outcomes of the two oxygenator systems, including mortality, major adverse events, hemorrhage, erythrocyte and platelet transfusions, and length of hospital stay, were similar.

Preoperative Localization of Spinal and Peripheral Pathologies for Surgery by Computed Tomography–Guided Placement of a Specialized Needle System

Neurosurgery ◽  
2010 ◽  
Vol 66 (4) ◽  
pp. 784-787 ◽  
Author(s):  
Philipp Slotty ◽  
Patrick Kröpil ◽  
Mark Klingenhöfer ◽  
Hans-Jakob Steiger ◽  
Daniel Hänggi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Peripheral Nerve ◽  
Radiation Exposure ◽  
Operating Room ◽  
Operating Room Personnel ◽  
Peripheral Nerve Surgery ◽  
Preoperative Marking ◽  
Intraoperative Fluoroscopy ◽  
Nerve Surgery ◽  
Intraoperative Localization

Abstract OBJECTIVE Exact intraoperative localization of pathologies in spinal and peripheral nerve surgery is not easily achieved. In spinal surgery, intraoperative fluoroscopy is the common method for identification of the level affected. It seldom visualizes the pathology itself and is prone to error in identifying anatomic disorders and superimposing structures. In peripheral nerve surgery, intraoperative fluoroscopy is of little value. The present technical study was conducted to evaluate the feasibility of using a preoperative computed tomography–guided needle marking system, which was previously developed for use in gynecology. The goal was to reduce intraoperative localization error and radiation exposure to patients and operating room personnel. METHODS We used a flexible hooked-wire needle marking system, which has previously been used for preoperative marking of breast lesions, to localize and tag spinal and peripheral nerve pathologies. Marking was carried out under computed tomographic control before surgery. Seven illustrative cases were chosen for this report: 6 patients with disorders of the spine and 1 patient with a peripheral nerve schwannoma. RESULTS No adverse reactions, aside from minor discomfort, were observed in this study. In all cases, the needle could be used as a reliable guide for the surgical approach and led directly to the pathology. In no case was additional intraoperative fluoroscopy needed. The level of radiation exposure to the patient as a result of computed tomography–based marking was similar to or less than that encountered in conventional intraoperative x-ray localization. Radiation exposure to the operating room personnel was eliminated by this method. CONCLUSION Preoperative marking of spinal level or peripheral nerve pathologies with a flexible hooked-wire needle marking system is feasible and appears to be safe and useful for neurosurgical spinal and peripheral procedures.

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