Planning local container drayage operations given a port access appointment system

2008 ◽  
Vol 44 (2) ◽  
pp. 185-202 ◽  
Author(s):  
Rajeev Namboothiri ◽  
Alan L. Erera
Keyword(s):  
Port Access ◽  
Appointment System ◽  
Drayage Operations

The Preferable Use of Port Access Surgical Technique for Right and Left Atrial Procedures

2005 ◽  
Vol 8 (5) ◽  
pp. E354-E363 ◽  
Author(s):  
B. Gersak ◽  
M. Sostaric ◽  
J. M. Kalisnik ◽  
R. Blumauer
Keyword(s):  
Surgical Technique ◽  
Left Atrial ◽  
Port Access

Managing Port-Site Bleeding during Less Invasive Coronary Artery Bypass Grafting

2012 ◽  
Vol 15 (5) ◽  
pp. 272 ◽  
Author(s):  
Soroosh Kiani ◽  
Mary-Lynn Brecht ◽  
Katherine Lovinger ◽  
Robert S. Poston
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Risk Score ◽  
Chest Tube ◽  
Artery Bypass ◽  
Hemostatic Agent ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Port Access

<p><b>Introduction:</b> Robotic-assisted coronary artery bypass grafting (r-CABG) requires the placement of ports bluntly through the chest wall. When removed, these ports create bleeding sites that can be difficult to detect and treat. This study evaluated whether a topical hemostatic agent placed locally within these sites helps to reduce bleeding and blood product requirements.</p><p><b>Methods:</b> We retrospectively analyzed outcomes for r-CABG cases where 5 mL of a flowable hemostatic agent was injected locally within all port sites (hemostat group, n = 62) compared with patients whose port sites were untreated (controls, n = 131). Outcomes included chest tube output, red blood cell (RBC) transfusions, length of hospital stay, and the risk of reoperation for bleeding. Analyses were adjusted for risk factors known to influence bleeding and Society of Thoracic Surgeons (STS) risk score as a weighted composite of variables, which controls for patient and clinical variables.</p><p><b>Results:</b> The 2 study groups had similar baseline characteristics and underwent the same r-CABG procedure. The hemostat group had significant reductions in RBC transfusion (24.2% versus 40.8% receiving blood; <i>P</i> = .026; 0.44 versus 1.39 U transfused postoperatively, <i>P</i> = .024). After adjustment for bleeding risks (using STS risk score), differences in transfusions remained significant. Reoperation rates for bleeding, length of stay, chest tube drainage, and intraoperative transfusions were not significantly different in the 2 groups.</p><p><b>Conclusions:</b> There was significantly reduced postoperative bleeding and less exposure to blood products in the hemostat group. These findings suggest that undetected bleeding from sites used for port access serves as an underappreciated source of morbidity after r-CABG.</p>

Sign in / Sign up

Export Citation Format

Share Document