scholarly journals Intraoperativne i postoperativne komplikacije splenektomije

2002 ◽  
Vol 49 (3) ◽  
pp. 81-84 ◽  
Author(s):  
M. Petrovic ◽  
Milos Popovic ◽  
S. Knezevic ◽  
Slavko Matic ◽  
Mirjana Gotic ◽  
...  
Keyword(s):  
Postoperative Period ◽  
Left Kidney ◽  
Postoperative Bleeding ◽  
Early Postoperative Period ◽  
Malignant Diseases ◽  
Pancreatic Tail ◽  
Postsplenectomy Sepsis ◽  
General Complication ◽  
Conservative And Surgical Treatment ◽  
Child Age

Spleen is being surgically removed because of trauma, in diagnostic and-or therapeutical purposes because of the benignant and malignant diseases. The percentage of morbidity during and after splenectomy is relatively low. During surgery might occur bleeding, trauma of the pancreatic tail, stomach, lineal flexure of the colon, left hemidiafragm, left suprarenal gland and upper pole of the left kidney, which must be correspondingly reclaimed during the same intervention. In the early postoperative period, postoperative bleeding, subfrenic abscess, pulmonal atelectasis, bronchopneumonia and left pleural extravasations might occur. Especially is important notification of these events in due time and adequate conservative and surgical treatment. After splenectomy, there is an increase of the number of trombocytes, which might lead to the tromboembolic complications. In the prevention of these complications in the postoperative period prolonged antiagregation therapy is suggested. Postsplenectomy sepsis is very late, general complication of splenectomy, which occurs because of the lower immunity in the child age. To prevent these complications, partial splenectomies, reimplantations of the spleen, prolonged application of the penicillin medicines after splenectomy and antipneumococcal vaccine are performed.

Urgent surgery for thyroid diseases and complications of early postoperative period

2013 ◽  
Vol 4 (4) ◽  
pp. 103-115 ◽  
Author(s):  
Anatoly Philippovich Romanchishen ◽  
Philipp Anatolievich Romanchishen ◽  
Igor Vladimirovich Karpatsky ◽  
Kristina Victorovna Vabalayte
Keyword(s):  
Postoperative Period ◽  
Postoperative Bleeding ◽  
Early Postoperative Period ◽  
Anaplastic Carcinoma ◽  
Thyroid Diseases ◽  
Endocrine Surgery ◽  
Urgent Surgery ◽  
Appropriate Treatment ◽  
Retrosternal Goiter ◽  
Life Threatening

The analysis of surgical treatment results of 27.253 patients with various diseases of thyroid cancer is performed in St. Petersburg, Endocrine Surgery and Oncology Center. A classification of urgent surgery for complications of disease (277/1.0 %) or postoperative states that required reinterventions (246/0.9 %) in period from 1973 to 2012 is developed. Altogether immediate and urgent operations are performed in 523 (1.9 %) patients. Various thyroid diseases (cervical-retrosternal goiter, anaplastic carcinoma, strumitis, thyroiditis) or the progression of inflammation of the neck and / or mediastinum became a cause of neck compression and subsequently required urgent interventions in 277 (1.0 %) cases. Complications of early postoperative period (mobility disorders of the vocal cords, postoperative bleeding, and rupture of the trachea) served as an occasion to emergency operations in 246 (0.9 %) cases. The measures of prevention, prompt diagnosis and appropriate treatment of patients with life-threatening complications in thyroid surgery are examined.

scholarly journals RESULTS OF KIDNEY TRANSPLANTATION IN AKTOBE REGION OF KAZAKHSTAN

2018 ◽  
Vol 20 (1) ◽  
pp. 66-69
Author(s):  
A. A. Kaliyev ◽  
В. S. Zhakiyev ◽  
E. В. Sultangereyev ◽  
M. S. Rysmakhanov ◽  
A. A. Elemesov ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Postoperative Period ◽  
Medical Center ◽  
Postoperative Bleeding ◽  
Chronic Kidney Failure ◽  
Early Postoperative Period ◽  
Regional Hospital ◽  
Initial Experience ◽  
The Republic ◽  
Kidney Transplantations

Aim:to analyse the results of the initial experience of kidney transplantation of the regional hospital of the Republic of Kazakhstan.Materials and methods.The results of kidney transplantations which were performed to 31 patients in the Aktobe Medical Center (AMC, Aktobesity) for the period from November 2014 to 2017 are presented. Kidney transplantations were performed in compliance with clinical protocols according to the generally accepted methodology. In 25 cases transplantation performed from a living donor, in 6 cases – from deceased donors. The most of living donors underwent laparoscopic nephroureterectomy with manual assistance (70.8%).Results.After nephrectomy operations complications were not observed in donors, all patients were discharged in a satisfactory state on the 5th–8th postoperative day. The following complications were observed in recipients in the early postoperative period: acute tubular necrosis – 1, postoperative bleeding (retroperitoneal hematoma) – 2, lymphorrhagia – 2, urinary leakages – 2. One recipient was died in the late postoperative period after infection complications and the development of sepsis.Conclusions.Kidney transplantation is undoubtedly effective method for treating patients with terminal chronic kidney failure. The results of the initial experience of kidney transplantation in the Aktobe regional hospital of the Republic of Kazakhstan are not differ from the average results of leading domestic and other foreign transplant clinics.

scholarly journals Recovery of early postoperative muscle strength after deep neuromuscular block by means of ultrasonography with comparison of neostigmine versus sugammadex as reversal drugs: study protocol for a randomised controlled trial

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e043935
Author(s):  
Xuan Wang ◽  
Yingyuan Li ◽  
Chanyan Huang ◽  
Wei Xiong ◽  
Qin Zhou ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Muscle Strength ◽  
Neuromuscular Blockade ◽  
Postoperative Period ◽  
Controlled Trial ◽  
Complete Recovery ◽  
Early Postoperative Period ◽  
Time Points ◽  
Muscle Groups ◽  
Randomised Controlled

IntroductionDespite the use of quantitative neuromuscular monitoring together with the administration of reversal drugs (neostigmine or sugammadex), the incidence of residual neuromuscular blockade defined as a train-of-four ratio (TOFr) <0.9 remains high. Even TOFr >0.9 cannot ensure adequate recovery of neuromuscular function when T1 height is not recovered completely. Thus, a mathematical correction of TOFr needs to be applied because the return of a normal TOFr can precede the return of a normal T1 twitch height. On the other hand, different muscles have different sensitivities to neuromuscular blockade agents; thus, complete recovery of one specific muscle group does not represent complete recovery of all other muscles. Therefore, our study aims to assess the muscle strength recovery of respiratory-related muscle groups by ultrasound and evaluate global strength using handgrip dynamometry in the early postoperative period when TOFr=0.9 and corrected TOFr (cTOFr)=0.9 with comparison of neostigmine versus sugammadex as reversal drugs.Methods and analysisThis study will be a prospective, single-blinded, randomised controlled trial involving 60 patients with American Society of Anesthesiologists physical status I–II and aged between 18 and 65 years, who will undergo microlaryngeal surgery. We will assess geniohyoid muscle, parasternal intercostal muscle, diaphragm, abdominal wall muscle and handgrip strength at four time points: before anaesthesia, TOFr=0.9, cTOFr=0.9 and 30 min after admission to the post anaesthesia care unit. Our primary objective will be to compare the effects of neostigmine and sugammadex on the recovery of muscle strength of different muscle groups in the early postoperative period when TOFr=0.9 and cTOFr=0.9. The secondary objective will be to observe the difference of muscle strength between the time points of TOFr=0.9 and cTOFr=0.9 to find out the clinical significance of cTOFr >0.9.Ethics and disseminationThe protocol was reviewed and approved by the Ethics Committee of The First Affiliated Hospital, Sun Yat-sen University. The findings will be disseminated to the public through peer-reviewed scientific journals.Trial registration numberChiCTR2000033832.

Frailty syndrome as an independent predictor of unfavorable outcome in patients undergoing coronary artery bypass grafting

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Krivoshapova ◽  
O.L Barbarash ◽  
E.A Wegner ◽  
N.A Terentyeva ◽  
I.I Grigorieva ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Postoperative Period ◽  
Artery Bypass ◽  
Early Postoperative Period ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Risk Of Death

Abstract Purpose To assess the prevalence of frailty in the preoperative period and to evaluate its effect on the risk of complications and adverse outcomes in patients undergoing coronary artery bypass grafting (CABG). Methods 303 patients undergoing preoperative management for elective primary CABG were recruited in the study. The study cohort was divided into three groups depending on the PRISMA-7 scores suggesting the presence or absence of frailty and the presence of prefrailty. Statistical analysis was performed using the commercially available software package STATISTICA 8.0.360.0 for Windows (StatSoft, Inc., USA) and SPSS Statistics v. 17.0.0. Results 46 (15%) patients had frailty, while 49 (16%) patients were diagnosed with prefrailty. 208 (69%) patients did not have any signs of frailty. All three groups had significant age differences, therefore only elderly patients aged of 67.0±6.5 years with frailty were allocated for subsequent analysis (prefrailty group - 62.3±7.4 years old, patients without frailty - 60.0±7.7 years, p=0.003). Patients with frailty or prefrailty more often suffered from diabetes mellitus (patients without frailty - 19.2%, prefrailty group - 30.6% and frailty group - 28.3%, p=0.05), arterial hypertension (69.2%, 93.9% and 95.7%, respectively, p&lt;0.001), atrial fibrillation or flutter (7.2%, 14.3% and 19.6%, respectively, p=0.03), chronic heart failure class 3–4 (7.2%, 10.2% and 8.7%, respectively, p=0.002), and peripheral arterial disease (22.6%, 38.8% and 58.7%, respectively, p&lt;0.001). Three groups were comparable in main clinical and demographic parameters. There were no significant differences found in the incidence of postoperative atrial fibrillation or flutter (15.9%, 8.2% and 6.5%, respectively, p=0.07) and infections (1.9%, 0% and 4.3%, respectively, p=0.640). The incidence of myocardial infarction in the intra- and early postoperative period after CABG did not differ significantly between the groups (0.5%, 2% and 0%, respectively, p=0.328) as well as the incidence of stroke (2.4%, 2% and 0%, respectively, p=0.640). Patients with frailty and prefrailty had significantly higher cerebrovascular and cardiovascular mortality compared to those without frailty (8.2%, 2.2% and 0.5%, respectively, p=0.001). Conclusion Almost 15% of patients referred to CABG suffered from frailty. The presence of prefrailty or frailty increases the risk of death in the early postoperative period after CABG. Funding Acknowledgement Type of funding source: None

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