scholarly journals The impact of non-hilar clamping open partial technique performed for the treatment of patients with small renal masses with lower R.E.N.A.L. nephrometry scores on renal functions during the early postoperative period

2014 ◽  
Vol 40 (2) ◽  
pp. 93-98
Author(s):  
Dogan Atilgan ◽  
Sahin Kilic ◽  
Yusuf Gencten ◽  
Nihat Uluocak ◽  
Fatih Firat ◽  
...  
Keyword(s):  
Postoperative Period ◽  
Early Postoperative Period ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Renal Functions ◽  
The Impact

The economic and clinical costs of chronic kidney disease following radical and partial nephrectomy in the management of small renal masses.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 353-353
Author(s):  
S. L. Chang ◽  
L. E. Cipriano ◽  
L. C. Harshman ◽  
B. I. Chung
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Health Outcomes ◽  
Partial Nephrectomy ◽  
Base Case ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Lifetime Horizon ◽  
Life Years ◽  
The Impact

353 Background: Postoperative chronic kidney disease (PCKD), defined as a glomerular filtration rate of < 60mL/min/1.73m2, is a recognized adverse outcome after extirpative therapy for small renal masses (SRM, ≤ 4cm). We quantified the long-term economic and clinical costs of PCKD following radical and partial nephrectomy for the management of SRM. Methods: Using a Markov model, we evaluated open and laparoscopic approaches for radical and partial nephrectomy in the treatment of SRMs. The base case was a 65-year old healthy individual with a unilateral SRM and normal renal function. We used a 3-month cycle length, lifetime horizon, societal perspective, and 3% discount rate. The costs, quality of life adjustments, and transition probabilities were estimated from the literature, Medicare, and expert opinion. Health outcomes were measured in quality-adjusted life-years (QALY) gained and costs in 2008 U.S. dollars. The model was tested with sensitivity analyses. Results: The average discounted lifetime outcomes are listed in the Table. There were minimal differences between the open and laparoscopic approaches. PCKD led to a substantial increase costs and decrease in health outcomes. The impact of PCKD was indirectly associated with age. Conclusions: Partial nephrectomy provides cost-savings and improved health outcomes compared to radical nephrectomy in the management of patients with SRMs. Both procedures incur significant economic and clinical costs due to the development of PCKD. A discussion about the potential for PCKD should be incorporated into the informed consent for surgical treatment of SRMs. [Table: see text] No significant financial relationships to disclose.

scholarly journals Factors affecting the early postoperative period of cochlear implantation

2020 ◽  
Vol 19 (6) ◽  
pp. 57-63
Author(s):  
Yu. S. Preobrazhenskaya ◽  
◽  
M. V. Drozdova ◽  
S. B. Sugarova ◽  
D. D. Kalyapin ◽  
...  
Keyword(s):  
Postoperative Period ◽  
Cochlear Implantation ◽  
Epstein Barr Virus ◽  
Molecular Genetic ◽  
Early Postoperative Period ◽  
Surgical Trauma ◽  
Herpesvirus Infection ◽  
Barr Virus ◽  
Epstein Barr ◽  
The Impact

Persistence of viral infections ((Epstein–Barr virus (EBV), cytomegalovirus (CMV)) contributes to the development of inflammatory pathology of the upper respiratory tract, as well as dystrophic processes in hepatocytes. The impact of this fact on the early postoperative period during cochlear implantation remains poorly understood. A clinical and audiological examination of 100 children with high-grade sensorineural hearing loss was performed. Within the framework of the work, a serological and molecular genetic examination of patients for herpesvirus infections (Epstein–Barr virus, cytomegalovirus) was performed. Two comparison groups are highlighted. The first group included 58 patients with detected latent infections. In the second group 42 patients did not have serological and molecular genetic markers of infection with herpesvirus infection. There is evidence in the literature that surgical trauma combined with general anesthesia can cause reactivation of persistent herpesvirus infection. In 4% (n = 4), markers of an active infectious process were detected. The analysis of the course of the postoperative period in children in two study groups after cochlear implantation was performed. In the hemostatic system, hypocoagulation disorders were found in a number of children. Persistent herpesvirus infection can be a trigger for the development of both inflammatory and non-inflammatory complications after surgical treatment.

scholarly journals The impact of desflurane and sevoflurane on the intraoperative and early postoperative period in liver transplantation

2021 ◽  
Vol 13 (4) ◽  
pp. 328-338
Author(s):  
S. V. Zhuravel ◽  
N. K. Kuznetsova ◽  
V. E. Aleksandrova ◽  
I. I. Goncharova
Keyword(s):  
Liver Transplantation ◽  
Reperfusion Injury ◽  
Postoperative Period ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion ◽  
Graft Function ◽  
Early Postoperative Period ◽  
Liver Graft ◽  
Inhalation Anesthetics ◽  
The Impact

Background. A pressing issue is the choice of an anesthetic agent for liver transplantation. The mechanism of the organprotective properties of desflurane and sevoflurane is not fully understood. It is important to understand the effects of desflurane and sevoflurane on the severity of ischemia-reperfusion injury of the liver graftAim. To study the effect of desflurane and sevoflurane on the intraoperative and early postoperative period in liver transplantation.Material and methods. The study included 47 patients with liver cirrhosis of various etiologies who underwent cadaveric liver transplantation between February and December 2020. The groups compared in the study included 24 patients who received desflurane and 23 patients who received sevoflurane.Results. There were no statistically significant differences in the effect of desflurane and sevoflurane on hemodynamic parameters, on the need for vasopressor drugs. Episodes of bradycardia and cardiac arrhythmias were significantly more frequent when using sevoflurane. Patients were extubated significantly faster after surgery in the desflurane group. In the early postoperative period, desflurane and sevoflurane did not adversely affect significantly the liver graft function and the degree of its ischemia-reperfusion injury. The groups appeared comparable in rates of using the renal replacement therapy, the incidence of the graft dysfunction development in the postoperative period, and the surgery outcomes.Conclusions. The use of modern inhalation anesthetics desflurane and sevoflurane to maintain anesthesia during liver transplantation does not adversely affect the course of the intraoperative and early postoperative period.

Treatment of localized renal cell cancer

2017 ◽  
Author(s):  
Ashraf Almatar ◽  
Michael A.S. Jewett
Keyword(s):  
Renal Cell ◽  
Patient Survival ◽  
Slow Growth ◽  
Cell Cancer ◽  
Laparoscopic Technique ◽  
Small Renal Masses ◽  
Renal Masses ◽  
History Of ◽  
Localized Renal Cell Carcinoma ◽  
The Impact

The incidence of localized renal cell carcinoma (RCC) has increased due to the widespread use of abdominal imaging, often for unrelated conditions. Despite improved understanding of the natural history of slow growth in many tumours and the impact of ageing and co-morbidities on patient survival, RCC is still the most lethal of genitourinary cancers and surgery remains the mainstay of treatment. Localized RCC is defined as stages T1-2 N0 M0. The relatively safe needle core biopsy is increasingly used, especially for small renal masses (SRMs), as we now know that up to 30% are benign and that RCC subtypes differ in biology and behaviour. Radical nephrectomy, either performed by open or laparoscopic technique, is indicated for stage T2 tumours or when partial nephrectomy (PN) is not believed to be feasible.

The impact of PET/CT imaging performed in the early postoperative period on the management of breast cancer patients

2013 ◽  
Vol 34 (6) ◽  
pp. 571-576 ◽  
Author(s):  
Feyza Sen ◽  
Ali T. Akpinar ◽  
Umit Ogur ◽  
Gani Duman ◽  
Feyzi Tamgac ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Postoperative Period ◽  
Early Postoperative Period ◽  
Ct Imaging ◽  
Breast Cancer Patients ◽  
Pet Ct ◽  
The Impact

scholarly journals DETERMINING STRATEGIES FOR PSYCHOLOGICAL SUPPORT IN REHABILITATION OF PATIENTS WITH ESOPHAGEAL VARICES IN THE EARLY POSTOPERATIVE PERIOD

2021 ◽  
Vol 13 (4) ◽  
pp. 21-29
Author(s):  
Evgenii Vasilievich Semichev ◽  
Mariya Sergeevna Sevostyanova ◽  
Polina Andreevna Chernomurova
Keyword(s):  
Postoperative Period ◽  
Esophageal Varices ◽  
Disease Duration ◽  
Rank Correlation ◽  
Early Postoperative Period ◽  
Psychological Status ◽  
Hospital Treatment ◽  
Self Assessment ◽  
Cognitive Beliefs ◽  
The Impact

Background. Despite numerous data on the impossibility of effective rehabilitation of somatic patients without taking into account their psychological status, the psychological profile of patients with esophageal varices remains unexplored and not taken into account in the early postoperative period. Aim. The paper aims to identify the psychological features of patients with esophageal varices to determine promising strategies for increasing the effectiveness of the rehabilitation process in the early postoperative period. Materials and methods. The sample included 22 patients with a verified diagnosis of I 85.9 (ICD-10) and a disease duration of 1 year, who underwent in-hospital treatment in connection with the forthcoming endoscopic sclerosis. Structured clinical interviews and a detailed self-assessment test of disease significance, anxiety level, depression, awareness skills and a system of fundamental cognitive beliefs were conducted. Statistical processing was performed using the Spearman's rank correlation coefficient. Results. Both subclinical and clinical anxiety was diagnosed in 7 patients (31.81 %) each. No correlation was found between age, disease duration, the number of hospitalizations and the expression of anxiety and depressive symptoms. A high or very high effect of esophageal varices was revealed on the following spheres of social status – a limited feeling of strength and energy (90.9 %), career restrictions (81.8 %), material damage (77.2 %), limited pleasure (68.1 %). The relationship between self-assessment of disease significance (experiencing the impact of the disease on various spheres of life), awareness skills and the system of cognitive beliefs was reliably confirmed. Conclusion. Effective rehabilitation of patients with esophageal varices using the strategies of mindfulness-based cognitive therapy during the early postoperative period has been proven.

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