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Journal articles on the topic 'Postoperative complications/diagnosis'
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Gore, Richard M., Jonathan W. Berlin, Vahid Yaghmai, Uday Mehta, Geraldine M. Newmark, and Gary G. Ghahremani. "CT diagnosis of postoperative abdominal complications." Seminars in Ultrasound, CT and MRI 25, no. 3 (June 2004): 207–21. http://dx.doi.org/10.1053/j.sult.2004.03.003.
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Kirshtein, Boris, Sergey Domchik, Solly Mizrahi, and Leonid Lantsberg. "Laparoscopic diagnosis and treatment of postoperative complications." American Journal of Surgery 197, no. 1 (January 2009): 19–23. http://dx.doi.org/10.1016/j.amjsurg.2007.10.019.
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Stojakov, Dejan, Predrag Sabljak, Bratislav Spica, Dejan Velickovic, Vladimir Sljukic, Brankica Nenadic, Ljubica Tomasevic, Marija Ðukanovic, Aleksandra Ðuric-Stefanovic, and Predrag Pesko. "Perioperative complications of esophagectomy - prevention, diagnosis and management." Acta chirurgica Iugoslavica 64, no. 1 (2017): 27–38. http://dx.doi.org/10.2298/aci1701027s.
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Esophageal resection with reconstruction is complex surgical procedure with high rate of postoperative morbidity, with decreasing mortality rate during last decades, particularly in high-volume hospitals. Numerous preoperative, intraoperative and postoperative factors have contribute to incidence and type of complications. Intraoperative haemorrhage and tracheobronchial lesions could be avoid by good surgical judgement and operative technique. Pulmonary complications are often, with multifactorial etiology, and they are the main cause of postoperative mortality after esophagectomy. Dehiscence of esophageal anastomosis could be fatal, and only high index of suspicion and early diagnosis lead to successful treatment. In majority of such cases conservative measures are successful, however, conduit necrosis is indication for surgical reoperation. Vocal cord palsy due to intraoperative injury of recurrent laryngeal nerves is not rare and increases pulmonary complications rate. New onset of arrhythmia could be associate with other surgical complications. Postesophagectomy chylothorax is life-threatening complication due to rapid development of immunosuppression and septic complications, and early ligation of thoracic duct is often mandatory. Intrathoracic herniation of intrabdominal viscera is rare, and ischemic spinal cord lesions are very rare after esophagectomy. Majority of perioperative complications could be prevented or solved, decreasing mortality rate of esophagectomy.
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Fantoni, Caterina, Carmen Erra, Eduardo Marcos Fernandez Marquez, Andrea Ortensi, Andrea Faiola, Daniele Coraci, Giulia Piccinini, and Luca Padua. "Ultrasound Diagnosis of Postoperative Complications of Nerve Repair." World Neurosurgery 115 (July 2018): 320–23. http://dx.doi.org/10.1016/j.wneu.2018.04.179.
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Schöffel, U., and E. M. Farthmann. "Diagnosis and Management of Postoperative Intra-Abdominal Complications." Digestive Surgery 12, no. 6 (1995): 308–13. http://dx.doi.org/10.1159/000172379.
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Ehlers, Niels. "Penetrating keratoplasty. Diagnosis and treatment of postoperative complications." Acta Ophthalmologica Scandinavica 79, no. 1 (February 2001): 103. http://dx.doi.org/10.1034/j.1600-0420.2001.790130-2.x.
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Qu, Yikun, Shiyan Ren, Chunmin Li, Songyi Qian, and Peng Liu. "Management of Postoperative Complications Following Splenectomy." International Surgery 98, no. 1 (February 1, 2013): 55–60. http://dx.doi.org/10.9738/cc63.1.
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Abstract Complications of post-splenectomy, especially intra-abdominal hemorrhage can be fatal, with delayed or inadequate treatment having a high mortality rate. The objective of this study was to investigate the cause, prompt diagnosis, and outcome of the fatal complications after splenectomy with a focus on early diagnosis and management of hemorrhage after splenectomy. The medical files of patients who underwent splenectomy between January 1990 and March 2011 were reviewed retrospectively. The cause, characteristics, management, and outcome in patients with post-splenectomy hemorrhage were analyzed. Fourteen of 604 patients (1.19%) undergoing splenectomy had intraperitoneal hemorrhage: reoperation was performed in 13 patients, and 3 patients died after reoperation, giving the hospital a mortality rate of 21.43%; whereas, 590 of 604 patients (98%) had no hemorrhage following splenectomy, and the mortality rate (0.34%) in this group was significantly lower (P < 0.001). The complications following splenectomy, including pneumonia pancreatitis, gastric fistula, gastric flatulence, and thrombocytosis, in patients with postoperative hemorrhage were significantly higher than those without hemorrhage (P < 0.001). According to the reasons for splenectomy, 14 patients with post-splenectomy hemorrhage were grouped into two groups: splenic trauma (n = 9, group I) and portal hypertension (n = 5, group II). The median interval between splenectomy and diagnosis of hemorrhage was 15.5 hours (range, 7.25–19.5 hours). No differences were found between groups I and II in terms of incidence of postoperative hemorrhage, time of hemorrhage after splenectomy, volume of hemorrhage, and mortality of hemorrhage, except transfusion. Intra-abdominal hemorrhage after splenectomy is associated with higher hospital mortality rate and complications. Early massive intraperitoneal hemorrhage is often preceded by earlier sentinel bleeding; careful clinical inquiry and ultrasonography are the mainstays of early diagnosis.
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Gitas, Georgios, L. Proppe, S. Baum, M. Kruggel, A. Rody, D. Tsolakidis, D. Zouzoulas, et al. "A risk factor analysis of complications after surgery for vulvar cancer." Archives of Gynecology and Obstetrics 304, no. 2 (January 9, 2021): 511–19. http://dx.doi.org/10.1007/s00404-020-05949-w.
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Abstract Introduction Despite the less frequent use of surgery in patients with vulvar cancer, the high rates of postoperative complications are still a matter of concern. The aim of the present study was to identify risk factors that influence postoperative complications rates in vulvar cancer and identify specific clinical parameters that may influence their incidence. Materials Patients who underwent curative-intent surgery for squamous cell carcinoma of the vulva from 2003 to 2018 were selected. All patient characteristics were analyzed as risk factors for the development of postoperative lymphocele, lymphedema, and wound dehiscence. The patients were followed up for 2 years postoperatively. Results The investigation comprised 121 patients, of whom 18.1% developed wound dehiscence, 17.7% a lymphocele, and 20.4% lymphedema. We found no significant evidence of an association between patient’s characteristics and postoperative complications. The depth of tumor invasion and the appearance of lymph-node metastasis were significantly associated with postoperative complications. Free resection margins of 5 mm or more were associated with a reduced risk of postoperative complications compared to resection margins less than 5 mm. No complications were encountered after sentinel node biopsy (SNB). Complication rates were associated with inguinofemoral lymphadenectomy, but not with the extent of lymphadenectomy. The development of a lymphocele or wound dehiscence may be correlated with the development of long-term lymphedema. Conclusion FIGO stage at diagnosis influences the risk of postoperative complications. The use of SNB minimized postoperative complications. Correlations between the free microscopic resection margin distance and the risk of postoperative wound dehiscence must be investigated further.
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Negrón, María E., Herman W. Barkema, Kevin Rioux, Jeroen De Buck, Sylvia Checkley, Marie-Claude Proulx, Alexandra Frolkis, et al. "Clostridium difficileInfection Worsens the Prognosis of Ulcerative Colitis." Canadian Journal of Gastroenterology and Hepatology 28, no. 7 (2014): 373–80. http://dx.doi.org/10.1155/2014/914303.
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BACKGROUND: The impact ofClostridium difficileinfections among ulcerative colitis (UC) patients is well characterized. However, there is little knowledge regarding the association betweenC difficileinfections and postoperative complications among UC patients.OBJECTIVE: To determine whetherC difficileinfection is associated with undergoing an emergent colectomy and experiencing postoperative complications.METHODS: The present population-based case-control study identified UC patients admitted to Calgary Health Zone hospitals for a flare between 2000 and 2009.C difficiletoxin tests ordered in hospital or 90 days before hospital admission were provided by Calgary Laboratory Services (Calgary, Alberta). Hospital records were reviewed to confirm diagnoses and to extract clinical data. Multivariate logistic regression analyses were performed among individuals tested forC difficileto examine the association betweenC difficileinfection and emergent colectomy and diagnosis of any postoperative complications and, secondarily, an infectious postoperative complication. Estimates were presented as adjusted ORs with 95% CIs.RESULTS:C difficilewas tested in 278 (58%) UC patients and 6.1% were positive.C difficileinfection was associated with an increased risk for emergent colectomy (adjusted OR 3.39 [95% CI 1.02 to 11.23]). Additionally, a preoperative diagnosis ofC difficilewas significantly associated with the development of postoperative infectious complications (OR 4.76 [95% CI 1.10 to 20.63]).CONCLUSION:C difficilediagnosis worsened the prognosis of UC by increasing the risk of colectomy and postoperative infectious complications following colectomy. Future studies are needed to explore whether early detection and aggressive management ofC difficileinfection will improve UC outcomes.
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Conti, Matthew S., Oleksandr Savenkov, and Scott J. Ellis. "Association of Peripheral Vascular Disease With Complications After Total Ankle Arthroplasty." Foot & Ankle Orthopaedics 4, no. 2 (April 1, 2019): 247301141984337. http://dx.doi.org/10.1177/2473011419843379.
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Background: Despite limited evidence, peripheral vascular disease is often cited as a contraindication for total ankle arthroplasty. The purpose of our study was to identify whether peripheral vascular disease in patients undergoing total ankle arthroplasty increased the rate of infection, postoperative irrigation and debridement, or failure of the implant. Methods: The PearlDiver Database was used to identify Medicare patients who underwent a total ankle arthroplasty from 2005 to 2014. These data were then analyzed for postoperative infections within 90 days, subsequent irrigation and debridements, and failure of total ankle arthroplasties. A diagnosis of preoperative peripheral vascular disease only included those patients who had peripheral vascular disease as an ICD-9 diagnosis code and underwent a preoperative lower extremity angiogram prior to total ankle arthroplasty. Medical comorbidities were identified using ICD-9 diagnosis codes. Three multivariable logistic regression models were then developed in order to identify risk factors associated with postoperative infections and failure after total ankle arthroplasty. Results: A total of 10 698 Medicare patients who underwent a primary total ankle arthroplasty were identified. There were 334 patients who had a postoperative infection within 90 days of their total ankle arthroplasty, and 95 of those patients required an irrigation and debridement. Regression analysis demonstrated that patients with peripheral vascular disease had the greatest risk of developing a postoperative infection within 90 days (OR 2.85, P < .01), requiring an irrigation and debridement postoperatively (OR 4.87, P < .001), and having a total ankle arthroplasty failure at any time point postoperatively (OR 2.51, P < .001). Conclusions: Our study suggests that preoperative peripheral vascular disease is a significant risk factor for an acute postoperative infection, postoperative irrigation and debridement, and failure of the implant in Medicare patients undergoing a total ankle arthroplasty. Level of Evidence: Level III, therapeutic.
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Samartsev, V. A., I. V. Kadyntsev, and E. G. Voluzhenkov. "Postoperative extremity metallosteosynthesis complications." Perm Medical Journal 35, no. 3 (December 15, 2018): 5–8. http://dx.doi.org/10.17816/pmj3535-8.
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Aim. To carry out the qualitative analysis of metal implant, inserted into the bone, determine tactics for treatment of inflammatory process in the postoperative period of metallosteosynthesis.
Materials and methods. The treatment of 1325 patients with the developing posttraumatic osteomyelitis of the upper and lower extremities in the Department of Complicated Traumatology of City Clinical Hospital № 6 and traumatology departments of Perm for 10 years (2004–2014) was analyzed.
Results. Metallosis was observed in 227 (17.2 %) persons. Matallosis was manifested by suppuration and fistula formation in the region of screw 2–3 months after operative treatment of fracture in 177 (76.3 %) patients, and in 50 (27.7 %) patients – by acute purulent inflammatory process immediately after the surgery. In 34 (15 %) patients, computed tomography and MRI demonstrated metal bone impregnations. All these 227 (17.2 %) patients underwent elimination of metal constructions. The postoperative wounds after elimination of metal constructions healed primarily in 152 (66 %) patients. Secondary healing of the postoperative wounds was noted in 75 (44 %) persons. The long-term results were studied during 3 years in 189 (83 %) patients. The development of the postoperative osteomyelitic process, connected with late removal of metal construction, was registered in 8 (4.4 %) persons. False joint was formed in 1 (0.5 %) patient with tibial fracture. Positive long-term result was reached in 180 (95.2 %) persons.
Conclusions. Timely diagnosis, correctly chosen technique of treatment permit to provide full restoration of the structure and function, and obtain positive medical and social rehabilitation in this category of patients.
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Yadla, Sanjay, Jennifer Malone, Peter G. Campbell, Mitchell G. Maltenfort, James S. Harrop, Ashwini D. Sharan, and John K. Ratliff. "Early complications in spine surgery and relation to preoperative diagnosis: a single-center prospective study." Journal of Neurosurgery: Spine 13, no. 3 (September 2010): 360–66. http://dx.doi.org/10.3171/2010.3.spine09806.
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Object The reported incidence of complications in spine surgery varies widely. Variable study methodologies may open differing avenues for potential bias, and unclear definitions of perioperative complication make analysis of the literature challenging. Although numerous studies have examined the morbidity associated with specific procedures or diagnoses, no prospective analysis has evaluated the impact of preoperative diagnosis on overall early morbidity in spine surgery. To accurately assess perioperative morbidity in patients undergoing spine surgery, a prospective analysis of all patients who underwent spine surgery by the neurosurgical service at a large tertiary care center over a 6-month period was conducted. The correlation between preoperative diagnosis and the incidence of postoperative complications was assessed. Methods Data were prospectively collected on 248 consecutive patients undergoing spine surgery performed by the neurosurgical service at the Thomas Jefferson University Hospital from May to December 2008. A standardized definition of minor and major complications was applied to all adverse events occurring within 30 days of surgery. Data on diagnosis, complications, and length of stay were retrospectively assessed using stepwise multivariate analysis. Patients were analyzed by preoperative diagnosis (neoplasm, infection, degenerative disease, trauma) and level of surgery (cervical or thoracolumbar). Results Total early complication incidence was 53.2%, with a minor complication incidence of 46.4% and a major complication incidence of 21.3%. Preoperative diagnosis correlated only with the occurrence of minor complications in the overall cohort (p = 0.02). In patients undergoing surgery of the thoracolumbar spine, preoperative diagnosis correlated with presence of a complication and the number of complications (p = 0.003). Within this group, patients with preoperative diagnoses of infection and neoplasm were more often affected by isolated and multiple complications (p = 0.05 and p = 0.02, respectively). Surgeries across the cervicothoracic and thoracolumbar junctions were associated with higher incidences of overall complication than cervical or lumbar surgery alone (p = 0.04 and p = 0.03, respectively). Median length of stay was 5 days for patients without a complication. Length of stay was significantly greater for patients with a minor complication (10 days, p < 0.0001) and even greater for patients with a major complication (14 days, p < 0.0001). Conclusions The incidence of complications found in this prospective analysis is higher than that reported in previous studies. This association may be due to a greater accuracy of record-keeping, absence of recall bias via prospective data collection, high complexity of pathology and surgical approaches, or application of a more liberal definition of what constitutes a complication. Further large-scale prospective studies using clear definitions of complication are necessary to ascertain the true incidence of early postoperative complications in spine surgery.
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Halushko, O. A. "HIDDEN COMPLICATIONS OF THE POSTOPERATIVE PERIOD: DIAGNOSIS AND TREATMENT." Likarska sprava, no. 3 (May 29, 2019): 43–47. http://dx.doi.org/10.31640/jvd.3.2019(6).
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One of the hidden complications of the postoperative period is hypophosphatemia (HPE), which often develops imperceptibly, but can worsen the overall results of treatment. The objective of the work: to investigate the frequency of development of disorders of phosphate exchange in the postoperative period and to establish the possibility and effectiveness of correction of such violations. Materials and methods. The determination of phosphate levels was carried out in 328 patients undergoing surgical treatment in surgical operations of various surgical status. Results. The highest rate of HPE was observed in patients with burns (23.08 %), after neurosurgical (17.94 %) and abdominal (17.64 %) surgical interventions. It is established that the correction of severe HPE is advisable by intravenous administration of sodium D-fructose-1,6-diphosphate. Conclusion. In the postoperative period, HPE is common, but is successfully corrected to abstract values, which coincides with the clinical improvement of patients.
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Demas, Peter N., and James B. Bridenstine. "Diagnosis and treatment of postoperative complications after skin resurfacing." Journal of Oral and Maxillofacial Surgery 57, no. 7 (July 1999): 837–41. http://dx.doi.org/10.1016/s0278-2391(99)90826-1.
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Yang, Haitao, Renfa Wang, Tianyou Luo, Yu Ouyang, Fajin Lv, Liming Xia, and Chengyuan Wang. "MRI manifestations and differentiated diagnosis of postoperative spinal complications." Journal of Huazhong University of Science and Technology [Medical Sciences] 29, no. 4 (August 2009): 522–26. http://dx.doi.org/10.1007/s11596-009-0426-4.
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Alkathiri, Omar, Saad Y. Salim, Lindsey M. Warkentin, Thomas A. Churchill, Puneeta Tandon, and Rachel G. Khadaroo. "Ultrasound diagnosis of sarcopenia is predictive of postoperative complications." Journal of the American College of Surgeons 221, no. 4 (October 2015): e18. http://dx.doi.org/10.1016/j.jamcollsurg.2015.08.344.
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Erman, Tahsin, Metin Tuna, A. İskender Göçer, Faruk İdan, Erol Akgül, and Suzan Zorludemir. "Postoperative radicular neuroma." Neurosurgical Focus 11, no. 5 (November 2001): 1–3. http://dx.doi.org/10.3171/foc.2001.11.5.9.
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Lumbar discectomy is the most common surgical procedure performed in neurosurgery clinics. Such a large number of procedures underscore not only the prevalence of conditions such as intervertebral disc herniation, but also the strong belief of surgeons that the operation does provide benefits to patients suffering from sciatica. In spite of this belief, sciatic pain may continue after the surgery. The recurrence of sciatic and/or back pain after primary discectomy is called the “failed back surgery syndrome.” The rate of the complications involved in standard lumbar discectomy ranges from 5.4 to 14%. One of the complications of the lumbar disc surgery is nerve root injury. The complication rate of this injury ranges from 0.7 to 2.2%. Postoperative radicular neuroma must be considered in differential diagnosis for the patient who has failed back surgery syndrome. In this study the authors evaluate a patient who had undergone surgery for lumbar disc herniation and suffered intractable pain. A traumatic radicular neuroma is demonstrated and the pertinent literature is presented.
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Akashi, Masaya, Yujiro Hiraoka, Takumi Hasegawa, and Takahide Komori. "Temporal Evaluation of Neurosensory Complications After Mandibular Third Molar Extraction: Current Problems for Diagnosis and Treatment." Open Dentistry Journal 10, no. 1 (December 30, 2016): 728–32. http://dx.doi.org/10.2174/1874210601610010728.
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Objective: This retrospective study aimed to report the incidence of neurosensory complications after third molar extraction and also to identify current problems and discuss appropriate management of these complications. Method: Patients who underwent extraction of deeply impacted mandibular third molars under general anesthesia were included. The following epidemiological data were retrospectively gathered from medical charts: type of neurosensory complication, treatment for complication, and outcome. Results: A total 369 mandibular third molars were extracted in 210 patients under general anesthesia during this study period. Thirty-one of the 369 teeth (8.4%) in 31 patients had neurosensory complications during the first postoperative week resulting from inferior alveolar nerve damage. Neurosensory complications lasting from 1 to 3 months postoperatively included 17 cases of hypoesthesia and 8 of dysesthesia in 19 patients. Five cases of hypoesthesia and 4 of dysesthesia in 5 patients persisted over 1 year postoperatively. Sixteen of 369 teeth (4.3%) in 16 patients had persistent neurosensory complications after third molar extraction under general anesthesia. Stellate ganglion block was performed in 4 patients. Early initiation of stellate ganglion block (within 2 weeks postoperatively) produced better outcomes than late stellate ganglion block (over 6 months postoperatively). Conclusion: Refractory neurosensory complications after third molar extraction often combine both hypoesthesia and dysesthesia. Current problems in diagnosis and treatment included delayed detection of dysesthesia and the lack of uniform timing of stellate ganglion block. In the future, routinely inquiring about dysesthesia and promptly providing affected patients with information about stellate ganglion block might produce better outcomes.
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Řezáč, Tomáš, Martin Stašek, Pavel Zbořil, and Petr Špička. "The role of CRP in the diagnosis of postoperative complications in rectal surgery." Polish Journal of Surgery 93, no. 5 (April 22, 2021): 1–5. http://dx.doi.org/10.5604/01.3001.0014.6591.
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Introduction: Postoperative anastomotic leak after rectal resection is a life-threatening complication. Late diagnosis and a severe symptomatic leak may cause almost 18 % mortality. Early diagnosis is a challenging issue because of nonspecific clinical signs in the early postoperative period. Minimally invasive rectal surgery and the implementation of ERAS protocol require appropriate markers of inflammatory complications and leak with high sensitivity. Postoperative serum C-reactive protein values seem to be the right answer for this question. Aim: The presented study aimed to determine the importance and cut-off level of serum C-reactive protein as a possible predictive factor for early anastomotic leak diagnosis in rectal surgery. Material and methods: The retrospective observational analysis of patients after resection for rectal cancer in a period of one year. The observation included risk factors (age, sex, BMI, bowel preparation and the acuteness of surgery), recording of complications and serum values of CRP. Results: The study included 178 patients. 63 patients (35,4 %) had non-complicated postoperative course. The complications were present in 115 cases (64,6 %), including surgical site infection (16,3 %) and anastomotic leak (7,3 %). The mortality was 2,2 %. CRP serum value reached the sensitivity 94,7 % and specificity 72,5 % at POD 4 with cut off value of 131,8 mg/l and the sensitivity of 84,2 % and specificity 82,4 % with cut off 175,4 mg/l, respectively. Conclusions: Postoperative serum C-reactive protein may be used as a predictor of anastomotic leakage. The examination of CRP on the 4th postoperative day may lead to early and safe discharge from the hospital after rectal resection. The implementation of the cut off values detects more than 90 % of anastomotic leaks or septic complications.
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Khadjibaev, F. A., V. Kh Sharipova, and P. K. Sultanov. "Analysis of complications after living-related kidney transplantation: a single-center experience." Transplantologiya. The Russian Journal of Transplantation 13, no. 1 (March 24, 2021): 63–73. http://dx.doi.org/10.23873/2074-0506-2021-13-1-63-73.
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Background. The one-year renal graft survival rates have grown to 93.4% for transplantation from cadaveric and 97.2% from living donors. Early detection and elimination of complications after kidney transplantation improve these figures.The study purpose was to develop an algorithm for the diagnosis and treatment tactics of postoperative complications after kidney transplantation by reviewing literature data and analyzing the results of our own experience.Material and methods. The study included 75 patients who underwent kidney transplantation from a living donor at the Republican Research Centre of Emergency Medicine from March 2018 to December 2019.Results. The original authors' algorithm developed for the diagnosis and treatment of complications after kidney transplantation covers all postoperative complications that lead to renal transplant dysfunction. It is based on assessing the symptoms that typically occur in a specific complication. The main instrumental methods in the diagnosis of postoperative complications are ultrasound and radiological investigational techniques. The biopsy has the main role in diagnosing a graft rejection. Among 75 patients after kidney transplantation, 23 (30.6%) developed various early postoperative complications, including both surgical and immunological ones. Renal graft dysfunction was eliminated in 17 (73.9%) of 23 patients. The loss of a transplanted kidney was associated with the death of 7 recipients (9.3%). The causes of death were pulmonary embolism in 2 (2.7%) cases, infection and sepsis as a result of immunosuppression in 2 (2.7%) cases, hypovolemic shock in 2 (2.7%) cases, and acute ischemic stroke in 1 (1.3%) case. Two recipients underwent renal transplant nephrectomy. The cause of nephrectomy was graft rejection and bleeding from the renal artery. A oneyear survival rate was 90.7%. The proposed treatment and diagnostic algorithm showed a 95.7% diagnostic value in identifying the complications, and 91.3% of the therapeutic effect in coping with a renal transplant dysfunction.Conclusions. Early treatment of revealed complications allows saving the transplanted kidney function. Step-bystep differential diagnosis of complications after kidney transplantation, according to the proposed algorithm, allows choosing the treatment tactics based on complication pathogenesis.
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HUNT, JUDITH M., G. B. EDWARDS, and KATHY W. CLARKE. "Incidence, diagnosis and treatment of postoperative complications in colic cases." Equine Veterinary Journal 18, no. 4 (July 1986): 264–70. http://dx.doi.org/10.1111/j.2042-3306.1986.tb03623.x.
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Ingraham, Angela, and Jason Sperry. "Operative Management of Cardiac Injuries: Diagnosis, Technique, and Postoperative Complications." Current Trauma Reports 1, no. 4 (September 5, 2015): 225–31. http://dx.doi.org/10.1007/s40719-015-0032-9.
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DENNISON, ROBIN DONOHOE. "Nurseʼs guide to common postoperative complications." Nursing 27, no. 11 (November 1997): 56–59. http://dx.doi.org/10.1097/00152193-199711000-00027.
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Atikuzzaman, Kazi, Khabir Uddin Ahmed, and Mahmudul Hassan. "Postoperative complications and its management after total laryngectomy." Bangladesh Journal of Otorhinolaryngology 19, no. 2 (January 13, 2014): 82–86. http://dx.doi.org/10.3329/bjo.v19i2.16366.
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Objectives: To find out the pattern of complications, frequency, risk factors and the management after total laryngectomy. Methods: It was a cross sectional study done in the Department of Otolaryngology & Head- Neck Surgery, Shaheed Suhrawardy Medical College Hospital, Dhaka from July 2007 to Dec 2009. 15 patients undergoing total laryngectomy for histologically proven Carcinoma larynx were included in this study. Patients were reviewed after surgery and any complication that occurred was recorded. The presentation, diagnosis and management of these complications were discussed after total laryngectomy. Results: There were 15 male patients, 3 non radiated cases and 12 post irradiated cases. Age of patients ranged from 35-75 years. Complications included wound infection (04), pharyngocutaneous fistula (03), flap necrosis (01), pharyngeal stenosis (01), stomal stenosis (01) and stomal recurrence (01). Conclusions: Wound infection and pharyngocutaneous fistula are most common complications after total laryngectomy. Preoperative radiotherapy is an important risk factor for development of pharyngocutaneous fistula in total laryngectomy patients. DOI: http://dx.doi.org/10.3329/bjo.v19i2.16366 Bangladesh J Otorhinolaryngol 2013; 19(2): 82-86
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Salahuddin, Masha Khan, Muhammad Anwar, Ali Nawaz, Muhammad Shoaib, Abdul `. Samad, Haq Nawaz, Yaqoob Zarkoon, and Saadat Khan. "Xanthogranulomatous pyelonephritis: Presentation and surgical complications." Professional Medical Journal 27, no. 07 (July 10, 2020): 1391–95. http://dx.doi.org/10.29309/tpmj/2020.27.07.3965.
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To review & evaluate the clinical presentation & surgical complications of Xanthogranulomatous Pyelonephritis (XGP). Objectives: XGP is usually considered as an uncommon destructive chronic inflammatory disease of the kidney. The disease is usually diagnosed only on postoperative histopathological reports of the surgically excised tissues and has given less emphasis on preoperative diagnosis. We retrospectively reviewed biopsy proven diagnosed cases of XGP over the past 7 years, with a specific emphasis on preoperative clinical presentation of the patients, to help improve the preoperative diagnosis of XGP. Study Design: Case Series study. Setting: Department of Urology Sandeman Provincial Teaching Hospital Quetta. Period: 7 years July, 2011 to June, 2018. Material & Methods: We retrospectively reviewed all biopsy proven cases of XGP who underwent surgery in the department of Urology of a tertiary care hospital from July, 2011 to June, 2018 regarding clinical characteristics, laboratory & radiological finding, interoperate & postoperative complications. Results: There were 42 patients of XGP. The mean age was 49.8+-16.04 years. Male & female percentage was 40.50 & 59.50 respectively. Majority (88.1%) of patients were of low socio-economic status. The most common presentation was flank pain in 100% patients. Fever & dysuria in 64.28%, anorexia in 85.71% and weight loss in 83.33%. In laboratory findings, pyuria was present 88.09%, anemia in 71.42%, azotemia & abnormal liver enzymes in 14.29% each. The most common associated conditions were renal calculi in 83.33% and diabetes in 47.61%. The commonest organism isolated on culture was E-Coli in 35.48%. Intra-operatively excessive bleeding occurred in 3(7.14%), including one with tear of inferior vena cava. Two patients suffered colonic injury & another one pleural injury. Postoperatively the common complications were, wound infections in 8(19.04%) patients & Incisional hernia in 2(4.76%) patients. Conclusion: Urolithiasis and urinary tract infection are two well known risk factors for the development of XPN. Our experience in the present series, demonstrates that low socioeconomic status could be another risk factor for XPN. Early diagnosis and proper treatment of urolithiasis & urinary tract infection is important to prevent their complications including XGP.
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Kotze, Paulo Gustavo, Daniela Oliveira Magro, Carlos Augusto Real Martinez, Antonino Spinelli, Takayuki Yamamoto, Janindra Warusavitarne, and Claudio Saddy Rodrigues Coy. "Long Time from Diagnosis to Surgery May Increase Postoperative Complication Rates in Elective CD Intestinal Resections: An Observational Study." Gastroenterology Research and Practice 2018 (2018): 1–6. http://dx.doi.org/10.1155/2018/4703281.
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Background. There is lack of data analyzing short-term postoperative complications and time from diagnosis to surgery in Crohn’s disease (CD). Aim. To compare complication rates after elective abdominal operations in CD patients with different durations of disease. Methods. Retrospective observational study with CD patients who submitted to elective intestinal resections. Patients were allocated in 2 groups according to time to surgery (TS) in less or more than 5 years. Short-term postoperative complications were analyzed and compared between the 2 groups, and binary logistic regression analysis was performed to check for significant variables. Results. 123 patients were finally included, 77 with TS > 5 years (62.6%) and 46 with TS < 5 years (37.4%). Patients with TS > 5 years had higher rates of overall surgical complications (p=0.011), reoperations (p=0.003), surgical site infections (p=0.014), anastomotic dehiscence (p=0.021), abdominal abscesses (p=0.021), and overall medical complications (p=0.019). On logistic regression, the single significant variable was the confection of stomas (OR: 3.203; 95% CI: 1.011–10.151; p=0.048). Conclusions. Patients with longer time to surgery showed a significant increase in overall medical and surgical postoperative early complications after elective intestinal resections.
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Moskowitz, Shaye I., James Liu, and Ajit A. Krishnaney. "Postoperative Complications Associated with Dural Substitutes in Suboccipital Craniotomies." Operative Neurosurgery 64, suppl_1 (March 1, 2009): ONS28—ONS34. http://dx.doi.org/10.1227/01.neu.0000334414.79963.59.
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Abstract Objective: Dural replacements are used in cranial surgery when primary closure of native dura is not possible. The goal is to recreate a watertight barrier to prevent cerebrospinal fluid leakage with few associated complications. We reviewed a single-institution experience with a variety of dural substitutes in posterior fossa neurosurgery, for which higher complication rates are well described. Methods: Patients were screened for suboccipital posterior fossa neurosurgery between November 2005 and April 2007. Surgical logs were reviewed for diagnosis, procedure, and use of dural replacement. Clinical courses were reviewed for hydrodynamic complications, including delayed hydrocephalus, clinically significant pseudomeningocele, aseptic meningitis, and persistent cerebrospinal leakage. Results: One hundred twenty-eight patients were included, and a dural replacement was used in 106. Overall, the complication rate was 21.9% (28 patients). Complications were seen for acellular human dermis in 33.3%, for collagen matrix in the original formulation in 18.2%, for the reformulation in 16.9%, for the suturable formulation in 50%, for nonautologous materials in 24%, and for no dural replacement in 16.7%. Univariate and multivariate analysis demonstrated that hydrodynamic complications were associated with use of the suturable collagen matrix (odds ratio, 10.8; 95% confidence interval, 2.5–46.1; P = 0.0014) and trended with use of acellular human dermis (odds ratio, 4.6; 95% confidence interval, 0.9–23.1; P = 0.06). Conclusion: The increased risk of hydrodynamic complications associated with suboccipital neurosurgery is modified by choice of dural replacement. Similar complication rates were seen for most materials with a variety of primary abnormalities, with the exception of suturable bovine collagen matrix, with hydrodynamic complications in 50% of patients.
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Rodrigues, Clarissa Garcia, Roberta Senger, Laura De Azevedo Guido, and Graciele Fernanda da Costa Linch. "Cardiac surgery postperative: diagnosis and nursing interventions." Revista de Enfermagem UFPE on line 4, no. 1 (December 29, 2009): 391. http://dx.doi.org/10.5205/reuol.681-5727-1-le.0401201050.
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ABSTRACTObjective: to conduct a survey of the studies regarding the main postoperative complications in cardiac surgery and main nursing diagnoses identified. Methods: this is a descriptive study that to select the papers, the following databases were used: SCIELO, LILACS and MEDLINE. The descriptors were: postoperative, cardiac surgery, nursing diagnoses. The following inclusion criteria have been considered: papers published in Brazil from 1997 to 2007, papers on postoperative complications in cardiac surgery in adults, papers using the diagnoses standardized by NANDA. The selected papers were distributed into categories. Results: the following categories have been defined: category I – Complications in the postoperative in cardiac surgery; and category II – Nursing diagnoses in postoperative in cardiac surgery. The relation among the main postoperative complications has been made – physiology and/or semiology of the complication – nursing diagnoses – nursing interventions, which has been presented through synoptic. Later, a nursing intervention plan has been proposed. Conclusion: in despite of the complexity of the development of a nursing plan, it is highlighted the assistance rendered, the necessity of clinical studies regarding complications and the postoperative scenario, and the logical thinking focused on scientific information contributing for knowledge construction and nursing improvement. Descriptors: postoperative complications; cardiology; nursing diagnosis. RESUMOObjetivo: realizar um levantamento dos estudos referentes às principais complicações em pós-operatório de cirurgia cardíaca e principais diagnósticos de enfermagem identificados. Métodos: estudo descritivo que para a seleção dos artigos optou-se pelas seguintes bases de dados: SCIELO, LILACS e MEDLINE. Os descritores foram: pós-operatório, cirurgia cardíaca; diagnósticos de enfermagem. Consideraram-se os seguintes critérios de inclusão: artigos publicados no Brasil no período de 1997 a 2007; artigos sobre complicações do pós-operatório de cirurgia cardíaca; artigos sobre diagnósticos de enfermagem no pós-operatório de cirurgia cardíaca padronizados pela NANDA. Os artigos selecionados foram distribuídos em categorias. Resultados: foram definidas as seguintes categorias: categoria I - Complicações no pós-operatório em cirurgia cardíaca; e categoria II - Os diagnósticos de enfermagem no pós-operatório em cirurgia cardíaca. Fez-se a relação principais complicações pós-operatórias – fisiologia e/ou semiologia da complicação – diagnósticos de enfermagem – intervenções de enfermagem, a qual foi apresentada em quadros sinópticos. A seguir, propôs um plano de intervenções de enfermagem. Conclusão: Apesar da complexidade do desenvolvimento do plano de enfermagem, ressalta-se a qualidade da assistência prestada, a necessidade de estudos clínicos referentes às complicações e ao cenário pós-operatório e o raciocínio lógico centrado em informações científicas, contribuindo para a construção do conhecimento e engrandecimento da enfermagem. Descritores: complicações pós-operatórias; cardiologia; diagnóstico de enfermagem. RESUMENObjetivo: realizar un levantamiento de los estudios referentes a las principales complicaciones en el pos-operatorio de cirugía cardiaca y principales diagnósticos de enfermería identificados. Métodos: el estudio es descriptivo cuya selección de los artículos se hizo opción por las siguientes bases de datos: SCIELO, LILACS y MEDLINE. Los descriptores fueron: pos-operatorio, cirugía cardiaca, diagnósticos de enfermería. Se consideraron los siguientes criterios de inclusión: artículos publicados en Brasil en el periodo de 1997 a 2007, artículos sobre complicaciones del pos-operatorio de cirugía cardiaca, artículos que utilizan los diagnósticos de enfermería por patrones de NANDA. Los artículos seleccionados fueron distribuidos en categorías. Resultados: fueron definidas las siguientes categorías: categoría I – Complicaciones en el pos-operatorio en cirugía cardiaca; y categoría II – Los diagnósticos de enfermería en el pos-operatorio en cirugía cardiaca. Se hizo la relación de las principales complicaciones pos-operatorias – fisiología y/o semiología de la complicación – diagnósticos de enfermería – intervenciones de enfermería, la que fue presentada a través de cuadros sinópticos. A seguir, se propuso un plan de intervenciones de enfermería. Conclusión: a pesar de la complexidad del desarrollo de un plan de enfermería, se resalta la calidad de la asistencia prestada, la necesidad de estudios clínicos concernientes a las complicaciones y al escenario pos-operatorio y el raciocinio lógico centrado en informaciones científicas, pretendiéndose así la contribución para la construcción del conocimiento y enaltecimiento de la enfermería. Descriptores: complicaciones postoperatorias; cardiología; diagnóstico de enfermería.
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Achkasov, S. I., M. A. Sukhina, A. I. Moskalev, and E. N. Nabiev. "THE ROLE OF BIOLOGICAL MARKERS IN THE DIAGNOSIS OF POSTOPERATIVE INFECTIONS IN COLORECTAL CANCER SURGERY (review)." Koloproktologia 18, no. 3(69) (August 23, 2019): 105–18. http://dx.doi.org/10.33878/2073-7556-2019-18-3-105-118.
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Infectious complications in colorectal cancer surgery is one of the major problems in postoperative complications structure. The frequency of the latter is 5-22%, and in 5-20% of cases such complications lead to death. It should be noted that the development of postoperative complications leads to a decrease in the quality of life of patients, general and relapse-free survival of patients operated on for colorectal cancer. One of the promising ways to diagnose postoperative infectious complications after surgery is to assess the level of biological markers of plasma inflammation. It can be used to identify patients with a high probability of infection and be an indication for earlier additional methods of diagnosing complications. Currently, biomarkers that are used for early postoperative infection detection include increase in the leukocytes level in peripheral blood, CRP, PCT, CD64 neutrophils and others. Despite the large number of studies, the question of the role of these biomarkers in postoperative infections diagnosis in the patients who under went colorectal cancer surgery remains unclear.
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Staudt, Michael D., Kristopher D. Langdon, Robert R. Hammond, and Stephen P. Lownie. "Incisional Seeding of Metastatic Squamous Cell Carcinoma Following Carotid Endarterectomy: An Unusual Case of an Unknown Primary Cancer Presenting as a Presumed Neck Abscess." Operative Neurosurgery 17, no. 2 (November 10, 2018): 202–7. http://dx.doi.org/10.1093/ons/opy335.
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Abstract BACKGROUND Carotid endarterectomy (CEA) is a safe and effective procedure, with a low risk of complications when performed by experienced surgeons. Postoperative infections are particularly rare, reportedly affecting less than 1% of cases. Incisional metastases have not been described. OBJECTIVE To describe a previously unreported complication, the incisional seeding of metastatic squamous cell carcinoma (SCC) during neck dissection, which presented and was treated as a presumed postoperative neck abscess. METHODS Clinical records were reviewed regarding a 73-yr-old female who underwent routine CEA and presented 2 mo postoperatively with neck induration and erythema. Tissue submitted during the initial CEA was reexamined given the updated clinical history. RESULTS Postoperatively, a complex, multi-cystic fluid collection beneath the incision was identified and percutaneously drained. Although cultures were negative, an infection was favored and antibiotic therapy initiated. The patient's symptoms worsened prompting surgical exploration, and tissue sent for pathological examination was consistent with metastatic SCC. Retrospective analysis of a lymph node excised during the initial dissection also revealed tumor deposits, indicating that the surgical site had been seeded during exposure. A primary origin was not identified. CONCLUSION The time from initial presentation of postoperative complications to a final diagnosis of metastatic SCC was 2 mo, during which time the patient was treated as having a postoperative infection. Further investigations were consistent with diffuse and incurable metastatic disease. This report highlights the diagnostic challenges and potential avoidance strategies when dealing with rare complications following CEA.
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De Souza Francisco, Leticia Marissol, Maick Willen Fernandes Neves, Telmo Augusto Barba Belsuzari, Paulo Henrique Pires De Aguiar, and João Flavio De Araújo Mattos. "Post-Surgical Hormonal Complications in Pituitary Adenomas." JBNC - JORNAL BRASILEIRO DE NEUROCIRURGIA 27, no. 2 (March 16, 2018): 105–10. http://dx.doi.org/10.22290/jbnc.v27i2.753.
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Introduction: Pituitary adenomas are benign tumors that are classified into functioning and nonfunctioning adenomas. The diagnosis is based on the clinical picture and MRI. The first-choice treatment is usually surgery. Objective: We aimed to evaluate the hormonal complications in the postoperative period of pituitary adenomas resection. Methods: Using the databases PubMed, MedLine, and Scielo, the terms “pituitary adenoma” and “postoperative” were investigated and 11 publications were selected, written in English and Portuguese between 2007 and 2016 to evaluate hormonal complications in the postoperative period of pituitary adenomas resection. Results: Nonfunctioning tumors were more frequent and occurred along with hypopituitarism, mainly affecting the gonadotrophic axis. Among the functional adenomas, prolactinomas were more common. The rate of postoperative hypopituitarism varied from 1.29% to 21.2% and the diabetes insipidus rate was from 5.1% to 15.7%. Hypopituitarism or panhypopituitarism, adrenal insufficiency, growth hormone deficiency and diabetes insipidus occurred in the postoperative period. Conclusion: Nonfunctioning adenomas are more common and present hypopituitarism. Prolactinomas and somatotrophinomas are the most frequent tumors among functioning adenomas; hypopituitarism is a frequent complication due to the compression and destruction of the pituitary gland, which may be the result of the surgical manipulation itself. Diabetes insipidus is another common surgical complication.
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Parra-membrives, Pablo, Darío Martínez-baena, and Fabricio Sánchez-sánchez. "Late Biliary Complications after Pancreaticoduodenectomy." American Surgeon 82, no. 5 (May 2016): 456–61. http://dx.doi.org/10.1177/000313481608200522.
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Since morbidity of pancreaticoduodenectomy (PD) has been improved, concerns about late complications have raised. We present a review of long-term biliary complications after PD attended at our institution. The data of 86 patients operated on from January 2001 to May 2014 were examined and incidence of late biliary complications was recorded. The preoperative features of the patients, timing of symptoms appearance, results of diagnostic imaging test, and the management strategies were analyzed. Late biliary complications occurred in 14 patients (16.3%). The median time to diagnosis was 9.50 months. The preoperative peak bilirubin level, need for pre-operative drainage and intraoperative blood loss were not significantly different for patients with long-term biliary events. Eight patients (57.14%) developed true biliary strictures. Three of them (37.5%) had experienced a postoperative biliary leak ( P < 0.0005) and resulted in benign strictures. The remaining five patients revealed tumor recurrence. Six patients had no biliary obstruction and cholangitis could only be explained through afferent-limb stasis. Late biliary strictures appear predominantly in the first postoperative year and develop more likely if a bile leak occurred in the postoperative period. However, biliary strictures are not always responsible for late biliary symptoms and afferent limb stasis may also be included in the differential diagnosis.
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Erol, Timuçin. "Stoma Complications." Acta Medica 50, no. 2 (June 30, 2019): 47–52. http://dx.doi.org/10.32552/2019.actamedica.364.
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An improper stoma creation can cause many complications, varying from minor to life-threatening ones. Conversely, a good functioning stoma, at the ideal site improves patient’s quality of life. Most of the stoma complications occur in the early postoperative period and all clinicians must be familiar to these complications. All measures before and during operation must be taken to avoid these complications. Careful follow up after post operative period can help early diagnosis, proper treatment quick recovery of the patient. This review focus on common complications and treatment options of stoma creation.
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Mutter, Thomas C., Dan Chateau, Michael Moffatt, Clare Ramsey, Leslie L. Roos, and Meir Kryger. "A Matched Cohort Study of Postoperative Outcomes in Obstructive Sleep Apnea." Anesthesiology 121, no. 4 (October 1, 2014): 707–18. http://dx.doi.org/10.1097/aln.0000000000000407.
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Abstract Background: Obstructive sleep apnea (OSA) is associated with increased risk of postoperative complications. The authors investigated whether preoperative diagnosis and prescription of continuous positive airway pressure therapy reduces these risks. Methods: Matched cohort analysis of polysomnography data and Manitoban health administrative data (1987 to 2008). Postoperative outcomes in adult OSA patients up to 5 yr before (undiagnosed OSA, n = 1,571), and any time after (diagnosed OSA, n = 2,640) polysomnography and prescription of continuous positive airway pressure therapy for a new diagnosis of OSA, were compared with controls at low risk of having sleep apnea (n = 16,277). Controls were matched by exact procedure, indication, and approximate date of surgery. Procedures used to treat sleep apnea were excluded. Follow-up was at least 7 postoperative days. Results were reported as odds ratio (95% CI) for OSA or subgroup versus controls. Results: In multivariate analyses, the risk of respiratory complications (2.08 [1.35 to 3.19], P < 0.001) was similarly increased for both undiagnosed and diagnosed OSA. The risk of cardiovascular complications, primarily cardiac arrest and shock, was significantly different (P = 0.009) between undiagnosed OSA (2.20 [1.16 to 4.17], P = 0.02) and diagnosed OSA patients (0.75 [0.43 to 1.28], P = 0.29). For both outcomes, OSA severity, type of surgery, age, and other comorbidities were also important risk modifiers. Conclusions: Diagnosis of OSA and prescription of continuous positive airway pressure therapy were associated with a reduction in postoperative cardiovascular complications. Despite limitations in the data, these results could be used to justify and inform large efficacy trials of perioperative continuous positive airway pressure therapy in OSA patients.
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Dunjic, Radica, and Zoran Vukasinovic. "Laboratory diagnosis in orthopaedic surgery." Srpski arhiv za celokupno lekarstvo 137, no. 3-4 (2009): 199–204. http://dx.doi.org/10.2298/sarh0904199d.
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Orthopaedic procedures and anaesthesia are not physiological states. To prevent orthopaedic sequelae, laboratory diagnoses are of proven value in preoperative and postoperative complications as well as preoperative diseases. Laboratory analyses have an important contribution to early diagnosis of infection, haemostasis disorders, electrolyte disbalance, and acid-base disturbance. Laboratory analyses also have a role in monitoring the effect of therapy. Metabolic bone diseases such as osteoporosis affect many patients. Laboratory analyses are useful in evaluating the treatment for preventing fractures. This article discusses specific factors causing postoperative bleeding and thrombosis after orthopaedic surgery.
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Karpukhin, O. Yu, Yu S. Pankratova, M. I. Cherkashina, A. F. Shakurov, and M. I. Ziganshin. "COMPLICATED DIVERTICULITIS: MANAGEMENT, DIAGNOSIS, TREATMENT." Koloproktologia, no. 2 (June 30, 2018): 68–72. http://dx.doi.org/10.33878/2073-7556-2018-0-2-68-72.
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AIM. To analyze the results of treatment of patients with diverticular disease in Coloproctology Department. MATERIALS AND METHODS. During the periodfrom 2001 to 2017, 223 patients with diverticular colon disease were treated in the hospital. RESULTS. 191 (85,7%) were treated conservatively, 32 (14,3%) patients were operated on. One-stage procedure was performed in 21 (67,7%) patients, in 10 (32,3%) bowel resection has been completed by stoma. Postoperative complications developed in 25% of cases. Postoperative mortality was 3,1%. Operations reconstructive the length of the intestinal tube were performed in 24 previously operated patients. Colostomy reversal was combined with secondary resection in 9 (37,5%) patients CONCLUSION. Diverticular disease of the colon is a widespread condition with a wide spectrum of severe complications requiring surgical correction. In work with this pathology it is necessary to strictly observe uniform standards of diagnostics and treatment.
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Ibrahim M. Eladl, Rania M. Hassan, Mona M. Eladl, Asmaa A. Alshamy, and Hanan A. Bahaaeldin. "MDCT Evaluation of Post-Operative Cranium: Spectrum of Normal Findings & Complications." International Journal of Research in Pharmaceutical Sciences 11, no. 4 (September 30, 2020): 6008–16. http://dx.doi.org/10.26452/ijrps.v11i4.3265.
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Imaging plays an essential role in the evaluation of patients after cranial surgery. Postoperative infection and hemorrhage are common complications after cranial surgeries. Life-threatening complications (like tension and paradoxical herniation) must be identified rapidly at imaging to secure a favorable prognosis. This cross-sectional study included 250 patients who underwent neurosurgical operations and were imaged for the developed postoperative complications using Computed Tomography(CT), Magnetic Resonance Imaging(MRI) with and without contrast. We reviewed the common normal and abnormal findings in post-operative neurosurgical patients. The expected postoperative CT and MRI appearances of these procedures are discussed, followed by complications. These include hemorrhage, tension , wound/soft tissue infection, bone flap infection and abscesses. Complications specifically related to include herniation, external brain , paradoxical herniation, and syndrome. In our study165 male; 58 % and 85 female; 42 % were included; age range (6months-69 years), mean age 34.7 ± 2.9 years. 130 patients underwent , infection (23%) was the most dominant complication followed by cranial hemorrhage (19 %). So to conclude;radiologist must know how to recognize postoperative complications and differentiate them from expected normal findings because an early and accurate diagnosis is important for proper postoperative care. tomography is fast, cost effective, and easily accessible for first-line imaging. Magnetic resonance imaging has higher sensitivity for detecting postoperative infection and ischemia.
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Wildeboer, G. J., H. R. Geerts, B. L. De Groot, and E. D. Ponne. "62 Early Diagnosis of Postoperative Complications After Liver Transplants in Children." Pediatric Research 68 (November 2010): 34–35. http://dx.doi.org/10.1203/00006450-201011001-00062.
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Gorbachenko, Vladimir. "Digital Model for Diagnosis of Postoperative Complications in Medicine Using Bioinformatics." International Journal of Applied Research in Bioinformatics 9, no. 2 (July 2019): 1–23. http://dx.doi.org/10.4018/ijarb.2019070101.
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Digital models are needed in medicine using bioinformatics for diagnosis and prediction. Such models are especially needed in personalized medicine using bioinformatics. In this area, it is necessary to evaluate and predict the patient's condition from a priori knowledge obtained from other patients. Therefore, a new direction appeared - predictive medicine using bioinformatics. Predictive medicine, or “in silico medicine” is the use of computer modelling and intelligent technologies in the diagnosis, treatment and prevention of diseases. Using predictive medicine, the doctor can determine the likelihood of the development of certain diseases and choose the optimal treatment using bioinformatics. Predictive medicine begins to be applied in surgery. The prognosis in surgery consists in the preoperative evaluation of various surgical interventions and in the evaluation of possible outcomes of surgical interventions.
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Moncada, I., J. Ascensios, I. López, D. Subirá, and P. Krishnappa. "Intraoperative and postoperative complications of penile implant surgery. Diagnosis and treatment." Actas Urológicas Españolas (English Edition) 44, no. 5 (June 2020): 357–66. http://dx.doi.org/10.1016/j.acuroe.2020.01.009.
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Mamedov, L. A., Ch M. Dzhafarov, E. A. Kuliev, and L. M. Guseinov. "Methods for diagnosis and prevention of pyoinflammatory complications of postoperative wounds." Bulletin of Experimental Biology and Medicine 127, no. 4 (April 1999): 433–35. http://dx.doi.org/10.1007/bf02433402.
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Świrta, Jarosław, Michał Romaniszyn, and Marcin Barczyński. "THE IMPACT OF ELECTIVE CENTRAL LYMPH NODE DISSECTION ON POSTOPERATIVE PATHOLOGICAL STAGING AND SURGICAL COMPLICATION RATE IN PATIENTS WITH RESULTS OF FINE NEEDLE ASPIRATION BIOPSY SUSPICIOUS FOR FOLLICULAR NEOPLASM OF THYROID." Wiadomości Lekarskie 73, no. 4 (April 2020): 629–37. http://dx.doi.org/10.36740/wlek202004102.
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Introduction: Follicular-patterned lesions of the thyroid are common; these include follicular adenoma, follicular cancer and follicular variant of papillary cancer. At present, preoperative discrimination between follicular adenoma and follicular cancer is infeasible and most patients require surgery to confirm diagnosis. The aim: To assess the impact of elective central lymph node dissection on postoperative pathological staging and early surgical complication rate in patients operated for suspicion for follicular neoplasm or suspicion for oxyphilic neoplasm of thyroid. Materials and Methods: Eighty consecutive patients operated between 2016–2018 in Third Department of General Surgery UJCM because of suspicious for follicular neoplasm of the thyroid were included into the study. Inclusion criteria were: the result of fine needle aspiration biopsy “ suspicious for follicular/oxyphilic neoplasm”, absence of invasive neoplasm features as follows infiltration of surrounding tissue or lymph nodes/distant metastases, informed consent. In all patients elective central lymph node dissection was performed. Surgical early postoperative complications were reported and the rate was compared between the study group and the control group consisting of patients operated on in the same period for benign nodular goitre.Results: In 10 (12,5%) patients thyroid cancer was diagnosed, including 8 (80%) patients with papillary cancer and 2 (20%) patients with follicular cancer. The most common benign lesion was follicular adenoma diagnosed in 42 (60%) patients. There were 129 lymph nodes dissected (mean 1.6 lymph node per 1 patient), all lymph nodes were clear of cancer cells. In 26 patients there were no lymph nodes in postoperative preparation. Metastatic lymph nodes were not identified in any patients of the study group with final diagnosis of thyroid cancer. No significant differences were identified in prevalence of early postoperative complications among the study group and the control group patients: unilateral recurrent laryngeal nerve (RLN) palsy 3.4% vs. 1.49%; p= 0,08), hypocalcemia (5% vs. 5.4%; p=0.86), postoperative hemorrhage (1.25% vs. 0.44; p=0.29).Conclusions: Elective central lymph node dissection at experienced surgical hands does not improve postoperative pathological staging and is not associated with higher risk of early postoperative complications.
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Orlev, Alon, Christopher M. Jackson, Andrew Luksik, Tomas Garzon-Muvdi, Wuyang Yang, Wade Chien, Sagi Harnof, and Rafael J. Tamargo. "Natural History of Untreated Transverse/Sigmoid Sinus Thrombosis Following Posterior Fossa Surgery: Case Series and Literature Review." Operative Neurosurgery 19, no. 2 (December 19, 2019): 109–16. http://dx.doi.org/10.1093/ons/opz396.
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Abstract BACKGROUND Transverse or sigmoid sinus thrombosis occurs in 4% to 11% of patients following posterior fossa surgery. Anticoagulation has been the mainstay treatment, mostly based on extrapolation from the literature on spontaneous sinus thrombosis. OBJECTIVE To analyze the rate and associated complications of postoperative transverse/sigmoid sinus thrombosis for patients undergoing posterior fossa tumor resection. In this series, no antithrombotic therapy was initiated, and no postoperative treatment alterations were made following thrombosis diagnosis. METHODS Prospectively accrued cases from a single surgeon operating at a single academic center were retrospectively reviewed to determine the natural history of untreated transverse/sigmoid sinus thrombosis following posterior fossa surgery. Inclusion criteria were patients 18 yr or older undergoing resection of a posterior fossa tumor. A total of 538 patients were analyzed. RESULTS In all 26 out of 538 (4.8%) patients were diagnosed with transverse/sigmoid sinus thrombosis on routine postoperative imaging. Early postoperative complication rate was 38% in the sinus thrombosis group, as compared to 15% in the no-thrombosis group (P = .02). A significantly higher rate of pseudomeningocele, dysphagia requiring gastrostomy, and cerebellar stroke signs were noted in patients with postoperative sinus thrombosis. However, only 3 of the 26 patients (12%) with postoperative sinus occlusion suffered prolonged central nervous system complications. CONCLUSION Transverse/sigmoid sinus thrombosis following suboccipital craniectomy results in a higher rate of early complications; however, most of these complications resolve without anticoagulation. It may be reasonable, therefore, to manage these patients conservatively in order to avoid the risks associated with anticoagulation in the perioperative period.
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Schober, Patrick, K. Hakki Karagozoglu, Stephan A. Loer, and Lothar A. Schwarte. "Postoperative Airway Obstruction by a Bone Fragment." Case Reports in Anesthesiology 2017 (2017): 1–3. http://dx.doi.org/10.1155/2017/4381819.
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Postoperative airway obstructions are potentially life-threatening complications. These obstructions may be classified asfunctional(sagging tongue, laryngospasm, or bronchospasm),pathoanatomical(airway swelling or hematoma within the airways), orforeign body-related. Various cases of airway obstruction by foreign bodies have previously been reported, for example, by broken teeth or damaged airway instruments. Here we present the exceptional case of a postoperative airway obstruction due to a large fragment of the patient’s maxillary bone, left accidentally in situ after transoral surgical tumor resection. Concerning this type of airway obstruction, we discuss possible causes, diagnosis, and treatment options. Although it is an exceptional case after surgery, clinicians should be aware of this potentially life-threatening complication. In summary, this case demonstrates that the differential diagnosis of postoperative airway obstructions should include foreign bodies derived from surgery, including tissue and bone fragments.
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Harper, Katharine, Justin Iorio, and Easwaran Balasubramanian. "Profunda Femoris Pseudoaneurysm following Total Hip Arthroplasty Revision." Case Reports in Orthopedics 2015 (2015): 1–5. http://dx.doi.org/10.1155/2015/301949.
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Vascular injuries following total hip arthroplasty (THA) are very rare, with pseudoaneurysm being a small subset. We report a case of profunda femoris artery (PFA) pseudoaneurysm in a 61-year-old male following a posterior approach revision left THA. Presentation involved continued blood transfusion requirements several weeks postoperatively. Diagnosis of the pseduoaneurysm was made by contrast CT of the lower extremity, with confirmation via IR angiography. Successful embolization was achieved with selective coiling and Gelfoam. Presenting complaints of such complications are often vague and therefore lead to delayed diagnosis. Causes of such complications are not completely understood, particularly with PFA injuries in THA. Possible mechanisms are discussed in this paper. Vascular complications following THA can be difficult to diagnose. High suspicion in the setting of continued postoperative pain or bleeding may allow prompt diagnosis and avoidance of serious limb-threatening complications.
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Lee, Yi Lin, Siying Pang, and Caroline Ong. "Non-cirrhotic hyperammonaemia: are we missing the diagnosis?" BMJ Case Reports 13, no. 3 (March 2020): e233218. http://dx.doi.org/10.1136/bcr-2019-233218.
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Hepatic encephalopathy secondary to hyperammonaemia is a known complication of chronic liver disease. In contrast, non-cirrhotic hyperammonaemia is a lesser-known entity that should be considered in a patient with acute encephalopathy as part of the diagnostic workup as prompt identification can help to avoid complications such as seizures and cerebral oedema. We present a case of a middle-aged woman who presented electively for a total pancreatectomy–duodenectomy with splenectomy, hepatico-jejunostomy, gastro-jejunostomy and developed encephalopathy on postoperative day 10 due to non-cirrhotic hyperammonaemia.
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Bai, Johnny W., Mandeep Singh, Anthony Short, Didem Bozak, Frances Chung, Vincent W. S. Chan, Anuj Bhatia, and Anahi Perlas. "Intrathecal Morphine and Pulmonary Complications after Arthroplasty in Patients with Obstructive Sleep Apnea." Anesthesiology 132, no. 4 (April 1, 2020): 702–12. http://dx.doi.org/10.1097/aln.0000000000003110.
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Abstract Background Intrathecal morphine is commonly and effectively used for analgesia after joint arthroplasty, but has been associated with delayed respiratory depression. Patients with obstructive sleep apnea may be at higher risk of postoperative pulmonary complications. However, data is limited regarding the safety of intrathecal morphine in this population undergoing arthroplasty. Methods This retrospective cohort study aimed to determine the safety of intrathecal morphine in 1,326 patients with documented or suspected obstructive sleep apnea undergoing hip or knee arthroplasty. Chart review was performed to determine clinical characteristics, perioperative events, and postoperative outcomes. All patients received neuraxial anesthesia with low-dose (100 μg) intrathecal morphine (exposure) or without opioids (control). The primary outcome was any postoperative pulmonary complication including: (1) respiratory depression requiring naloxone; (2) pneumonia; (3) acute respiratory event requiring consultation with the critical care response team; (4) respiratory failure requiring intubation/mechanical ventilation; (5) unplanned admission to the intensive care unit for respiratory support; and (6) death from a respiratory cause. The authors hypothesized that intrathecal morphine would be associated with increased postoperative complications. Results In 1,326 patients, 1,042 (78.6%) received intrathecal morphine. The mean age of patients was 65 ± 9 yr and body mass index was 34.7 ± 7.0 kg/m2. Of 1,326 patients, 622 (46.9%) had suspected obstructive sleep apnea (Snoring, Tired, Observed, Pressure, Body Mass Index, Age, Neck size, Gender [STOP-Bang] score greater than 3), while 704 of 1,326 (53.1%) had documented polysomnographic diagnosis. Postoperatively, 20 of 1,322 (1.5%) patients experienced pulmonary complications, including 14 of 1,039 (1.3%) in the exposed and 6 of 283 (2.1%) in the control group (P = 0.345). Overall, there were 6 of 1 322 (0.5%) cases of respiratory depression, 18 of 1,322 (1.4%) respiratory events requiring critical care team consultation, and 4 of 1,322 (0.3%) unplanned intensive care unit admissions; these rates were similar between both groups. After adjustment for confounding, intrathecal morphine was not significantly associated with postoperative pulmonary complication (adjusted odds ratio, 0.60 [95% CI, 0.24 to 1.67]; P = 0.308). Conclusions Low-dose intrathecal morphine, in conjunction with multimodal analgesia, was not reliably associated with postoperative pulmonary complications in patients with obstructive sleep apnea undergoing joint arthroplasty. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New
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Hrdlicka, Courtney M., Jeffrey Wang, and Magdy Selim. "Neurological Complications of Cardiac Procedures." Seminars in Neurology 41, no. 04 (June 15, 2021): 398–410. http://dx.doi.org/10.1055/s-0041-1728761.
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AbstractNeurological complications after cardiac surgery and percutaneous cardiac interventions are not uncommon. These include periprocedural stroke, postoperative cognitive dysfunction after cardiac surgery, contrast-induced encephalopathy after percutaneous interventions, and seizures. In this article, we review the incidence, pathophysiology, diagnosis, and management of these complications. Improved understanding of these complications could lead to their prevention, faster detection, and facilitation of diagnostic workup and appropriate treatment.
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KITAGAWA, Y., H. ITO, T. SAWAIZUMI, M. MATSUBARA, M. YOKOYAMA, and Z. NAITO. "Fine Needle Aspiration Cytology for Soft Tissue Tumours of the Hand." Journal of Hand Surgery 28, no. 6 (December 2003): 582–85. http://dx.doi.org/10.1016/s0266-7681(03)00225-0.
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The purpose of this study was to evaluate the usefulness of fine needle aspiration cytology for the preoperative diagnosis of soft tissue tumours of the hand. Fine needle aspiration cytology was performed on 93 soft tissue tumours of the hand which were classified as malignant, benign or unclassified based on cytological findings. We also attempted to make specific diagnosis by cytology. The cytological diagnosis was then compared with the postoperative histopathological diagnosis. The cytological differentiation between benign and malignant tumours showed neither false-positive nor false-negative results. Of the 47 lesions with sufficient material for cytology and that were postoperatively diagnosed histologically, 35 (including one recurrent lesion) were correctly diagnosed by fine needle aspiration cytology. No complications were encountered. Fine needle aspiration cytology has a high degree of diagnostic accuracy and safety for soft tissue tumours of the hand.
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Backman, Torbjörn, Helén Sjövie, Malin Mellberg, Anna Börjesson, Magnus Anderberg, Carl-Magnus Kullendorff, and Einar Arnbjörnsson. "Pre- and Postoperative Vomiting in Children Undergoing Video-Assisted Gastrostomy Tube Placement." Surgery Research and Practice 2014 (2014): 1–5. http://dx.doi.org/10.1155/2014/871325.
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Background. The aim of this study was to determine the incidence of pre- and postoperative vomiting in children undergoing a Video-Assisted Gastrostomy (VAG) operation.Patients and Methods. 180 children underwent a VAG operation and were subdivided into groups based on their underlying diagnosis. An anamnesis with respect to vomiting was taken from each of the children’s parents before the operation. After the VAG operation, all patients were followed prospectively at one and six months after surgery. All complications including vomiting were documented according to a standardized protocol.Results. Vomiting occurred preoperatively in 51 children (28%). One month after surgery the incidence was 43 (24%) in the same group of children and six months after it was found in 40 (22%). There was a difference in vomiting frequency both pre- and postoperatively between the children in the groups with different diagnoses included in the study. No difference was noted in pre- and postoperative vomiting frequency within each specific diagnosis group.Conclusion. The preoperative vomiting symptoms persisted after the VAG operation. Neurologically impaired children had a higher incidence of vomiting than patients with other diagnoses, a well-known fact, probably due to their underlying diagnosis and not the VAG operation. This information is useful in preoperative counselling.