PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Surgical Procedures, Operative”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 199 records · Page 11Linked to original sources
PubMed2002

Is surgery getting safer? National trends in operative mortality.

BACKGROUND: Although mortality rates for some cardiovascular procedures seem to have declined, it is unclear whether other high-risk procedures are becoming safer over time. STUDY DESIGN: We examined national trends between 1994 and 1999 in operative mortality for 14 high-risk cardiovascular and cancer procedures in the national population of Medicare beneficiaries over age 65. Secular trends were examined using logistic regression adjusting for age, gender, race, socioeconomic status, admission acuity, comorbidities, and hospital volume. RESULTS: Observed mortality rates varied widely across the 14 procedures, from 2% (carotid endarterectomy) to 16% (esophagectomy). Over the 6-year study period, average patient age increased for all procedures, and patients were more likely to undergo operation at high-volume hospitals for some procedures (pancreatic resection, esophagectomy, cystectomy, and pneumonectomy). After accounting for these changes, operative mortality declined significantly for three cardiovascular procedures, as evidenced by adjusted odds ratios (OR) for the 6-year effect on operative mortality (coronary artery bypass graft OR = 0.85, 95% confidence interval [CI] 0.81 to 0.88; carotid endarterectomy OR = 0.86,95% CI 0.80 to 0.93; mitral valve replacement OR = 0.89, 95% CI 0.81 to 0.97). In contrast, operative mortality did not decline for any of the cancer procedures. In fact, adjusted mortality increased for colectomy for colon cancer (OR= 1.13, 95% CI 1.07 to 1.19). CONCLUSIONS: Although risks of some cardiovascular procedures are declining over time, there is no evidence that other types of high-risk surgery are becoming safer. These findings suggest the need for systematic efforts to monitor and improve surgical performance.

Aged↗
PubMed2003

A prospective study of surgical site infections in a pediatric hospital in Mexico City.

BACKGROUND: Pediatric surgical site infection (SSI) rates in the United States range from 2.5% to 4.4%. There is little data regarding their risk factors among children. We quantified SSI rates and identified risk factors of SSI in a tertiary care pediatric teaching hospital in Mexico City. METHODS: All neurosurgical, cardiovascular, and general surgical patients who underwent operation between Aug 1, 1998, and Jan 31, 1999, were followed-up daily during hospitalization. On postoperative day 30, a full review of microbiology reports and medical records was performed. Univariate and multivariate analyses were done to identify risk factors. RESULTS: Four hundred twenty-eight of 530 children completed follow-up. The overall SSI rate was 18.7%. Forty percent of SSI were superficial incisional, 21% were deep incisional, and 39% were organ/space infections. For clean, clean-contaminated, contaminated, and dirty procedures, SSI infection rates were 12.4%, 24.4%, 14.3%, and 32.4%, respectively. Open drains (OR = 2.3; 95% CI = 1.3-4.2; P <.005) and surgery that lasted 90 or more minutes (OR = 2.9; 95% CI = 1.6-5.1; P <.001) were associated with infection. CONCLUSIONS: Our rates are greater than comparable reported data among children. Duration of surgery and use of open drains were associated with SSI.

Child, Preschool↗
PubMed1975

Operative morbidity and mortality in renovascular disease.

There were 104 major complications (13.1%) and 34 deaths (5.9%) among 502 patients with evidence of renovascular disease who underwent 577 operative procedures. The operative mortality rate in patients with atherosclerotic renovascular disease was 9.3% vs 3.4% with fibromuscular hyperplasia. Important determinants of renovascular operative mortality are (1) cause of disease, (2) presence of coronary artery disease, (3) presence of bilateral renal functional impairment, (4) the complexity of the renal operative procedure, and (5) concurrent extrarenal surgery.

Adult↗
PubMed1991

Minimal access surgery and the future of interventional laparoscopy.

Minimal access surgery is intended to minimize the trauma of access without compromising exposure of the operative field. Its major benefits include diminished cost of therapy due to a reduced hospital stay and accelerated recovery with early return to full activity. The approaches used in minimal access surgery are laparoscopic, endoluminal, perivisceral, intra-articular, and combined. Many abdominal and thoracic procedures are being adapted to the minimal access approach. Developmental requirements include improvements in light delivery systems; three-dimensional television imaging; better surgical instrumentation; ultrasound probes for internal and external scanning; stapling devices; and tunable, portable solid-state diode lasers. In addition, however, adequate prospective evaluation of laparoscopic procedures, established or new, must be undertaken in the major academic institutions.

Evaluation Studies as Topic↗
PubMed1995

[Surgical treatment of interrupted aortic arch with aorticopulmonary window].

From January, 1988, through September, 1993, 3 neonates underwent one-stage repair for interrupted aortic arch (IAA) with aorticopulmonary window (APW). Their mean weight was 3.0 kg (2.7-3.3 kg). IAA was Celloria-Patton classification type B in two patients and type A in the other. In all cases, APW was Mori's classification type II. Two patients took a sudden turn for worse during the stay of our hospital and underwent emergency operation. Surgical procedures were as follows; In the first patient, aortic arch reconstruction was performed with phi 8 mm Golaski graft, under extracorporeal circulation for only upper body under moderate hypothermia. After distal anastomosis, perfusion for lower body was restarted through the graft branch, then proximal anastomosis was done. In the other two patients, arch reconstruction was performed by end to side direct anastomosis under total circulatory arrest and deep hypothermia, and APW was divided during recirculation, rewarming period. In the first patient, graft was anastomosed to the defect of the ascending aorta. In the other two patients the defect of the aorta was directly closed. The defect of the pulmonary artery was closed directly in two patients and with autopericardium in the other. There was no operative deaths. Two cases who underwent emergency operation due to sudden turn for worse didn't become well soon. Thus, we concluded that surgical intervention should be done as soon as possible before patient became critically ill and one-stage repair should be recommended because of the difficulty of palliation such as PA banding in this disease.

Anastomosis, Surgical↗
PubMed2000

The legendary superior strength of the Pfannenstiel incision: a myth?

OBJECTIVE: This study was undertaken to determine whether there is a difference in the frequency of fascial dehiscence between midline vertical lower abdominal and Pfannenstiel incisions among women undergoing obstetric and gynecologic operations. STUDY DESIGN: A case-control study of 48 cases of fascial dehiscence complicating 17, 995 major operations (8950 cesarean deliveries and 9405 gynecologic procedures) during a 6-year period at Wayne State University Hutzel Hospital, Detroit, was performed. Univariate analysis identified significant independent variables related to fascial dehiscence. Stepwise logistic regression analysis then identified those risk factors that were independently associated with fascial dehiscence. RESULTS: Among the 48 patients who underwent repair of fascial dehiscence after a major obstetric or gynecologic operation, 27 were from the obstetric service and 21 were from the benign and cancer gynecologic services. Wound dehiscence occurred in 10 vertical incisions and 17 Pfannenstiel incisions among the obstetric patients and in 12 vertical and 9 Pfannenstiel incisions among the gynecologic patients. The risk for dehiscence with vertical lower abdominal incisions was not increased with respect to that associated with Pfannenstiel incisions (P =.39, 2-tailed). This finding was true for all patients (odds ratio, 1.3; 95% confidence interval, 0.7-2.6), obstetric patients (odds ratio, 1.3; 95% confidence interval, 0.5-3.4), and gynecologic patients (odds ratio, 1.5; 95% confidence interval, 0.5-4.0). Forty-seven of the 48 case patients had documented wound infections, compared with 1 of the 144 control subjects (P <.0001, odds ratio, 37.8; 95% confidence interval, 14.8-96.8). CONCLUSION: Wound infection was the most important risk factor for fascial dehiscence among women who underwent major obstetric and gynecologic operations. Our results do not support the long-held belief that Pfannenstiel incisions are stronger than lower abdominal vertical incisions and reduce the risk for fascial dehiscence.

Abdomen↗
PubMed1980

Effectiveness of the closed method utilizing iodophors in the degermination of hands and arms of the surgical team and operative sites.

A closed method utilizing the E-Z Prep Tray and the E-Z Scrub with iodophors is an effective means of degerming the hands and arms of surgical team members and the patients' operative sites. Fifty unselected surgical cases were evaluated bacteriologically, pre-preparation, post-preparation, and post-operatively. The data indicated that bacterial colony counts decreased, and the postoperative wound infection rate decreased to two percent.

Adolescent↗
PubMed1996

[New antiseptics and disinfectants in surgery (2)].

Various forms of plivasept, an agent produced by Pliva (Croatia), were studied in the laboratory and clinic and found to be highly effective. For the prevention of intrahospital infections the use of 0.02% and 0.05% water solutions of plivasept without PAV is advisable as an antiseptec for inyracavitary administration, 0.05% water solution of plivasept for disinfection of surfaces and equipment, 0.5% alcohol plivasept solution for disinfection of instruments, a plivasept tincture for surgical treatment of the skin on the hands and the injection and operative fields, and foam-forming plivasept for hygienic treatment of the hands.

Anti-Infective Agents, Local↗