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At least 55 records · Page 3Linked to original sources
PubMed2003

Plastic iodophor drape during liver surgery operative use of the iodophor-impregnated adhesive drape to prevent wound infection during high risk surgery.

We retrospectively investigated factors associated with wound infection after liver resection for hepatocellular carcinoma (HCC), with special reference to use of a plastic adhesive drape impregnated with iodophor. The subjects were 296 patients undergoing liver resection for HCC. Wound infection was defined as purulent drainage from the superficial incision with or without laboratory confirmation. One or more of the following signs was required: pain or tenderness, localized swelling, or redness or heat. Wound infection developed in 25 patients. Regression analysis indicated that low body mass index (BMI), smoking, long preoperative hospital stay, and nonuse of iodophor drapes were risk factors for wound infection. Wound infection was significantly less likely with the use of iodophor drapes (3.1%) than for surgery without iodophor drapes (12.1%). By multivariate regression analysis, BMI, smoking, and lack of drape use were independent risk factors. Most of the bacteria isolated were skin bacteria, including Staphylococcus aureus and Staphylococcus epidermidis. In conclusion, low BMI, smoking, a long preoperative hospital stay, and the lack of iodophor drape use were risk factors for wound infection after liver resection for HCC. The drapes presumably prevented contamination from the skin during the operation.

Adult↗
PubMed1990

[Operative surgery of the kidneys and ureters using a retroperitoneoscope].

Operative interventions on the kidneys and ureters were performed in 85 patients. In revision of the upper pole of a kidney and its median segment, the authors have used the original technique of retroperitoneoscopy (paranephroscopy) in the 11-th intercostal space. The techniques of decapsulation of a kidney, pyelo-, nephrostomy by means of the retroperitoneoscope, operative approaches to the different parts of the ureter, technique for removal of its stones are presented.

Adult↗
PubMed2001

[Day-surgery operative hysteroscopy with loco-regional anesthesia].

BACKGROUND: Nowadays hysteroscopic surgery offers the opportunity of treating in Day Hospital even patients who cannot undergo a traditional surgery because of high anesthesiological risk. The aim of this study is to prove that minimal invasive hysteroscopic procedures in loco-regional anesthesia can replace laparotomic gynecological surgery in many intrauterine lesions with the same effectiveness on pain and outcome. METHODS: From September 1999 to December 2000 at the Obstetric and Gynecological Department in Asti 200 hysteroscopic procedures have been performed. The patients (all i.v. line inserted, ECG and pulsometer monitored, and sublingual BDZ sedated) were divided into two groups: a group of 50 patients who underwent operation on paracervical block alone, and the other one of 150 women on paracervical block plus periorificial infiltration of local anesthetic. RESULTS: Only one woman in the first group paracervical block was totally insufficient and she needed a general anesthesia. In the same group, 44% of paracervical blocks required an additional conscious sedation with Propofol and Fentanyl. In the second group only 16 % of cases required an additional sedation. In all cases outcome was very good with complete recovery of the patients dismissed the same afternoon. CONCLUSIONS: In our experience operative hysteroscopies under loco-regional anesthesia with paracervical block and periorificial infiltration is a very satisfactory alternative to general anesthesia. Moreover the type of intrauterine lesion did not influence the tolerability of the operation.

Adult↗
PubMed2001

[Long-term complaints after minimal invasive thoracic surgery operations and thoracotomy].

BACKGROUND: Minimally invasive techniques are now frequently used in general thoracic surgery. More than 30% of all minimally invasive procedures are operations in patients with spontaneous pneumothorax. Recently, it has been shown that the video-assisted approach compared to the standard anterolateral thoracotomy results in a significant reduction of the early postoperative pain. However, little is known about the influence of video-assisted surgery on long-term complaints. METHODS: We analyzed the frequency and characteristics of chronic complaints in 60 patients after video-assisted operations for spontaneous pneumothorax using a standardized questionnaire. For comparison, 27 patients after anterolateral thoracotomy for benign diseases were interviewed 24 months postoperatively using the same questionnaire. RESULTS: After minimally invasive surgery and a median observation time of 59 months, 19 (31.7%) out of 60 patients suffered from chronic complaints. Two of them (3.3%) required daily oral pain medication. On a visual analog pain scale (ranging from 0 to 100), 17 patients described a pain intensity of < 20 and 2 (3.3%) patients > 50. After thoracotomy 14 (51.8%) out of 27 patients suffered from chronic complaints, 5 (18.5%) of them with regular use of oral pain medications. The mean pain intensity (analog scale) was 3.6 points after minimally invasive operations and 14.4 points after thoracotomy (P = 0.01). CONCLUSIONS: In conclusion, even after minimally invasive thoracic operations some patients suffer from chronic complaints. However, they are less frequent and of lower intensity than after thoracotomy.

Adolescent↗
PubMed2001

Retrograde cerebral perfusion with hypothermic circulatory arrest in aortic arch surgery: operative and long-term results.

METHODS: Clinical data were retrospectively collected for 207 consecutive patients who underwent aortic arch surgery using continuous retrograde cerebral perfusion (CRCP) and hypothermic circulatory arrest (HCA) at Tenri Hospital (138 patients) from 1988 to 1999, and at Nagoya University Hospital (69 patients) from 1990 to 2000. One hundred and 3 patients (50%) were operated upon for aortic dissection, and 104 patients (50%) for atherosclerotic aneurysm. RESULTS: Hospital mortality was 12% (25 patients). HCA times were 44+/-20 minutes. Cardiopulmonary bypass time longer than 6 hours, low cardiac output syndrome, respiratory failure, and central nervous system (CNS) dysfunction contributed to hospital deaths. Late mortality was 16% (34 patients). The predictors of late deaths were age (>70 years), total arch replacement, HCA time >60 min., non-dissecting aneurysm, and postoperative CNS injury. CONCLUSIONS: Operative results of aortic arch surgery using CRCP was generally satisfactory. However, the long-term results of total arch replacement for patients older than 70 years, non-dissecting aneurysm (particularly ruptured), and postoperative CNS injury were poor. Although prolonged duration of HCA may contribute to these poor results, other factors such as emergent surgery, late death due to aging, and systemic atherosclerosis are also considered to be risk factors.

Adult↗
PubMed2003

A hierarchical multiple criteria mathematical programming approach for scheduling general surgery operations in large hospitals.

Limited staff and equipment within surgical services require efficient use of these resources among multiple surgeon groups. In this study, a set of hierarchical multiple criteria mathematical programming models are developed to generate weekly operating room schedules. The goals considered in these models are maximum utilization of operating room capacity, balanced distribution of operations among surgeon groups in terms of operation days, lengths of operation times, and minimization of patient waiting times. Because of computational difficulty of this scheduling problem, the overall problem is broken down into manageable hierarchical stages: (1) selection of patients, (2) assignment of operations to surgeon groups, and (3) determination of operation dates and operating rooms. Developed models are tested on the data collected in College of Medicine Research Hospital at Cukurova University as well as on simulated data sets using MPL optimization package.

Analysis of Variance↗