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 91 records · Page 5Linked to original sources
PubMed1982

Iatrogenic complications in surgery. Five years' experience in general and vascular surgery in a University Hospital.

Advances in medicine that have led to more sophisticated methods of diagnosing, treating and monitoring patients take an ever increasing toll in iatrogenic complications. It may be argued that the net effect is an improvement in care, but it is self-evident that minimizing iatrogenic complications will increase the benefit to the patients of the ever increasing complex methods of treatment. Iatrogenic complications tend to be sporadic and varied in nature, and are difficult to study as a group. Psychological and medicolegal problems add to this difficulty. However, if the incidence of iatrogenic complications is to be decreased, a concerted effort has to be made to study them. Them report deals with an effort.

Arteries↗
PubMed2000

Surgical wound morbidity in an austere surgical environment.

Surgical wound morbidity was analyzed for a U.S. military field hospital deployed to the Republic of Haiti in support of Operation New Horizons 1998. The purpose of the analysis was to determine if procedures performed in the field hospital had greater infectious risks as a result of the environment compared with historical reports for traditional hospital or clinic settings. Acceptable historical infection rates of 1.5% for clean surgical cases, 7.7% for clean contaminated cases, 15.2% for contaminated cases, and 40% for dirty cases have been noted. There were 827 operations performed during a 6-month period, with the majority of patients assigned American Society of Anesthesiologists Physical Status Classification class I or II. The distribution of these cases was: 72% clean cases, 5% clean contaminated cases, 4% contaminated cases, and 19% dirty cases. The overall wound complication rate was 3.6%, which included 5 wound infections, 11 wound hematomas, 8 superficial wound separations, and 6 seromas. The infectious morbidity for clean cases, the index for evaluation of infectious complications, was 0.8%, well within the accepted standards. There were two major complications that required a return to the operating room: a wound dehiscence with infection in an orchiectomy, and a postoperative hematoma with airway compromise in a subtotal thyroidectomy. There were no surgical mortalities. The infectious wound morbidity for operations performed in the field hospital environment was found to be equivalent to that described for the fixed hospital or clinic settings. No special precautions were necessary to ensure a low infection rate. The safety for patients undergoing elective surgical procedures has been established. Further training using these types of facilities should not be limited based on concerns for surgical wound morbidity.

Adolescent↗
PubMed2006

Duration of operation as a risk factor for surgical site infection: comparison of English and US data.

T times are used to categorize surgical procedures into long and short durations. They constitute a part of the US National Nosocomial Infection Surveillance (NNIS) risk index that is widely used internationally in surveillance for surgical site infections (SSIs). The objective of this study was to compare the US NNIS T times with data collected in England. The Surgical Site Infection Surveillance Service in England holds data collected by 168 hospitals in 13 categories of surgical procedures between 1997 and 2002. The 75(th) percentile and corresponding T time were calculated from English data and compared with US times. Differences in rates of SSI above and below the T times were compared. Graphical methods were used to assess the cut points that exhibited an association with risk of SSI. The results show that English and US T times were the same for all surgical categories except coronary artery bypass graft and vascular surgery, where the English T time was 4 h. The 75(th) percentile time for hip hemiarthroplasties was 40 min less than for total hip replacements (THR). Although the incidence of SSI in THR was significantly higher in operations lasting for longer than the T time (P<0.05), no association between risk of SSI and T times set at 1, 1.5 or 2 h was observed for hip hemiarthroplasties. In conclusion, operations lasting for longer than the T time were associated with a higher risk of SSI in most categories. In the hip prosthesis category, this association only applied to THR.

Humans↗
PubMed1981

Relation between surgical volume and incidence of postoperative wound infection.

We used a statewide program for the surveillance and reporting of infections acquired in the hospital to examine the relation between volume of surgery and the incidence of postoperative wound infection. Over a 29-month period 25,941 surgical procedures performed at 22 hospitals were studied. For all procedures studied, the mean number of operations performed was directly related to hospital size (number of beds). A highly significant inverse relation was found between the logarithm of the frequency of operation and the infection rate for appendectomy, herniorrhaphy, cholecystectomy, colon resection, and abdominal hysterectomy. (The relation was borderline [P = 0.055] for laminectomy and not significant for cesarean section.) Although these data clearly demonstrate higher morbidity in hospitals performing relatively little surgery, there are several possible explanations, and no conclusions for health policy can yet be drawn.

Data Collection↗
PubMed2002

[Surgical treatment of spinal myeloma, report of 19 cases].

OBJECTIVES: To discuss the indications for surgical procedures of spinal myeloma. METHODS: A retrospective analysis was made of the data of operation results of Nineteen patients with spinal myeloma, 13 males and 6 females, with the mean age of 45.1 (range 31 approximately 52). Pain was present in all patients. Nine patients had neurological deficit. According to Frankel classification 5 cases were Frankel B, 3 cases were Frenkel C, and 1 case was Frenkel D. Fourteen cases were diagnosed before operation, and 5 cases were diagnosed by pathology after operation. Surgical procedures performed included anterior approach in 11 cases, posterior approach in 7 cases and combined approach in 1 case. RESULTS: Decrease of pain was observed in all cases after surgery. Neurological improvement was observed in 8 out of the 9 cases. Complication (alteration of intestinal flora) occurred in one case. Follow-up lasted more than 1 year except in one case with a follow-up of only 6 months. Four cases were lost of follow-up. One case was still alive during the follow-up 8 years after operation. Other cases survived for 26.5 months on average (range 16 approximately 48 months). CONCLUSION: Surgery can ensure neurological improvement and spinal stability for patients with spinal myeloma, but should be associated with adjunctive medical treatment.

Adult↗
PubMed1990

[The effect of the duration of the surgical procedure on the appearance of surgical wound infection].

In order to search the influence of longitudiness of surgical intervention in the appearance of the surgical wound, there were analysed 90 operations. There were 32 operations of the "clean" group out of which 19 took longer than one hour and with the infection of 10,5% and 13 less than one hour, without infection. In the "potentially contaminated" wound there were 22 operations. Out of 22 operations, 12 took longer than one hour with the frequency of infections 50% and 10 operations took less than one hour with frequency of infections of 10%. In the "contaminated" group there were 36 operations out of which 25 took longer than one hour with the infection frequency of 72% and 11 operations that took no longer than one hour with the infection frequency of 27,7%. We come to conclusion that the frequency of wound infection grow in all groups of patients if the operations takes longer than one hour, and even more if the surgical intervention is done upon potentially contaminated or contaminated wound.

Humans↗
PubMed1997

Surgery of the pancreas.

The author deal with the surgery of diseases of the pancreas in this article. On the basis of the literature, timing of operation, surgical procedures in acute pancreatitis are discussed. In chronic pancreatitis, results of different decompression operations, resection of the pancreas and endoscopic biliary stenting are evaluated. Regarding the carcinoma of the pancreas, operative methods and factors of survival are the most important questions.

Acute Disease↗
PubMed1985

Cardiac operations in patients over 80 years of age.

Twenty-five patients between 80 and 89 years of age underwent a variety of cardiac surgical procedures. Operative mortality was 4%. Perioperative complications were frequent and resulted in an increased hospital stay postoperatively (mean 19.5 days). At a mean follow-up of 29.1 months, 21 patients (84%) are alive, with improvement in functional class from 3.4 to 2.0 (p less than 0.005). Cardiac operations can be performed in patients over 80 years of age with low mortality and significant symptomatic benefit. A high incidence of complications necessitates careful monitoring but should not represent a contraindication to the surgical management of advanced heart disease in this group.

Aged↗
PubMedDate not supplied

Total extraperitoneal preperitoneal laparoscopic hernia repair using spinal anesthesia.

BACKGROUND: Laparoscopic herniorrhaphy is a well-debated approach to inguinal hernia repair. Multiple technical and outcome variables have been compared with those of traditional open inguinal hernia repairs. One of these variables is the choice of anesthesia. To date, no reports describe the use of spinal anesthesia for laparoscopic hernia repairs. We present herein a review of our experience with spinal anesthesia for the total extraperitoneal preperitoneal laparoscopic hernia repair (TEP). METHODS: We prospectively reviewed 30 patients undergoing TEP while under spinal anesthesia. Methods of anesthesia, surgical procedure, operative and anesthesia delivery times, as well as outcomes were reviewed. Patients were followed up over a 2-year period. Short- and long-term results of the surgical procedure and anesthesia delivered were noted. RESULTS: All patients underwent successful laparoscopic hernia repair while under spinal anesthesia without conversion to general anesthesia. Forty-four hernias were repaired in 30 patients. Short- and long-term follow-up (2 years) revealed no significant untoward affects from the spinal anesthesia in this series of patients. Aside from inguinodynia in 3 patients in the short-term, no other short-term or long-term untoward sequelae occurred. CONCLUSIONS: Spinal anesthesia is a feasible, and in our experience, the preferable method of anesthesia for total extraperitoneal laparoscopic hernia repair.

Anesthesia, Spinal↗
PubMed1980

Colon interposition versus esophagogastrostomy for esophageal carcinoma.

Thirty-eight patients underwent either a colon interposition (18 patients) or an esophagogastrostomy (20 patients) for cancer of the distal two-thirds of the esophagus. Both procedures had essentially the same 30-day mortality (22% versus 20%), a similar major complication rate (78% versus 75%), and recurrent dysphagia rate (17% versus 15%). The lowest complication rate was seen in the colon interposition for cure (33%), as compared to esophagogastrostomy for cure (70%). The longest average survival time (14.6 months) was seen after a colon interposition for cure, with 33 per cent of patients alive at two years, compared to 12.4 months average survival and 30 per cent alive at two year seen in the esophagogastrostomy for cure group. There were no five-year survivals. Preoperative radiation appeared to have a beneficial effect regardless of tumor cell type or operative procedure. Surgical management of esophageal cancer appears to be palliative in most instances, regardless of operation performed.

Adenocarcinoma↗
PubMed1980

Management of glioma of the optic nerve and/or chiasm: an analysis of 20 cases.

The records of 20 patients with biopsy-proven glioma of the optic nerve and chiasm are reviewed. Symptoms and physical findings on admission are reported. Patients were classified, according to the operative findings, into disease limited to the optic nerve and a more extensive disease group. Surgical procedures, operative complications, irradiation technique, and outcome are analyzed. Patients with disease limited to the optic nerve may be adequately managed by resection alone. In the more extensive lesions, high morbidity is associated with resection; therefore, biopsy and irradiation offer the best alternatives for this group of patients.

Adolescent↗
PubMed2004

Home study program. Can we build a safer OR?

PEOPLE WHO WORK in health care are among the brightest and most dedicated workers in the United States, but they are human, and humans make mistakes. HEALTH CARE FACILITIES are moving away from a culture of perfection and exploring how human factors predispose people to make certain types of errors. THIS ARTICLE discusses the types of errors being made and the organizations that are working to redesign the health care system to make it easier to do the job more safely and more difficult to make a mistake.

Fires↗
PubMed1999

Morbidity of major hepatic resections: a 100-case prospective study.

OBJECTIVE: To assess the morbidity and its main risk factors after major hepatic resection. DESIGN: Retrospective study of prospectively collected data. SETTING: University hospital, France. SUBJECTS: 100 consecutive patients who underwent major hepatic resections, 1989-95. INTERVENTIONS: Major hepatic resection, defined as resection involving 3 or more segments according to Couinaud's classification, in all cases. MAIN OUTCOME MEASURES: All complications that affected outcome or prolonged hospital stay. Risk factors identified by univariate and multivariate analysis. RESULTS: 45 patients developed at least 1 complication and 7 died. The most common complications were: pleural effusion (n = 21), hepatic failure (n = 12), and ascites (n = 9). Univariate analysis showed that the following variables were significantly related to the morbidity: age >55 years, American Society of Anesthesiologists (ASA) grade II or more, bilirubin >80 micromol/L, alkaline phosphatase activity more than double the reference range, malignant tumours, abnormal liver parenchyma, simultaneous surgical procedures, operative time >4 hours, and perioperative blood transfusion > or =600 ml. The extent of resection did not correlate with postoperative complications. Multivariate analysis showed that volume of blood transfusion > or =600 ml and simultaneous surgical procedures were the most important independent risk factors for complicated outcome. CONCLUSIONS: The morbidity associated with major hepatic resections remains high, and the main determinants of outcome are intraoperative surgeon-related factors.

Adult↗