Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “POSTOPERATIVE COMPLICATIONS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the 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
PubMed2006

Predictors of in-hospital postoperative complications among adults undergoing bariatric procedures in New York state, 2003.

BACKGROUND: Our aim was to determine the relationship between patient level characteristics and in-hospital postoperative complications among obese adults who underwent a bariatric procedure in New York state in 2003. Understanding patient level factors that predict or are associated with adverse outcomes among bariatric surgery patients can help to identify patients who need to be monitored particularly carefully. METHODS: Using New York's inpatient discharge database, we identified adults who underwent a bariatric operation between January 1, 2003 and December 31, 2003 (n=7,868). Following preliminary descriptive analyses, a stepwise logistic regression model was constructed to identify significant patient level predictors of postoperative complications. Patient level risk factors included age, gender, race/ethnicity, and 24 co-morbid conditions. RESULTS: 6.8% of adults undergoing a bariatric procedure in New York in 2003 experienced one or more of the postoperative complications included in the study. Respiratory complications were the most common type of complication, with >2% of patients experiencing pneumonia, collapsed lung, and/or respiratory complications secondary to the operation. Multivariate analyses by stepwise logistic regression identified age > or =50 years, male gender, Hispanic ethnicity, congestive heart failure, cardiac arrhythmia, other neurological disorders, and peptic ulcer as predictors of complications. CONCLUSIONS: Certain subpopulations of persons undergoing bariatric procedures may be at increased risk for adverse events and will need to be monitored carefully.

Adult↗
PubMed1999

Enterocutaneous fistula as a postoperative complication of laparoscopic inguinal hernia repair.

Trocar injuries to the small bowel during laparoscopic hernia repair are a rare complication, the most common complications being postoperative neuralgias, scrotal swelling, scrotal ecchymosis, and hematoma. A 15-year-old boy was admitted 5 days status-post transabdominal laparoscopic inguinal hernia repair of a symptomatic right pantaloon hernia, with signs and symptoms of a retrocecal abscess. Despite laparotic intervention and appendectomy, the next 2 years passed with almost daily, purulent, right lower quadrant wound drainage, in an otherwise asymptomatic patient. Superficial wound exploration and sinogram in 1996 revealed a sinus tract in direct communication with the small bowel. Elective laparotomy in December 1997 involved a successful resection of a 2.5-cm fistula with involved mesh, and the communicating small bowel through a midline incision, followed by a primary closure of the small-bowel opening. The patient has recovered without complications.

Adolescent↗
PubMed2002

Surgery: not just for hospitals anymore. Part 2: EMS response to postoperative complications.

Patients who have undergone a surgical procedure at an ambulatory surgery center, hospital or physician's office may experience postoperative complications. This article examines the types of postoperative complications that can occur following outpatient procedures, with recommendations for EMS patient care and issues related to patient transport.

Ambulatory Surgical Procedures↗
PubMed1999

A comparative analysis of the postoperative complications of thyroid cancer surgery related to surgical approach.

A retrospective study of the postoperative complications in 129 patients treated for thyroid cancer in the clinics of surgery of the Higher Medical Institute for a period of 9 years (1988-1996) was performed. The majority of the patients (90) were treated by total thyroidectomy. Subtotal thyroidectomy was performed in 21 and thyroid lobectomy in 15 patients. Postoperative complications occurred in 56 of the operated patients. Of these 5 had permanent and 51 transient complications. Most of the complications (80.35 +/- 3.56%) ensued from total thyroidectomy. The variety of the complications included permanent hypoparathyroidism in 3 patients, transient hypocalcemia in 37 patients, injury of the recurrent laryngeal nerves in 11 patients, esophageal damage in 1 patient, hematoma within the operation field in 1 patient and suppuration of the operative wound in 1 patient. Four of the patients with injury of the recurrent laryngeal nerve suffered from obstruction of the airways which required temporary tracheostoma to be performed. No lethal postoperative outcome was observed. The data of the study are discussed in relation with the literature data.

Humans↗
PubMed2002

[Effect of extending the resection on postoperative complications of total gastrectomies: experience with 161 operations].

Authors operated on 416 patients for gastric cancer between 1st of June 1991 and 31st of May 2001. Among them 305 lesions were resectable. So the resection rate was 73.3 per cent. Gastrectomy was performed in 161 patients (52.8 per cent of resections). Total gastrectomy with omentectomy was performed in 44 patients. In 96 patients splenectomy, in 19 patients splenectomy with the resection of the left side of the pancreas, in 33 patients distal esophageal resection and in 8 patients other organ resection was performed with total gastrectomy. Standard, two field lymphadenectomy has been performed only in the past few years. Uneventful recovery followed in 100 cases (62 per cent), 61 patients (38 per cent) suffered complications in the postoperative period. The most frequent surgical complication was anastomotic leak, which was observed in 8 patients (5 per cent). Septic complications, intraluminal bleeding, postoperative pancreatitis, intraabdominal bleeding, pancreatic fistula and small bowel obstruction were the most frequent surgical complications. Most general complications occurred in the cardiorespiratory system. In 9 patients reoperation was necessary. Eight patients (5 per cent) died in the postoperative period. In patients with extended gastrectomy significantly more complications occurred--compared with gastrectomy + omentectomy only. This could also be observed in patients with only splenectomy. If more organs were removed or resected with total gastrectomy and splenectomy, the complication rate increased only if pancreatic resection was performed. Mortality rate increased in these patients as well. The esophageal or other neighbouring organ (colon, small-bowel, liver, diaphragm etc.) resection had no influence on the postoperative morbidity or mortality. Extended operations should be performed, as the risk is acceptable, if there is hope for tumour clearance.

Female↗
PubMed1996

[Quality assurance in surgery--more than documentation of postoperative complications].

This review discusses several aspects of surgical quality assurance: 1. The surgical audit to collect data and analyze postoperative complications. 2. Quality assurance by measurement of patients' postoperative long-term outcome. 3. The elaboration of therapeutical guidelines. 4. Measurement of costs and benefit of the surgical intervention including patients' postoperative quality of life. 5. Quality assurance of clinical trials and medical publications. It is demonstrated that the regular documentation of postoperative complications and an internal data analysis improve the results, dependent on the quality of the data which is best guaranteed by a neutral observer. The late results after operation are mainly influenced by the quality of the surgeon, as prove recurrence rates after hernia repair ranging between 0 and 10% using identical operation techniques, or locoregional recurrences of 30-60% after abdominal perineal resection of the rectum. The elaboration of therapeutical guidelines may be helpful for the evaluation of the benefit of the intervention and for the prevention of unnecessary operations as has been demonstrated for the treatment of symptomatic and asymptomatic carotid artery stenoses. Qualified clinical studies performed according to the GCP rules with biometrical planning, clear cut definition of the purpose of the study and listing of inclusion and exclusion criteria are the prerequisites of substantiated therapeutical guidelines. Under increasing economic pressure not only the benefit, but also the costs of treatment are of major importance, the evaluation of the cost effectiveness ratio by measuring the cost per quality adjusted year of life saved will become essential for future therapeutical recommendations.

Cost-Benefit Analysis↗
PubMed1999

[Pre- and postoperative complications of elderly patients with femoral neck fractures--a report of 525 cases].

Pre- and postoperative complications of 525 cases of femoral neck fractures in elderly patients were studied. The mean age was 81.5 years. Preoperative complications were found in 94.5% of the patients. Circulatory and respiratory complications were 68.4% and 29.7%, respectively. Dementia was present in 55.6% of the patients. Operations for fractures were performed under spinal anesthesia only or under both spinal and epidural anesthesia. We tried to avoid hypotension and hypoxia during operations and postoperative periods under pulse oximeteric monitoring. In the postoperative period, circulatory and respiratory diseases exacerbated or newly developed in 4.4% and 5.7% of all cases, respectively. Postoperative mortality within a month was 1.0%, and it was 3.6% within a year. Many elderly patients with femoral neck fractures had preoperative complications, but postoperative complications could be avoided by careful management during pre- and postoperative periods.

Aged↗
PubMed2000

Effect of sepsis and cardiac surgery with cardiopulmonary bypass on plasma level of nitric oxide metabolites, neopterin, and procalcitonin: correlation with mortality and postoperative complications.

OBJECTIVES: To examine the hypothesis that nitrite/nitrate, neopterin, and procalcitonin (PCT) levels can be useful predictors of sepsis-associated mortality and predictors of the postoperative complications after cardiopulmonary bypass (CPB). DESIGN: Prospective clinical study. SETTING: Intensive care unit of the Medical University Hospital. PATIENTS: 41 patients with sepsis, 42 patients subjected to open heart surgery with CPB, and 30 healthy volunteers. MEASUREMENTS AND RESULTS: Nitrite/nitrate, neopterin, and PCT levels were measured in septic patients as soon as sepsis was recognized and then on the 2nd, 3rd, and 5th days of treatment. Statistically significant differences between survivors and nonsurvivors were found for neopterin and PCT. The area under receiver operating characteristic curve (AUC) for both parameters as predictors of mortality was above 0.8. The nitrite/nitrate level was also higher in nonsurvivors, but the AUC remained below 0.8, which indicates poor predictive power. The same parameters were measured in patients undergoing cardiac surgery before, during and after CPB establishment. The development of post-operative complications was correlated with increased postoperative neopterin and PCT levels. Additionally, neopterin was found as an early marker for the prognosis of postoperative complications, since patients who developed organ dysfunction had had elevated concentration of this parameter even before surgery (AUC 0.83). Measurement of NO metabolite levels was less specific and less sensitive. CONCLUSIONS: Our results confirm the value of PCT and neopterin measurement as diagnostic tools in monitoring the clinical course of patients in intensive care units.

Area Under Curve↗
PubMed2000

Preventing postoperative complications.

Learn nursing interventions for preventing or dealing with some common postoperative complications--including how the latest research may affect standard techniques.

Anti-Bacterial Agents↗
PubMed2003

Risk factors for the development of postoperative complications after bronchial sleeve resection for malignancy: a univariate and multivariate analysis.

BACKGROUND: This study was designed to identify risk factors responsible for postoperative complications after bronchoplastic procedures. METHODS: Excluding sleeve pneumonectomies between January 1994 and December 2001, 108 patients underwent bronchoplastic procedures for bronchial malignancy. Prospectively documented data were age, gender, side, type of bronchial reconstruction, extended resection, histology, TNM stage, diseased lobe, and bronchial tumour occlusion. Cardiovascular (CV) risk factors included heart disease, arterial hypertension, cerebro-occlusive disease, peripheral artery disease of the lower extremities, diabetes mellitus, and abdominal aortic aneurysm. Patients were grouped according to the presence/absence of any CV risk factor and the absolute number of CV risk factors present (zero to four). Non-CV risk factors included neoadjuvant chemotherapy, alcoholism, lung disease, sleep apnea, history of recent pneumococcal sepsis, and repeat thoracotomy. Groups were assembled according to the presence or absence of any non-CV risk factor, neoadjuvant chemotherapy, and alcoholism. Respiratory risk factors included lung function and blood gas analysis. Groups were assembled according to the absolute number of respiratory risk factors in each person (zero to three) and the combination of respiratory and CV risk factors. Complications were defined as septic (pneumonia, empyema, brochopleural fistula, colitis) and aseptic. For univariate statistical analysis, t test, cross-tabulation, and chi2 test were used. All factors with a significance of p < 0.1 were entered into a binary backwards-stepwise logistic regression model. RESULTS: The combination of respiratory and CV risk factors (p = 0.012, OR = 0.165) was predictive for overall complications. Coronary artery disease (p = 0.02, OR = 0.062) and the combination of two respiratory risk factors (p = 0.008, OR = 0.062) were predictive for septic complications. Peripheral artery disease (p = 0.024, OR = 0.28), moderate (p = 0.01, OR = 0.13) and severe chronic obstructive pulmonary disease (p = 0.018, OR = 0.11), and extended resections (p = 0.003, OR = 0.017.) were predictive for aseptic complications. CONCLUSIONS: Comorbidity significantly influences the postoperative complication rate and is therefore crucial for evaluation of patients for bronchoplastic procedures. Different risk factors are responsible for the occurrence of septic and aseptic complications after bronchoplastic procedures.

Adult↗
PubMed1991

Risk factors in relation to postoperative complications and mortality after total gastrectomy in aged patients.

To clarify the risk factors contributing to postoperative complications in elderly patients undergoing total gastrectomy, 84 patients with primary gastric cancer were evaluated. Twenty-seven patients were older than 65 years of age; they had much more preoperative cardiac (P = 0.00003), respiratory (P = 0.0008), and multiorgan impairment (P = 0.009) than did the control group (age less than 65 yrs). Although overall morbidities (44.4% vs. 19.2%; P = 0.01) and overall septic complication rates (33.3% vs. 12.2%; P = 0.02) were higher in aged patients, no significant differences between the two groups were found in the incidence of major surgical complications (18.5% in aged patients vs. 10.5% in control groups; P = NS), serious septic (sepsis score greater than 10) complications (18.5% vs. 7.0%; P = NS) and hospital mortalities (11.1% vs. 3.5%; P = NS). In older patients the occurrence of multiorgan impairment and malnutrition was significantly related to postoperative complication rates. These results suggest that the degree of organ impairment rather than age is predictive of postoperative difficulty and should be used in assessing preoperative risk.

Adult↗
PubMed1999

Immediate and postoperative complications of transurethral prostatectomy in the 1990s.

PURPOSE: We compare the morbidity, mortality, hospitalization and urethral catheter time of contemporary transurethral prostatectomy to historical series, and evaluate recent trends in hospitalization and urethral catheter time during the last 8 years. MATERIALS AND METHODS: A retrospective chart review of 520 consecutive patients who underwent transurethral prostatectomy between 1991 and 1998 at a single institution for symptomatic benign prostatic hyperplasia was performed. Inpatient and outpatient charts, clinic records, operative reports and discharge summaries were reviewed. For each patient 43 data points were collected. Telephone followup was performed when data were lacking. All retrieved data were compiled in a computer database. Perioperative and late postoperative morbidity and mortality, hospitalization and urethral catheter time were analyzed. RESULTS: A total of 520 patients were identified with an average age of 67 years (range 44 to 89). Significant co-morbidity (2 or more co-morbid disease processes) was identified preoperatively in 30.3% of the patients. The most common indications for transurethral prostatectomy were lower urinary tract symptoms (80.9%) and urinary retention (15.2%). Average preoperative International Prostate Symptom Score was 23.8. Average weight of resected tissue was 18.8 gm. There was no perioperative patient mortality. Blood transfusion rate was 0.4%. The rate of intraoperative and immediate postoperative complications was 2.5% and 10.8%, respectively. Average hospital stay was 2.4 days, and 1.1 from 1997 through 1998. The rate of late postoperative complication was 8.5% and the average postoperative symptom score was 6.4 with an average followup of 42 months (range 6 to 84). CONCLUSIONS: Contemporary perioperative and postoperative complications of transurethral prostatectomy are significantly lower than rates in historical series. The average hospital stay and urethral catheter time have steadily decreased during the last 8 years.

Adult↗
PubMed2002

Postoperative complications after local resection of the stomach.

PURPOSE: Local resection of the stomach for early gastric cancer is being performed more frequently, despite which no report focusing on the postoperative complications has been published. The purpose of this study was to investigate the incidence and factors affecting postoperative complications after local resection of the stomach. METHODS: Local resection of the stomach was performed in 37 patients with gastric cancers, submucosal tumors (SMT), or bleeding gastric ulcers, 24 of whom underwent gastroscopy at least once after their operation. We retrospectively examined the complications and background relating to the operations performed in those 24 patients. RESULTS: Postoperative hemorrhage occurred in 2 patients, an open ulcer developed on the suture line in 2 and leakage developed in 1. The hemorrhage and open ulcer were observed only when wide resection with regional lymph node dissection was performed for early gastric cancers in the middle third of the stomach. CONCLUSION: These findings show that the possibility of postoperative hemorrhage and open ulcers on the suture line should be borne in mind, especially when wide local resection with lymph node dissection is performed for cancers in the middle part of the stomach.

Gastrectomy↗
PubMed2006

Albumin-glutaraldehyde bioadhesive ("Bioglue") for prevention of postoperative complications after stapled hemorrhoidopexy: A randomized controlled trial.

BACKGROUND: Hemorrhoidopexy using the circumferential stapler is an established method for surgical treatment of patients with prolapsing hemorrhoids. Despite its advantages, complications such as anal canal stenosis, hemorrhage and anastomosis leak with eventual intrapelvic sepsis can cause serious postoperative problems. The aim of this study was to evaluate the utility of a surgical adhesive, the biological albumin-glutaraldehyde glue "Bioglue", in reduction of these postoperative complications. PATIENTS AND METHODS: Between January 2002 and November 2004, 200 patients undergoing stapled hemorrhoidopexy were enrolled in a prospective, randomized clinical trial. One hundred patients were randomly assigned to the control group; the study group consisted of 100 patients who received Bioglue in the mucosa anastomosis area. All patients received standardized postoperative analgesic, laxative and antibiotic treatment. We then evaluated the two groups for postoperative complications (after surgery and 6 months postoperatively). RESULTS: From the control group (no Bioglue application), two patients presented with anal stenosis, two with hemorrhage, three had anastomosis leak and one had thrombosis, whereas none of the patients from the Bioglue group had any of these complications. Both groups had patients with severe postoperative pain (3 each) and fecal incontinence (1 patient each). The overall difference in the number of complications in the two groups was statistically significant (p < 0.05). CONCLUSION: In this first study using Bioglue in patients undergoing circumferential stapled hemorrhoidopexy we have shown that application of the glue is effective in reducing postoperative complications.

Chi-Square Distribution↗