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Results for “POSTOPERATIVE COMPLICATIONS”

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At least 613 records · Page 34Linked to original sources
PubMed2003

Ruptured internal jugular vein: a postoperative complication of modified/selected neck dissection.

BACKGROUND: Postoperative hemorrhage from the internal jugular vein after a modified or selective neck dissection is an infrequent, yet potentially life-threatening, complication. Despite the increasing frequency of modified or selective neck dissections, this complication has not been previously highlighted in the literature. SETTING: Tertiary referral academic center. MATERIAL AND METHODS: The records of six patients who experienced this complication were reviewed and analyzed for risk factors that might predict its occurrence. RESULTS: Common risk factors included postoperative pharyngeal fistula formation, significant tobacco history, and poor nutritional status. A more complete circumferential dissection of the vein low in the neck in the presence of hypopharyngeal fistula may place it at a higher risk for rupture. CONCLUSIONS: Patients who have a complete circumferential dissection of the internal jugular vein low in the neck and go on to have fistulas develop may be more prone to internal jugular vein rupture.

Aged↗
PubMed2005

Harmonic scalpel reduces bleeding and postoperative complications in redo cardiac surgery.

BACKGROUND: Intraoperative and postoperative bleeding and injuries to cardiac structures are among the main determinants of complications and hospital and intensive care unit stay after cardiac reinterventions. The harmonic scalpel has been reported to achieve optimal tissue dissection with little blood loss. The present retrospective work was performed to evaluate the safety and usefulness of this device in redo cardiac surgery. METHODS: Ninety-six redo cardiac surgery patients were operated on with the use of harmonic scalpel, and 105 redo patients operated on by traditional electrocautery and scissors were selected from our database and served as controls. Intraoperative and postoperative data of the two groups were collected and compared. Univariate and multiple logistic regression analyses were performed for identification of factors associated with death and with major and minor complications in the overall study population and in both groups, separately. RESULTS: Although mortality and major postoperative morbidity were comparable in the two groups, harmonic scalpel patients presented markedly reduced postoperative bleeding, lower incidence of minor complications, cardiac injuries, major arrhythmias, and need for transfusions. Operative time and mean intensive care unit stay were shorter. Use of ultrascissor was found to be a protective factor against minor morbidity at multivariate analysis. CONCLUSIONS: Our data suggest that harmonic scalpel is safe and is associated with better in-hospital outcome and lower postoperative blood loss in redo cardiac surgery.

Aged↗
PubMedDate not supplied

[Relationship of immune imbalance with the development of multiple organ failure in patients with complicated postoperative period after the cardiac surgery].

A relationship of the functional status of the viscera with the immune system was studied in 38 cardiac surgical patients with septic complications and multi-organ failure in the postoperative period. In deceased patients (n = 13), the total functional organ compensation index was lower whereas the total functional decompensation index was higher than those in survivors (n = 25). In the deceased patients, each vital organ was more commonly decompensated than that in the survivors, but a definite discrepancy was ascertained only in the immune system (92% versus 16%, p < 0.0001). The average number of decompensated organs was found to increase with the severity of immunological disorders. Therefore, there is a rather high correlation between the functional status of vital organs and the degree of immunological imbalance. The authors show it necessary to use immunity-corrective drugs (splenopid) to enhance the efficiency of treatment organ failure.

Adjuvants, Immunologic↗
PubMed1997

[Pars plana implantation of a ganciclovir drug carrier in patients with cytomegalovirus retinitis and AIDS. Indications, follow-up and postoperative complications].

UNLABELLED: We performed an open clinical trial to assess the safety and efficacy of a 1 microgram/h ganciclovir implant for the treatment of newly and pretreated cytomegalovirus (CMV) retinitis in patients with the acquired immunodeficiency syndrome (AIDS). PATIENTS AND METHODS: Thirty-two eyes (20 patients) received the ganciclovir intraocular device and were prospectively followed up from 30 to 365 days. We used a modified technique for fixation of the device in half of the patients. The modification improved the fixation of the implant with a two-hole technique in the strut. RESULTS: Thirty eyes showed stabilization of the retinitis over the time, but in two patients resistance against ganciclovir and other nucleoside analogue compounds developed. Postoperative complications included vitreous hemorrhage (n = 1), cataract (n = 1), and uveitis anterior (n = 1). Late retinal detachment was seen in five eyes (25%) at 30 to 60 days after implantation. Followup until 1 year after implantation did not show progression of CMV retinitis in 18 to 20 patients. All received antiviral CMV therapy to protect noninfected eyes and intestinum against CMV infection. CONCLUSIONS: The ganciclovir intraocular device seemed to be effective in most cases of CMV retinitis and offers a promising alternative for cytomegalovirus retinitis. Patients pretreated longer than 6 months with i.v. ganciclovir have to be carefully selected for implantation, because resistance against ganciclovir could be three times more likely than in i.v.-therapy naive patients.

AIDS-Related Opportunistic Infections↗
PubMed1982

Levamisole and postoperative complications: a controlled clinical trial.

We studied the relationship between cell-mediated immunity (assessed by preoperative skin reactions to four recall antigens) and postoperative infective complications in 166 patients undergoing major laparotomies. They were randomly allocated to receive 150 mg of levamisole or placebo on the day of operation and for the following 2 days; their course was followed for at least 1 month. Neither the degree of preoperative anergy nor the administration of levamisole resulted in any significant differences in numbers of postoperative deaths or infective complications, but the levamisole group had significantly less postoperative pyrexia than the control group.

Adolescent↗
PubMed1999

Functional evaluations for pulmonary resection for lung cancer in octogenarians. Investigation from postoperative complications.

We have reviewed the records of our twenty-four patients aged 80 years or older who underwent lung resections for bronchogenic carcinoma between 1983 and 1997 in our department. Eighteen patients were male and six were female. Adenocarcinoma was the histology in more than half of the cases (13 patients), along with 8 squamous cell carcinoma, 2 large cell carcinoma, and one small cell lung carcinoma. More than single lobectomy was performed in each patient. Unilateral pulmonary occlusion tests were employed in patients with impairment in pulmonary functions. Every patient, who underwent the unilateral pulmonary occlusion test, was certified that the total pulmonary vascular resistance index during unilateral pulmonary arterial occlusion test was less than 700 dyne.sec.cm-5.m2. Postoperative cardiovascular complications, such as paroxysmal atrial tachycardia, premature atrial contraction, premature ventricular contraction or atrial fibrillation, were seen in 10 patients. Postoperative respiratory complications, namely, sputa retention, retained secretions or atelectasis, were seen in 7 patients. The extent of dissection of mediastinal lymph node was not correlated to the postoperative pulmonary complications. However, the incidence of arrhythmias in the patients who received R2 mediastinal lymphnode dissection was much higher than in those who received R1 or R0 dissection. Complete blood counts and serum biochemical analysis performed at about three weeks after operations revealed leukocytosis and increases in levels of serum transaminase. These phenomena in leukocytosis and increases in the levels of serum transaminase in these patients were similar to those in younger patients. There was no operative death. We conclude that some patients over 80 years are candidates for lung resection after careful preoperative cardiopulmonary evaluation.

Adenocarcinoma↗
PubMed1997

Association between preoperative acute phase response and postoperative complications.

OBJECTIVE: To find out if there is an association between the acute phase response preoperatively and the development of postoperative infective complications. DESIGN: Prospective open study. SETTING: Teaching hospital Germany. SUBJECTS: 229 patients who were to undergo major abdominal operations. INTERVENTIONS: Measurements of serum concentrations of interleukin 6 (IL-6), alpha-1-antitrypsin, C-reactive protein (CRP), albumin, and prealbumin. MAIN OUTCOME MEASURES: Abnormal values of substances measured. RESULTS: Serum concentrations of IL-6, alpha-1-antitrypsin and CRP were raised, and those of albumin and prealbumin were reduced in 5% to 14% of patients. 25 (11%) developed major complications, of whom 9 (4%) died. 9 Patients (4%) had a severe systemic inflammatory response caused by infective complications that did not result from technical failure of the operative technique. Of these 9 patients, 7 (78%) already had signs of an increased acute phase response before operation that was significantly different from the incidence among patients who recovered without complications (21/204. p < 0.001) CONCLUSION: These data suggest that if there are signs of an acute phase response preoperatively the patient's response to operation and infection during the postoperative period may be adversely affected.

Acute-Phase Reaction↗
PubMed2005

[Pierre Robin sequence: postoperative complications following cleft palate surgery. A retrospective study covering 25 years].

BACKGROUND: In a 25-year retrospective review of 1976-2000, the postoperative course after cleft palate surgery and pharyngeal flap surgery in 87 children with Pierre Robin sequence was studied. PATIENTS AND METHODS: The study comprised 114 interventions with 87 primary palatoplasties; 17 patients required palatal fistulae repair and 10 children were treated with secondary pharyngoplasty procedures. All children were divided into three postnatal risk groups according to the severity of their symptoms at birth and in the course of the early months of life. RESULTS: A direct correlation was seen between the incidence of early postnatal difficulties and the postoperative obstructive complications after cleft palate surgery and pharyngeal flap surgery. Thus, children experiencing obstructive problems at birth (high postnatal risk group) displayed more severe complications at the time after cleft palate repair. In children undergoing pharyngeal flap surgery not only early postoperative obstruction but also late obstructive sleep apnea can occur.

Abnormalities, Multiple↗
PubMed1999

[Postoperative complication in stapedectomy: excessive introduction of the prothesis in the oval window].

Postoperative failures and complications detected in patients who undergo surgery for otosclerotic disease are not uncommon in stapes surgery. Prosthesis displacement and incus necrosis are the most common findings in review stapedectomy. We report the case of a patient who had tinnitus, vertigo, and non-recovery of air conduction thresholds without neurosensorial lesions after stapes surgery. The suspected diagnosis of excessive introduction of the prosthesis in the oval window was confirmed by computed tomography, which showed the radio-opaque image of the McGee metal prosthesis. The prosthesis replacement and literature review are discussed.

Female↗