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 631 records · Page 35Linked to original sources
PubMed1997

Thoracic epidural anaesthesia for coronary artery bypass graft surgery. Effects on postoperative complications.

We have performed a retrospective analysis of the peri-operative course of 218 consecutive patients who underwent routine coronary artery bypass graft surgery in this institution. All patients received a standardised general anaesthetic using target-controlled infusions of alfentanil and propofol. One hundred patients also received thoracic epidural anaesthesia with bupivacaine and clonidine, started before surgery and continued for 5 days after surgery. The remaining 118 patients received target-controlled infusion of alfentanil for analgesia for the first 24 h after surgery, followed by intravenous patient-controlled morphine analgesia for a further 48 h. Using computerised patient medical records, we analysed the frequency of respiratory, neurological, renal, gastrointestinal, haematological and cardiovascular complications in these two groups. New arrhythmias requiring treatment occurred in 18% of the thoracic epidural anaesthesia group of patients compared with 32% of the general anaesthesia group (p = 0.02). There was also a trend towards a reduced incidence of respiratory complications in the thoracic epidural anaesthesia group. The time to tracheal extubation was decreased in the epidural group, with the tracheas of 21% of the patients being extubated immediately after surgery compared with 2% in the general anaesthesia group (p < 0.001). There were no serious neurological problems resulting from the use of thoracic epidural analgesia.

Adult↗
PubMed2005

Surgical oncotaxis--excessive surgical stress and postoperative complications contribute to enhancing tumor metastasis, resulting in a poor prognosis for cancer patients.

We investigated the relationship between surgical stress and tumor metastasis. The excessive surgical stress of a thoracolaparotomy enhanced tumor metastasis remarkably in an experimental model. We would like to propose that this phenomenon be termed "surgical oncotaxis". This effect has previously been attributed to some mechanisms of immunosuppression, excessive secretion of corticoids, and active oxygen production of granulocytes. An increase in lipid peroxide (LPO) in the liver was observed after a thoracolaparotomy, but a strong radical scavenger of a DL-alpha-tocopherol-L-ascorbic acid 2-0-phosphate diester (EPC-K1) restrained LPO levels in the liver and the effect of tumor metastasis in parallel. As clinical strategies for restraining the surgical oncotaxis, the control of any cytokine storm after surgery and/or the scavenging of active oxygen appears to be possible and hopeful, since it might be intermediated by cytokine. When pre-administration findings for EPC-K1 and methylpredonisolone were compared, EPC-K1 was found to be more suitable for restraining surgical oncotaxis, because serum LPO was only controlled with EPC-K1. The cytokine storm which occurs after surgery is augmented by a second stimulation, such as the administration of lipopolysaccharide, and no drug could control this well experimentally. Postoperative complications are a clinical model of a second stimulation (a so-called second attack). Our data showed the prognosis of a group with complications to be worse than that of a group without them even though no difference existed in the background of the esophageal cancer patients studied. Based on these results, safe surgery and the choice of minimally invasive surgery are the best ways to control surgical oncotaxis. Following a major surgical procedure, such as a thoracolaparotomy, the use of corticoids and/or radical scavengers can contribute to restraining surgical oncotaxis.

Animals↗
PubMed1987

Postoperative complications: factors of significance to anaesthetic practice.

In an attempt to define what factors are important to the development of postanaesthetic complications, the data from a nine-year prospective study of anaesthetic practice in a large tertiary care institution were evaluated. A model of anaesthetic morbidity dependent upon factors of patient illness, surgical practice, anaesthetic technique and physician experience, and duration of anaesthesia was developed. Postoperative anaesthetic morbidity was defined as any anaesthetic-related complication which, in the opinion of the follow-up nurse, was associated with prolonged hospitalization or documented compromise of the patient. Using a multiple logistic regression, ASA physical status was a risk factor for postoperative complications (odds ratio = 1.95) but the number of preoperative conditions and age were not. The type of surgical procedure, classified by site or by degree of trauma, did not influence postanaesthetic complication rates. The duration of anaesthetic exposure was an important determinant of risk (odds ratio = 2.53), with complications increasing with the length of anaesthetic time. As to factors under control of the anaesthetist those patients experiencing operating room complications (odds ratio = 3.36) or those receiving pure spinal (odds ratio = 5.53) or narcotic techniques (odds ratio = 2.14) had higher risks of postoperative complications. Finally, it would appear that the greater the experience of the anaesthetist the less the risk of postoperative problems (odds ratio = 0.52).

Anesthesia↗
PubMedDate not supplied

Immediate postoperative complications following hemodialysis access procedures.

From August 1989 to August 1994, 173 arteriovenous fistules were constructed in 162 patients for permanent hemodialysis: 49 autogenous and 124 graft fistulas (polytetraflouroethylene (PTFE)-119, others-5). Previous access procedures were noted in 93 graft fistulas (76%) versus 8 autogenous fistulas (16.3%). In the immediate postoperative period, 13 graft fistulas (10.6%) developed complications (5 anastomotic hemorrhages, 4 thrombosis, 3 hypotension without hemorrhage, and 1 sepsis), while 2 (4.1%) autogenous fistulas developed immediate postoperative complications (1 anastomotic hemorrhage and 1 thrombosis). Graft fistulas had a higher, although not statistically significant incidence of immediate postoperative complications versus autogenous fistulas. These graft fistula complications were associated with multiple access procedures and required surgical exploration. Based on these results, we should make every effort to construct the autogenous fistula as the first choice of hemodialysis access procedure in properly selected patients.

Arteriovenous Shunt, Surgical↗
PubMed1992

Pharyngeal flap surgery: postoperative complications.

Using a protocol specifically designed to decrease the risk factors for postoperative morbidity and upper airway obstruction, we have essentially eliminated major complications after pharyngeal flap surgery while maintaining excellent speech results. The protocol includes inserting a short pharyngeal flap into a tissue "sandwich" and keeping an NP tube in place for 48 hours postoperatively. The complications reduced by use of this protocol include apnea and other upper respiratory complications, as well as bleeding. In addition, postoperative discomfort is decreased with the current protocol. Using this approach, pharyngeal flap surgery is highly effective in improving speech and is associated with low morbidity.

Adolescent↗
PubMed2003

Probiotics for the treatment of postoperative complications following intestinal surgery.

Probiotics are living micro-organisms that belong to the normal enteric flora and exert a beneficial effect on health and well-being. The rationale for the therapeutic use of probiotics in pouchitis (the most frequent long-term complication following pouch surgery for ulcerative colitis) and postoperative recurrence in Crohn's disease is based on convincing evidence suggesting a crucial role for the endogenous intestinal microflora in the pathogenesis of these conditions. Positive results have been obtained with the administration of highly concentrated probiotic preparations in preventing the onset and relapses of pouchitis. Further controlled studies are needed to establish the efficacy of probiotics in the prophylaxis of postoperative recurrences of Crohn's disease and in the treatment of mild pouchitis.

Crohn Disease↗
PubMed2003

[Postoperative complications in patients with peritonitis].

One thousand three hundred and ten patients with peritonitis have undergone surgery: local limited peritonitis was in 230 patients, local unlimited--in 342, general--in 738 patients. After surgery suppuration of the wound was seen in 92 (7.1%) patients, phlegmons of the abdominal wall--in 16 (1.3%), progressive peritonitis--in 40 (3.1%), abscesses of abdominal cavity--in 13 (1.0%), eventration--in 19 (1.5%), adhesive intestinal obstruction--in 17 (1.3%). Laparoscopy was used for diagnosis of intraabdominal complications in 47 patients. This allowed to avoid unjustified laparotomies in 20 patients. Application of laparoscopy is limited by degree of bacterial contamination of peritoneal exudates. Early adhesive intestinal obstruction in 7 patients was treated with endoscopic procedure. Sonography is effective in diagnosis of intraabdominal complications, detection of site of safe puncture before postoperative laparoscopy and drainage of abscesses.

Abdominal Abscess↗
PubMed2003

Nutritional risk factors for postoperative complications in Brazilian elderly patients undergoing major elective surgery.

OBJECTIVE: In this prospective study, we assessed nutritional and immunologic risk factors for infectious complications and deaths related to infection in elderly patients undergoing major elective surgery. METHODS: Seventy patients 60 y or older were enrolled in this study. The preoperative variables analyzed were body mass index, body mass index knee height, triceps skinfold, subscapular skinfold, mid-arm muscle circumference, mid-arm muscle area, albumin, transferrin, prealbumin, and retinol-binding protein levels, immunoglobulins G, A, and M, C3, and C4 levels, total lymphocyte counts, and the occurrence of delayed hypersensitivity reactions (multitest). RESULTS: Abnormally low levels of prealbumin (P = 0.004), retinol-binding protein (P = 0.05), and transferrin (P = 0.04) were related to infectious complications. Prealbumin levels (P = 0.02) and lymphocyte counts below 1500 cells/mm(3) (P = 0.04) were associated with mortality secondary to infection. Univariate regression analysis showed that levels of prealbumin (P = 0.02, odds ratio = 13.3, 95% confidence limits = 1.6, 110.9), retinol-binding protein (P = 0.03, odds ratio = 4.8, 95% confidence limits = 1.2, 19.3), and transferrin (P = 0.03; odds ratio = 4.2, 95% confidence limit = 1.2, 15.6) were associated with infectious complications. Multivariate analysis associated only prealbumin levels with infectious complications (P = 0.02, odds ratio = 13.3, 95% confidence limit = 1.6, 110.9). Regression analysis provided no conclusion regarding mortality because of the small number of deaths recorded. CONCLUSIONS: In patients with a good cardiac index (Goldman I and II) who underwent major elective surgery, prealbumin protein, retinol-binding protein, and transferrin levels below normal values represented a significant risk for postoperative infectious complications. Lymphocyte counts lower than 1500/m(3) and abnormal prealbumin values were associated with postoperative mortality secondary to infection. The anthropometric variables evaluated did not predict postoperative infectious complications and mortality.

Aged↗