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[Postoperative complications in lung resections for carcinoma (author's transl)].

There will be analyzed the postoperative results in 1351 resected patients with bronchial carcinoma from 1957 to 1975 with special reference to the problem of postoperative complications.1. The rates of complications and lethality have been dropped remarkably during the last years. The frequency of complications is now 11.9% and the lethality 4.1%. The mean value of all patients: 19.2% complications; 6.2% lethality. 2. On the top of all complications there are the empyemas, embolisms, haemorrhages-also those of the gastrointestinal tract-and the insufficiency of the cardiorespiratory system, which has a lethality of about 50%. 3. Age, lung-function and the extent of the resection are influencing the complication rate. 4. Excluding wound healing disturbances central tumors show twice as much complications (20%) as peripheral tumors (10%). But wound healing disturbances have the highest rate in intermediate tumors (9.9%), in contrast to the central tumors (3.9%) and peripheral neoplasms (6.2%). 5. The postoperative lethality has a direct and remarkable effect on to the 5 year-healing results. 6. In view of the therapy of the empyemas the plastic surgical methods should be reduced in favour to new standards of conservative therapy, which have to be worked out.

Adolescent↗

Prevention of postoperative complications in jaundiced rats. Internal biliary drainage versus oral lactulose.

In an experiment mimicking a severe surgical trauma by deliberate renal ischemia, the postoperative outcome in jaundiced rats was studied. Intervention studies were performed with preoperative oral lactulose (to reduce endotoxin toxicity) or preoperative internal biliary drainage. Compared to control, obstructive jaundice in rats significantly reduced survival time (p less than 0.001) and enhanced renal impairment (p less than 0.001) after renal ischemia. Preoperative supportive therapy of jaundiced rats with oral lactulose increased survival time (p less than 0.01) but did not reduce deterioration of renal function. Preoperative internal biliary drainage proved to be superior, with a significant reduction of renal impairment (p less than 0.001) and an improved survival time (p less than 0.001). Our experiments provide further evidence that obstructive jaundice increases the complication rate following major surgical procedures. Based on our results in rats, we suggest that in obstructive jaundice preoperative internal biliary drainage is the supportive therapy of choice. However, if adequate drainage is not possible, oral treatment with lactulose may help reduce postoperative complications.

Administration, Oral↗

Volvulus of the transverse colon: a postoperative complication of truncal vagotomy and gastrojejunostomy.

An instance of volvulus of the transverse colon in the postoperative period following truncal vagotomy and anterior gastrojejunostomy is reported. The clinical features of volvulus of the transverse colon are sudden onset of abdominal colic, distension and vomiting. A plain X-ray film of the abdomen is diagnostic. Laparotomy is recommended, followed by untwisting alone, or untwisting and colostomy when the bowel is viable, or resection with a transverse colostomy and mucous fistula as a first stage when the bowel is gangrenous.

Colonic Diseases↗

[The role of microcirculatory disorders in the development of postoperative complications in thoracic and abdominal injuries].

Alterations in the system of microcirculation were found in the postoperative period in 30 patients with trauma of the chest and abdomen which depended upon the blood loss volume and are of plastic character. The main cause of these alterations in the early postoperative period is the change of the microvessels tone. In remote terms of the postoperative period changes of blood rheology play the leading role in alterations of microcirculation. The alterations of microcirculation as one of the mechanisms of the development of polyorganic insufficiency in trauma disease need permanent control and therapy, aimed at correction of tonic and vasomotor activity of resistant and capacitance microvessels, rheological components of blood and ratio of globular volume and plasma.

Abdominal Injuries↗

Management of paediatric traumatic cataract by epilenticular intraocular lens implantation: long-term visual results and postoperative complications.

PURPOSE: This study was carried out to evaluate the postoperative visual results and complications following epilenticular intraocular lens implantation in paediatric traumatic cataracts. MATERIALS AND METHODS: A total of 30 patients undergoing epilenticular intraocular lens implantation for traumatic pediatric cataract were evaluated prospectively for visual results and complications. After-cataract formation was the prime area of interest. Follow-up of patients ranged from 2 to 8 years (mean 5 years). In all, 90% of eyes had a visual acuity of 6/60 or worse at the time of presentation. RESULTS: In total, 80% of our patients achieved a visual acuity of 6/12 or better postoperatively after a mean follow-up of 5 years. None of our patients had after-cataract formation and the visual axis remained clear until the last follow-up in all the patients. CONCLUSION: Epilenticular intraocular lens implantation in paediatric traumatic cataracts is associated with favourable anatomic and visual results.

Cataract↗

Using the McGill Pain Questionnaire to study common postoperative complications.

For many individuals undergoing routine surgical procedures, their satisfaction with the operation may depend upon their postoperative experience. We used the McGill Pain Questionnaire and the McGill Nausea Questionnaire to study the intensity of 5 common postoperative problems--sore throat, muscle pain, headache, backache, and nausea. We found that the questionnaires were able to determine the intensity of the postoperative problem but due to time pressures, a shorter version would be needed to study large numbers of patients. Using a discriminant analysis, we found that the 25 most frequently chosen words were able to distinguish between the 4 pain-related problems. As well the Present Pain Intensity (PPI) correlated highly with the standard form word choices and appeared to be measuring the same dimension of intensity for these complaints.

Back Pain↗

The influence of rheumatoid chemotherapy, age, and presence of rheumatoid nodules on postoperative complications in rheumatoid foot and ankle surgery: analysis of 725 procedures in 104 patients [corrected].

The records of 104 patients who underwent reconstructive foot and ankle surgery for deformities secondary to rheumatoid arthritis were reviewed. The use of rheumatoid chemotherapeutic agents, age, sex, rheumatoid nodule status, and the number of concurrent surgical procedures performed was analyzed to determine any association with the postoperative outcome for wound healing and infectious complications. The 104 patients, ranging in age from 23 to 83 years, underwent 725 operative procedures. An overall 32% complication rate was recorded. Analysis of five specific rheumatoid chemotherapeutic agents (NSAIDs, steroids, methotrexate, hydroxychloroquine, gold), age, sex, number of operative procedures performed, and presence of rheumatoid nodules, either alone or in combination, failed to prove a statistical association with either a healing or infectious postoperative complication.

Adult↗