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[Colorectal carcinoma. Which factors are decisive for development of postoperative complications?].

This retrospective study analyses the prognostic effect of different factors on morbidity and lethality based on selected, primarily resecting colon carcinoma operations (n = 222). In all, 12.2% of our operations were performed under emergency conditions. The total complication rate was 31.5%, the lethality rate 7.7%. The left hemicolectomy cases showed the highest morbidity (48.4%), the rectum amputation the highest lethality (11.8%). Tumour staging tumour differentiation and the sex of the patient showed no significant influence on the postoperative morbidity and lethality. However, a correlation was proved between the age of the patient, tumour localisation, co-morbidity, duration of operation and the conditions under which the operation was performed (emergency or elective), on the one hand, and morbidity and lethality on the other.

Adult↗

[Fiber bronchoscopy in the treatment of postoperative complications in thoracic surgery].

Evaluating the records of the Thoracic Endoscopy Unit of the Department of Surgery, University of Chieti, Italy--from November 1987 to November 1991, data related to the use of fiber bronchoscopy in preventing and treating complications after thoracotomy are referred. The usefulness of fiber bronchoscopy as a therapeutic procedure is underlined.

Age Factors↗

[Compartment syndrome as a postoperative complication of lithotomy position].

Surgical procedures necessitating the use of the lithotomy position can be associated with neuromuscular lesions, usually arising from compression of nerves and muscles. Compartment syndrome of the lower extremities is a grave complication which, if unrecognized, can lead to either permanent neuromuscular dysfunction or limb loss. We report two cases of compartment syndrome complicating surgery in the lithotomy position.

Adult↗

[Laser in situ keratomileusis (LASIK). Intraoperative and postoperative complications].

PURPOSE: To quantify the incidence and type of complications after LASIK for the correction of myopia with special consideration to the time lapse after surgery and the possible consequences regarding high-contrast sensitivity and other modalities of visual acuity. MATERIAL AND METHODS: Between January 1995 and April 1997, 125 eyes of 88 patients with myopia greater than -6.0 D who could not wear contact lenses were operated on at our institute. In this prospective study the patients were examined consecutively preoperatively as well as postoperatively at day 4 and months 1, 3 and 6. The complications were divided into three groups (intraoperative, early postoperative and late postoperative). RESULTS: Our complication rate was 7.2% (loss of 2 lines of visual acuity)--with cutting artifacts related to the microkeratome, wrinkling of the flap and epthelial ingrowth. CONCLUSIONS: LASIK is a microsurgical procedure that requires adequate experience and the desire by the surgeon for self-evaluation. In spite of the good clinical results in the correction of high myopia the complication rates seems still to be too high. This should be the objective for further improvement primarily related to the microkeratomes.

Cornea↗

[Prognosis of postoperative complications from the chronomedicine viewpoint].

In 57 convalescence courses after surgery, temperature, pulse rate and complications recorded daily for 24 days were investigated. Complications were synchronized approximately with temperature. The time structure of the temperature proved to be periodical (reactive periods). The approximately 7-day periods (medium waves) predominated, frequently superimposed by short waves (< or = 4-day periods) and long waves (> or = 14-day periods). There was an intermediate band of approximately 10-day periods. The phases were synchronized with the day of operation, mostly with maxima, otherwise with minima. Periods and phases could jump, the periods preferably in integer ratios, the phases approximately 180 degrees. The long waves yielded a steep drop initially and a reascent of the temperature in the approximately 3rd week. As the number of complications was coincident with the temperature, it also dropped quickly after operation but rose again during the 3rd week. Apart from long waves, temperature and complications descended slowly, synchronizing with the medium waves. The reascent time structure is generally associated with a trophotropic type of patient (late reactive), the gradual descent with an ergotropic type (early reactive). As both of them can be recognized preoperatively, the time structure of the late complications expected can be predicted. Besides the long waves the time structure of the complications is related to the medium waves. Therefore a peak of the complications often occurs at the end of the 1st week.

Adult↗

[Purulent arthritis of the knee joint and septic microembolism of the foot as postoperative complications of an infected femoral anastomosis aneurysm].

Septic peripheral embolism due to infective complication of vascular infrainguinal procedures has been occasionally reported. The combination, however, of purulent arthritis of the knee joint and septic microembolism of the foot, as consequence of an infected pseudoaneurysm, is a very rare entity. We report a case of an infected anastomotic femoral aneurysm, following an iliofemoral "in situ repair" which was complicated with purulent arthritis of the knee joint and multiple small necrotic lesions of the plantar surface of the foot. Treatment included removal of the infected graft, an extra-anatomic revascularization and arthrotomy with pus evacuation. The patient had an uneventful postoperative course and remained well at four-year follow-up, with a mild dysfunction in the knee joint flexion.

Anastomosis, Surgical↗

Surgical technique and postoperative complications in congenital cataract surgery.

BACKGROUND: We evaluated cases that underwent congenital cataract surgery in terms of the surgical technique, post-operative complications, and visual prognosis. MATERIAL/METHODS: We retrospectively evaluated 132 eyes in 76 patients with congenital cataracts who underwent cataract surgery between January 1995 and December 2000. The patient age at surgery, surgical technique, post-operative complications, and final visual prognosis were evaluated. RESULTS: Thirty eyes underwent aspiration, posterior capsulotomy, and intraocular lens (IOL) implantation; 22 eyes underwent aspiration and posterior capsulotomy; 39 eyes underwent aspiration, posterior capsulotomy, and anterior vitrectomy; and 41 eyes underwent aspiration, posterior capsulotomy, anterior vitrectomy, and IOL implantation. The most frequent complications were secondary cataract (24.2%), posterior synechiae (9.1%), and glaucoma (3%). Groups were compared according to surgical technique and incidence of complications. Complications occurred most frequently with aspiration and posterior capsulotomy and occurred less frequently with aspiration, posterior capsulotomy, and anterior vitrectomy; these differences were statistically significant (p<0.05). The difference in the final visual prognosis was statistically significant in the aspiration, posterior capsulotomy, anterior vitrectomy, and IOL implantation groups as compared with the other groups (p<0.05). The mean follow up times was 15.5+/-1.78 months. CONCLUSIONS: The most frequent complication of congenital cataract surgery is secondary cataract formation. Today, posterior capsulotomy with anterior vitrectomy is the preferred method for decreasing the incidence of this complication.

Adolescent↗