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At least 19 recordsLinked to original sources
PubMed2003

Management of intraoperative complications associated with autogenous patellar tendon graft anterior cruciate ligament reconstruction.

With the increasing number of anterior cruciate ligament (ACL) reconstructions being performed each year in the United States, sound surgical technique and preoperative planning are essential to decrease complications. Most intraoperative complications associated with ACL surgery are preventable with adequate planning and a reproducible surgical technique. When an autogenous bone-patellar tendon-bone graft is used for ACL reconstruction, pitfalls may occur at each step during the surgical procedure--preoperative assessment, graft harvest, notch preparation, tunnel preparation, graft passage and fixation, and rehabilitation. An array of options should be available for fixation of a patellar tendon graft, as well as alternative graft sources and graft preparation techniques.

Anterior Cruciate Ligament↗
PubMed1985

Sonographically monitored amniocentesis to decrease intraoperative complications.

The rates of intraoperative complications (dry and bloody taps) of two amniocentesis techniques were compared in 1300 patients undergoing second trimester procedures for genetic indications. The sonographically guided technique consisted of the selection of a site for needle insertion with ultrasound, removal of the transducer, and immediate amniocentesis. The sonographically monitored technique consisted of the continuous visualization of the needle during the entire procedure. Six hundred twelve amniocenteses were performed with the sonographically guided technique and 688 with the sonographically monitored technique. There was a statistically significant decrease in the incidence of bloody and dry taps of the first needle insertion (relative risk = 38%, P less than .0001) and also in the number of patients that required multiple needle insertions (relative risk = 42%, P less than .0001) with the sonographically monitored technique.

Amniocentesis↗
PubMed2006

Intraoperative complications of cataract surgery in the very old.

AIM: To identify whether the risk of an intraoperative complication of phakoemulsification cataract surgery increases with age. METHODS: 1441 consecutive patients undergoing phakoemulsification cataract surgery were assessed preoperatively, and data on the occurrence of intraoperative complications were collected prospectively. Data were entered into a computerised database, and logistic regression was used to examine evidence of an association between age and the risk of an intraoperative complication. In addition, the rates of intraoperative complications were compared between patients > or =88 years and those <88 years, and between patients > or =96 years and those <96 years. RESULTS: No significant association was found between age and the risk of an intraoperative complication. The authors found little evidence that patients > or =88 years were at a greater risk of an intraoperative complication than those <88 years, or that those > or =96 years are at increased risk; however, numbers were small. CONCLUSIONS: These results suggest that age alone is not a major risk factor for any intraoperative complications occurring during phakoemulsification cataract surgery. This has implications not just for tailoring the risk of complications occurring to individual patients but also for meaningful comparisons between national complication rates and those of individual surgeons, and better selection of cases suitable for instruction.

Age Distribution↗
PubMed1995

Intraoperative complications of revision hip arthroplasty using a fully porous-coated straight cobalt-chrome femoral stem.

The operative complications of a consecutive series of 135 cementless revision total hip arthroplasties using a fully porous-coated straight cobalt-chrome femoral stem were reviewed. Intraoperative complications occurred in 59 cases (44%), 22 of which (37%) involved more than one complication. Three categories of intraoperative complications were recorded: eccentric reaming, femoral perforation, and femoral fracture. Complications were noted to decrease throughout the period of the study. Surgical approach did not affect the complication rate. Stem length, stem diameter, and host-bone quality all affected the complication rate. Femoral perforations and fractures were more numerous with femoral stems longer than 200 mm. Larger-diameter femoral stems (> or = 18 mm) were associated with a higher complication rate (55%). Complications were also more numerous with poorer-quality host-bone. In cases of multiple complications, eccentric reaming often predisposed bone to perforation and subsequently to fracture. There was also greater blood loss in patients with intraoperative complications. Intraoperative complications may be avoided with the use of implants, as well as reaming no longer than absolutely necessary, and the use of intraoperative radiographs or flexible reamers early in femoral canal preparation.

Adult↗
PubMed1983

Complications of vitreous surgery for diabetic retinopathy. I. Intraoperative complications.

One hundred seventy-nine eyes were analyzed to determine the incidence of intraoperative complications during vitrectomy for proliferative diabetic retinopathy. Inadvertent corneal epithelial defects occurred in 51 eyes (28%). The lens was removed in 42 (25%) of 170 phakic eyes. This was done through a pars plana approach. Accidental mechanical lens damage occurred in one eye, and mild pharmacologic lens damage occurred in two eyes. Some bleeding from fibrovascular tissue occurred in nearly every case, but this was controlled with diathermy except in seven eyes (4%) in which severe bleeding required premature termination of the operation. Latrogenic retinal tears occurred in 36 (20%) of the 179 eyes. Fifteen (34%) of the total of 44 retinal tears were anterior to the equator, and 11 (73%) of the 15 anterior tears were located posterior to the sclerotomy through which the vitrectomy probe was introduced. Twenty-nine (66%) of the 44 retinal tears were posterior to the equator, and 19 of the 29 occurred within 15 degrees radius of the fovea.

Adult↗
PubMed1998

Pseudoexfoliation syndrome: a cohort study on intraoperative complications in cataract surgery.

Our aim was to determine the rate of intraoperative complications induced by pseudoexfoliation syndrome (PSX) in cataract surgery. We report our experience regarding 1,052 consecutive patients who underwent phacoemulsification. Exact logistic regression was used to examine the role of PSX in intraoperative complications. Odds ratio for intraoperative complications (vitreous loss, capsular break, zonular break) was estimated to be 5.1 for PSX present as compared to when it is absent. PSX was associated with a statistically significant increase in intraoperative complications during cataract surgery (p<0.0001).

Aged↗
PubMed1983

[Intraoperative complications in the implantation of permanent pacemakers].

Intraoperative complications occurring during 2323 pacemaker implantations were analysed. The most frequent complications were arrhythmias in the form of ventricular fibrillation and asystole. Ventricular perforation with the stimulatory probe was observed in 0.21%. Vascular lesions, pneumothorax and pulmonary arterial embolism were extremely rare complications. The intraoperative mortality of all operations, done within 11 years, was 0.13%.

Humans↗
PubMed2006

Surgeon experience and trends in intraoperative complications in laparoscopic cholecystectomy.

BACKGROUND: Intraoperative complications, particularly bile duct injuries (BDIs), have increased since the introduction of laparoscopic cholecystectomy (LC). This excess risk is expected to decline as surgeon experience in laparoscopic surgery increases. METHODS: This was a population-based study of trends in intraoperative injuries in 33 309 cholecystectomies carried out in Western Australia between 1988 and 1998, based on hospital discharge abstracts. Endpoints were identified from diagnostic and procedure codes in index or postoperative readmissions, or a register of endoscopic retrograde cholangiopancreatography procedures, and validated using hospital records. Multivariate analysis was used to estimate the risk of complications associated with potential risk factors. RESULTS: Following the introduction of LC in 1991, the prevalence of all complications doubled by 1994 then stabilized, whereas that of BDI declined after 1994. The risk of complications increased with age, was higher in men, teaching and country hospitals, and was higher for LC and more complicated operations. It was lower when intraoperative cholangiography was performed and with increasing surgeon experience. Approximately 20 per cent of all complications and 30 per cent of BDIs were attributable to surgeons who had performed 200 or fewer cholecystectomies in the previous 5 years. CONCLUSION: The risk of intraoperative complications declined with increasing surgical experience and use of intraoperative cholangiography.

Bile Ducts↗
PubMed2005

Intraoperative complications of phacoemulsification in eyes with and without pseudoexfoliation.

PURPOSE: To determine the intraoperative complications in a large series of phacoemulsification procedures, including patients with and without pseudoexfoliation, excluding those with marked phacodonesis or lens subluxation. SETTING: Department of Ophthalmology, Carmel Medical Centre, Haifa, Israel. METHODS: This institutional case-control study included 1501 consecutive phacoemulsification procedures: 137 eyes with pseudoexfoliation and 1364 eyes without this condition. Baseline demographics and clinical factors were collected from the medical files. A comparative analysis of the incidence of intraoperative complications in eyes with or without pseudoexfoliation was calculated. Univariate analysis and multiple logistic regression were used to identify ocular factors that predicted intraoperative complications. RESULTS: There was no significant difference (P>.05) in the rate of intraoperative complications between the pseudoexfoliation (5.8%) and control (4.0%) groups. There were no significant differences in the incidence of capsular breaks, vitreous loss, and zonular ruptures without vitreous loss in the 2 groups. Pseudoexfoliation did not confer a statistically higher risk for intraoperative complications (odds ratio 1.62, 95% confidence interval 0.74-3.55). CONCLUSION: Phacoemulsification by experienced surgeons is safe in eyes with pseudoexfoliation without marked phacodonesis or lens subluxation.

Aged↗
PubMed2004

A system for preoperative stratification of cataract patients according to risk of intraoperative complications: a prospective analysis of 1441 cases.

AIM: To devise a simple, robust scoring system for assessing the risk of intraoperative complications in patients undergoing cataract surgery. METHODS: 1441 consecutive patients undergoing phacoemulsification cataract surgery were assessed preoperatively according to weighted criteria. According to the points of risk they accumulated using this system, the patients were preoperatively allocated to one of four risk groups. Data were prospectively collected on the occurrence of intraoperative complications and entered into a computerised database. The total rate of intraoperative complications for each risk group as well as the rate of each reported complication for each risk group were calculated. RESULTS: The rate of intraoperative complications increased in frequency through the risk groups: 1 = 4.32%, 2 = 7.45%, 3 = 13.48%, and 4 = 32.00% (p<0.001). Furthermore, the following complications also increased in frequency through the risk groups in their own right (p<0.05 in each case): posterior capsule rupture, vitreous loss, incomplete capsulorrhexis, zonule dehiscence, wound burn/leak, and lost nuclear fragment into vitreous cavity. CONCLUSION: These results suggest that candidates for cataract surgery can be simply and uniformly assessed preoperatively and categorised to a "risk group" according to their risk of intraoperative complications. This allows for: (1) individualised counselling on the chances of operative complications, (2) meaningful comparisons between national complication rates and those of individual units or surgeons, and (3) better selection of cases suitable for instruction.

Aged↗
PubMed1996

Intraoperative complications of planned extracapsular cataract extraction versus manual nucleofragmentation.

PURPOSE: To compare the intraoperative complications of planned extracapsular cataract extraction (ECCE) with those of manual nucleofragmentation. SETTING: Hospital de la Esperanza, Universitat Autónoma de Barcelona, Spain. METHODS: This retrospective study comprised 567 eyes; 444 had planned ECCE and 123, manual nucleofragmentation through a scleral tunnel incision. RESULTS: No significant differences between techniques were found in terms of intraoperative complications (P < .05). Manual nucleofragmentation did not increase the risk of intraoperative complications (P < .05). CONCLUSIONS: Although phacoemulsification is the procedure of choice in many cases, manual nucleofragmentation is a safe and valid alternative that achieves the goals of small incision cataract surgery.

Aged↗
PubMed2003

[Intraoperative complications of thoracoscopic surgery for mediastinal tumors].

We report intraoperative complications of thoracoscopic surgery for mediastinal tumors. Forty cases of mediastinal tumor were undergone thoracoscopic surgery at the hospital from 1999 to 2002. The patient's ages ranged from 18 to 74 years old with a mean of 47.7. Location of these tumors were anteriormediastinal in 20 cases, middlemediastinal in 6 cases, posteriormediastinal in 11 cases, and superiormediastinal in 3 cases. Intraoperative complications were rupture of the cyst in 9 cases, bleeding over 150 ml in 5 cases, injury of lung caused by adhesiolysis in 5 cases, and injury of nerve in 3 cases. The mean operation time was 103.8 minutes. Postoperative hospital stay ranged from 2 to 22 days with a mean of 5.9 days. All are alive with no recurrences or postoperative complications.

Adolescent↗
PubMed1999

Intraoperative complications of perfluoroperhydrophenanthrene: subretinal perfluorocarbon, retinal slippage and residual perfluorocarbon. Vitreon Study Group.

BACKGROUND: An earlier analysis of postoperative complications of the perfluorocarbon liquid perfluoroperhydrophenanthrene (Vitreon) showed a low overall rate of posterior segment complications. A study was conducted to determine the incidence of specific intraoperative complications in a wide variety of vitreoretinal procedures performed by many different surgeons using Vitreon. METHODS: The records of consecutive patients enrolled in the Vitreon Collaborative Study were reviewed to determine the incidence of subretinal Vitreon, retinal slippage and residual Vitreon. A total of 1867 vitreoretinal procedures performed between Nov. 16, 1989, and Dec. 14, 1994, at 35 participating centres were studied. Vitreon was used as a surgical tool at the surgeon's discretion after informed consent was obtained. The incidence of intraoperative complications was determined, and preoperative, intraoperative and postoperative characteristics were tabulated. RESULTS: Subretinal Vitreon was observed in 24 patients (1.3%), retinal slippage in 20 patients (1.1%) (15 [6.9%] of the 216 patients with giant retinal tears) and residual Vitreon in 68 patients (3.6%). INTERPRETATION: Vitreon can be used as a surgical tool in a wide variety of vitreoretinal procedures with a low incidence of intraoperative complications.

Adolescent↗
PubMed2005

Incidence of intraoperative complications during phacoemulsification in vitrectomized and nonvitrectomized eyes: prospective study.

PURPOSE: To compare the incidence of intraoperative complications during phacoemulsification surgery in patients with and without prior pars plana vitrectomy (PPV). SETTING: Department of Ophthalmology, Norfolk, and Norwich University Hospital, Norwich, United Kingdom. METHODS: Prospective collection of operative complications in 2000 consecutive cataract extractions performed by 1 surgeon (R.L.B.). Details of all patients who had intraoperative complications including age at operation and sex were recorded. It was also noted whether the eye previously PPV. Complications recorded were posterior capsule rupture (PCR) with and without vitreous loss, iris trauma, loss of nuclear fragment into vitreous, and choroidal hemorrhage. RESULTS: Of 2000 eyes, 117 had previous PPV. Of these, there were 2 (1.70%) cases of PCR. There were no cases of iris trauma, choroidal hemorrhage, or dropped nucleus fragments into the posterior chamber. Nonvitrectomized eyes totaled 1883. Rates of complications were as follows: PCR without vitreous loss, 0.16%; PCR with vitreous loss, 0.53%; iris trauma, 0.16%; choroidal hemorrhage, 0.16%; and dropped nucleus fragment in the vitreous, 0.11%. CONCLUSION: Despite well-known difficulties encountered in vitrectomized eyes such as zonular damage, increased mobility of the lens-iris diaphragm, and altered intraocular fluid dynamics, the incidence of intraoperative complication rates is similar to nonvitrectomized eyes in the hands of an experienced surgeon.

Adult↗
PubMed2000

Intraoperative complications during cataract surgery in the very old.

PURPOSE: To determine if there is a difference in intraoperative complications during cataract surgery in very old patients (> or = 88 years) compared with younger patients (< 88 years). METHODS: The records of 802 consecutive cataract operations were reviewed. Identical techniques of small-incision phacoemulsification were used in all cases. A total of 102 eyes were in patients aged 88 to 98, designated as the "very old." The remaining 700 eyes were in patients under 88, designated as "younger." The incidence of intraoperative complications in the 2 groups was compared. RESULTS: Posterior capsule tears, vitreous loss, and loss of the nucleus were found as complications. Overall, these events occurred in 10% of the very old and in only 3% of those under age 88. Vitreous loss occurred in 7% of the very old and in only 1.6% of those under 88. There was 1 dropped nucleus in the very old. In the younger patients, 90.5% of eyes with complicated surgery achieved 20/40 visual acuity or better, but only 40% of complicated cases in the very old achieved this. Furthermore, 50% of complicated cases in the very old had visual acuity of 20/200 or worse, all directly attributed to surgical difficulties. Fifteen percent of patients in both groups had trabeculectomies with no influence on complications. We noted that 8% of the very old required pupil stretching compared with 2% of those under 88. CONCLUSIONS: This study strongly suggests that very old patients (i.e., those 88 years and older) have a higher incidence of intraoperative complications during cataract surgery than younger patients. Furthermore, such complications may result in severe visual loss. These findings may have significance as the population ages.

Adult↗
PubMed2004

Intraoperative complications of revision hip arthroplasty using a porous-coated, distally slotted, fluted femoral stem.

Intraoperative complications of 175 cementless revision total hip arthroplasties done at four institutions using a porous-coated, uncemented, distally slotted, fluted femoral stem were reviewed. Three types of complications were recorded: eccentric reaming, femoral perforation, and femoral fracture. Intraoperative complications occurred in 16 patients (9.1%). There was no statistically significant association between complication rate and type of surgical approach, stem length, stem diameter, or host bone quality. This complication rate is comparable to or lower than that reported with the use of similar uncemented long femoral revision stems.

Adult↗