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At least 19 recordsLinked to original sources
PubMed1999

Adenotonsillectomy in the very young patient: cost analysis of two methods of postoperative care.

Postoperative management of the patient younger than 36 months undergoing adenotonsillectomy has been the subject of many debates. Concerns for early postoperative complications such as airway obstruction, emesis, dehydration, and hemorrhage have led many physicians to consider overnight hospitalization following adenotonsillectomy in very young children. Trends in health care management have had increasing focus on cost effective means of treating patients to limit unnecessary expenditure on the part of the patient, physician, and hospital facility. The purpose of this retrospective review was to analyze two methods of early postoperative management in children less than 36 months old undergoing adenotonsillectomy at the Children's Hospital, San Diego from 1992 to 1997. Three hundred and seven cases were reviewed. Same-day discharge was compared with overnight inpatient observation based on the cost analysis of these two methods of postoperative care. Postoperative care was based on length of stay in the recovery room and as an inpatient. Expense of postoperative care was based on cost calculation for the recovery room and overnight hospitalization. Of the 307 patients, 194 went home the day of surgery and 113 were observed overnight in the hospital. Average hospital cost was higher in the outpatient group than in the inpatient group (P < 0.001). This difference reflects longer recovery room stay (350 min) in the outpatient group compared to the inpatient group (108 min) (P < 0.001). Outpatient adenotonsillectomy in the patient under 36 months may be safe; however, prolonged recovery room stays may actually make outpatient surgery less cost-effective than overnight admission. Recovery room costs are significantly higher per unit time than costs of inpatient hospitalization. Further investigation of cost-effective outpatient observation units may improve cost containment in the outpatient surgical setting.

Adenoidectomy↗
PubMed1984

[Progress in postoperative care and postoperative combined therapy of esophageal carcinoma by total parenteral nutrition (TPN)].

Intravenous hyperalimentation which consisted of 30% hypertonic glucose solution and 10% amino acid solution via central venous catheterization and 10% lipid solution via peripheral venous lines has been applied to the postoperative patients with esophageal cancers since 10 years ago. sixty-five percent of the patients who underwent surgical treatment showed abnormal signs of the glucose tolerance function test. Positive application of insulin for these patients was performed according to the algorism of continuous insulin infusion method devised by us. Serum glucose levels have been kept within the normal range during the postoperative days. Non-protein Calorie per nitrogen (Cal/N) was optimal at 190, and 10% of the total Calorie administered should be obtained as lipid solution. Postoperative changes of glucose synthase I and D, and phosphorylase a and b of leukocytes were analysed periodically. Chemiluminescence of leukocytes were also checked. Postoperative combined therapies were actively performed under the nutritional support of TPN. The cases of n (-), n1(+) and n2(+) were treated with radio-chemoimmunotherapy (4000 R, Bleomycin 80 mg, Tegaful 500-750 mg/day, PSK or OK-432). The cases of n3(+) and n4(+) were treated with aggressive chemotherapy (Adriamycin, Mitomycin and Pepleomycin). Remarkable improvement of the prognosis in these patients was obtained.

Animals↗
PubMed1996

Pediatric functional endoscopic sinus surgery: postoperative care.

An effective postoperative care regimen is vital for a successful outcome. Children pose special postoperative challenges due to small anatomy, differences in underlying causes of sinus disease, and difficulties encountered with sinonasal cleansing and debridement. This article provides the clinician with a chronologic guide on how to manage the child after functional endoscopic sinus surgery.

Airway Obstruction↗