Tag Archives: Postoperative Complications

Risk Factors for Chronic Pain after Open Ventral Hernia Repair by Underlay Mesh Placement

Posted on by
Reply

“Incisional hernia is one of the most frequent long-term complications after abdominal surgery (11%–20%). After primary repair, rates of recurrence range from 24% to 54%. It has been clearly demonstrated that the use of prostheses for a tension-free repair allows for a
significant reduction in recurrence rate, and even for the treatment of small defects. However, the type and position of the mesh and the mesh fixation technique used are still a matter of debate. The underlay position of the mesh allows for easy treatment of major parietal defects with limited dissection and potentially lower rates of mesh infection, but this position exposes the patient to the risk of small bowel occlusion and enterocutaneous fistula.”

Continue reading →

Robotic compared with laparoscopic cholecystectomy

Posted on by
Reply

“Robotic cholecystectomy was independently associated with a lower risk of serious complications, lower rate conversion to open, and hospitalization ≥24 hours compared with laparoscopic cholecystectomy. These findings suggest that new technologies might enhance the safety of minimally invasive surgery.”

Continue reading →

Noninvasive positive pressure ventilation for acute respiratory failure following upper abdominal surgery

Posted on by
Reply

“More than four million abdominal surgeries are performed in the US every year and in England about 250,000 abdominal operations are performed per year. Adults undergoing upper abdominal surgery are at an increased risk of postoperative pulmonary complications.
Acute respiratory failure is a relatively common complication after abdominal surgery and is associated with significant morbidity and mortality. According to Michelet 2010, the development of respiratory complication may be explained by two pathological mechanisms.
The first is linked to surgical complications, notably with the occurrence of anastomotic leakage leading to mediastinitis, septic shock, and acute respiratory distress. The second is of medical origin, with multifactorial impairment of respiratory function.”

Continue reading →

Predicting the Risk of Readmission From Dehydration After Ileostomy Formation

Posted on by
Reply

“Readmission within 30-days of hospital discharge has received widespread attention as a
potential healthcare quality indicator. In 2013, the Center for Medicare and Medicaid
Services established the Hospital Readmission Reduction Program (HRRP), a cost-
containment strategy that financially penalizes hospitals with higher than expected 30-day
readmission. Though conditions targeted by the HRRP have been predominately medical, it
is anticipated that readmission after surgical procedures will be used to structure financial
incentives and hospital compensation in the near future.”

Continue reading →

Preoperative pulmonary risk stratification for noncardiothoracic surgery

Posted on by
Reply

“Postoperative pulmonary complications contribute importantly to the risk for surgery and anesthesia. The most important and morbid postoperative pulmonary complications are atelectasis, pneumonia, respiratory failure, and exacerbation of underlying chronic lung disease. Clinicians who care for patients in the perioperative period may be surprised to learn that postoperative pulmonary complications are equally prevalent and contribute similarly to morbidity, mortality, and length of stay.”

Continue reading →

Management of Postoperative Complications Following Operations for Breast Cancer

Posted on by
Reply

At bottom of post Surgical Clinics of North America issue on postoperative complications.

“The reported complication rates after breast cancer surgery are low, with rates ranging
from 2% to 50%, and are reportedly more common when performed in conjunction with axillary surgery and immediate breast reconstruction. A breakdown by procedure type has shown morbidity rates between 5% and 50% after mastectomy and from 3% to 35% after lumpectomy with or without reconstruction.”

Hilli
Continue reading →

The STITCH Trial. Small bites versus large bites for closure of abdominal midline incisions.

Posted on by
Reply

“Incisional hernia is a frequent complication of abdominal operations with an incidence of 10–23%, which can increase to 38% in specific risk groups. In the USA 4 million to 5 million laparotomies are done annually, suggesting that at least 400 000–500 000 incisional hernias can be expected to occur every year. Incisional hernia is associated with pain and discomfort, resulting in a decreased quality of life. Moreover, incarceration and strangulation of abdominal contents can take place, for which emergency surgery is indicated, with associated morbidity and mortality. About 348 000 operations for incisional hernia are done every year in the USA with US$3·2 billion in annual associated costs. Prevention of
incisional hernia is therefore of paramount importance.”

Continue reading →