Search results for "Blood Loss"

The ‘Difficult’ Polyp: Pitfalls for Endoscopic Removal

2012

Adenomatous polyps are early neoplasias of colorectal cancer (adenoma-carcinoma sequence). The majority of adenomas or early invasive cancers (T1sm1) can be resected by endoscopy. Endoscopic resection techniques include classic loop polypectomy, endoscopic mucosectomy with preceding lifting of the (almost flat) lesion, endoscopic submucosal dissection and transanal microsurgical resection, an alternative to endoscopic submucosal dissection in the rectum. Endoscopic polyp removal should always aim to resect the lesion in ‘one piece’ and avoid, whenever possible, ‘piecemeal resection’. One-piece polypectomy is the basis for a precise histopathological analysis and for proving complete removal…

Ketorolac, diclofenac, and ketoprofen are equally safe for pain relief after major surgery

2002

Background Ketorolac is approved for the relief of postoperative pain but concerns have been raised over a possible risk of serious adverse effects and death. Two regulatory reviews in Europe on the safety of ketorolac found the data were inconclusive and lacked comparison with other non-steroidal anti-inflammatory drugs. The aim of this study was to compare the risk of serious adverse effects with ketorolac vs diclofenac or ketoprofen in adult patients after elective major surgery. Methods This prospective, randomized multicentre trial evaluated the risks of death, increased surgical site bleeding, gastrointestinal bleeding, acute renal failure, and allergic reactions, with ketorolac vs di…

Prediction of complexity and complications of laparoscopic liver surgery: The comparison of the Halls‐score to the IWATE‐score in 100 consecutive lap…

2020

BACKGROUND The development of laparoscopic liver surgery is slower than in other disciplines. Two different scoring systems have been proposed to estimate difficulty of laparoscopic liver resections (LLR) preoperatively. The aim of this analysis was to compare these two scores in an independent patient cohort regarding the predictability of morbidity. METHODS All LLRs performed between 01/2011 until 01/2019 were identified from our prospective institutional database. Patient characteristics as well as intra- and postoperative data were analyzed. Postoperative complications were graded according to Dindo-Clavien classification. Difficulty of LLR was classified using IWATE- and Halls-score. R…

Invasive procedures and minor surgery in factor VII deficiency

2012

Efficacy and safety during formulation switch of a pasteurized VWF/FVIII concentrate: results from an Italian prospective observational study in pati…

2012

Summary Von Willebrand disease (VWD) is an inherited bleeding disorder caused by the quantitative or qualitative deficiency of von Willebrand factor (VWF). Replacement therapy with plasma-derived VWF/factor VIII (FVIII) concentrates is required in patients unresponsive to desmopressin. To assess the efficacy, safety and ease of use of a new, volume-reduced (VR) formulation of VWF/FVIII concentrate Haemate® P in patients requiring treatment for bleeding or prophylaxis for recurrent bleeding or for invasive procedures. Pharmacoeconomic variables were also recorded. Data were analysed using descriptive statistics. This was a multicentre, prospective, observational study. Consecutively enrolled…

Prophylactic chimera anterolateral thigh/vastus lateralis flap: preventing complications in high-risk head and neck reconstruction

2014

Purpose In high-risk head and neck cases treated with tumor resection and associated radical neck dissection, orocutaneous fistulas and wound breakdowns in the neck are relatively frequent and can have serious consequences, such as carotid blowout syndrome (CBS), the need for salvage reoperations, and prolonged recovery time. The authors present the application of a prophylactic chimeric anterolateral thigh (ALT) and vastus lateralis (VL) flap to prevent complications. Materials and Methods A retrospective review was performed of a historical group (96 patients) of patients with head and neck cancer treated with tumor resection, radical neck dissection, and microsurgical reconstruction of t…

Distal pancreatectomy with multivisceral resection: A retrospective multicenter study - Case series.

2020

Abstract Background Multivisceral resection (MVR) is sometimes necessary to achieve disease-free margins in cancer surgery. In certain patients with pancreatic tumors that invade neighboring organs these must be removed to perform an appropriate oncological surgery. In addition, there is an increasing need to perform resections of other organs like liver not directly invaded by the tumor but which require synchronous removal. The results of MVR in pancreatic surgery are controversial. Material and methods A distal pancreatectomy retrospective multicenter observational study using prospectively compiled data carried out at seven HPB Units. The period study was January 2008 to December 2018. …

Use of topical tranexamic acid in primary total hip arthroplasty. Efficiency and safety. Our experience.

2019

Abstract Background and aim Intravenous tranexamic acid has been shown to reduce bleeding and the need for transfusions in total hip arthroplasty, although it has a theoretical risk of producing thromboembolic phenomena. Recently some papers have been published using the topical application of tranexamic acid, but the ideal administration protocol has not yet been clearly defined. The aim of this paper was to demonstrate that our protocol of topical tranexamic acid is effective and safe. Methods Prospective data collection from a case series of 80 primary hip arthroplasties, in which the following topical tranexamic acid protocol is used: 1.5 g diluted to a total volume of 60 ml were admini…

Robotic Versus Laparoscopic Gastric Resection for Primary Gastrointestinal Stromal Tumors5 cm: A Size-Matched and Location-Matched Comparison.

2017

This study compared robotic (RR) and laparoscopic resection (LR) for primary gastrointestinal stromal tumors (GISTs) of the stomach >5 cm. Twelve consecutive patients who underwent RR from 2012 to 2015 were matched for tumor size and location with 24 patients who underwent LR from 2000 to 2012. The median tumor size was 7.1 cm (range, 5.5 to 11.5). GISTs were resected by wedge resection (91.7%) or distal gastrectomy. The median RR operative time was longer than that of LR (162.5 vs. 130 min, respectively; P=0.004). Only 1 LR patient required conversion. The time to flatus and hospital stay were similar between groups. Overall, 3 patients developed minor postoperative complications that w…

Factors Influencing Morbidity and Mortality after Pancreaticoduodenectomy: Critical Analysis of 221 Resections

1999

A critical analysis of morbidity and mortality for pancreatico-duodenectomy was performed on 221 patients. During the 1960s and 1970s, the morbidity and mortality for pancreaticoduodenectomy were so high that many thought the operative procedure ought to be abandoned. During the 1980s, however, many centers reported mortality rates around 5% and a morbidity of 25% to 35%. Others still reported a mortality of more than 10% and a morbidity of up to 65%. The reasons for these discrepancies are of major interest. In a prospective case-control study 760 patients with malignant and benign diseases of the pancreas were treated in our hospital between September 1, 1985 and April 30, 1997. In 221 ca…