Search results for "Length of Stay"
showing 10 items of 179 documents
Randomized clinical trial of pancreaticogastrostomy versus pancreaticojejunostomy on the rate and severity of pancreatic fistula after pancreaticoduo…
2013
Abstract Background Anastomotic leakage of pancreaticojejunostomy (PJ) remains the single most important source of morbidity after pancreaticoduodenectomy (PD). The primary aim of this randomized clinical trial comparing PG with PJ after PD was to test the hypothesis that invaginated PG would result in a lower rate and severity of pancreatic fistula. Methods Patients undergoing PD were randomized to receive either a duct-to-duct PJ or a double-layer invaginated PG. The primary endpoint was the rate of pancreatic fistula, using the definition of the International Study Group on Pancreatic Fistula. Secondary endpoints were the evaluation of severe abdominal complications (Clavien–Dindo grade …
Management of Pneumothoraces Detected on Chest Computed Tomography: Can Anatomical Location Identify Patients Who Can Be Managed Expectantly?
2014
Abstract Background Pneumothorax (PTX) can be readily detected by computed tomography (CT) or ultrasound. However, management of PTX in hemodynamically stable patients remains controversial. Study Objectives We sought to investigate whether a distinct anatomical distribution of PTX along prespecified chest zones as detected by CT can be described in patients with or without subsequent chest tube thoracotomy (CTT), thus potentially allowing the extended focused assessment with sonography for trauma (EFAST) ultrasound examination to guide PTX management. Methods We performed a retrospective review of chest CT scans performed in the emergency department (ED) of a Level I trauma center. CT scan…
Outcome of orbital decompression for disfiguring proptosis in patients with Graves' orbitopathy using various surgical procedures
2009
Aim: To compare the outcome of various surgical approaches of orbital decompression in patients with Graves' orbitopathy (GO) receiving surgery for disfiguring proptosis.Method: Data forms and questionnaires from consecutive, euthyroid patients with inactive GO who had undergone orbital decompression for disfiguring proptosis in 11 European centres were analysed.Results: Eighteen different (combinations of) approaches were used, the swinging eyelid approach being the most popular followed by the coronal and transconjunctival approaches. The average proptosis reduction for all decompressions was 5.0 (SD 2.1) mm. After three-wall decompression the proptosis reduction was significantly greater…
Association between night-time extubation and clinical outcomes in adult patients
2021
Background: Whether night-time extubation is associated with clinical outcomes is unclear. Objective: The aim of this systematic review and meta-analysis was to evaluate the association between night-time extubation and the reintubation rate, mortality, ICU and in-hospital LOS in adult patients, compared with daytime extubation. Design: A systematic review and meta-analysis. Data sources: PubMed, EMBASE, CINAHL and Web of Science from inception to 2 January 2021 (PROSPERO registration - CRD42020222812). Eligibility criteria: Randomised, quasi and cluster randomised, and nonrandomised studies describing associations between adult patients' outcomes and time of extubation (daytime/night-time)…
Metoclopramide and diphenhydramine in the treatment of hyperemesis gravidarum: effectiveness and predictors of rehospitalisation.
2007
Abstract Objectives Hyperemesis gravidarum (HG) is the second most common reason for hospitalisation during pregnancy. Since 2002, a new HG treatment protocol consisting of metoclopramide plus diphenhydramine was put in place at CHU Sainte-Justine, affiliated to University of Montreal, Quebec, Canada. The objectives of this study were to evaluate the effectiveness of this new HG protocol regarding length of hospitalisation for HG, rate of rehospitalisation, evolution of nausea and vomiting symptoms, and rate of adverse events. Study design A retrospective cohort study was conducted from 2002 to 2006 on the population of pregnant women diagnosed with HG, and treated at CHU Sainte-Justine wit…
Noninvasive ventilation in chest trauma: systematic review and meta-analysis
2013
Purpose: Single studies of Noninvasive Ventilation (NIV) in the management of acute respiratory failure in chest trauma patients have produced controversial findings. The aim of this study is to critically review the literature to investigate whether NIV reduces mortality, intubation rate, length of stay and complications in patients with chest trauma, compared to standard therapy. Methods: We performed a systematic review and meta-analysis of randomized controlled trials, prospective and retrospective observational studies, by searching PubMed, EMBASE and bibliographies of articles retrieved. We screened for relevance studies that enrolled adults with chest trauma who developed mild to sev…
From laparoscopic assisted radical vaginal hysterectomy to vaginal assisted laparoscopic radical hysterectomy
2011
Radical hysterectomy with pelvic lymphadenectomy is the standard surgical treatment for patients with early stage cervical cancer. The majority of radical hysterectomies are performed with the open technique. However, laparoscopic, combined laparoscopic and vaginal, and robotic-assisted approaches may also be used. Compared with the abdominal radical hysterectomy (ARH), laparoscopic techniques are associated with less blood loss, shorter hospital stay, better cosmesis, and faster recovery. A further breakthrough in laparoscopic technique can only be made if safety and oncological clearance are comparable with ARH. We describe the technique and results of laparoscopic assisted radical vagina…
Fully robotic left hepatectomy for malignant tumor: technique and initial results
2018
Robotic liver surgery has been considered as a unique opportunity to overcome the traditional limitations of laparoscopy; thus, it can potentially extend the indications of minimally invasive liver surgery. From April 2015 to May 2017, 35 patients underwent fully robotic left hepatectomy. The mean operative time was 315 min (200-445 min) and the mean estimated blood loss was 245 ml (125-628 ml). Pringle maneuver was required in six cases. Cancer was the indication for surgery in all patients (14 liver metastases, 18 hepatocellular carcinomas and 3 cholangiocarcinomas). There were one to four lesions in a patient and the mean lesion size was 39.2 mm (15-85 mm). The average length of hospital…
Laparoscopic Splenectomy for Secondary Cytoreduction in Ovarian Cancer Patients With Localized Spleen Recurrence: Feasibility and Technique
2016
Abstract Study Objective To investigate the feasibility of laparoscopic splenectomy in patients with recurrent ovarian cancer with isolated spleen metastasis. Design (Canadian Task Force classification III). Setting Tertiary referral centre in Rome, Italy. Patients Eight women with an isolated platinum-sensitive splenic relapse of ovarian cancer. Intervention Between February 2013 and May 2015, 8 women with an isolated platinum-sensitive splenic relapse of ovarian cancer were submitted to laparoscopic splenectomy. Measurements and Main Results All patients underwent laparoscopic splenectomy without conversion to an open approach. The median estimated intraoperative blood loss was 100 mL (ra…
Clinical significance of increased intraabdominal pressure in severe acute pancreatitis.
2002
The aim of the study was to assess whether increased intra-abdominal pressure affects the clinical course and reflects on the effectiveness of the conservative treatment in patients with severe acute pancreatitis. Data on 37 consecutive patients with severe acute pancreatitis that were collected prospectively included APACHE II score, daily measurement of the intra-abdominal pressure, and clinical routine. Group A consisted of 26 patients with intra-abdominal pressure < 25 cm/H 2 O during their treatment period, and group B consisted of 11 patients with intraabdominal pressure ≥ 25 cm/H 2 O. SIRS, MODS, complication rate and mortality were analysed. The age, APACHE II scores and hospital st…