• Title/Summary/Keyword: Operative time

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Factors Influencing Intra-Operative Body Temperature in Laparoscopic Colectomy Surgery under General Anesthesia: An Observational Cohort

  • Kong, Mi Jin;Yoon, Haesang
    • Journal of Korean Biological Nursing Science
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    • v.19 no.3
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    • pp.123-130
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    • 2017
  • Purpose: This study aimed to identify factors influencing intra-operative core body temperature (CBT), and to develop a predictive model for intra-operative CBT in laparoscopic abdominal surgery. Methods: The prospective observational study involved 161 subjects, whose age, weight, and height were collected. The basal pre-operative CBT, pre-operative blood pressure, and heartbeat were measured. CBT was measured 1 hour and 2 hours after pneumoperitoneum. Results: Explanatory factors of intra-operative hypothermia (< $36^{\circ}C$) were weight (${\beta}=.361$, p< .001) and pre-operative CBT (${\beta}=.280$, p= .001) 1 hour after pneumoperitoneum (Adjusted $R^2=.198$, F= 7.56, p< .001). Weight was (${\beta}=.423$, p< .001) and pre-operative CBT was (${\beta}=.206$, p= .011) 2 hours after pneumoperitoneum (Adjusted $R^2=.177$, F= 5.93, p< .001). The researchers developed a predictive model for intra-operative CBT ($^{\circ}C$) by observing intra-operative CBT, body weight, and pre-operative CBT. The predictive model revealed that intra-operative CBT was positively correlated with body weight and pre-operative CBT. Conclusion: Influence of weight on intra-operative hypothermia increased over time from 1 hour to 2 hours after pneumoperitoneum, whereas influence of pre-operative CBT on intraoperative hypothermia decreased over time from 1 hour to 2 hours after pneumoperitoneum. The research recommends pre-warming for laparoscopic surgical patients to guard against intra-operative hypothermia.

Arthroscopic Repair versus Non-operative Treatment of First-time Traumatic Anterior Shoulder Dislocations: A Numbers-needed-to-treat Analysis for Prevention of Recurrent Dislocations

  • Park, Jihong;Cosby, Nicole L.
    • Clinics in Shoulder and Elbow
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    • v.19 no.2
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    • pp.110-116
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    • 2016
  • Background: Arthroscopic surgical repair is a better intervention than non-operative (conservative) treatment for patients with shoulder dislocations. This systematic review determined the numbers-needed-to-treat (NNT) and relative risk reduction (RRR) associated with arthroscopic surgical repair versus non-operative treatment in reducing recurrence rates among patients with first-time traumatic anterior shoulder dislocations. Methods: We searched Google Scholar, MEDLINE, SPORTDiscus, and CINAHL from inception in 2015. All articles had to compare arthroscopic surgical repair and non-operative treatment and be written in English. We used the total number of subjects and the number of recurrent dislocations within each treatment to calculate the NNT and RRR for each study and the pooled data. Results: Six articles were selected and all clearly demonstrated that the arthroscopic surgical repair was more effective than non-operative treatment in reducing the recurrence episodes. The pooled NNT was 1.76 (95% confidence interval [CI]=NNT to benefit 1.50-2.13) and the pooled RRR was 86.0% (95% CI=77.0%-92.0%) among individuals who underwent arthroscopic repair. The average follow-up time was 56 months. Conclusions: A Strength of Recommendation Taxonomy level of evidence of 1 with a grade A recommendation supports the use of arthroscopic surgical repair over non-operative treatment in prevention of first-time traumatic anterior shoulder dislocations. We suggest that sports medicine practitioners consider the patients' age, occupation, and physical activity level when making a clinical decision.

Evaluation of Stapled versus Hand-Sewn Techniques for Colo-Rectal Anastomosis after Low Anterior Resection of Mid-Rectal Carcinoma: a Study on 50 Patients

  • Fayek, Ihab Samy
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.13
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    • pp.5427-5431
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    • 2014
  • Aim: To evaluate the outcome of stapled versus sutured colo-rectal anastomosis after low anterior resection of mid-rectal carcinoma. Patients and Methods: A prospective study of fifty patients who underwent colo-rectal anastomosis following low anterior resection (LAR) of T2 mid-rectal cancers at the Egyptian National Cancer Institute during the time period from June 2010 to June 2013 was conducted. Classification was into two groups; a stapled anastomosis group I (25 patients) and a hand-sewn anastomosis group II (25 patients). All operations are evaluated regarding intra-operative complications such as anastomotic line bleeding, visceral injuries or major blood loss. The anastomotic time and operative time are documented for each operation. All patients are evaluated post-operatively for anastomotic leakage (AL), wound infection and ileus. Results: The distance of the tumor from the anal verge was $9.6{\pm}2.0cm$ in group I and $9.9{pm}2.4cm$ in group II. The mean operative time was $191.5{\pm}16.2min$ in the stapled group and $208{\pm}18.6min$ in the sutured group (p=0.002). The mean anastomotic times were $9.0{\pm}1.9min$ and $19.7{pm}12.2min$ (p=0.001). Anastomotic leakage developed in three (12.0%) patients in the stapled group and in four (16.0%) patients in the sutured group (p=1.000). Post-operative ileus was observed in 3 patients in group I and one patient in group II. Wound infection developed in three (12.0%) patients in the stapled group and four (16.0%) patients in the sutured group (p=1.000). Conclusion: Colo-rectal anastomosis after low anterior resection for mid rectal carcinoma can be conducted safely either by stapling or hand-sewn techniques; however the stapling technique showed shorter anastomotic and operative times with no significant advantages regarding intra- or post-operative complications or hospital stay.

Storage of laboratory animal blood samples causes hemorheological alterations : Inter-species differences and the effects of duration and temperature

  • Nemeth, Norbert;Baskurt, Oguz K.;Meiselman, Herbert J.;Kiss, Ferenc;Uyuklu, Mehmet;Hever, Timea;Sajtos, Erika;Kenyeres, Peter;Toth, Kalman;Furka, Istvan;Miko, Iren
    • Korea-Australia Rheology Journal
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    • v.21 no.2
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    • pp.127-133
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    • 2009
  • Hemorheological results may be influenced by the time between blood sampling and measurement, and storage conditions (e.g., temperature, time) during sample delivery between laboratories may further affect the resulting data. This study examined possible hemorheological alterations subsequent to storage of rat and dog blood at room temperature ($22^{\circ}C$) or with cooling ($4{\sim}10^{\circ}C$) for 2, 4, 6, 24, 48 and 72 hours. Measured hemorheological parameters included hematological indices, RBC aggregation and RBC deformability. Our results indicate that marked changes of RBC deformability and of RBC aggregation in whole blood can occur during storage, especially for samples stored at room temperature. The patterns of deformability and aggregation changes at room temperature are complex and species specific, whereas those for storage at the lower temperature range are much less complicated. For room temperature storage, it thus seems logical to suggest measuring rat and dog cell deformability within 6 hours; aggregation should be measured immediately for rat blood or within 6 hours for dog blood. Storage at lower temperatures allows measuring EI up to 72 hours after sampling, while aggregation must be measured immediately, or if willing to accept a constant decrease, over 24~72 hours.

Factors influencing the prognosis after total correction of tetralogy of Fallot (Fallot 4징증의 근치수술후 예후에 영향을 미치는 요소)

  • Min, Yong-Il;O, Bong-Seok;Lee, Dong-Jun
    • Journal of Chest Surgery
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    • v.20 no.1
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    • pp.71-80
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    • 1987
  • Twenty six patients were operated a total correction of tetralogy of Fallot between Jan., 1984 and July, 1985 at the Dept. of thoracic and cardiovascular surgery, Chonnam University Medical School, and a comparison between the survived group [n = 18] and the dead group [n = B was performed to detect factors influencing laboratory data, cineangiographic findings, operative findings and methods, and pump time. Following results were obtained, 1. There was no significant difference between two groups in the preoperative P.O2 and hematocrit level. 2. The size of the interventricular defect was not related to the operative mortality. 3. There was a significant difference in mortality rate between combined type of stenosis of pulmonary artery, valve and infundibulum and other types of right ventricular outflow tract stenosis. 4. There was a significant difference in mortality rate between the transannular patch reconstruction and other types of operative procedure. 5. There was no significant difference between two groups in total bypass time and aortic time. 6. There was no significant difference between two groups in left ventricular end diastolic volume and right ventricular end diastolic volume. 7. The operative mortality was related to the ratio of the diameter of the pulmonary valve annulus or each pulmonary artery to the ascending or descending aorta in cineangiographic findings, but there was no statistical significance of which probably is due to the lack of the total number of patients.

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Can Robotic Gastrectomy Surpass Laparoscopic Gastrectomy by Acquiring Long-Term Experience? A Propensity Score Analysis of a 7-Year Experience at a Single Institution

  • Hong, Sung-Soo;Son, Sang-Yong;Shin, Ho-Jung;Cui, Long-Hai;Hur, Hoon;Han, Sang-Uk
    • Journal of Gastric Cancer
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    • v.16 no.4
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    • pp.240-246
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    • 2016
  • Purpose: It is hypothesized that robotic gastrectomy may surpass laparoscopic gastrectomy after the operators acquire long-term experience and skills in the manipulation of robotic arms. This study aimed to evaluate the long-term learning curve of robotic distal gastrectomy (RDG) for gastric cancer compared with laparoscopic distal gastrectomy (LDG). Materials and Methods: From October 2008 to December 2015, patients who underwent LDG (n=809) were matched to patients who underwent RDG (n=232) at a 1:1 ratio, by using a propensity score matching method after stratification for the operative year. The surgical outcomes, such as trends of operative time, blood loss, and complication rate, were compared between the two groups. Results: The RDG group showed a longer operative time (171.3 minutes vs. 147.6 minutes, P<0.001) but less estimated blood loss (77.6 ml vs. 116.6 ml, P<0.001). The complication rate and postoperative recovery did not differ between the two groups. The RDG group showed a longer operative time and similar estimated blood loss compared with the LDG group after 5 years of experience (operative time: 159.2 minutes vs. 136.0 minutes in 2015, P=0.003; estimated blood loss: 72.9 ml vs. 78.1 ml in 2015, P=0.793). Conclusions: In terms of short-term surgical outcomes, RDG may not surpass LDG after a long-term experience with the technique.

Sevoflurane with opioid or dexmedetomidine infusions in dogs undergoing intracranial surgery: a retrospective observational study

  • Marquez-Grados, Felipe;Vettorato, Enzo;Corletto, Federico
    • Journal of Veterinary Science
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    • v.21 no.1
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    • pp.8.1-8.11
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    • 2020
  • This study reports the clinical use of two sevoflurane-based anesthetic techniques in dogs undergoing craniectomy. Twenty-one animals undergoing elective rostrotentorial or transfrontal craniectomy for brain tumor excision, anesthetized with sevoflurane, were enrolled in this retrospective, observational study. Anesthetic records were allocated to two groups: Sevo-Op (sevoflurane and short acting opioid infusion): 8 dogs and Sevo-Dex (sevoflurane and dexmedetomidine infusion): 13 dogs. Average mean arterial pressure (MAP), heart rate, end-tidal carbon dioxide, end-tidal sevoflurane and intraoperative infusion rates during surgery were calculated. Presence of intra-operative and post-operative bradycardia, tachycardia, hypotension, hypertension, hypothermia, hyperthermia was recorded. Time to endotracheal extubation, intraoperative occurrence of atrioventricular block, postoperative presence of agitation, seizures, use of labetalol and dexmedetomidine infusion were also recorded. Data from the two groups were compared with Fisher's exact test and unpaired t tests with Welch's correction. Odds ratio (OR) and 95% confidence interval (CI) were calculated for categorical variables. Intra-operatively, MAP was lower in Sevo-Op [85 (± 6.54) vs. 97.69 (± 7.8) mmHg, p = 0.0009]. Time to extubation was longer in Sevo-Dex [37.69 (10-70) vs. 19.63 (10-25), p = 0.0033]. No differences were found for the other intra-operative and post-operative variables investigated. Post-operative hypertension and agitation were the most common complications (11 and 12 out of 21 animals, respectively). These results suggest that the infusion of dexmedetomidine provides similar intra-operative conditions and post-operative course to a short acting opioid infusion during sevoflurane anesthesia in dogs undergoing elective rostrotentorial or transfrontal intracranial surgery.

CONSIDERABLE FACTORS FOR FINAL OCCLUSION IN PRE-ORTHODONTIC LOWER ANTERIOR SEGMENTAL SURGERY AND ITS AVAILABILITY (교정전 하악전치부 분절골절단술 시행시 고려사항 및 그 유용성)

  • Lee, Baek-Soo;Choi, Hyun-Jung;Nam, Kwang-Ho;Ryu, Dong-Mok
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.29 no.1
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    • pp.43-47
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    • 2003
  • Anterior set back segmental surgery has been used for shortening the period of orthodontic treatment in case of bimaxillary or maxillary protrusion. In most cases, it requires pre-operative orthodontic treatment. Through properly performed leveling and tooth aligning, the operative porcedure can be easier and post-operative occlusal stability can be increased. But it takes time for orthodontic treatment. Recently, we have been using anterior segmental surgery before orthodontic treatment and have reliable results from that. Therefore, we have to consider arch shape, curve of Spee, tooth selection to be extracted for obtaining of post-operative occlusal stability without pre-operative orthodontic treatment.

A comparison of using a smartphone versus a surgical microscope for microsurgical anastomosis in a non-living model

  • Jianmongkol, Surut;Vinitpairot, Chaiyos;Thitiworakarn, Navapong;Wattanakamolchai, Settapon
    • Archives of Plastic Surgery
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    • v.49 no.1
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    • pp.121-126
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    • 2022
  • Background Although they may not replace standard training methods that use surgical microscopes, smartphones equipped with high-resolution screens and high-definition cameras are an attractive alternative for practicing microsurgical skills. They are ubiquitous, simple to operate, and inexpensive. This study compared anastomoses of chicken femoral vessels using a smartphone camera versus a standard operative microscope. Methods Forty anastomoses of non-living chicken femoral vessels were divided into four groups. A resident and an experienced microsurgeon performed anastomoses of femoral chicken vessels with 8-0 and 10-0 sutures, using a smartphone camera and a surgical microscope. The time to complete the anastomosis and the number of anastomosis errors were compared using the Mann-Whitney U test. Results The time taken to perform an anastomosis by the experienced microsurgeon was significantly longer when using the smartphone (median: 32.5 minutes vs. 20 minutes, P<0.001). The resident completed the anastomoses with both types of equipment without a significant difference in the operative times. When using a smartphone, the operation times were not significantly different between the resident and the experienced microsurgeon (P=0.238). The resident showed non-significant differences in operation time and the number of errors when using a smartphone or an operative microscope (P=1.000 and P=0.065, respectively). Conclusions Microsurgical practice with non-living chicken femoral vessels can be performed with a smartphone, though it can take longer than with an operative microscope for experienced microsurgeons. The resident may also experience frustration and tend to make more anastomosis errors when using a smartphone versus an operative microscope.

Improvement of Parent and Family Satisfaction by Offering Informational Interventions throughout Surgery (수술 중 정보제공을 통한 환자 부모 및 가족의 만족도 증진)

  • Hong, Hee Jung;Lee, Myoung Ae
    • Quality Improvement in Health Care
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    • v.7 no.1
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    • pp.90-104
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    • 2000
  • Background : This study was designed to assess the effects of information on the satisfaction of parents and families whose children underwent elective surgery in the Pediatric Operating Room. Methods : We measured parent and family satisfaction with information given before and after offering informational interventions. The data were collected from 510 patients parents and families whose children had undergone elective surgery in the Pediatric Operating Room of Seoul National University Hospital in Seoul. South Korea. The data collection ran from May 3. 1999 to May 30. 1999 and from September 6, 1999 to September 30, 1999. The research instrument consisted of four categories (pre-operative period, intra-operative period, post-operative period, others) and 24 questionnaires. SPSS was used to analyze the data. Results : The major findings of this study are summarized as follows: 1. Before surgery, the satisfaction with the following was increased: the explanations of the necessary preparation for the surgery (6.0%), the time the patient would enter the operating room (20.6%), the operative procedure (2.0%), and the use of the waiting room (10.0%). 2. During the operation, the satisfaction with the situation board (15.1%), public announcements in the waiting room (8.4%), and the answering of the families questions (12.2%) was increased. however, the satisfaction with the surgeons explanations of the surgical outcomes decreased by 8.3%, even though the frequency of these explanations increased by 5%. 3. After surgery, the satisfaction with the following was increased: the explanations of patient's status of recovery(10.3%) the time the patient would be moved from the recovery room (17.6%), how the patient would be transferred to the ward (19.2%), and post-operative care (6.3%). Conclusion : Based upon the above findings, we concluded that pre-, intra-, and post-operative informational interventions were effective in increasing the satisfaction of the parents and families of children undergoing elective surgery.

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