• Title/Summary/Keyword: postoperative complications

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Association between Physical Activity and Postoperative Complications after Esophagectomy for Cancer: A Prospective Observational Study

  • Tatematsu, Noriatsu;Park, Moonhwa;Tanaka, Eiji;Sakai, Yoshiharu;Tsuboyama, Tadao
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.1
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    • pp.47-51
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    • 2013
  • Background: Postoperative complications after esophagectomy can lead to considerable patient discomfort and prolonged length of hospital stay. Lack of physical activity can be one of the independent risk factors for postoperative complications because physical activity is closely related to physical function. The objective of this study was to determine whether physical activity among esophageal cancer patients decreases their risk of postoperative complications after esophagectomy. Materials and Methods: We investigated 51 consecutive patients with newly diagnosed resectable esophageal cancer who were scheduled to receive esophagectomy between January 2009 and November 2011. Demographic, clinicopathologic, and treatment information were recorded and physical function was measured. The last 7-days short version of the International Physical Activity Questionnaire was used to assess physical activity before the operation. Stepwise multiple logistic regression analysis was used to determine whether preoperative physical activity is related to the risk of postoperative complications. Results: Male gender [OR 18.6, (95%CIs: 1.2-284.4); P=0.035], 3-field lymph node dissection (OR 9.6, [95%CIs: 1.4-66.6]; P=0.022), low-level physical activity (OR 28.3, [95%CIs: 3.5-227.7]; P=0.002), and preoperative comorbidities [OR 5.9, (95%CIs: 1.1-31.5); P=0.037] were found to be independently associated with postoperative complications. Conclusions: The present study shows that low-level physical activity, preoperative comorbidities, and 3-field lymph node dissection are independent and significant risk factors for postoperative complications after esophagectomy. Although further study is required, maintaining high-level physical activity preoperatively may decrease the risk of postoperative complications.

Low Serum Albumin Level, Male Sex, and Total Gastrectomy Are Risk Factors of Severe Postoperative Complications in Elderly Gastric Cancer Patients

  • Kang, Sung Chan;Kim, Hyun Il;Kim, Min Gyu
    • Journal of Gastric Cancer
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    • v.16 no.1
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    • pp.43-50
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    • 2016
  • Purpose: It is well known that old age is a risk factor for postoperative complications. Therefore, this study aimed to explore the risk factors for poor postoperative surgical outcomes in elderly gastric cancer patients. Materials and Methods: Between January 2006 and December 2015, 247 elderly gastric cancer patients who underwent curative gastrectomy were reviewed. In this study, an elderly patient was defined as a patient aged ${\geq}65$ years. All possible variables were used to explore the risk factors for poor early surgical outcomes in elderly gastric cancer patients. Results: Based on multivariate analyses of preoperative risk factors, preoperative low serum albumin level (<3.5 g/dl) and male sex showed statistical significance in predicting severe postoperative complications. Additionally, in an analysis of surgery-related risk factors, total gastrectomy was a risk factor for severe postoperative complications. Conclusions: Our study findings suggest that low serum albumin level, male sex, and total gastrectomy could be risk factors of severe postoperative complications in elderly gastric cancer patients. Therefore, surgeons should work carefully in cases of elderly gastric cancer patients with low preoperative serum albumin level and male sex. We believe that efforts should be made to avoid total gastrectomy in elderly gastric cancer patients.

Factors Affecting Postoperative Complications and Outcomes of Cervical Spondylotic Myelopathy with Cerebral Palsy : A Retrospective Analysis

  • Kim, Hyung Cheol;Jeon, Hyeongseok;Jeong, Yeong Ha;Park, Sangman;An, Seong Bae;Heo, Jeong Hyun;Shin, Dong Ah;Yi, Seong;Kim, Keung Nyun;Ha, Yoon;Cho, Sung-Rae
    • Journal of Korean Neurosurgical Society
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    • v.64 no.5
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    • pp.808-817
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    • 2021
  • Objective : Cervical surgery in patients with cervical spondylotic myelopathy (CSM) and cerebral palsy (CP) is challenging owing to the complexities of the deformity. We assessed factors affecting postoperative complications and outcomes after CSM surgery in patients with CP. Methods : Thirty-five consecutive patients with CP and CSM who underwent cervical operations between January 2006 and January 2014 were matched to 35 non-cerebral palsy (NCP) control patients. Postoperative complications and radiologic outcomes were compared between the groups. In the CP group, the Japanese Orthopaedic Association score; Oswestry neck disability index; modified Barthel index; and values for the grip and pinch, Box and Block, and Jebsen-Taylor hand function tests were obtained pre- and postoperatively and compared between those with and without postoperative complications. Results : Sixteen patients (16/35%) in the CP group and seven (7/35%) in the NCP group (p=0.021) had postoperative complications. Adjacent segment degeneration (p=0.021), postoperative motor weakness (p=0.037), and revisions (p=0.003) were significantly more frequent in the CP group than in the NCP group; however, instrument-related complications were not significantly higher in the CP group (7/35 vs. 5/35, p=0.280). The number of preoperative fixed cervical deformities were significantly higher in CP with postoperative complications (5/16 vs. 1/19, p=0.037). In the CP group, clinical outcomes were almost similar between those with and without postoperative complications. Conclusion : The occurrence of complications during the follow-up period was high in patients with CP. However, postoperative complications did not significantly affect clinical outcomes.

Frailty and elderly in urology: implications for postoperative complications

  • Song, Phil Hyun
    • Yeungnam University Journal of Medicine
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    • v.37 no.4
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    • pp.296-301
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    • 2020
  • The geriatric population is at a greater risk of postoperative complications than young adults. This risk is associated with the physiologic decline seen in this population known as frailty. Unlike fitter patients, frail patients who undergo operative treatment have a greater likelihood of developing postoperative complications and endure prolonged hospital stays. This circumstance is comparable to the urological status. Therefore, tolerable measurement of frailty as a domain of preoperative health status has been suggested to ascertain vulnerability in elderly patients. In this review, we will elaborate on the concept of frailty and examine its importance with respect to surgical complications, focusing on the urological status.

Complications in the Recipient Sites of Autologous Rib Cartilage Grafts for Microtia (소이증에서 자가늑연골 이식수혜부의 합병증)

  • Kim, Suk Wha;Ahn, Seung Hyun
    • Archives of Plastic Surgery
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    • v.35 no.6
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    • pp.703-708
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    • 2008
  • Purpose: Microtia is a congenital anomaly resulting from abnormal development of the branchial apparatus. Although significant modification and improvement of operative procedures for the reconstruction of the auricle with a natural appearance have been reported, postoperative complications, such as infection, flap necrosis and deformity, still remain serious problems in patients. Many studies with long-term results have focused mainly on operative procedures for an acceptable auricular shape without consideration of possible complications. Methods: We conducted a retrospective study on postoperative complications at the recipient sites of 183 patients who underwent auricular reconstruction with autologous rib cartilage grafts from November 1987 to January 2007 at the Division of Pediatric Plastic Surgery, Seoul National University Children's Hospital. Patients were analyzed in terms of the kinds and incidences of complications, and their treatment options. Results: Postoperative complications included wound dehiscence, flap necrosis, infection, hypertrophic scar, auricular deformity and absorption of rib cartilage grafts. The complications occurred in 47 patients with a complication rate of 25.7%. Fourteen patients were successfully managed with conservative treatment. However, surgical treatment was required in 51 reoperations(33 patients) of total 329 operations. Conclusion: Postoperative complications at the recipient sites of autologous rib cartilage grafts occurred with relatively high incidences and required long-term treatments and multiple surgeries. The results of this study may provide information on the causes and proper management of postoperative complications as well as safe procedures for the reconstruction of the auricle.

Postoperative care of geriatric patients (노인 수술환자의 수술후관리)

  • Lee, Dong Kyu;Kim, Yun Hee;Kim, Jae Hwan
    • Journal of the Korean Medical Association
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    • v.60 no.5
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    • pp.384-390
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    • 2017
  • The geriatric surgical population experiences greater morbidity and mortality than the general surgical population. Understanding the characteristics of postoperative complications in elderly patients and carrying out adequate preventive measures and treatments are the best way to reduce postoperative complications in the geriatric surgical population. The proportion of the geriatric population has gradually increased in the Republic of Korea, and this is a worldwide trend. The postoperative care of elderly patients has drawn particular attention given the increasing interest in geriatric medicine. We introduce several postoperative complications that are closely associated with the elderly surgical population and the possible etiology of these complications, and discuss the differences between the general patient population and elderly patients.

Postoperative Complications of Surgical Treatment for Graves' Disease (그레이브스병의 갑상선 절제술후 합병증)

  • Chang Hang-Seok;Kim Jong-Kwan;Chung Woong-Youn;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.15 no.1
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    • pp.61-65
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    • 1999
  • Introduction: The surgical treatment of Graves' disease has several advantage such as rapid and long lasting therapeutic effect, relatively low incidence of postoperative hypothyroidism and recurrence. Because of less frequent but serious postoperative complications, the operation have not been casually used for treatment of Graves' disease. Hypoclacemia, hoarseness and hematomas are common complications after operative treatment. However, the causative mechanisms of these complications have not been well explained. Objective: We aimed to analyze the risk factors affecting the occurance of complications in surgical treatment for Graves' disease and to evaluate what are the causative mechanisms of postoperative complications. Patients and Methods: From January 1985 to December 1998, a total of 668 surgically treated patients for Graves' disease were enrolled in this study. The incidence of postoperative complications were analyzed in relation to types of surgery, preoperaive preparation, specimen weight, bleeding amount and remnant weight. Results: Postoperative complication was developed in 108(16.2%) of 668 patients. The most common complication was transient hypocalcemia in 85 cases(12.7%). Other complications were: Hematoma in 9 cases(1.3%), transient hoarseness in 5 cases(0.7%), permanent hypocalcemia in 6 cases(0.9%), permanent hoarseness in 3 case(0.4%). The important etiologic factors affecting the occurance of complications were preoperative preparation, perioperative thyroid weight, and remnant thyroid weight. Since 1993, the incidence of complication was more decreased than that in before. Conclusion: To decrease the incidence of postoperative complications of Graves' disease, the patients should be selected carefully, sufficient preoperative preparation should be achieved, and the operation should be performed by well-experienced surgeons.

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Impact of Lifestyle Diseases on Postoperative Complications and Survival in Elderly Patients with Stage I Non-Small Cell Lung Cancer

  • Jeong, Sang Seok;Choi, Pil Jo;Yi, Jung Hoon;Yoon, Sung Sil
    • Journal of Chest Surgery
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    • v.50 no.2
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    • pp.86-93
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    • 2017
  • Background: The influence of lifestyle diseases on postoperative complications and long-term survival in patients with non-small cell lung cancer (NSCLC) is unclear. The aim of this study was to determine whether lifestyle diseases were significant risk factors of perioperative and long-term surgical outcomes in elderly patients with stage I NSCLC. Methods: Between December 1995 and November 2013, 110 patients aged 65 years or older who underwent surgical resection of stage I NSCLC at Dong-A University Hospital were retrospectively studied. We assessed the presence of the following lifestyle diseases as risk factors for postoperative complications and long-term mortality: diabetes, hypertension, chronic obstructive pulmonary disease, stroke, and ischemic heart disease. Results: The mean age of the patients was 71 years (range, 65 to 82 years). Forty-six patients (41.8%) had hypertension, making it the most common lifestyle disease, followed by diabetes (n=23, 20.9%). The in-hospital mortality rate was 0.9% (n=1). The 3-year and 5-year survival rates were 78% and 64%, respectively. Postoperative complications developed in 32 patients (29.1%), including 7 (6.4%) with prolonged air leakage, 6 (5.5%) with atrial fibrillation, 5 (4.5%) with delirium and atelectasis, and 3 (2.7%) with acute kidney injury and pneumonia. Univariate and multivariate analyses showed that the presence of a lifestyle disease was the only independent risk factor for postoperative complications. In survival analysis, univariate analysis showed that age, smoking, body mass index, extent of resection, and pathologic stage were associated with impaired survival. Multivariate analysis revealed that resection type (hazard ratio [HR], 2.20; 95% confidence interval [CI], 1.08 to 4.49; p=0.030) and pathologic stage (HR, 1.89; 95% CI, 1.02 to 3.49; p=0.043) had independent adverse impacts on survival. Conclusion: This study demonstrated that the presence of a lifestyle disease was a significant prognostic factor for postoperative complications, but not of survival, in elderly patients with stage I NSCLC. Therefore, postoperative complications may be influenced by the presence of a lifestyle disease.

Comparing the Postoperative Complications, Hospitalization Days and Treatment Expenses Depending on the Administration of Postoperative Prophylactic Antibiotics to Hysterectomy (자궁적출술 후 예방적 항생제 사용 여부별 수술 후 합병증, 재원기간 및 치료비 비교)

  • Jung, Mi Young;Park, Kyung-Yeon
    • Korean Journal of Women Health Nursing
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    • v.23 no.1
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    • pp.42-51
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    • 2017
  • Purpose: This study was conducted to compare postoperative complications, hospitalization days and treatment expenses to postoperative prophylactic antibiotics administrated to hysterectomy or not. Methods: A retrospective survey study was performed with 128 cases in which elective hysterectomy had undergone. They were divided into two groups by identifying whether postoperative prophylactic antibiotics was administered for hysterectomy: a) one group who received postoperative prophylactic antibiotics and; b) those who did not. Data were collected using the electric medical record at a hospital and analyzed by SPSS 23.0 for $x^2$ test, t-test and ANCOVA. Results:Postoperative complications including wound infection (p=1.000), pneumonia (p=.496), hematoma (p=.530), and pneumoperitoneum (p=.496) showed no significant differences between two groups. Hospitalization days for the prophylactic antibioticsadministrated group were significantly longer than the non-administered for prophylactic antibiotics (p=.004). The treatment expenses of the prophylactic antibiotics-administrated group were significantly higher than those of the non-administered prophylactic antibiotics (F=4.31, p=.040). Conclusion: These results can be provided for the evidence of administrating postoperative prophylactic antibiotics to hysterectomy. Additionally, it can contribute to decreasing the medication errors caused by infrequently administrating postoperative prophylactic antibiotics as well as to lessening likelihood of infection of intravenous injection site.

Impact of Various Types of Comorbidities on the Outcomes of Laparoscopic Total Gastrectomy in Patients with Gastric Carcinoma

  • Jeong, Oh;Jung, Mi Ran;Ryu, Seong Yeob
    • Journal of Gastric Cancer
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    • v.18 no.3
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    • pp.253-263
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    • 2018
  • Purpose: With increasing life expectancy, the presence of comorbidities has become a major concern in elderly patients who require surgery. However, little is known about the impact of different comorbidities on the outcomes of laparoscopic total gastrectomy (LTG). In this study, we investigated the impact of comorbidities on postoperative complications in patients undergoing LTG for gastric carcinoma. Materials and Methods: We retrospectively reviewed the cases of 303 consecutive patients who underwent LTG for gastric carcinoma between 2005 and 2016. The associations between each comorbidity and postoperative complications were assessed using univariate and multivariate analyses. Results: A total of 189 patients (62.4%) had one or more comorbidities. Hypertension was the most common comorbidity (37.0%), followed by diabetes mellitus (17.8%), chronic viral hepatitis (2.6%), liver cirrhosis (2.6%), and pulmonary (27.1%), ischemic heart (3.3%), and cerebrovascular diseases (2.3%). The overall postoperative morbidity and mortality rates were 20.1% and 1.0%, respectively. Patients with pulmonary disease significantly showed higher complication rates than those without comorbidities (32.9% vs. 14.9%, respectively, P=0.003); patient with other comorbidities showed no significant difference in the incidence of LTG-related complications. During univariate and multivariate analyses, pulmonary disease was found to be an independent predictive factor for postoperative complications (odds ratio, 2.14; 95% confidence interval, 1.03-4.64), along with old age and intraoperative bleeding. Conclusions: Among the various comorbidities investigated, patients with pulmonary disease had a significantly higher risk of postoperative complications after LTG. Proper perioperative care for optimizing pulmonary function may be required for patients with pulmonary disease.