Background: Laparoscopic cholecystectomy (LC) is incapacitated by occurrence of bile duct injury (BDI). Precise identification of the frequently variable biliary anatomy is important for prevention of BDI. Rouviere’s sulcus received a significant interest as useful landmark to prevent BDI. This study aims to describe the frequency of Rouviere’s sulcus, its various patterns, dimension and to assess its usefulness as a landmark during LC. Methods: The study was carried on 100 consecutive cases of LC performed at our center between July 2017 and July 2018. Analysis of video recording of the laparoscopic procedure together with operative measurements was used to assess frequency, pattern, direction and various measurements of Rouviere’s sulcus. Results: Rouviere’s sulcus was evident during LC in 86% of cases and the sulcus type (whether open or closed) constituted 80.2% of evident Rouviere’s sulcus. The average measurement for this type was found to be about an inch in length, and less than 1 cm in both width and depth. Closed type of Rouviere’s sulcus was significantly narrower compared to open type (p = 0.00), while the difference in length and depth did not reach statistical significance. Conclusion: Rouviere’s sulcus is evident in majority of cases with sulcus type as its commonest pattern. Rouviere’s sulcus served as a useful landmark if it was visualized and not vertically directed. It allows for safe biliary dissection through identifying the level of common bile duct in more 86% of cases.
{"title":"The Laparoscopic Anatomy of Rouviere’s Sulcus","authors":"M. Abdelfattah","doi":"10.2147/oas.s341710","DOIUrl":"https://doi.org/10.2147/oas.s341710","url":null,"abstract":"Background: Laparoscopic cholecystectomy (LC) is incapacitated by occurrence of bile duct injury (BDI). Precise identification of the frequently variable biliary anatomy is important for prevention of BDI. Rouviere’s sulcus received a significant interest as useful landmark to prevent BDI. This study aims to describe the frequency of Rouviere’s sulcus, its various patterns, dimension and to assess its usefulness as a landmark during LC. Methods: The study was carried on 100 consecutive cases of LC performed at our center between July 2017 and July 2018. Analysis of video recording of the laparoscopic procedure together with operative measurements was used to assess frequency, pattern, direction and various measurements of Rouviere’s sulcus. Results: Rouviere’s sulcus was evident during LC in 86% of cases and the sulcus type (whether open or closed) constituted 80.2% of evident Rouviere’s sulcus. The average measurement for this type was found to be about an inch in length, and less than 1 cm in both width and depth. Closed type of Rouviere’s sulcus was significantly narrower compared to open type (p = 0.00), while the difference in length and depth did not reach statistical significance. Conclusion: Rouviere’s sulcus is evident in majority of cases with sulcus type as its commonest pattern. Rouviere’s sulcus served as a useful landmark if it was visualized and not vertically directed. It allows for safe biliary dissection through identifying the level of common bile duct in more 86% of cases.","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47101115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Cecal volvulus is a rare cause of adult intestinal obstruction occurring 2.8– 7.1 persons per million per year. Its rarity and the variety of clinical symptoms may lead to a delay in the diagnosis and appropriate intervention. Case Presentation: Here, we present a 25-year old female patient from a rural area who presented with a 3-day history of colicky abdominal pain and vomiting of bilious intestinal content; she had also developed abdominal distension, failed to pass feces, and flatus. She underwent emergency laparotomy, where the intraoperative finding was a perforated 360 degrees counterclockwise volvulated cecum, and a right hemicolectomy was performed with primary ileotransverse anastomosis. Discussion: Cecal volvulus is the axial rotation of the cecum, ascending colon, and terminal ileum. This can result either in complete or partial obstruction of the affected segment of the intestine with impending vascular compromise and gangrene, which mandates a timely diagnosis and intervention. Conclusion: Cecal volvulus is a rare cause of adult intestinal obstruction, and urgent surgical intervention saves the life of patients. of surgery from to surgical procedures covered. Novel techniques and the utilization of new instruments and materials, including implants and prostheses that optimize outcomes constitute areas of interest. The manuscript management system completely online includes a very and peer-review all to
{"title":"Cecal Volvulus: A Case Report and Review of the Literature","authors":"Binyam Yohannes, M. Muleta","doi":"10.2147/oas.s324705","DOIUrl":"https://doi.org/10.2147/oas.s324705","url":null,"abstract":"Background: Cecal volvulus is a rare cause of adult intestinal obstruction occurring 2.8– 7.1 persons per million per year. Its rarity and the variety of clinical symptoms may lead to a delay in the diagnosis and appropriate intervention. Case Presentation: Here, we present a 25-year old female patient from a rural area who presented with a 3-day history of colicky abdominal pain and vomiting of bilious intestinal content; she had also developed abdominal distension, failed to pass feces, and flatus. She underwent emergency laparotomy, where the intraoperative finding was a perforated 360 degrees counterclockwise volvulated cecum, and a right hemicolectomy was performed with primary ileotransverse anastomosis. Discussion: Cecal volvulus is the axial rotation of the cecum, ascending colon, and terminal ileum. This can result either in complete or partial obstruction of the affected segment of the intestine with impending vascular compromise and gangrene, which mandates a timely diagnosis and intervention. Conclusion: Cecal volvulus is a rare cause of adult intestinal obstruction, and urgent surgical intervention saves the life of patients. of surgery from to surgical procedures covered. Novel techniques and the utilization of new instruments and materials, including implants and prostheses that optimize outcomes constitute areas of interest. The manuscript management system completely online includes a very and peer-review all to","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48186450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Kobayashi, Eiji Yoshida, Takuro Kyuno, R. Kawagishi, Kei Sato, Tsuyoshi Kono, T. Chiba, H. Yonezawa, O. Funato, A. Takagane
Purpose: Faster surgery has been associated with better outcomes. In the present study, we aimed to determine whether surgical duration affected overall survival (OS) in patients undergoing esophagectomy. Additionally, we assessed factors that influence surgical duration. Patients and Methods: This single-center retrospective cohort study included 128 patients who underwent Ivor-Lewis esophagectomy by a single surgeon between 2005 and 2019. The Cox proportional hazard model was used to evaluate the association of OS with the following variables: surgical duration, neo-adjuvant chemotherapy, pathological grade of depth of tumor invasion, lymph node (LN) metastasis, body mass index (BMI), and cervical LN dissection. Additionally, factors associated with prolonged surgical duration were examined by logistic regression analysis. Results: Based on the multivariate analysis, surgical duration was not associated with OS [hazard ratio (HR), 1.065; 95% confidence interval (CI), 0.586–1.937; P = 0.837]. On the other hand, tumor invasion (HR, 2.901; 95% CI, 1.483–5.674; P = 0.002) and LN metastasis (HR, 2.338 2.403; 95% CI, 1.237–4.420 1.257–4.593; P = 0.009 0.008) significantly influenced OS. The assessment of variables affecting surgical duration showed that BMI had a significant effect on surgical duration (odds ratio, 2.790; 95% CI, 1.254–6.204, P = 0.012). Conclusion: According to the analysis of patients who underwent the same surgical approach by a single surgeon, surgical duration of esophagectomy for esophageal cancer was significantly influenced by BMI; however, surgical duration had no impact on patient survival.
{"title":"A Study on the Impact of Surgical Duration on Esophageal Cancer","authors":"M. Kobayashi, Eiji Yoshida, Takuro Kyuno, R. Kawagishi, Kei Sato, Tsuyoshi Kono, T. Chiba, H. Yonezawa, O. Funato, A. Takagane","doi":"10.2147/oas.s319899","DOIUrl":"https://doi.org/10.2147/oas.s319899","url":null,"abstract":"Purpose: Faster surgery has been associated with better outcomes. In the present study, we aimed to determine whether surgical duration affected overall survival (OS) in patients undergoing esophagectomy. Additionally, we assessed factors that influence surgical duration. Patients and Methods: This single-center retrospective cohort study included 128 patients who underwent Ivor-Lewis esophagectomy by a single surgeon between 2005 and 2019. The Cox proportional hazard model was used to evaluate the association of OS with the following variables: surgical duration, neo-adjuvant chemotherapy, pathological grade of depth of tumor invasion, lymph node (LN) metastasis, body mass index (BMI), and cervical LN dissection. Additionally, factors associated with prolonged surgical duration were examined by logistic regression analysis. Results: Based on the multivariate analysis, surgical duration was not associated with OS [hazard ratio (HR), 1.065; 95% confidence interval (CI), 0.586–1.937; P = 0.837]. On the other hand, tumor invasion (HR, 2.901; 95% CI, 1.483–5.674; P = 0.002) and LN metastasis (HR, 2.338 2.403; 95% CI, 1.237–4.420 1.257–4.593; P = 0.009 0.008) significantly influenced OS. The assessment of variables affecting surgical duration showed that BMI had a significant effect on surgical duration (odds ratio, 2.790; 95% CI, 1.254–6.204, P = 0.012). Conclusion: According to the analysis of patients who underwent the same surgical approach by a single surgeon, surgical duration of esophagectomy for esophageal cancer was significantly influenced by BMI; however, surgical duration had no impact on patient survival.","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47501049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. B. Bayissa, Mohammad Mummud, Fufa Miressa, Gelana Fekadu
{"title":"Postoperative Complications and Associated Factors Among Surgical Patients Treated at a Tertiary Hospital, Eastern Ethiopia: A Prospective Cohort Study","authors":"B. B. Bayissa, Mohammad Mummud, Fufa Miressa, Gelana Fekadu","doi":"10.2147/oas.s320506","DOIUrl":"https://doi.org/10.2147/oas.s320506","url":null,"abstract":"","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2021-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47091918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aragaw Tesfaw, Mekdim Eshetu, F. Teshome, Efrem Fenta, Moges Gelaw, G. Mihret, Getaneh Atiklt, Tewodros Yosef
Background: Head injury is one of the most common reasons for patient admission and death in surgical units of Ethiopian hospitals, but little is known about the problem in North-central Ethiopia. Therefore, this study aimed to assess the magnitude and associated factors of head injury at Debre Tabor Teaching and Referral Hospital in south Gondar zone, North-central Ethiopia. Methods: A cross-sectional study was conducted on 370 trauma patients at Debre Tabor Teaching and Referral Hospital from November 1 to December 30, 2019, using a systematic random sampling technique. The data were collected through a face-to-face interview. The data were analyzed using SPSS version 23. Bivariate and multivariable logistic regression analyses were performed to identify factors associated with head injury. P-value <0.05 was used to declare statistical significance. Results: The mean (±SD) age of patients was 41.4 (± 11.6) years. The prevalence of head injury was 39.7%, 95% CI (34.9–44.9%). Two hundred sixty-five (72%) were male and 259 (70%) of all trauma patients were from rural residents. The study also found that younger age (20–24 years) [AOR=1.2; 95% CI (1.29–8.86)], being male [(AOR=2.02; 95% CI (1.31– 6.24)], alcohol use [(AOR=6.31; 95% CI (2.03–16.08)], and rural residence [(AOR= 1.40; 95% CI (1.13–6.94)] were the factors associated with head injury. Conclusion: Like other studies done in Ethiopia, head injury is a major problem in the study area. The study also revealed that socio-demographic and behavioral factors are mainly associated with head injury. Therefore, appropriate prevention strategies should be devised and implemented against the contributing factors both at the individual and community level to minimize the risk of head injury.
{"title":"Prevalence of Head Injury Among Trauma Patients at Debre Tabor Comprehensive Specialized Hospital, North Central Ethiopia","authors":"Aragaw Tesfaw, Mekdim Eshetu, F. Teshome, Efrem Fenta, Moges Gelaw, G. Mihret, Getaneh Atiklt, Tewodros Yosef","doi":"10.2147/oas.s321404","DOIUrl":"https://doi.org/10.2147/oas.s321404","url":null,"abstract":"Background: Head injury is one of the most common reasons for patient admission and death in surgical units of Ethiopian hospitals, but little is known about the problem in North-central Ethiopia. Therefore, this study aimed to assess the magnitude and associated factors of head injury at Debre Tabor Teaching and Referral Hospital in south Gondar zone, North-central Ethiopia. Methods: A cross-sectional study was conducted on 370 trauma patients at Debre Tabor Teaching and Referral Hospital from November 1 to December 30, 2019, using a systematic random sampling technique. The data were collected through a face-to-face interview. The data were analyzed using SPSS version 23. Bivariate and multivariable logistic regression analyses were performed to identify factors associated with head injury. P-value <0.05 was used to declare statistical significance. Results: The mean (±SD) age of patients was 41.4 (± 11.6) years. The prevalence of head injury was 39.7%, 95% CI (34.9–44.9%). Two hundred sixty-five (72%) were male and 259 (70%) of all trauma patients were from rural residents. The study also found that younger age (20–24 years) [AOR=1.2; 95% CI (1.29–8.86)], being male [(AOR=2.02; 95% CI (1.31– 6.24)], alcohol use [(AOR=6.31; 95% CI (2.03–16.08)], and rural residence [(AOR= 1.40; 95% CI (1.13–6.94)] were the factors associated with head injury. Conclusion: Like other studies done in Ethiopia, head injury is a major problem in the study area. The study also revealed that socio-demographic and behavioral factors are mainly associated with head injury. Therefore, appropriate prevention strategies should be devised and implemented against the contributing factors both at the individual and community level to minimize the risk of head injury.","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":"1 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45092844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. Nguyen Van, P. N. Hung, L. Dung, Le Viet Anh, D. C. Pho, Bui Dang The Anh, V. A. Hai
{"title":"Short-Term and Mid-Term Outcomes of Video-Assisted Thoracic Surgery in Patients with Early-Stage Non-Small Cell Lung Cancer","authors":"N. Nguyen Van, P. N. Hung, L. Dung, Le Viet Anh, D. C. Pho, Bui Dang The Anh, V. A. Hai","doi":"10.2147/OAS.S315389","DOIUrl":"https://doi.org/10.2147/OAS.S315389","url":null,"abstract":"","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2021-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48386529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ahmed Aly Khalil, Mohamed Elshawy, M. Elbarbary, Yasser Elghamrini
Background: Pilonidal sinus (PNS) is a common disorder that mainly affects young adults. It can be asymptomatic or presented by discomfort, inflammation, abscess or sinus formation. Despite current advances in surgical techniques, the best option to treat PNS is not yet well defined. Many studies reported techniques that involved excision of the sinus and closure of the deep and superficial layers but leaving the skin open. Aim: We aim to compare between the excision and primary midline closure with suction drain versus the partial closure technique as treatment options for PNS in terms of recovery, wound complications and recurrence rate. Patients and Methods: A prospective comparative study at Ain Shams University Hospitals that included 80 patients with PNS was conducted from January 2018 to June 2019. They were divided randomly into group A; 40 patients that had the midline closed method with suction drain and group B; 40 patients that underwent the partial closure technique. Both groups were followed up for 1 year, detecting healing time, wound complications, return to usual activities and recurrence rate. Results: We detected significant differences between both groups as regards to pain and discomfort postoperatively, favoring the partial closure group. Mean time to wound healing was significantly shorter among group A (14.43 ± 3.13) though mean time of return to usual activities was faster among the partial closure group (14.45 ± 1.15). There were no statistically significant differences between both groups as regards to wound infection, dehiscence or hematoma formation. Wound seroma was more among group A. Conclusion: The partial midline closure technique showed comparable results to the closed method with suction drain in management of PNS disease. Indeed, it shows less postoperative complications and a faster return to usual daily activity. Yet, more studies are required to demonstrate its reproducibility.
{"title":"Closed Technique with Suction Drain versus Partial Closure Technique in Midline Repair of Pilonidal Sinus: A Comparative Study","authors":"Ahmed Aly Khalil, Mohamed Elshawy, M. Elbarbary, Yasser Elghamrini","doi":"10.2147/OAS.S308212","DOIUrl":"https://doi.org/10.2147/OAS.S308212","url":null,"abstract":"Background: Pilonidal sinus (PNS) is a common disorder that mainly affects young adults. It can be asymptomatic or presented by discomfort, inflammation, abscess or sinus formation. Despite current advances in surgical techniques, the best option to treat PNS is not yet well defined. Many studies reported techniques that involved excision of the sinus and closure of the deep and superficial layers but leaving the skin open. Aim: We aim to compare between the excision and primary midline closure with suction drain versus the partial closure technique as treatment options for PNS in terms of recovery, wound complications and recurrence rate. Patients and Methods: A prospective comparative study at Ain Shams University Hospitals that included 80 patients with PNS was conducted from January 2018 to June 2019. They were divided randomly into group A; 40 patients that had the midline closed method with suction drain and group B; 40 patients that underwent the partial closure technique. Both groups were followed up for 1 year, detecting healing time, wound complications, return to usual activities and recurrence rate. Results: We detected significant differences between both groups as regards to pain and discomfort postoperatively, favoring the partial closure group. Mean time to wound healing was significantly shorter among group A (14.43 ± 3.13) though mean time of return to usual activities was faster among the partial closure group (14.45 ± 1.15). There were no statistically significant differences between both groups as regards to wound infection, dehiscence or hematoma formation. Wound seroma was more among group A. Conclusion: The partial midline closure technique showed comparable results to the closed method with suction drain in management of PNS disease. Indeed, it shows less postoperative complications and a faster return to usual daily activity. Yet, more studies are required to demonstrate its reproducibility.","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":"Volume 14 1","pages":"21-27"},"PeriodicalIF":1.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41522608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Saif Ghabisha, F. Ahmed, Saleh Al-wageeh, E. Al-shami, K. Al-naggar, Ghamdan Obaid, M. Askarpour
: Cord congenital hernia is a condition in which due to a patent umbilical ring, intestinal components protrude into the umbilical cord. Although post-natal umbilical hernia is not uncommon, its congenital form is an uncommon phenomenon (incidence rate about 0.2%) with an excellent post-surgical prognosis. It is frequently misdiagnosed as a small omphalocele. Additionally, if it is undiagnosed at the time of birth, clamping the umbilical cord can cause iatrogenic atresia of the ileum. Hence, during a physical exam, it is mandatory to look carefully for any skin folds in the form of a collar or defects in the umbilical ring or abdominal wall to avoid misdiagnosis. We report a full-term male newborn present with umbilical cord hernia, who underwent successful open surgery, with extra focus on the management and outcome of this disease. return to the abdominal cavity, the umbilical cord hernia would occur. Compared to post-natal umbilical hernia, Its congenital form is less common, with an incidence rate of 1 in 5000 newborns. We report a full-term male newborn product cesarean section with hernia of the umbilical cord, which was successfully treated with open surgery. The post-operation recovery period was uneventful, and the patient was discharged to home within three days and is currently under follow-up.
{"title":"Newborn with Hernia Umbilical Cord: A Case Report and Review of Literature","authors":"Saif Ghabisha, F. Ahmed, Saleh Al-wageeh, E. Al-shami, K. Al-naggar, Ghamdan Obaid, M. Askarpour","doi":"10.2147/OAS.S307223","DOIUrl":"https://doi.org/10.2147/OAS.S307223","url":null,"abstract":": Cord congenital hernia is a condition in which due to a patent umbilical ring, intestinal components protrude into the umbilical cord. Although post-natal umbilical hernia is not uncommon, its congenital form is an uncommon phenomenon (incidence rate about 0.2%) with an excellent post-surgical prognosis. It is frequently misdiagnosed as a small omphalocele. Additionally, if it is undiagnosed at the time of birth, clamping the umbilical cord can cause iatrogenic atresia of the ileum. Hence, during a physical exam, it is mandatory to look carefully for any skin folds in the form of a collar or defects in the umbilical ring or abdominal wall to avoid misdiagnosis. We report a full-term male newborn present with umbilical cord hernia, who underwent successful open surgery, with extra focus on the management and outcome of this disease. return to the abdominal cavity, the umbilical cord hernia would occur. Compared to post-natal umbilical hernia, Its congenital form is less common, with an incidence rate of 1 in 5000 newborns. We report a full-term male newborn product cesarean section with hernia of the umbilical cord, which was successfully treated with open surgery. The post-operation recovery period was uneventful, and the patient was discharged to home within three days and is currently under follow-up.","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":"Volume 14 1","pages":"17-20"},"PeriodicalIF":1.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42076777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Assefa Hika, W. Ayele, B. Aberra, Adugna Aregawi, Abere Tilahun Bantie, S. Mulugeta, Dinkisisa Chemeda, Ashenafi Seifu
Background: Laryngeal mask airway (LMA) is a useful airway device which provides an alternative to ventilation through a face mask or endotracheal tube during ophthalmic surgery. It can be removed either when a child awakens or deeply anesthetized. But there is little evidence for best practice on the timing of their removal after ophthalmic surgery in the pediatric population. It has been studied by various investigators but with conflicting results and conclusions. Objective: The aim of this study was to evaluate the effect of depth of anesthesia (awake or deep anesthesia) on the incidence of airway associated complications during LMA removal. Methodology: A prospective observational cohort study was conducted from January to April 2018. Sixty-two American Society of Anesthesiologists physical status I and II pediatric (aged 2–8 years) patients who underwent ophthalmic procedures under general anesthesia with LMA were recruited. Grouping (awake group or deep group) was done based on independent decision of on duty anesthetist and halothane 1–1.5% was used as maintenance anesthesia. The incidence of airway-related adverse events like coughing, upper airway obstruction (Laryngospasm), breath holding, desaturation, excessive salivation, biting, vomiting, and retching with LMA removal were evaluated. Collected data were entered into Epi Info™ version 7.0 and transported to the SPSS version 22 for analysis. Fisher’s exact test and Chi-square test were used to analyze dependent variables and P-values less than 0.05 were considered statistical significance. Results: There were no significant differences in airway-related adverse events. The incidence of coughing (12.9%, 6.5%), upper airway obstruction (41.9%, 35.5%), breath holding (9.7%, 3.2%), desaturation (16.1%, 22.6%), excessive salivation (19.4%, 12.9%), and biting (6.5%, 0%) between awake and deep groups respectively with (p > 0.05). Laryngospasm, vomiting, and retching did not occur in either group. Conclusion: There was no significant difference in the incidence of airway-related adverse events whether the LMA was removed in a deep or awake condition.
{"title":"A Comparison of Awake Versus Deep Removal of Laryngeal Mask Airway in Children Aged 2 to 8 Years Who Underwent Ophthalmic Procedures at Menilik II Hospital: A Prospective Observational Cohort Study","authors":"Assefa Hika, W. Ayele, B. Aberra, Adugna Aregawi, Abere Tilahun Bantie, S. Mulugeta, Dinkisisa Chemeda, Ashenafi Seifu","doi":"10.2147/OAS.S287507","DOIUrl":"https://doi.org/10.2147/OAS.S287507","url":null,"abstract":"Background: Laryngeal mask airway (LMA) is a useful airway device which provides an alternative to ventilation through a face mask or endotracheal tube during ophthalmic surgery. It can be removed either when a child awakens or deeply anesthetized. But there is little evidence for best practice on the timing of their removal after ophthalmic surgery in the pediatric population. It has been studied by various investigators but with conflicting results and conclusions. Objective: The aim of this study was to evaluate the effect of depth of anesthesia (awake or deep anesthesia) on the incidence of airway associated complications during LMA removal. Methodology: A prospective observational cohort study was conducted from January to April 2018. Sixty-two American Society of Anesthesiologists physical status I and II pediatric (aged 2–8 years) patients who underwent ophthalmic procedures under general anesthesia with LMA were recruited. Grouping (awake group or deep group) was done based on independent decision of on duty anesthetist and halothane 1–1.5% was used as maintenance anesthesia. The incidence of airway-related adverse events like coughing, upper airway obstruction (Laryngospasm), breath holding, desaturation, excessive salivation, biting, vomiting, and retching with LMA removal were evaluated. Collected data were entered into Epi Info™ version 7.0 and transported to the SPSS version 22 for analysis. Fisher’s exact test and Chi-square test were used to analyze dependent variables and P-values less than 0.05 were considered statistical significance. Results: There were no significant differences in airway-related adverse events. The incidence of coughing (12.9%, 6.5%), upper airway obstruction (41.9%, 35.5%), breath holding (9.7%, 3.2%), desaturation (16.1%, 22.6%), excessive salivation (19.4%, 12.9%), and biting (6.5%, 0%) between awake and deep groups respectively with (p > 0.05). Laryngospasm, vomiting, and retching did not occur in either group. Conclusion: There was no significant difference in the incidence of airway-related adverse events whether the LMA was removed in a deep or awake condition.","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2021-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45637791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Clinical record-keeping is a crucial part of professional practice and the delivery of quality healthcare. Poor intraoperative recording contributes to poor patient safety and unavailability of data in cases of medico-legal review or research purpose. Additionally, such records may provide an invaluable guide to subsequent practitioners involved with the patients’ management. Method and Materials: A descriptive study was conducted at Dilla University Referral Hospital from October 1 to November 30, 2020. Fifty-one intraoperative record indicators were developed and those requiring a definition for completeness were predefined. The expected completion rate was 100% for all indicators. Indicators with >90% completion rate were marked as acceptable and completion rate of <50% was considered as areas of the critical need for improvement. SPSS version 20 was used for data analysis. Results: A total of 164 intraoperative anesthesia record tools were reviewed, and none of the indicators had a completion rate of 100%. The intraoperative anesthesia record tools completion rate was >90% for documentation of sex, procedure starting time, name of the procedure, dose/volume and route of a specific drug given, standards of monitoring used, intraoperative blood pressure, and pulse rate record with time. Patient identity, name of professionals, baseline oxygen saturation, unit of measures of baseline vital signs, patient’s status on transfer, the total amount of each drug administered, intraoperative electrocardiographic rhythm, total amount of blood loss, total amount of urine output, and postoperative management plan were among indicators found below average (<50%) completion rate. Conclusion and Recommendation: Most of the indicators for manual intraoperative anesthesia recording were found incomplete and below the standards. Different strategies like regular feedback and monitoring to improve the practice have to be instituted. Introducing an electronic recording system may also help to overcome the problem.
{"title":"Assessment of Manual Intraoperative Anesthesia Record-Keeping Practice at Dilla University Referral Hospital, Dilla, Ethiopia","authors":"Abebayehu Zemedkun, Hailemariam Mulugeta, Hailemariam Getachew, Belete Destaw, Simeneh Mola, Mesay Milkias","doi":"10.2147/OAS.S298387","DOIUrl":"https://doi.org/10.2147/OAS.S298387","url":null,"abstract":"Introduction: Clinical record-keeping is a crucial part of professional practice and the delivery of quality healthcare. Poor intraoperative recording contributes to poor patient safety and unavailability of data in cases of medico-legal review or research purpose. Additionally, such records may provide an invaluable guide to subsequent practitioners involved with the patients’ management. Method and Materials: A descriptive study was conducted at Dilla University Referral Hospital from October 1 to November 30, 2020. Fifty-one intraoperative record indicators were developed and those requiring a definition for completeness were predefined. The expected completion rate was 100% for all indicators. Indicators with >90% completion rate were marked as acceptable and completion rate of <50% was considered as areas of the critical need for improvement. SPSS version 20 was used for data analysis. Results: A total of 164 intraoperative anesthesia record tools were reviewed, and none of the indicators had a completion rate of 100%. The intraoperative anesthesia record tools completion rate was >90% for documentation of sex, procedure starting time, name of the procedure, dose/volume and route of a specific drug given, standards of monitoring used, intraoperative blood pressure, and pulse rate record with time. Patient identity, name of professionals, baseline oxygen saturation, unit of measures of baseline vital signs, patient’s status on transfer, the total amount of each drug administered, intraoperative electrocardiographic rhythm, total amount of blood loss, total amount of urine output, and postoperative management plan were among indicators found below average (<50%) completion rate. Conclusion and Recommendation: Most of the indicators for manual intraoperative anesthesia recording were found incomplete and below the standards. Different strategies like regular feedback and monitoring to improve the practice have to be instituted. Introducing an electronic recording system may also help to overcome the problem.","PeriodicalId":56363,"journal":{"name":"Open Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49565503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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