BACKGROUND: When managing patients who require repeated venous access, gaining a viable intravenous route has been problematic. To improve the situation, various studies on techniques for venous access have been conducted. The aim of this study is to evaluate the clinical results of complications following totally implanted central venous access port (TICVAP) insertion. METHODS: A retrospective analysis was conducted on 163 patients, from December 2008 to March 2013. The occurrence of complications was studied in three separate periods of catheter use: the intraoperative period, postoperative period, and period during the treatment. RESULTS: A total of 165 cases of TICVAP insertions involving 156 patients were included in the final analysis. There were 35 complications (21%) overall. Among these, 31 cases of complications (19%) occurred during the treatment period and the other 4 cases were intraoperative and postoperative complications (2%). There were no statistically significant differences in age and gender of the patients between the two groups to be risk factors (p=0.147, p=0.08). Past history of chemotherapy, initial laboratory findings, and the locations of TICVAP insertion also showed no statistical significance as risk factors (p>0.05). CONCLUSION: Because the majority of complications occurred after port placement and during treatment, meticulous care and management and appropriate education are necessary when using TICVAPs.
Catheters ; Chemotherapy, Adjuvant ; Drug Therapy ; Education ; Humans ; Intraoperative Complications ; Intraoperative Period ; Postoperative Complications ; Postoperative Period ; Retrospective Studies* ; Risk Factors

OBJECTIVE: To observe the effect of bronchial lavage (BL) on infant bronchial foreign bodies with pneumonia during the bronchoscopic surgery, and assess its clinical value. METHOD: One hundred and twenty-three cases aged between 1-3 years were randomly divided into two groups. The control group (n=58) underwent rigid bronchoscopic retrieval of foreign bodies under general anaesthesia, and the BL group (n=65) received an additional BL using 1% lidocaine (2 ml) with 1:100000 epinephrine, and 0.125% metronidazole (5 ml) during the bronchoscopic procedure. We compared intraoperative complications and postoperative recovery time between the two groups. RESULT: The incidence rate of complications in the BL group was significantly lower than that in the control group (P<0.05). An earlier recovery after surgery was achieved in the BL group (P<0.05). CONCLUSION Intraoperative BL is a safe and effective therapy for reducing the incidence of complications and improving the recovery in infant patients of bronchial foreign bodies with subsequent pneumonia.
Bronchi ; Bronchoalveolar Lavage ; Child, Preschool ; Female ; Foreign Bodies ; complications ; therapy ; Humans ; Infant ; Intraoperative Complications ; Male ; Pneumonia ; complications ; therapy

Hip fracture patients preoperative and postoperative exist hidden blood loss which often affect patients' wound healing, increase the probability of infection, prolong rehabilitation exercise, influence postoperative effect. At the same time, the body's blood loss increase the activation of the blood clotting mechanism, promote the incidence of deep vein thrombosis, bleeding and deep vein thrombosis has become the main causes of high risk in hip operation. It is very important to stop bleeding, anticoagulation should not be ignored, so how to effectively deal with the prominent contradiction between the postoperative anticoagulation and bleeding or looking for a best balance has become a intractable problems in hip fracture treatment.
Anticoagulants ; therapeutic use ; Blood Loss, Surgical ; prevention & control ; Hip Fractures ; complications ; surgery ; Humans ; Intraoperative Complications ; drug therapy ; etiology ; prevention & control

BACKGROUND AND OBJECTIVES: For the treatment of glottic T1 cancer, several methods such as laser cordectomy, conservative laryngeal surgery and radiation therapy are possible. This study was performed to investigate the utility of laser cordectomy in the oncological and phonetic aspects. MATERIALS AND METHOD: Eighteen patients with glottic T1 cancer, who had undergone laser cordectomy at Kosin Medical Center from March, 1997 to July, 2001, were retrospectively investigated. The method of the operation was classified according to European Laryngological Society Classification. We analysed intraoperative complication, the duration of admission, postoperative complication, and tumor recurrence. Twelve patients were phonetically analysed using MATLAB and have undergone perceptual analysis. Videostroboscopy was performed for every patient to analyze the mechanism of phonation. As a control group, six normal persons were used. RESULTS: Intraoperative complications were not found in any of the 18 patients, but 5 patients who had suspicious lesions during following up after operation, have undergone biopsy which gave negative results. Among 4 patients who had granulation tissues, 2 patients were spontaneously regressed, and the other 2 patients have undergone removal of tissue with no recurrences. The vocal parameters such as Fo, S.D.Fo, jitter, shimmer and NHR differed significantly between the surgery group and the control group. The parameters maximum phonation time, speech rate and speech intelligiblity did not differ between two groups. CONCLUSION: Laser cordectomy for glottic T1 cancer provides time-and cost-effectiveness, a low level of morbidity, excellent local control rate, and acceptable voice quality.
Biopsy ; Classification ; Glottis ; Granulation Tissue ; Humans ; Intraoperative Complications ; Laser Therapy ; Phonation ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Voice Quality ; Voice*

Intraoperative and postoperative complications that occurred within 30 days after the surgery and factors that affect morbidity were considered.RESULTS: The study involved 359 patients. Forty-six intraoperative complications occurred in 42 (11.6%) patients. Advanced stage and cancer antigen level of 125 were independently and significantly associated with operative complications (hazard ratio [HR], 1.66; 95% confidence interval [CI], 1.01–2,73; P=0.044, and HR, 1.47; 95% CI, 1.05–2.06; P=0.025, respectively). The need for intensive care unit admission was significantly higher in patients with intraoperative complications (28.6% vs. 8.8%, P=0.001). Intraoperative and postoperative complication rates were significantly higher in extended surgery than in standard surgery (18.9%vs. 8.5%, P=0.005 and 38.7% vs. 10.9%, P < 0.001, respectively). Intraoperative and postoperative transfusion need, hospital stay duration, and chemotherapy start day were also significantly higher in extended surgery than in standard surgery. Hundred postoperative complications occurred in 70 patients. Age, extended surgery, presence of ascites, and presence of operative complications were independently and significantly associated with postoperative complications.CONCLUSION: Morbidity of extensive surgical approach should be kept in mind in ovarian cancer surgery aimed at leaving no residual tumor. Patient-based management with an appropriate preoperative evaluation may avoid morbidity of extended/extensive surgical approaches.]]>
Ascites ; Drug Therapy ; Humans ; Intensive Care Units ; Intraoperative Complications ; Length of Stay ; Neoplasm, Residual ; Ovarian Neoplasms ; Postoperative Complications

OBJECTIVETo observe the protective effect of acupuncture-drug compound anesthesia with different frequency electroacupuncture on stress reaction in pneumonectomy and to explore potential mechanisms.

METHODSEighty patients scheduled for pneumonectomy were randomly divided into four groups, named group A, B, C and D, 20 cases in each group. General anesthesia and single lung protective mechanical ventilation were produced in all the groups. They were treated with acupuncture at Houxi (SI 3), Zhigou (TE 6), Neiguan (PC 6), and Hegu (Li 4) 30 min before general anesthesia, and then with Han's acupoint nerve stimulator (HANS-200). The acupuncture needles without needle bodies were pasted on the acupoints and the electroacupuncture were not turned on in group A, and the 2 Hz continuous wave were produced in group B, and 100 Hz continuous wave were produced in group C and the 2 Hz/100 Hz were produced in group D. The supplementary anesthesia medicine during pneumonectomy, heart rate (HR), mean arterial pressure (MAP), CD4+ /CD/ in venous blood before and after the surgery, and the contents of epinephrine (E) and cortisol (Cor) in plasma at the time of inter-room and outer-room were detected.

RESULTS(1) The supplementary fentanyl in group B and C were lower than those in group A and D (P < 0.05, P < 0.01). (2) The MAP in the four groups at intratracheal intubation (T1) were all higher than those at before anesthesia (T0) (all P < 0.01), and the ascending extent in group B, C and D were lower than that in group A (all P < 0.01). The HR at T in group A was higher than that at T0 (P < 0.05) and there were no significant differences in the other groups (all P > 0.05), and the ascending extent in group B and D were lower than that in group A (both P < 0.05). The MAP and HR at the other moment in all the groups were maintained stable. (3) CD4+ /CD8+ in group A after pneumonectomy was lower than that before the surgery (P < 0.05), and there were no significant differences in the other groups (all P > 0.05). (4) The content of E and Cor after the surgery were all increased (all P < 0.01), and the ascending extent of E in group D was lower than that in group A (P < 0.05), and the ascending level of Cor in group B and D were lower than that in group A (P < 0.01) and group B compared with group C and D were got the same result.

CONCLUSIONAcupuncture-drug compound anesthesia can attenuate the stress reaction so as to protect organs under the condition of less drug and can alleviates the undulate phenomenon of MAP and HR at intubation and stabilize CD4+ /CD8+ after pneumonectomy. Among them, the 2 Hz and 2 Hz/100 Hz electroacupuncture groups have the comparatively better effects.

Acupuncture Analgesia ; Adult ; Anesthesia, General ; Blood Pressure ; Electroacupuncture ; Female ; Heart Rate ; Humans ; Intraoperative Complications ; physiopathology ; therapy ; Intraoperative Period ; Lung ; physiopathology ; surgery ; Male ; Middle Aged ; Pneumonectomy ; Stress, Physiological

Adult ; Bronchoalveolar Lavage ; adverse effects ; Female ; Humans ; Intraoperative Complications ; Male ; Middle Aged ; Pneumoconiosis ; therapy ; Retrospective Studies ; Young Adult

OBJECTIVETo evaluate the perioperative risk factors of the cleft palate repair in Pierre Robin sequence patients at early age and to investigate how to control the risk factors.

METHODSSix consecutive patients with Pierre Robin sequence underwent primary repair of cleft palate in Department of Oral Maxillofacial Surgery, Peking University School of Stomatology from June 2001 to February 2004. The patients underwent von Longenbeck operation by the same perioperative observation of serum oxygen saturation were obtained for these patients. patients included 4 males and 2 females with age of 9 months to 5 surgeon. Pre- and post-operative polysomnographic studies and years.

RESULTSAll the patients suffered various degree of hypoxaemia during the period of intubation. There was only one patient who had hypoxaemia within the first 2 hours during postanaesthetic recovery period. No obvious difference was found in apnea and hypopnea index (AHI) among the patients before and after operation.

CONCLUSIONSSevere hypoxaemia may happen in perioperative period when the patients with PRS underwent cleft palate repair. Most patients with PRS could undergo cleft palate repair safely performed by experienced surgeon at early age under comprehensive consideration and careful control of the risk factors.

Child, Preschool ; Cleft Palate ; surgery ; Female ; Humans ; Hypoxia ; etiology ; Infant ; Intraoperative Complications ; therapy ; Male ; Pierre Robin Syndrome ; surgery ; Postoperative Complications ; therapy ; Risk Factors

OBJECTIVETo examine the outcome of damage control surgery (DCS) in patients with acute mesenteric ischemia (AMI).

METHODSClinical data of 15 consecutive AMI cases treated with DCS from May 2001 to March 2009 at the Research Institute of General Surgery, Jinling Hospital were retrospectively analyzed. Eleven patients had acute superior mesenteric vein thrombosis (MVT) on admission, and 4 suffered from acute mesenteric arterial embolism/thrombosis (MAE/MAT). The staged damage control approach included immediate resection of the involved bowel (but no attempts to restore gastrointestinal continuity), open thrombectomy, transfer of the patients to ICU for resuscitation, and thrombolysis prior to the planned definitive reconstructive procedure.

RESULTSOf 15 patients, 10 (66.7%) survived. The mean remnant small bowel length was (209.0+/-53.8) cm (120 to 280 cm). None of the survived patients was parenteral nutrition-dependent. Of the 5 deaths, 2 died of recurrence of thrombosis and necrosis of the remaining bowel,1 of massive gastrointestinal bleeding. One patient abandoned treatment intra-operatively, and another with total small bowel resection abandoned treatment postoperatively.

CONCLUSIONSDamage control approach improves the survival of patients with AMI. Thrombectomy and thrombolysis are necessary for AMI management to prevent progression or further development of the thrombosis.

Acute Disease ; Adult ; Female ; Humans ; Intraoperative Complications ; Ischemia ; surgery ; therapy ; Male ; Mesenteric Vascular Occlusion ; surgery ; therapy ; Mesentery ; surgery ; Middle Aged ; Retrospective Studies ; Thrombectomy ; Thrombolytic Therapy

OBJECTIVETo analyze the incidence and cause of complications during and after interventional therapy for congenital heart disease (CHD).

METHODSFrom April 1986 to April 2009, 388 out of 6029 patients with CHD developed complications during and post interventional therapy, another 5 patients died post procedure, clinical data from these 393 patients were retrospectively analyzed. The patients with severe functional insufficiency requiring intervention or surgery during and after interventional therapy were classified as severe complications.

RESULTSThe overall complication rate was 6.44% [7.69% post atrial septal defect occlusion, 4.20% post patent ductus arteriosus (PDA) occlusion, 1.31% post percutaneous balloon pulmonary valvuloplasty, 14.94% post ventricular septal defect occlusion, 3.13% post percutaneous closure of aortopulmonary collaterals, 30.95% post catheter embolotherapy of pulmonary arteriovenous malformations, 12.50% post transcatheter closure of coronary artery fistulae, 20.00% post transcatheter closure of ruptured sinus of Valsava aneurysm, 66.67% post percutaneous balloon aortic valvuloplasty]. The severe complication rate was 0.65%(39/6029). The procedure-related mortality rate was 0.08% (5/6029), 0.26% (2/761) post percutaneous balloon pulmonary valvuloplasty, 0.05% (1/2070) post PDA occlusion, 9.10% (1/11) post balloon atrial septostomy, 33.33% (1/3) post percutaneous balloon aortic valvuloplasty. Emergency Cardiovascular surgery rate was 0.22% (13/6029). Selective surgery was required in 0.13% (8/6029) of patients post procedure. Two patients (0.03%) received permanent pacemaker implantation.

CONCLUSIONSThe severe complications and mortality rate of interventional therapy for CHD are relative low. Post procedure follow-up is needed fro monitoring possible procedure-related complications.

Cardiac Catheterization ; adverse effects ; Cardiovascular Surgical Procedures ; Heart Defects, Congenital ; surgery ; therapy ; Humans ; Incidence ; Intraoperative Complications ; epidemiology ; Postoperative Complications ; epidemiology ; mortality ; Retrospective Studies ; Treatment Outcome