Humans ; Pulmonary Embolism/etiology* ; Humeral Fractures/surgery*

Humans ; Angioplasty, Balloon/adverse effects* ; Antithrombin III/metabolism* ; Chronic Disease ; Pulmonary Artery ; Pulmonary Embolism/etiology* ; Thromboembolism/therapy*

PURPOSE: Static progressive stretch (SPS) can be applied to treat chronic joint stiffness. However, the impacts of subacute application of SPS to the distal lower limbs, where deep vein thrombosis (DVT) is common, on venous thromboembolism remain unclear. This study aims to explore the risk of venous thromboembolism events following subacute application of SPS. METHODS: A retrospective cohort study was conducted on patients diagnosed with DVT following a lower extremity orthopedic surgery before being transferred to the rehabilitation ward from May 2017 to May 2022. Patients with unilateral lower limb comminuted para-articular fractures, transferred to rehabilitation ward for further treatment within 3 weeks after operation, followed up more than 12 weeks since initial manual physiotherapy, and diagnosed DVT by ultrasound before rehabilitation course were included in the study. Patients with polytrauma, without evidence of previous peripheral vascular disease or incompetence, had medication for thrombosis treatment or prophylaxis before the operation, detected with paralysis due to nervous system impairment, infected after operation during the regime, or with acute progression of DVT were excluded. The included patients were randomized to the standard physiotherapy and the SPS integrated groups for observation. Associated DVT and pulmonary embolism data were collected during the physiotherapy course to compare the groups. SSPS 28.0 and GraphPad Prism 9 were used for data processing. A p < 0.05 was set significant difference. RESULTS: In total of 154 patients with DVT participating in this study, 75 of them were treated with additional SPS for postoperative rehabilitation. The participants in the SPS group showed improved range of motion (12.3° ± 6.7°). However, in the SPS group, there was no difference in thrombosis volume between the start and termination (p = 0.106, p = 0.787, respectively), although difference was seen intra-therapy (p < 0.001). Contingency analysis revealed the pulmonary embolism incidence (OR = 0.703) in the SPS group compared to the mean physiotherapy. CONCLUSION The SPS technique is a safe and reliable option to prevent potential joint stiffness without aggravating the risk of distal DVT for postoperative patients suffering from relevant trauma.
Humans ; Venous Thromboembolism/prevention & control* ; Venous Thrombosis/etiology* ; Retrospective Studies ; Pulmonary Embolism/complications* ; Lower Extremity ; Risk Factors

Bone Neoplasms/complications* ; Humans ; Osteosarcoma/complications* ; Pulmonary Embolism/etiology*

BACKGROUND: To summarize the clinical features of patients with pulmonary embolism after lobectomy and to explore the methods of diagnosis and treatment of pulmonary embolism after lobectomy. METHODS: The clinical data of 6 patients with pulmonary embolism after lobectomy between July 2007 and July 2017 were retrospectively analyzed. RESULTS: Of the 6 patients, 3 died within 24 h of onset and 3 patients were cured and discharged. CONCLUSIONS Pulmonary embolism after lobectomy is a rare postoperative complication in thoracic surgery. It is difficult to diagnose and has a high mortality rate. Preoperative thromboembolic risk assessment and postoperative prevention are important.
Aged ; Female ; Humans ; Lung Neoplasms ; surgery ; Male ; Middle Aged ; Pneumonectomy ; adverse effects ; Postoperative Complications ; diagnosis ; etiology ; therapy ; Pulmonary Embolism ; diagnosis ; etiology ; therapy ; Retrospective Studies ; Thoracic Surgery, Video-Assisted ; adverse effects

BACKGROUND: Pulmonary thrombosis embolism (PTE) is one of the most severe complications of perioperative radical mastectomy. Massive PTE is often accompanied by shock and hypotension which is characterized by rapid progression and high mortality. There is no standard for the treatment of these patients, which is thoracic surgery, and it is a critical issue in the thoracic surgeons. This article summarizes and analyzes the treatment of two patients with high-risk PTE at the early stage of postoperative lung cancer in our hospital. In addition, we discusses the diagnosis and treatment strategies of these cases to provide a reference for the thoracic surgeons. METHODS: We presented two patients with high-risk PTE at the early stage after thoracic surgery for radical surgery in our hospital back in 2017. One case was treated with intravenous venous interventional thrombolysis, and the other was treated with thrombolysis alone. The treatment effect of two patients and the complications during the treatment has been recorded to detail and summarized. RESULTS: Both patients were female who aged 66 and 61 years old. The time point of pulmonary embolism was 48 h and 45 h after operation, and the time of interventional thrombolysis was 70 minutes and 50 minutes after onset respectively. After 120 minutes and 100 minutes, the drainage after interventional thrombolysis was 4,690 mL and 520 mL respectively. The hospitalization time after thrombolysis was 21 days and 14 days respectively. There was no obvious complication through a follow-up of 6 months. CONCLUSIONS Early postoperative acute massive pulmonary embolism in lung cancer should be treated with pulmonary interventional thrombolysis as soon as possible. Compared with intravenous thrombolysis, pulmonary interventional thrombolysis shows accuracy, easy controlling of dosage, fast curative effect and low bleeding risk.
Female ; Humans ; Lung Neoplasms ; surgery ; Middle Aged ; Postoperative Complications ; etiology ; therapy ; Pulmonary Embolism ; etiology ; therapy ; Retrospective Studies ; Thoracic Surgery, Video-Assisted ; adverse effects ; Thrombolytic Therapy

BACKGROUND: Pulmonary embolism (PE) is one of the most severe complications after thoracic surgeries. Thus it is of great importance to learn the characteristics of acute PE after thoracic surgeries. This study summarized the clinical characteristics and experience on the diagnosis and treatment of 37 patients with postoperative acute pulmonary embolism, in order to improve its prophylaxis and management level. METHODS: We retrospectively reviewed 37 patients with postoperative acute pulmonary embolism following thoracic surgeries. Age, gender, body mass index (BMI), diagnosis, surgical procedure, onset time, clinical presentation, diagnosis and management were comprehensively analyzed. RESULTS: There were 16 males (43.2%) and 21 females (56.8%). The average age was (65.64±6.29) years (range from 53 years to 82 years) and 32 patients were over 60 years. BMI ranged from 17.1 kg/m² to 30.8 kg/m² with median of 26.3 kg/m². And 27 patients' BMI (73.0%) were over 25.0 kg/m². Thirty-four patients (91.9%) were with malignancies. Median presentation time was the 4th day postoperatively, while 11 patients were presented on the 3rd day postoperatively which accounted for the most. Patients with acute pulmonary embolism accounted for 77.8% from 9 am to 9 pm. D-dimer (D-D) ranged from 1.0 μg/mL-20.0 μg/mL (FEU) with median of (7.09±4.45) μg/mL (FEU) and 32 (86.5%) patients' D-D were over 3.00 μg/mL (FEU). CONCLUSIONS The survival rate of postoperative acute pulmonary embolism can be increased by fully understanding its clinical characteristics, early diagnosis and multiple disciplinary treatment.
Acute Disease ; Aged ; Aged, 80 and over ; Female ; Humans ; Lung Neoplasms ; surgery ; Male ; Middle Aged ; Postoperative Complications ; diagnosis ; etiology ; therapy ; Pulmonary Embolism ; diagnosis ; etiology ; therapy ; Retrospective Studies ; Survival Rate ; Thoracic Surgical Procedures ; adverse effects

Adult ; Catheter-Related Infections ; etiology ; Catheterization, Central Venous ; instrumentation ; Central Venous Catheters ; adverse effects ; Female ; Humans ; Pulmonary Embolism ; etiology ; Recurrence ; Sepsis ; etiology ; Tomography, X-Ray Computed

Surgical operation in treating obesity and type 2 diabetes is popularizing rapidly in China. Correct prevention and recognition of perioperation-related operative complications is the premise of ensuring surgical safety. Familiar complications of the operation include deep venous thrombosis, pulmonary artery embolism, anastomotic bleeding, anastomotic fistula and marginal ulcer. The prevention of deep venous thrombosis is better than treatment. The concrete measures contain physical prophylaxis (graduated compression stocking and intermittent pneumatic compression leg sleeves) and drug prophylaxis (unfractionated heparin and low molecular heparin), and the treatment is mainly thrombolysis or operative thrombectomy. The treatment of pulmonary artery embolism includes remittance of pulmonary arterial hypertension, anticoagulation, thrombolysis, operative thrombectomy, interventional therapy and extracorporeal membrane oxygenation (ECMO). Hemorrhage is a rarely occurred but relatively serious complication after bariatric surgery. The primary cause of anastomotic bleeding after laparoscopic gastric bypass is incomplete hemostasis or weak laparoscopic repair. The common bleeding site in laparoscopic sleeve gastrectomy is gastric stump and close to partes pylorica, and the bleeding may be induced by malformation and weak repair technique. Patients with hemodynamic instability caused by active bleeding or excessive bleeding should timely received surgical treatment. Anastomotic fistula in gastric bypass can be divided into gastrointestinal anastomotic fistula and jejunum-jejunum anastomotic fistula. The treatment of postoperative anastomotic fistula should vary with each individual, and conservative treatment or operative treatment should be adopted. Anastomotic stenosis is mainly related to the operative techniques. Stenosis after sleeve gastrectomy often occurs in gastric angle, and the treatment methods include balloon dilatation and stent implantation, and surgical treatment should be performed when necessary. Marginal ulcer after gastric bypass is a kind of peptic ulcer occurring close to small intestine mucosa in the junction point of stomach and jejunum. Ulcer will also occur in the vestige stomach after laparoscopic sleeve gastrectomy, and the occurrence site locates mostly in the gastric antrum incisal margin. Preoperative anti-HP (helicobacter pylorus) therapy and postoperative continuous administration of proton pump inhibitor (PPI) for six months is the main means to prevent and treat marginal ulcer. For patients on whom conservative treatment is invalid, endoscopic repair or surgical repair should be considered. Different surgical procedures will generate different related operative complications. Fully understanding and effectively dealing with the complications of various surgical procedures through multidisciplinary cooperation is a guarantee for successful operation.
Anastomosis, Surgical ; adverse effects ; Anticoagulants ; therapeutic use ; Bariatric Surgery ; adverse effects ; Catheterization ; China ; Conservative Treatment ; Constriction, Pathologic ; etiology ; therapy ; Digestive System Fistula ; etiology ; therapy ; Endoscopy, Gastrointestinal ; methods ; Extracorporeal Membrane Oxygenation ; Gastrectomy ; adverse effects ; Gastric Bypass ; adverse effects ; Gastric Mucosa ; pathology ; Gastric Stump ; physiopathology ; surgery ; Gastrointestinal Hemorrhage ; etiology ; prevention & control ; surgery ; Hemostasis, Surgical ; adverse effects ; methods ; Hemostatic Techniques ; Heparin ; therapeutic use ; Humans ; Intermittent Pneumatic Compression Devices ; Intestine, Small ; pathology ; Laparoscopy ; adverse effects ; Margins of Excision ; Peptic Ulcer ; etiology ; therapy ; Postoperative Complications ; diagnosis ; prevention & control ; therapy ; Pulmonary Embolism ; etiology ; therapy ; Stents ; Stockings, Compression ; Thrombectomy ; Thrombolytic Therapy ; Venous Thrombosis ; etiology ; prevention & control ; therapy

INTRODUCTIONThere are currently no guidelines supporting the use of routine chemoprophylaxis to prevent deep vein thrombosis (DVT) in arthroscopic surgery. Studies and meta-analysis show opposing views on its routine use in arthroscopy. This study aimed to examine the incidence of DVT in a prospective cohort of knee arthroscopy and knee arthroplasty patients, and to analyse the risk factors contributing to DVT.

METHODSAll patients scheduled to undergo knee arthroscopy or arthroplasty over a two-year period were included. A standardised regimen of postoperative mechanical prophylaxis and rehabilitation was applied to all patients. Only patients who were postoperatively symptomatic were referred for ultrasonography. DVT incidence was calculated, and univariate and multivariate analyses of the risk factors were performed.

RESULTSThe overall incidence of DVT was 0.5% among the 1,410 arthroscopy patients and 3.1% among the 802 arthroplasty patients. The incidence of proximal DVT among the arthroscopy and arthroplasty patients was 0.4% and 1.1%, respectively. Multivariate analysis showed that age was the only significant predictor of DVT incidence. Using the receiver operating characteristic method, the cut-off age for the arthroscopy and arthroplasty patients was 52 years, while that for the arthroscopy patients only was 40 years (increased risk of DVT: 5.46 and 6.44 times, respectively; negative predictive value: 99.7% and 99.8%, respectively).

CONCLUSIONDVT incidence among Asian arthroplasty and arthroscopy patients remains low, even without chemoprophylaxis. Since age was found to be a significant risk factor for DVT, DVT prophylaxis can be considered for patients in high-risk age groups.

Adult ; Arthroplasty ; Arthroplasty, Replacement, Knee ; adverse effects ; Asian Continental Ancestry Group ; Female ; Humans ; Incidence ; Knee Joint ; surgery ; Male ; Middle Aged ; Multivariate Analysis ; Prospective Studies ; Pulmonary Embolism ; prevention & control ; Rehabilitation ; Risk Factors ; Singapore ; Venous Thrombosis ; etiology