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postoperative complications in patients with portal vein thrombosis after liver transplantation:Evaluation with Doppler ultrasonography

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World Journal of Gastroenterology 2007年第34期13卷 4636-4640页

作者： Yi-Ping Jia Qiang Lu Shu Gong Bu-Yun Ma Xiao-Rong Wen Yu-Lan Peng Ling Lin Hong-Yan Chen Li Qiu Yan Luo Department of Ultrasound West China Hospital Sichuan University Chengdu610041 Sichuan Province China Department of General Surgery West China HospitalSichuan University Chengdu 610041 Sichuan Province China

AIM： To study the postoperative complications in patients with preoperative portal vein thrombosis （PVT） undergoing liver transplantation （LT） and to evaluate the complications with Doppler ultrasonography.METHODS： Retrospective studies were performed on 284 patients undergoing LT （286 LT） with respect to pre- and postoperative clinical data and Doppler ultrasonography. According to the presence and grade of preoperative PVT, 286 LTs were divided into three groups： complete PVT （c-PVT）, partial PVT （p-PVT） and non-PVT, with 22, 30 and 234 LTs, respectively. Analyses were carried out to compare the incidence of early postoperative complications.RESULTS： PVT, inferior vena cava （IVC） thrombosis, hepatic artery thrombosis （HAT） and biliary complications were found postoperatively. All complications were detected by routine Doppler ultrasonography and diagnoses made by ultrasound were confirmed by clinical data or/and other imaging studies. Nine out of 286 LTs had postoperative PVT. The incidence of the c-Pv-r group was 22.7%, which was higher than that of the p-Pv-r group （3.3%, P 〈 0.05） and non- PVT group （1.3%, P 〈 0.005）. No difference was found between the p-PVT and non-PVT groups （P 〉 0.25）. Of the 9 cases with postoperative PVT, recanalizations were achieved in 7 cases after anticoagulation under the guidance of ultrasound, 1 case received portal vein thrombectomy and 1 case died of acute injection. Ten LTs had postoperative 1VC thrombosis. The c-PVT group had a higher incidence of IVC thrombosis than the non- PVT group （9.1% vs 2.6%, P 〈 0.05）; no significant difference was found between either the c-PV-T and p-PVT groups （9.1% vs 6.7%, P 〉 0.5） or between the p-PVT and non-PVT groups （P 〉 0.25）. Nine cases with IVC thrombosis were cured by anticoagulation under the guidance of ultrasound, and 1 case gained natural cure without any medical treatment after 2 mo. HAT was found in 2 non-PVT cases, giving a rate of 0.7% among 286 LTs. Biliary complications wer

关键词： Portal vein thrombosis Liver transplantation postoperative complications Doppler ultrasonography

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Reoperation for early postoperative complications after gastric cancer surgery in a Chinese hospital

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World Journal of Gastroenterology 2010年第1期16卷 98-103页

作者： Birendra Kumar Sah Department of General Surgery Ruijin HospitalShanghai Jiaotong UniversitySchool of MedicineShanghai Institute of Digestive Surgery

AIM:To investigate the occurrence of postoperative complications of gastric cancer surgery,and analyze the potential causes of reoperation for early postoperative complications. METHODS:A total of 1639 patients who underwent radical or palliative gastrectomies for gastric cancer were included in the *** study endpoint was the analysis of postoperative complications in inpatients. RESULTS:About 31%of patients had early postoperative complications,and complications of infection occurred most ***-abdominal hemorrhage and anastomotic leak were the main causes of reoperation,which accounted for about 2.2%.Mortality was 11.1%in the reoperation group,but was only 0.8%in other *** duration of postoperative stay in hospital was significantly longer and the total expenditure was markedly higher in the patients who underwent reoperation(P<0.001).There was no significant association of any available factors in this study with the high rate of ***:Reoperation significantly increases the mortality rate and raises the burden of the surgical *** prospective studies are required to explore the potential risk factors.

关键词： Reoperation Gastric cancer Surgery postoperative complications

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Does testosterone prevent early postoperative complications after gastrointestinal surgery?

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World Journal of Gastroenterology 2009年第44期15卷 5604-5609页

作者： Birendra Kumar Sah Department of General Surgery&Shanghai Institute of Digestive Surgery Rui Jin HospitalShanghai Jiao Tong UniversitySchool of Medicine

AIM:To investigate the role of sex hormones in the early postoperative complications of gastrointestinal diseases. METHODS:A total of 65 patients who underwent operations for gastric and colorectal diseases(mainly malignant diseases)were included in the study. Peripheral venous blood samples were collected at different times for analysis of estradiol,testosterone and *** only study endpoint was analysis of postoperative complications. RESULTS:Patients of both sexes were uniform but postoperative complication rate was significantly higher in female patients(P=0.027).There was no significant association of estradiol and progesterone with postoperative *** levels in complicated patients were significantly lower than in uncomplicated patients(Pcomplications. CONCLUSION:Patients with low testosterone level were prone to higher postoperative complications,which was evident in both ***,further studies are necessary to support this result.

关键词： Stomach neoplasms Testosterone Sex differences postoperative complications

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Prognostic nutritional index predicts postoperative complications and long-term outcomes of gastric cancer

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World Journal of Gastroenterology 2014年第30期20卷 10537-10544页

作者： Nan Jiang Jing-Yu Deng Xue-Wei Ding Bin Ke Ning Liu Ru-Peng Zhang Han Liang Key Laboratory of Cancer Prevention and Therapy Department of Gastrointestinal OncologyTianjin Medical University Cancer Institute and HospitalNational Clinical Research Center for Cancer Key Laboratory of Cancer Prevention and Therapy

AIM: To investigate the impact of prognostic nutritional index (PNI) on the postoperative complications and long-term outcomes in gastric cancer patients undergoing total gastrectomy.

关键词： Prognostic nutritional index gastric cancer postoperative complications total gastrectomy prognosis

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Imaging panorama in postoperative complications after liver transplantation

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Gastroenterology Report 2016年第2期4卷 96-106,I0001页

作者： Binit Sureka Kalpana Bansal S Rajesh Amar Mukund Viniyendra Pamecha Ankur Arora Department of Radiology/Interventional Radiology Institute of Liver and Biliary SciencesVasant KunjNew DelhiIndia Department of Hepatobiliary Surgery Institute of Liver and Biliary SciencesVasant KunjNew DelhiIndia

The liver is the second most-often transplanted solid organ after the kidney,so it is clear that liver disease is a common and serious problem around the *** the advancements in surgical,oncological and imaging techniques,orthotopic liver transplantation has become the first-line treatment for many patients with end-stage liver ***,and Doppler are the most economical and cost-effective imaging modalities for evaluating postoperative fluid collections and vascular *** tomography(CT)is used to confirm the findings of ultrasound and look for pulmonary *** resonance imaging(MRI)is used for the diagnosis of biliary complications,bile leaks and neurological *** article illustrates the imaging options for diagnosing the various complications that can be encountered in the postoperative period after liver transplantation.

关键词： liver transplant postoperative complications imaging

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Cost of postoperative complications:How to avoid calculation errors

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World Journal of Gastroenterology 2020年第21期26卷 2682-2690页

作者： Roberto De la Plaza Llamas JoséM Ramia Department of General and Digestive Surgery Hospital Universitario de GuadalajaraGuadalajara 19002Spain

postoperative complications(PC)are a basic health outcome,but no surgery service in the world records and/or audits the PC associated with all the surgical procedures it *** studies that have assessed the cost of PC suffer from poor quality and a lack of transparency and *** payment system in place often rewards the volume of services provided rather than the quality of patients’clinical *** a thorough registration of PC,the economic costs involved cannot be *** accurate,reliable appraisal would help identify areas for investment in order to reduce the incidence of PC,improve surgical results,and bring down the economic *** article describes how to quantify and classify PC using the Clavien-Dindo classification and the comprehensive complication index,discusses the perspectives from which economic evaluations are performed and the minimum postoperative follow-up established,and makes various *** availability of accurate and impartially audited data on PC will help reduce their incidence and bring down ***,the health authorities,and society as a whole are sure to benefit.

关键词： Morbidity postoperative complications Costs and cost analysis Economic evaluation Healthcare costs Opportunity cost Clavien-Dindo classification Comprehensive complication index

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Combinative approach of transzonular triamcinolonemoxifloxacin and perioperative drops to minimize postoperative complications of cataract surgery

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International Journal of Ophthalmology(English edition) 2024年第5期17卷 845-851页

作者： Behnam Rabiee Muhamad Festok Michael Gaspari Abid Haseeb Aaila Chaudhry Layla Kamoun Imtiaz Chaudhry Iftikhar Chaudhry Department of Ophthalmology Trinity Health Mid-AtlanticNazareth HospitalPhiladelphiaPA 19020USA IC Laser Eye Care BensalemPA 19020USA

AIM: To investigate the effectiveness of combinationtherapy with transzonular triamcinolone-moxifloxacin andconventional perioperative drops in reducing postoperativecomplications of cataract surgery. METHODS: Electronic medical records of cataractsurgery patients (single surgeon) were reviewed fromJanuary 2018 to September 2021. The rate of postoperativecomplications including prolonged and/or recurrentpostoperative inflammation, endophthalmitis, cystoid macularedema (CME), and intraocular pressure (IOP) was comparedbetween the patients receiving combinative therapy andpatients receiving drops only. RESULTS: Totally 596 patients and 1057 eyes(Combinative-Therapy group 493 and Drop-Only group 564)were included in this study. Using combination therapyreduced the relative risk of postoperative inflammationby 26.9% (16.6% Combinative-Therapy vs 22.7% Drop-Only, P=0.013). The incidence of endophthalmitis was 0in Combinative-Therapy group vs 0.5% in Drop-Only group(relative risk reduction 100%), although not statisticallysignificant (P=0.10). The incidence of severe IOP spikeswas not significantly different between Combinative-Therapy (2.4%) and Drop-Only (1.6%) groups (P=0.33).The relative risk of postoperative CME was 51.4% less inthree months follow up visit in Combinative-Therapy group,although not statistically significant (P=0.07). The visualoutcome 1-month postop. (best corrected visual acuity) wassignificantly better in Combinative-Therapy (logMAR 0.10)compared to Drop-Only (logMAR 0.14) groups (P=0.02) whilethe baseline visual acuity was not significantly different. CONCLUSION: The combinative approach oftranszonular triamcinolone-moxifloxacin plus perioperativeeyedrops is an effective method to minimize postoperativeinflammation, with better visual outcomes. It couldpotentially reduce the risk of postoperative endophthalmitisand CME (near-significant P-values;larger studies couldanalyze better considering low incidence).

关键词： cataract endophthalmitis cystoid macular edema postoperative complications transzonular injection

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Initial suction drainage decreases severe postoperative complications after pancreatic trauma:A cohort study

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World Journal of Gastrointestinal Surgery 2023年第8期15卷 1652-1662页

作者： Kai-Wei Li Kai Wang Yue-Peng Hu Chao Yang Yun-Xuan Deng Xin-Yu Wang Yu-Xiu Liu Wei-Qin Li Wei-Wei Ding The First School of Clinical Medicine Southern Medical UniversityGuangzhou 510515Guangdong ProvinceChina Department of Critical Care Medicine Jinling HospitalAffiliated Hospital of Medical SchoolNanjing UniversityNanjing 210002Jiangsu ProvinceChina Division of Trauma and Surgical Intensive Care Unit Research Institute of General SurgeryJinling HospitalAffiliated Hospital of Medical SchoolNanjing UniversityNanjing 210002Jiangsu ProvinceChina Division of Data and Statistics Department of Critical Care MedicineJinling HospitalAffiliated Hospital of Medical SchoolNanjing UniversityNanjing 210002Jiangsu ProvinceChina

BACKGROUND Few studies have addressed the question of which drain types are more beneficial for patients with pancreatic trauma(PT).AIM To investigate whether sustained low negative pressure irrigation(NPI)suction drainage is superior to closed passive gravity(PG)drainage in PT *** PT patients who underwent pancreatic surgery were enrolled consecutively at a referral trauma center from January 2009 to October *** primary outcome was defined as the occurrence of severe complications(Clavien-Dindo grade≥Ⅲb).Multivariable logistic regression was used to model the primary outcome,and propensity score matching(PSM)was included in the regression-based sensitivity *** In this study,146 patients underwent initial PG drainage,and 50 underwent initial NPI suction *** the entire cohort,a multivariable logistic regression model showed that the adjusted risk for severe complications was decreased with NPI suction drainage[14/50(28.0%)vs 66/146(45.2%);odds ratio(OR),0.437;95%confidence interval(CI):0.203-0.940].After 1:1 PSM,44 matched pairs were *** proportion of each operative procedure performed for pancreatic injury-related and other intra-abdominal organ injury-related cases was comparable in the matched *** suction drainage still showed a lower risk for severe complications[11/44(25.0%)vs 21/44(47.7%);OR,0.365;95%CI:0.148-0.901].A forest plot revealed that NPI suction drainage was associated with a lower risk of Clavien-Dindo severity in most *** This study,based on one of the largest PT populations in a single high-volume center,revealed that initial NPI suction drainage could be recommended as a safe and effective alternative for managing complex PT patients.

关键词： Pancreatic trauma Drainage postoperative complications Clavien-Dindo Propensity score matching

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Predicting short-term major postoperative complications in intestinal resection for Crohn’s disease:A machine learning-based study

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World Journal of Gastrointestinal Surgery 2024年第3期16卷 717-730页

作者： Fang-Tao Wang Yin Lin Xiao-Qi Yuan Ren-Yuan Gao Xiao-Cai Wu Wei-Wei Xu Tian-Qi Wu Kai Xia Yi-Ran Jiao Lu Yin Chun-Qiu Chen Diagnostic and Treatment Center for Refractory Diseases of Abdomen Surgery Shanghai Tenth People’s HospitalTongji University School of MedicineShanghai 200072China

BACKGROUND Due to the complexity and numerous comorbidities associated with Crohn’s disease(CD),the incidence of postoperative complications is high,significantly impacting the recovery and prognosis of ***,additional stu-dies are required to precisely predict short-term major complications following intestinal resection(IR),aiding surgical decision-making and optimizing patient *** To construct novel models based on machine learning(ML)to predict short-term major postoperative complications in patients with CD following *** A retrospective analysis was performed on clinical data derived from a patient cohort that underwent IR for CD from January 2017 to December *** study participants were randomly allocated to either a training cohort or a validation *** logistic regression and random forest(RF)were applied to construct models in the training cohort,with model discrimination evaluated using the area under the curves(AUC).The validation cohort assessed the performance of the constructed *** Out of the 259 patients encompassed in the study,5.0%encountered major postoperative complications(Clavien-Dindo≥III)within 30 d following IR for *** AUC for the logistic model was 0.916,significantly lower than the AUC of 0.965 for the RF *** logistic model incorporated a preoperative CD activity index(CDAI)of≥220,a diminished preoperative serum albumin level,conversion to laparotomy surgery,and an extended operation time.A nomogram for the logistic model was *** for the surgical approach,the other three variables ranked among the top four important variables in the novel ML *** Both the nomogram and RF exhibited good performance in predicting short-term major postoperative complic-ations in patients with CD,with the RF model showing more superiority.A preoperative CDAI of≥220,a di-minished preoperative serum albumin level,and an extended operation time might be the most crucial ***

关键词： Crohn’s disease postoperative complications Nomogram Random forest Intestinal resection

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Intraoperative Blood Pressure Lability Acts as a Key Mediator in the Impacts of Goal-Directed Fluid Therapy on postoperative complications in Patients Undergoing Major Spine Surgery

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Chinese Medical Sciences Journal 2023年第4期38卷 257-264页

作者： Lu Che Jia-Wen Yu Yue-Lun Zhang Li Xu Yu-Guang Huang Department of Anesthesiology Peking Union Medical College HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China

Objective Although goal-directed fluid therapy(GDFT)has been proven to be effective in reducing the incidence of postoperative complications,the underlying mechanisms remain *** aim of this study was to examine the mediating role of intraoperative hemodynamic lability in the association between GDFT and the incidence of postoperative *** further tested the role of this mediation effect using mean arterial pressure,a hemodynamic *** This secondary analysis used the dataset of a completed nonrandomized controlled study to investigate the effect of GDFT on the incidence of postoperative complications in patients undergoing posterior spine *** used a simple mediation model to test whether there was a mediation effect of average real variability between the association of GDFT and postoperative *** conducted mediation analysis using the mediation package in R(version 3.1.2),based on 5,000 bootstrapped samples,adjusting for *** Among the 300 patients in the study,40%(120/300)developed postoperative complications within 30 *** was associated with fewer 30-day postoperative complications after adjustment for confounders(odds ratio:0.460,95%CI:0.278,0.761;P=0.003).The total effect of GDFT on postoperative complications was-0.18(95%CI:-0.28,-0.07;Ppostoperative *** research is needed to clarify whether actively reducing intraoperative blood pressure lability can prevent postoperative complications.

关键词： goal-directed fluid therapy mediation analysis postoperative complications hemodynamic stability

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