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Average Hospital Stay (average + hospital_stay)
Selected AbstractsVertical partial hemilaryngectomy with reconstruction by false cord imbricationANZ JOURNAL OF SURGERY, Issue 5 2010Kuauhyama Luna-Ortiz Abstract Background:, To evaluate global survival, disease-free period, complications, evolution and function in vertical partial hemilaryngectomy (VPHL) plus reconstruction with false cord. Methods:, Descriptive and retrospective study. In aertiary care medical center in Mexico City. Eight patients with early diagnosis of early glottic cancer (T1 and T2), treated with VPHL plus reconstruction with false cord imbrication. Results:, Fifty percent of the patients were clinical stage I, 37.5% stage II and 12.5% stage III. Nasogastric tube was not placed and oral feeding was reinitiated within 3 days on average. Tracheostomy was removed after an average of 2.1 days. Average hospital stay was 3.3 days. Average of the PSS-HNC (Performance Status for Head and Neck Cancer) and Karnofsky Performance Status evaluation was 91 to 97 and 100 at 1 year of evaluation. Voice evaluation demonstrated normal voice in 87.5% of patients. Intensity was below normal with improvement on annual evaluation. Global survival was 100% and disease-free period was 71% at 3 years. Conclusions:, VPHL with reconstruction by false cord imbrication is an excellent therapeutic option for early glottic cancers. Multiple functional advantages are demonstrated without sacrificing oncological control as well as providing an audible and intelligible voice. In cases of recurrence, various management options are available. [source] Fijian seasonal scourge of mango tree fallsANZ JOURNAL OF SURGERY, Issue 12 2009Anuj Gupta Abstract Background:, Mango tree falls are a frequent presentation at any health facility in the South Pacific. This study aims to identify (i) the number of admissions because of falls from mango trees; (ii) epidemiology; (iii) seasonal trend; (iv) injury profile; and (v) hospital care provided. Methods:, Retrospective case review on all mango tree falls related injuries resulting in admissions at the Lautoka Hospital, Fiji during a 1-year period (2007). Patient records were analysed to identify specific injury patterns such as upper/lower limb fractures, spinal cord injury and head injury, caused by mango tree falls. Results:, Thirty-nine cases were identified. Eighty-two percent (n= 32) of the falls occurred in the mango season (June,November). Seventy-two percent (n= 28) of the patients were males and 28% (n= 11) were females. Seventy-six percent were aged 5,13 and only 21% were adults. Also, 77% (n= 30) of the patients were ethnic Fijians and 23% (n= 9) were Fijian-Indians. Sixty-four percent (n= 25) had closed fractures and 17% (n= 7) had open fractures. Fifty-six percent (n= 22) of the fractures were of the fore arm. There were two cases of spinal cord injury, four cases of head injury, one ICU admission and one death. Average hospital stay was 7.56 days. Conclusion:, All these injuries were recreational and the majority in the urban setting. They were all avoidable. [source] Comparison of three methods in surgical treatment of pilonidal diseaseANZ JOURNAL OF SURGERY, Issue 6 2001Hasan Aydede Background: The present study was designed to compare three methods that are still used for the surgical treatment of pilonidal disease: marsupialization, primary midline closure and skin flaps. Methods: One hundred and one out of a total of 203 pilonidal disease patients underwent excision and marsupialization, while 82 patients had excision and primary closure and the remaining 20 were treated with excision and skin flaps. The minimum and maximum follow-up periods for the aforementioned surgical methods were 4 and 5 years, respectively. All patients were reviewed for in-hospital stay, return to work, wound infection and recurrence rates. Student's t -test and Fisher's exact test were used for statistical analysis. Results: Average hospital stays for marsupialization, primary closure and skin flaps were 2.84 ± 0.13, 2.62 ± 0.12 and 5.95 ± 0.52 days, respectively. Hospital stay for the skin flaps method was longer than that for the other two methods. The average time to return to work after marsupialization was 5.42 ± 0.08 weeks; but the time needed to return to work after undergoing the primary closure or the skin flaps methods was much shorter: 2.15 ± 0.05 and 2.90 ± 0.20 weeks, respectively (P < 0.001). There was no difference in wound infection rate (P = 1.000) or recurrence rates. Conclusion: The fact that there were no differences in terms of wound infection or recurrence rates between the three groups, and the relatively shorter period for returning to work, emphasize the usefulness of the excision and repair techniques in the surgical treatment of pilonidal disease. [source] Glucose-6-phosphate dehydrogenase deficiency is associated with increased initial clinical severity of acute viral hepatitis AJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 11 2001Israel Gotsman Abstract Background and Aim: In glucose-6-phosphate dehydrogenase (G6PD) deficiency, the enzyme is deficient in liver cells as well as in erythrocytes. It has been suggested that this may be associated with a more severe clinical presentation of acute viral hepatitis A. The aim of this study is to determine the severity of liver disease in patients with viral hepatitis and G6PD deficiency. Methods: Eighteen patients with diagnosed G6PD deficiency and acute hepatitis A were compared with 18 matched control patients with hepatitis A in a university hospital for liver disease severity and clinical outcome. Results: Two of 18 patients with G6PD deficiency had neurological deterioration. Patients with G6PD deficiency had a mean peak prothrombin time (PT) that was significantly prolonged as compared with the control group (15.5 ± 3.7 vs 12.9 ± 2.0 s, respectively, P < 0.02), and a significantly higher proportion had an abnormal PT (PT > 13.3 s): 61 versus 11% (P < 0.0001). Hemolysis occurred in 44% of the G6PD deficiency patients. Total and direct bilirubin were significantly higher in all patients with G6PD deficiency, including patients without hemolysis. There was no significant difference in liver enzyme levels between the two groups. Patients with G6PD deficiency had a longer average hospital stay (9.5 ± 4.8 vs 3.4 ± 0.8 days, respectively, P < 0.001). There was no difference in the final clinical outcome between the two groups, and recovery of liver function was seen in all patients. Conclusions: Glucose-6-phosphate dehydrogenase deficiency in patients with hepatitis A causes a more severe initial clinical presentation, but does not alter the final clinical outcome. [source] Original Article: Complications of laparoscopic myomectomy: A single surgeon's series of 1001 casesAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 4 2010G. P. Paul Objective:, The objective of this retrospective study was to evaluate the safety, intra-operative and post-operative morbidity of laparoscopic approach for myomectomy. Methods:, The total 1001 subjects who underwent endoscopic surgery over a 16-year period were studied retrospectively. All the data were collected regarding clinical presentation, intra-operative findings, intra-operative and post-operative complications, and hospital stay, and statistically analysed. Results:, The average age of subjects was 32.62 years and the most common indication for surgery was infertility (48.5%). A total of 2167 myomas were removed; 43.98% of subjects required removal of multiple myomas. The average blood loss was 248 mL, and the average hospital stay was 1.5 days. The overall major and minor complication rate is very low except one subject who required laparotomy for post-operative bleeding, and there was one unexplained post-operative death. Conclusions:, Laparoscopic myomectomy is comparable to laparotomy myomectomy in terms of duration of surgery, blood loss and complication rates. This large single surgeon series on laparoscopic myomectomy also shows a low complication rate suggesting that laparoscopic myomectomy is a safe and reliable procedure, even in the presence of multiple or large myomas. [source] Implementation of a Clinical Pathway in Management of the Postoperative Vestibular Schwannoma Patient,THE LARYNGOSCOPE, Issue 11 2001Katrina R. Stidham MD Abstract Objective The purpose of the study was to evaluate the effectiveness of a new clinical pathway in management of patients with postoperative vestibular schwannoma. The impact on duration of hospitalization and quality of care was evaluated. Study Design The study was a retrospective review of 59 consecutive patients undergoing surgical intervention for vestibular schwannoma between January 1995 and July 1999. Methods A new clinical pathway for management of postoperative vestibular schwannoma patients was implemented at The California Ear Institute at Stanford (Palo Alto, CA) in January 1995. All patients undergoing surgical intervention subsequent to initiation of the pathway were included in the study. Data including surgical approach, patient age, sex, and tumor size were included. Duration of hospitalization and postoperative complications were recorded. During the same time period, data for patients undergoing radiation therapy for vestibular schwannomas were evaluated for length of hospital stay and in-hospital complications. Data were compared with norms recorded in the literature for duration of hospitalization and complications following surgical intervention. Results Fifty-nine patients underwent 35 middle fossa approaches and 24 translabyrinthine approaches to their tumors. The average patient age was 53 years; there were 34 female and 25 male patients. The average length of hospital stay was 3.83 days (SD = 1.4 days) with a range from 2 to 10 days. Postoperative complications were observed in 19% of patients, including eight (13%) cerebrospinal fluid (CSF) leaks, two requiring lumbar drains (3.4%); one hematoma (1.6%), one postoperative fever (1.6%), and one dural tear with associated hyponatremia (1.6%). These results compared favorably with previously recorded average hospital stays of 5.95 to 9.5 days 1,5,7 and CSF leak complication rates of 7% to 15%. 9,10 Conclusions Implementation of a clinical pathway for management of the patient with postoperative vestibular schwannoma improves efficiency of patient care, allowing decreased duration of hospitalization. This goal is achieved without increasing complication rates and, in our experience, actually improving the quality of clinical care. The cost-effectiveness of clinical pathways may become increasingly important in a managed care,driven environment. [source] | ||||||||||