Articles: postoperative-complications.
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Journal of neurosurgery · Jun 1982
Results and complications of surgical management of 809 intracranial aneurysms in 722 cases. Related and unrelated to grade of patient, type of aneurysm, and timing of surgery.
Data from 722 consecutive causes with intracranial aneurysms were stored in a computer and later retrieved for analysis. Results and complications (including preoperative death and morbidity) of the surgical management of these patients were correlated with the Botterell grade of the patient in individuals with a recent subarachnoid hemorrhage (SAH), with the type of aneurysm, and with the timing of the surgical procedure. Patients with no SAH within 30 days prior to hospital admission were classified as "no SAH." Approximately 30% of all patients had sustained more than one hemorrhage. ⋯ Intraoperative complications were related both to the size of the aneurysm and to its location. Repair of multiple aneurysms did not adversely affect the result. The surgical approach, the importance of using a self-retaining brain retractor, and the technical complications in these cases are discussed.
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Randomized Controlled Trial Clinical Trial
The conduct of cholecystectomy: incision, drainage, bacteriology and postoperative complications.
The benefits of some ancillary techniques of cholecystectomy are exaggerated by retrospective study of selected patients. Therefore, the authors performed a prospective, randomized study of 100 consecutive patients who underwent simple elective cholecystectomy for chronic cholecystitis and cholelithiasis. No patient was excluded because of incomplete hemostasis or fear of bile leakage. ⋯ Peritoneal drainage was found to be unnecessary. Short-term drainage may increase the frequency of postoperative fever, but did not increase pulmonary complications or wound infections. In these patients, intra-abdominal sepsis is rare; wound infections were uncommon and the gallbladder bile was usually sterile and not the cause of postoperative infection.
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Randomized Controlled Trial Clinical Trial
Intercostal nerve block with thoracoabdominal and flank incisions.
A double-blind study was done in 90 patients undergoing a rib-resecting thoracoabdominal incision for testicular cancer or a flank incision for renal surgery to determine the effect of intraoperative intercostal nerve block with bupivacaine hydrochloride on postoperative pain and complications, day of ambulation, and day of oral fluid intake. In the patients treated with bupivacaine, we found a significant reduction in the amount of postoperative analgesia required, but no difference in the day of ambulation or fluid intake. Ten of 45 patients given a placebo nerve block experienced postoperative atelectasis, whereas only 4 of 45 patients in the treated group experienced this complication. We believe that intercostal nerve block is a valuable postoperative adjuvant in patients undergoing flank surgery to reduce the postoperative analgesic requirements and incidence of atelectasis.