Articles: postoperative-complications.
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J. Cardiothorac. Vasc. Anesth. · Oct 2024
ReviewPrognostic Impact of Anemia and Blood Transfusions on Cardiovascular Outcomes in Patients Undergoing Vascular Surgery: A Scoping Review.
Prior studies suggest an association of anemia and blood transfusion with increased morbidity and mortality in patients undergoing cardiac surgery. However, the impact of perioperative anemia and blood transfusion on clinical outcomes in patients undergoing major vascular surgery has been poorly defined yet. The primary objectives of this scoping review were to determine the extent of the evidence base that links anemia and blood transfusions to mortality and cardiovascular outcomes in patients undergoing major vascular surgery, and identify recurring themes or gaps in the literature to guide future research. ⋯ The weight of the evidence suggests that anemia carries a substantial burden of cardiovascular complications, mortality, and multiorgan complications, resulting in increased health care costs. Peripheral and endovascular aortic surgery are affected deeply by the impact of anemia. Anemia itself stands out as a crucial predictor for requiring transfusions. In turn, the effect of transfusion of blood products is associated with worse outcomes and complications.
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Background and Objectives: Duodenal atresia and stenosis are common causes of intestinal obstruction. Associated anomalies significantly influence early postoperative mortality, while postoperative complications impact long-term survival. Materials and Methods: Over a 13-year period from January 2010 to August 2023, a total of 74 infants and children with congenital duodenal obstruction were treated at "Grigore Alexandrescu" Children's Emergency Hospital and met the inclusion criteria. ⋯ Surgical complications included adhesive bowel obstruction (n = 7), incisional hernia (n = 3), peritonitis (n = 3), dysfunctional duodenoduodenostomy or duodenojejunostomy (n = 3), pneumoperitoneum (n = 5), enteric fistula (n = 3), and volvulus (n = 4). Conclusions: Surprisingly, this retrospective study revealed that an Apgar score below 8, along with neurological and pulmonary abnormalities, is associated with postoperative complications. Conversely, other congenital anomalies, low birth weight, and age at admission do not serve as prognostic factors.
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Background and Objectives: Postoperative ileus (POI) is a delay in gastrointestinal transit following surgery that leads to various complications. There is limited understanding of its effective treatment options. CKD-495 and eupacidin are natural products licensed for treating mucosal lesions in acute and chronic gastritis; however, little is known about their effects on intestinal permeability. ⋯ No significant differences were observed in the expression of tight junction proteins. Conclusions: CKD-495, cinnamic acid, eupacidin, and eupatilin exerted protective effects against increased intestinal permeability and inflammation in an animal model of POI. These natural products have potential as therapeutic options for the treatment of POI.
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Randomized Controlled Trial
Continuous or Interrupted Suture for Hepaticojejunostomy in Pancreaticoduodenectomy (the HEKTIK Trial): Findings of a Randomized, Controlled, Single-Center Superiority Trial.
Over 6000 pancreaticoduodenectomies are performed each year in Germany, and hepaticojejunostomy is a crucial step of the procedure. An anastomotic leak of hepaticojejunostomy can cause major postoperative complications. The aim of this trial was to compare the morbidity and efficiency of continuous versus interrupted suturing for hepaticojejunostomy in pancreaticoduodenectomy. ⋯ These data imply that continuous and interrupted suturing techniques yield equally good clinical outcomes in hepaticojejunostomies of hepatic ducts with diameter 5 mm or more. Continuous suturing is, however, both faster and cheaper.