Conectar
by Zhi-Hua Huang, Jun Zhang, Xiao-ying Xu, Ying Wang, Xiao-jian Lu, Yan Luo
BackgroundPostoperative delirium is a common complication after various types of major surgery. The aim of this study was to identify risk factors associated with delirium following pancreatic surgery.
MethodsData from the patients who had pancreatic surgery between July 2020 and March 2021 in Ruijin Hospital affiliated with Shanghai Jiao Tong University School of Medicine were retrospectively analysed. The postoperative risk factors related to delirium were analyzed by univariate and multivariate Logistic regression analysis.
Results59 of 385 patients (15.3%) developed postoperative delirium after pancreatic surgery. The ROC curve revealed the optimal cutoff of intraoperative fluid balance was 2863ml. Furthermore, the multivariate analysis demonstrated that age ≥ 65 years old [Odds ratio (OR) 2.01; 95% Confidence interval (CI) 1.12-3.63; p = 0.019], hypnotic drug use (OR 4.17; 95% CI 1.50-11.10; p = 0.005), and intraoperative fluid balance (OR 2.57; 95% CI 1.37-4.84; p = 0.003) were the independent risk factors of postoperative delirium.
ConclusionThis study identified that intraoperative fluid balance and hypnotic drug use were independent risk factors associated with postoperative delirium development after pancreatic surgery.
This meta-analysis assesses the impact of Enhanced Recovery After Surgery (ERAS) protocols on surgical site wound infections (SSWIs) in urological procedures. Analysing data from 10 studies, our focus was on SSWI rates on the third and seventh postoperative days. The results reveal a significant reduction in SSWI rates for patients managed under ERAS protocols compared with traditional care. Notably, Figure 4 demonstrates a substantial decrease in SSWI on the third day (I 2 = 93%; random: standardized mean difference [SMD]: −6.25, 95% confidence interval [CI]: −7.42 to −5.05, p < 0.01), and Figure 5 mirrors this trend on the seventh day (I 2 = 95%; random: SMD: −4.72, 95% CI: −6.28 to −3.16, p < 0.01). These findings underscore the effectiveness of ERAS protocols in minimizing early postoperative wound infections, emphasizing their importance for broader implementation in urological surgeries.
Laparoscopic-assisted vaginal radical hysterectomy (LARVH) and abdominal radical hysterectomy (ARH) have been widely applied to treat cervical carcinoma. But LARVH and ARH have not been fully investigated in treating cervical carcinoma after injury associated with injury. This research is intended to provide an up-to-date basis for comparing LARVH with ARH in early stage cervical carcinoma. Comparison between LARVH and ARH in cervical carcinoma was carried out through a combination of related research. Eligible articles from databases such as PubMed and Embase were screened using an established search strategy. This report covered the results of LARVH versus ARH in cervical carcinoma. The average difference and the 95% confidence interval (CI) were used for the combination of consecutive variables. The combination of categorical variables was performed with the odds ratio (OR) 95% confidence interval. Through the identification of 1137 publications, eight of them were chosen to be analysed. Among them, 363 were treated with LARVH and 326 were treated with ARH. Eight trials showed that LARVH was associated with a reduced risk of postoperative wound infection than ARH (OR, 0.23; 95% CI, 0.1–0.55, p = 0.0009). Five trials showed that there was no difference in the risk of postoperative bleeding after surgery (OR, 1.17; 95% CI, 0.42–3.29, p = 0.76). We also did not differ significantly in the duration of the surgery (OR, 1.79; 95% CI, −6.58 to 10.15, p = 0.68). So, the two surgical methods differ significantly only in the risk of postoperative wound infection.
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