Showing 9 results for Operation
M Abasi Moghadam ,
Volume 56, Issue 6 (7-1998)
Abstract
This study was focused on analysis of expenditure on all the medical services given at Neuro-Surgery Department of Imam-Khomeini Hospital in the year of 1994 (1373). In this study, all the information on descriptive method and the techniques of cost analysis and cost per unit of service provided accountancy, were analysed. 573 patients were considered in this study. 522 of them underwent 13 different types of neuro-surgery operations. 92.6% of them total departmental costs were related to current expenditures and 7.4% of that was related to the capial expenditures. The personnel costs with 49% was the highest portion of the total costs. Percentage wise, the costs were as follows: Medicine, materials and equipment 22%, food 17.6%, depreciation 7.4%, fuel, water, electricity and telephone 3.5%. The mean duration of stay was 16.3 days for every in-patient. The percentage of occupied bed was 58% if the percentage of desired bed occupancy was supposed 80%, therefore, 22% of the bed, plus 3512 bed-day were gone wasted. The real cost of med-care policy need to be more rational for the operation and hospitalization. It should be mentioned that the wasted time was 886 hours and wasted cost was 71, 708, 410 Rials in operation room.
Radmehr H, , ,
Volume 59, Issue 2 (5-2001)
Abstract
Valvular and coronary artery disease are among the most important causes of disability and death in the world and Iran as well. Every year, half a million death because of these diseases is reported in United State. The incidence of degenerative and valvular diseases of heart is increasing. Considering the industrialization of our country, the incidence of these kind of problems are increasing as well. In this study, there is an attempt to recognize the causes of cardiac surgery. We conducted a retrospective study in 915 cardiac surgery patients (630 CABG and 285 valve replacement) from 1374 to 1377. In CABG patients, there were 46 cases of reoperation (78.3 percent male 21.7 percent female). The most reoperations for bleeding was less than 24 hours in 90.3 percent. In valvular patients the causes of reoperation were: A) Valvular complications (female/male=3/1), B) Non valvular complications (female/male=1/3). The most common nonvalvular complication was bleeding (66.6 percent). The most common valvular complication was bioprosthetic valve degeneration. The meantime between two operation in valvular complications was 11.8 years. In all cases (915) the incidence of bleeding was 3.8 percent, mediastinitis 0.8 percent, cardiac tamponade 0.8 percent and GI bleeding 0.5 percent.
Radmehr H,
Volume 59, Issue 3 (6-2001)
Abstract
Valvular and coronary artery disease are among the most important causes of disability and death in the world and Iran as well. Every year, half a million death because of these diseases is reported in United State. The incidence of degenerative and valvular diseases of heart is increasing. Considering the industrialization of our country, the incidence of these kind of problems are increasing as well. In this study, there is an attempt to recognize the causes of cardiac surgery. We conducted a retrospective study in 915 cardiac surgery patients (630 CABG and 285 valve replacement) from 1374 to 1377. In CABG patients, there were 46 cases of reoperation (78.3 percent male 21.7 percent female). The most reoperations for bleeding was less than 24 hours in 90.3 percent. In valvular patients the causes of reoperation were: A) Valvular complications (female/male=3/1), B) Non valvular complications (female/male=1/3). The most common nonvalvular complication was bleeding (66.6 percent). The most common valvular complication was bioprosthetic valve degeneration. The meantime between two operation in valvular complications was 11.8 years. In all cases (915) the incidence of bleeding was 3.8 percent, mediastinitis 0.8 percent, cardiac tamponade 0.8 percent and GI bleeding 0.5 percent.
Kazemi Khaledi A, Rahmani Reaza,
Volume 61, Issue 1 (4-2003)
Abstract
Prosthetic valve re-operation has greater mortality and morbidity than primary valve replacement. By recognition of factors influencing on causes of redo operation and preoperative survival, one can select appropriate prosthesis at primary valve replacement and when operation performed at appropriate time, surgical risk can be reduced.
Methods and Materials: Two hundred patients that underwent prosthetic valve re-operation from October 1991 through November 2001 were included in this study. There were 68 men and 132 women with the mean age of 42:tl 1.8 years. Structural failure was the commonest cause of bio-prosthesis replacement (93%). Valve thrombosis was the common cause of mechanical valve replacement (32%). Age younger Than 50 (P= 0.01) and interval after the first implantation more than 10 years (P= 0.01) affected bio-prosthesis degeneration.
Results: Atrial fibrillation (P<0.01), Older age especially more than 40 (P<0.05) and mitral position (P<0.01) affected mechanical valve thrombosis. Cross clamp time (P= 0.005), Tricuspid insufficiency (P = 0.001), NYHA IV (P = 0.005) and emergent operation (P= 0.001) were independent determinants of hospital mortality.
Conclusion: In conclusion, in patients with more than 10-years life expectancy and age younger than 50, mechanical valve can be selected for primary valve replacement. If operation performed before patients reach deteriorated condition, preoperative survival would be excellent.
Atri A, Taj Mj, Yalda A R,
Volume 61, Issue 3 (6-2003)
Abstract
The genus acinetobacter are intestinal gram negative, encapsulated, non motile, aerobic bacilli, which are rod shaped during rapid growth and cocobacillary in stationary phase. Risk factors associated with nosocomial infections include: length of hospital stay, surgery, wounds, previous infection, fecal colonization, treatment with broad spectrum antibiotics, parenteral nutrition, indwelling central intravenous or urinary catheters, admission to a burn unite or ICU and mechanical ventilation. Acinetobacter meningitis occur infrequently and is generally found after neurosurgical procedures.
Here, we are presenting a 19 year-old female patient who developed multi-drug resistant (MDR) acinetobacter meningitis after operation on maxillary bone, but despite good clinical response to imipenem and amikacin succumbed aminoglycoside induced otoxicity.
Tavassoli A, Abdollahi A, Golmohammadzadeh H,
Volume 70, Issue 5 (8-2012)
Abstract
Background: Regarding the limited number of studies on the feasibility of resection and repair of the small intestine by ligasure, we performed this study to compare ligasure with linear stapler for the previously mentioned operation.
Methods: This phase 1 clinical trial study was performed in Ghaem Hospital, an educational hospital affiliated to Mashhad University of Medical Sciences, from 2010 to 2011. After obtaining permission from the University's ethics committee and a written informed consent from each patient, we recruited 18 patients. The participants who had morbid obesity and were candidates for laparoscopic gastric bypass surgery were randomly allocated to two stapler and ligasure groups. The data were collected and analyzed by three statistical tests, including Mann-Whitney U test, by SPSS 16.
Results: All patients were female with the age range of 20-65 years. Cost in the stapler group ranged between 29,500,000 to 40,000,000 Rial (mean 31,830,000± 3,500,000 Rials) and in ligasure group it was between 24,000,000 to 35,000,000 Rials (mean 26,720,000± 3,290,000 Rials). There was a significant difference between the two groups in cost (P=0.004(. Duration of the operations were 200±3.4 and 240±10 minutes in the stapler and ligasure groups, respectively. The difference in duration was significant between the two groups (P=0.043). No significant differences were observed in complications.
Conclusion: Application of ligasure in resection and reconstruction of small intestine is more cost-effective than stapler, although duration of surgery is longer.
Amir Keshvari , Mohammad Sadegh Fazeli , Alireza Kazemeini , Alipasha Meysamie , Mohammad Kazem Nouri Taromlou,
Volume 71, Issue 10 (1-2014)
Abstract
Background: Colorectal carcinoma is considering as a curable disease. Treatment of recurrent cases is hard and sometimes impossible. Evaluation of the rate and affecting factors of recurrence in each hospital would help to decreasing recurrent cases. The aim of this study is evaluation of the rate, clinical and pathologic features, and outcome of recurrent colorectal carcinoma in a referral teaching hospital in Tehran.
Methods: Clinical data of 166 curative resections of colorectal carcinoma who were operated between Mehr 1384 and Mehr 1388 (between 23 September 2005 and 23 September 2009) in Imam Khomeini Hospital and were accessible for follow up was collected. Follow up data was collected prospectively up to Farvardin 1391 (19 April 2012). Forty nine recurrences were happened in this period. We compared recurrent and non-recurrent cases for different variables
Results: Average age of the patients was 53.5 years, and 47% of them were female. The median time to the diagnosis of recurrent disease was 12 months (range 1 months to 54 months). There were no significant differences between recurrent and non-recurrent patients about age, sex, sub-site of the tumor and sub-type of primary operation. Rate of overall recurrence, local recurrence and distant metastasis were 29.5%, 15.7% and 12.1% respectively.
Local recurrence rate was higher in colon cancer (16.44% vs. 15.05%) but distant metastasis rate was higher in rectal cancer (12.9% vs. 10/96%). Rate of curative re-resection was about 25%. Overall survival of the recurrent patients who underwent surgery was better than who underwent chemo or radiotherapy (66.7% vs. 56.8%). Median survival time of recurrent patients after primary surgery was 28 months, and after diagnosis was 12 months (9.28- 14.72,95% CI).
Conclusion: In this study the rate of overall recurrence was 29.5%. Local recurrence rate was higher in colon cancer (16.44% vs. 15.05%) but distant metastasis rate was higher in rectal cancer (12.9% vs. 10/96%).
Ali Mohammad Mosadeghrad , Fatemeh Khalaj ,
Volume 74, Issue 5 (8-2016)
Abstract
Background: Operation theatre in a hospital requires considerable human and physical resources to deliver surgery services on an agreed schedule. However, operation theatres are sometimes underutilized due to avoidable last minute cancellations of operations. Cancellation of operations on the day of intended surgery results in operation theatre planning difficulties, hospital inefficiency and resource wastage. In addition, it causes stress for patients and their relatives and results in unnecessary hospital staying. Cancellation of planned operations could be avoided by applying appropriate management strategies and techniques. Quality management as an organizational strategy helps enhance hospital departments’ productivity.
Methods: This study aimed to reduce cancelled surgeries in Shahid Rajaei Hospital in Tehran using a quality management model. A participatory action research was used for the intervention between April 2013 and March 2014. Information on operations cancelled on the day of surgery obtained each day from the operating theatre list. Using a checklist, the reasons for operations cancellation were identified, investigated and an action plan was developed for its reduction. The plan was implemented using the action research cycle.
Results: The number of surgeries increased by 4.06 percent and operations cancellation was reduced by 32.4 percent using the quality management strategy. Surgeon and anesthetist related factors, over-running of previous surgery, changes in patient clinical status and lack of intensive care unit beds were the main reasons for cancelling surgeries. Standardization of processes, proper planning and using anesthetics clinic helped reduce the operations cancellation.
Conclusion: Last minute surgeries cancellation is potentially avoidable. Implementing an appropriate quality management model helps enhance hospital departments’ productivity and reduce surgical cancellation.
Masoomeh Tabari , Marjaneh Farazestanian, Helena Azimi, Maryam Esmaeilpour, Malihe Hasanzadeh Mofrad ,
Volume 79, Issue 9 (12-2021)
Abstract
Today surgery is supposed as the cure for many diseases and the fear of post-operation pain burdens stress over the patients. Postoperative pain can, especially if severe, complicate the patient's condition and may lead to chronic postoperative pain. post-operation pain control is effective in the recovery process, hospitalization period and patients’ satisfaction. Insufficient post-operation pain control increases complications and care costs. Local analgesia is one of the components of multimodal postoperative. analgesic protocol to control pain. Local analgesia technique is a simple, accessible and feasible method for various surgeries. The opioid analgesics to control post-operation pain are associated with some complications such as opium addiction, nausea and vomiting, late return of bowel function and social costs. This review study aims. to review previous studies on the effect of injection of analgesic agents in the surgical incision in post-operation pain control. This is a Narrative review study. to related scientific documentaries a search was conducted in Persian and English using the keywords of local injection of the incision site, wound infiltration with analgesic agents and post-operation pain control in Google scholar, PubMed and Scopus database during the years 2000 to 2020. The obtained articles included systematic reviews, Meta-analyses and randomized clinical trials (RCT). We reviewed studies that had utilized single-dose injection of analgesic agents in surgical incisions at the end of surgery to control post-operation pain. A total of ten studies were reviewed. There were 4 studies in the field of laparoscopic gynecological and non-gynecological surgeries, three studies in the field of laparotomy and three review studies. injection of analgesic agents in the surgical incision to control post-operation pain is easily available and does not necessitate any special skill. On the other hand, it is a safe method without further complications and does not increase the duration of surgery. Regardless of the differences in various studies and the kind of analgesic agents, a general reduction in pain severity and consumption of opioid and non-opioid analgesic agents were observed using the injection of analgesic agents in surgical site incision.
