We are describing a case of a female infant with ventriculoperitoneal shunt scheduled for inguinal hernia repair under spinal anesthesia. The child was a premature newborn who, in a recent past, underwent surgery in g...We are describing a case of a female infant with ventriculoperitoneal shunt scheduled for inguinal hernia repair under spinal anesthesia. The child was a premature newborn who, in a recent past, underwent surgery in general anesthesia for retinopathy correction with subsequent difficult mechanical ventilation weaning. The benefit of spinal anesthesia in high-risk infant was described and the risks of spinal anesthesia in the presence of a ventricular shunt device-especially dural leakage and infections were briefly discussed.展开更多
BACKGROUND Few series have reported the utility of fast-track protocols(FTP)in minimally invasive liver surgery.AIM To report the applicability of FTP in minimally invasive liver surgery and to correlate with difficul...BACKGROUND Few series have reported the utility of fast-track protocols(FTP)in minimally invasive liver surgery.AIM To report the applicability of FTP in minimally invasive liver surgery and to correlate with difficulty scores.METHODS The series of patients undergoing minimally invasive liver surgery from 2014 was analyzed.Iwate,Southampton and Gayet’s scores were compared as predictors of FTP adherence.Accomplishment of FTP was considered within 24-h,48-h and 72-h.Multivariate models were performed to define discharge<24 h,<72 h,complications and readmissions.RESULTS From 160 cases,78 were candidates for FTP,of which 22(28.2%),19(24.4%)and 14(17.9%)were discharged in<24-h,48-h and 72-h,respectively(total=71.5%).Iwate,Southampton and Gayet’s scores achieved area under the receiver operating characteristic values for<24-h stay of 0.780,0.687 and 0.698,respectively.Sensitivity and specificity values for the best score(Iwate)were 87.7%and 66.7%,respectively(cutoff=5.5).In multivariate models,<72 h stay and complications revealed body mass index as a risk factor independent from difficulty scores.CONCLUSION The development of aggressive FTP is feasible and<24-h stay can be achieved even in moderate and advanced complexity cases.Difficulty scores,including body mass index value,may be useful to predict which cases may adhere to these protocols.展开更多
文摘We are describing a case of a female infant with ventriculoperitoneal shunt scheduled for inguinal hernia repair under spinal anesthesia. The child was a premature newborn who, in a recent past, underwent surgery in general anesthesia for retinopathy correction with subsequent difficult mechanical ventilation weaning. The benefit of spinal anesthesia in high-risk infant was described and the risks of spinal anesthesia in the presence of a ventricular shunt device-especially dural leakage and infections were briefly discussed.
文摘BACKGROUND Few series have reported the utility of fast-track protocols(FTP)in minimally invasive liver surgery.AIM To report the applicability of FTP in minimally invasive liver surgery and to correlate with difficulty scores.METHODS The series of patients undergoing minimally invasive liver surgery from 2014 was analyzed.Iwate,Southampton and Gayet’s scores were compared as predictors of FTP adherence.Accomplishment of FTP was considered within 24-h,48-h and 72-h.Multivariate models were performed to define discharge<24 h,<72 h,complications and readmissions.RESULTS From 160 cases,78 were candidates for FTP,of which 22(28.2%),19(24.4%)and 14(17.9%)were discharged in<24-h,48-h and 72-h,respectively(total=71.5%).Iwate,Southampton and Gayet’s scores achieved area under the receiver operating characteristic values for<24-h stay of 0.780,0.687 and 0.698,respectively.Sensitivity and specificity values for the best score(Iwate)were 87.7%and 66.7%,respectively(cutoff=5.5).In multivariate models,<72 h stay and complications revealed body mass index as a risk factor independent from difficulty scores.CONCLUSION The development of aggressive FTP is feasible and<24-h stay can be achieved even in moderate and advanced complexity cases.Difficulty scores,including body mass index value,may be useful to predict which cases may adhere to these protocols.
