RESUMEN
OBJECTIVES: This study reports the results of a single center experience on the use of pharmacological venous thromboembolism (VTE) prophylaxis in laparoscopic cholecystectomy patients. BACKGROUND: The prevention of VTE is of crucial importance in surgical practice. However, the severity of thromboembolism risk and the necessity of thromboprophylaxis for laparoscopic cholecystectomy is still being debated. METHODS: The data of the patients, who underwent laparoscopic cholecystectomy for symptomatic cholelitiasis in a single center between the years 2005 and 2015 were analysed retrospectively for incidents of symptomatic VTE and bleeding complications. Fisher Exact Test was used to compare the outcomes of the patients who did and did not receive thromboprophylaxis. RESULTS: Of the 1485 patients who were included in the study, 307 (20.67 %) having a low VTE risk, did not receive any thromboprophylaxis; while 1178 (79.33 %) with a medium, high or a very high risk received VTE prophylaxis. A bleeding complication occurred in 14 (1.18 %) patients receiving prophylaxis and in 2 (0.65 %) patients not receiving prophylaxis (p = 0.548). No patients in this study experienced clinically symptomatic VTE. CONCLUSIONS: The findings of this study indicate that the selective use of thromboprophylaxis does not significantly increase the risk of bleeding after laparoscopic cholecystectomy and probably decreases the incidence of symptomatic thrombotic complications (Ref. 18) Keywords: laparoscopic cholecystectomy, bleeding, venous thromboemboly, prophylaxis, low molecular weight heparin.
Asunto(s)
Anticoagulantes/uso terapéutico , Colecistectomía Laparoscópica , Heparina de Bajo-Peso-Molecular/uso terapéutico , Hemorragia Posoperatoria/epidemiología , Tromboembolia Venosa/prevención & control , Adulto , Anciano , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Turquía/epidemiología , Tromboembolia Venosa/epidemiología , Adulto JovenRESUMEN
OBJECTIVE: The study was designed to compare the early postoperative results of the commonly used two surgical flap procedures in pilonidal disease: Karydakis and Limberg. METHOD: One hundred patients were randomized into two groups and standard Limberg or Karydakis procedures were performed. All had primary sinus orifices. Infected cases and the ones with secondary orifices over 2 cm distant from primary were excluded. Data were recorded concerning complications, need for analgesia and wound dressing, periods of time off work and off driving. Patients were asked to classify their first defecation manner after the operation and also pain according to a Visual Analogue Scale with range of 1-10. RESULTS: There was a significantly higher wound infection rate in the Karydakis group than in the Limberg group (13/50 and 4/50 respectively). This also resulted in significantly higher values for wound dressings and need for analgesia. The time off work and off driving and also the Visual Analogue Scale scores were not significantly different between the two groups. CONCLUSION: Both procedures can be safely performed in pilonidal disease with a standard length of stay in hospital and a similar loss of productive power. However, the Karydakis flap seems to have a significant higher infection rate and this probably increases the cost.