Background: Cardiovascular disease (CVD) remains the leading cause of death worldwide despite the coexistence of the current COVID-19 pandemic. Current emergency management involves revascularization of the coronary arteries. background: Cardiovascular disease (CVD) remains the leading cause of death worldwide despite the coexistence of the current COVID-19 pandemic. Current emergency management involves revascularization of the coronary arteries. Aims: Retrospectively evaluate the association between the used number of shunts and postoperative complications. Objectives: Several complications are reported after coronary artery bypass graft (CABG) surgery, such as postoperative arrhythmia and postoperative stroke. However, the risk factors for the development remain not elaborated. method: A retrospective cohort study involved 290 patients for the period 2017-2021 treated surgically for ischemic heart disease. The surgery includes shunts of the internal thoracic arteries with the post-occlusion coronary arteries. The number of shunts is varied depending on the size and number of occluded arteries. According to the number of shunts, the patient may be operated with artificial circulation (CPB; cardiopulmonary bypass), or without working heart (OFF pump; without artificial circulation). For statistical analysis, t test, the one- and two-way ANOVA test, and the Pearson correlation test were used using Statistica program. Material and methods: A retrospective cohort study involved 290 patients for the period 2017-2021 treated surgically for ischemic heart disease. The surgery includes shunts of the internal thoracic arteries with the post-occlusion coronary arteries. The number of shunts is varied depending on the size and number of occluded arteries. According to the number of shunts, the patient may be operated on with artificial circulation (CPB; cardiopulmonary bypass), or without a working heart (OFF pump; without artificial circulation. For statistical analysis, T-test, one-way ANOVA test, X2 test, COX proportional hazards, and Pearson correlation test were used by using the Statistica program. Results: The most frequently reported complication is postoperative hydrothorax, in 28 (11.20%) patients. Patients with post-CABG LV aneurysm had a longer CPB time and aortic cross-clamp time, t-value -5.58113, p < 0.000000; t-value -4.72802, p < 0.000004, respectively. Patients with postoperative hydrothorax with low BMI and longer CPB and Aortic cross-clamp time, t-value of-2.33929, p <0.020021; t-value 3.83233, P < 0.000157; t-value 2.71109, p < 0.007119, respectively. Subsequently, post-operative hydrothorax increases the intensive care unit (ICU) and total hospitalization days, t-value 5.80811, p < 0.000000; t-value 7.37431, p < 0.000000, respectively. Patients who have preoperative progressive angina have a higher number of complications, t-value of 2.108504, p < 0.035866. Post-myocardial infarction patients with myocardial sclerosis (PMIMS) have a higher number of complications, t value of 2.516784, p < 0.012396. A direct correlation between the number of complications and age/CPB time/ aortic cross-clamp time/ICU hospitalization days/total hospitalization days, r= 0.138565, 0.204061, 0.162078, 0.487048, 0.408381; respectively. Conclusion: Postoperative complication rate associated with the pre-existence of progressive angina and PMIMS. Elderly people undergoing CABG are at higher risk of psychosis, arrhythmia, longer total and ICU hospitalization days, and stroke. Advanced age, longed CPB time, prolonged aortic cross-clamp time, long ICU hospitalisation, and long total hospitalization days are risks of more frequent post-CABG complications. Others: The number of complications is not associated with the dead and alive status of patients or with the number of shunts.
Background: Hernia is a common pathology in the globe and reported more frequently, particularly, inguinal hernia. Aims: To identify the surgery of choice for the treatment of hernias by evaluating the required postoperative hospitalization time, as no other complications have been reported according to data from Mordovian Republic hospital. Material and methods: A retrospective cohort study involved 790 patients for the period 2017-2022 treated surgically for various types of hernia; inguinal hernia, umbilical hernia, spontaneously reduced strangulated post-operative ventral hernia, incarcerated post-operative ventral hernia, and hernia of the Lina Alba. For statistical analysis, used T test, one way ANOVA test, and Pearson correlation test by using Statistica program. Results: The hospitalization period after Lichtenstein surgery is statistically less than Postemsky surgery (mean 6.88 days, 7.43 days, respectively, t value -2.29593, p<0.02) and laparoscopic surgery (mean 6.88 days, 8.19072 days, respectively, t value 4,206817, p<0,000031). Whereas, Postemsky surgery has shorter post-operative hospitalization period in compare to laparoscopic surgery (mean 7.43 days, 8.19072 days, respectively, t value -2.19326, p<0.02). According to the used surgical approach, the patients post-operative hospitalization days differs (mean days: min. days; max. days, 7.50192: 0.00; 30.00). According to Postemsky (M m; 7.43262, 0.167012), according to Martynov (M m; 8.37500, 0.113440), according to Lichtenstein (M m; 6.88153, 0.146845), according to Mayo (M m; 7.51282, 0.280156), according to Bassini (M m; 8.77778, 2.379179), laparoscopically (M m; 8.19072, 0.268434), according to Sapezhko (M m; 8.25000, 1.380074), and another type of surgery (M m; 11.40000, 2.501999). Women (mean 8.525114 days) hospitalized longer than men (mean 7.065371 days), t value 5.871044, p< 0.001. A statistically significant correlation has been found between age and post-operative hospitalization time (Pearson Rank Order Correlations r=0.215561, p <0.05). Conclusions: The study shows that the Lichtenstein surgery is the surgery of choice in terms of hospitalization time after the surgery. Straight association between sex and age with postoperative hospitalization days.
Background: Cholithiasis remains the leading cause of obstructive jaundice. A tendency to cholithiasis is suggested in women. However, the underlying risk factors and statistical conformation are lacking. Aims: Retrospectively describe and assess the causes of obstructive jaundice, as well as demonstrate the changes in laboratory parameters in response to treatment. Objectives: The study describes a sample of patients with obstructive jaundice due to various causes. Material and methods: A retrospective cohort study involved 101 patients with cholithiasis for the period 14.01.2016-13.04.2018 treated surgically and or conservatively. The study involved 60 (59.40594 %) men and 41 (40.59406 %) females aged 16 to 100 years (mean; 64.9901, Std Err: 1.53787). Of 101, 54 (53.46535 %) patients live in the city and 47 (46.53465 %) live in the village. The patients passed a full blood count and biochemical analysis for at least two times. Data were collected from the Mordovian Republic Hospital and retrospectively analyzed. The consent of the patients has been taken for scientific purposes to analyze and publish the results of the study. For statistical analysis, used T test, one way ANOVA test, and Spearman correlation test by using Statistica program. Results: By the etiology of obstructive symptoms, the frequency of gallstones is reported in 37 (36.63366%) patients, acute pancreatitis in 23 (22.77228%) patients, post-cholecystectomy syndrome (PCS) in 8 (7.92079 %) patients, Hilar cholangiocarcinoma (HC, Klatskin tumor) in 1 (0.99010 %) patient, pancreatic cancer in 12 (11.88119 %) patients, acute biliary pancreatitis in 8 (7.92079 %) patients, pancreatic pseudotumor in 4 (3.96040%) patients, acute cholecystitis in 3 (2.97030 %) patients, papillary tumor in 2 (1.98020 %) patients, and pancreatic cyst in 3 (2.97030%) patients. In male group, the mean age is 62.7805 years (min; max, 16.00000; 86.000) years, (median; Std Err, 66.0000; 2.40541). In the female group, the mean age is 66.5000 years (min; max, 24.00000; 100.000) years, (median; Std Err, 65.5000; 1.99300). Of 101 patients, 20 (19.80%) patients underwent surgical treatment and 81 (80.20%) patients did not require surgery. The mean total hospitalization days for patients who passed EPST surgery is 16.20000 days (Std Err 1.008850), CBD 21.50000 days (Std Err 1.565248), CDBD 25.00000 days, cholecystostomy 14.00000 days and hepaticocholecystoenterostomy 16.00000 days (Std Err 2.000000). In male group, the mean total hospitalization days 15.8537 (min; max, 5.00000; 30.000) days, (median; Std Err, 15.0000; 0.89071). In the female group, the mean total hospitalization days 14.0833 (min; max, 6.00000; 29.000) days, (median; Std Err, 13.5000; 0.68901). A direct association between the glucose value and the age, the correlation coefficient value -0.961980. Conclusions: Tendency to the early occurrence of obstructive jaundice symptoms in men compared to women. In treatment plans, men and females required the same total hospitalization days. The incidence rate of cholithiasis in females is higher than in males. Other findings: A straight association between age and the etiology of obstructive jaundice symptoms as well as a straight association between total hospitalization days and the type of surgery.
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