Background:Cancellation of operations in hospitals is a significant problem with far reaching consequences. This study was planned to evaluate reasons for cancellation of elective surgical operation on the day of surgery in a 500 bedded Government hospital.Materials and Methods:The medical records of all the patients, from December 2009 to November 2010, who had their operations cancelled on the day of surgery in all surgical units of the hospital, were audited prospectively. The number of operation cancelled and reasons for cancellation were documented.Results:7272 patients were scheduled for elective surgical procedures during study period; 1286 (17.6 %) of these were cancelled on the day of surgery. The highest number of cancellation occurred in the discipline of general surgery (7.1%) and the least (0.35%) occurred in Ear-Nose-Throat surgery. The most common cause of cancellation was the lack of availability of theater time 809 (63%) and patients not turning up 244 (19%) patients. 149 cancellations (11.6%) were because of medical reasons; 16 (1.2%) were cancelled by the surgeon due to a change in the surgical plan; 28 (2.1%) were cancelled as patients were not ready for surgery; and 40 (3.1%) were cancelled due to equipment failure.].Conclusion:Most causes of cancellations of operations are preventable.
Background: Myomectomy at the time of caesarean delivery has been discouraged because of the risk of intractable haemorrhage and increased postoperative morbidity. The aim of this study is to determine the safety and feasibility of caesarean myomectomy.
Materials and Methods:A retrospective case control study done between June 2012 to May 2013 in a tertiary care teaching hospital in Karnataka, India which included 21 pregnant women with uterine fibroids who underwent myomectomy during caesarean section and were compared with 42 matched controls without uterine fibroids who had caesarean section alone during the same period. Primary outcome measures studied were incidence of haemorrhage and need for blood transfusion. Secondary outcome measures were duration of operation, length of hospital stay, postpartum fever and wound infection. Statistical analysis is done using IBMSPSS 20.0 software and students t-test. For calculation of incidence of haemorrhage Fisher's exact test is used.Results: Mean age of the 21 cases was 31.81yrs and 47.62% were primigravida. Total 37 fibroids were removed. Subserosal were 30 cases(81.08%) while 1(2.07%) was submucous. 21(56.76%)fibroids were situated in fundal region and 3(8.11%) were in lower segment. Mean change in the haemoglobin from preoperative to postoperative period in the cases was 1.3gm/ dl(±1.155mg/dl) and control was 1.05% (±.854mg/dl). Two of the cases(9.52%) required blood transfusion compared to none in control. None in either group required hysterectomy. Mean duration of surgery was 68.57min (±15.012min)and 51.55min (±9.595min) for controls which is statistically significant.
Conclusion:This study shows that myomectomy during caesarean section is a safe procedure and is not associated with major intraoperative and postoperative complications.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.