Prolonged operative duration is associated with complications: a systematic review and meta-analysis

Cheng, Hongbo; Clymer, Jeffrey W.; Chen, Brian Po-Han; Sadeghirad, Behnam; Ferko, Nicole; Cameron, Chris; Hinoul, Piet

doi:10.1016/j.jss.2018.03.022

Cited by 471 publications

(305 citation statements)

References 98 publications

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“…Our study also showed that the operative time was an independent factor associated with IAI following major hepatectomy. A prolonged operative time is associated with an increased risk of postoperative SSI . Procter et al performed a retrospective study of 299,359 operations performed at 173 hospitals from the ACS‐NSQIP and found that the infectious complication rate increased linearly with the operative duration.…”

Section: Discussionmentioning

confidence: 99%

“…They concluded that the operative duration is independently associated with increased infectious complications and the LOH after adjustment for procedure‐ and patient‐related risk factors . A prolonged operative time is associated with increased exposure of microbes to the environment, heightened surgical stress to the immune system, and diminished efficacy of antimicrobial prophylaxis over time . Several studies have shown that the operative time is a significant independent factor associated with SSI, including organ/space SSI, in patients undergoing hepatectomy .…”

Section: Discussionmentioning

confidence: 99%

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Preoperative serum albumin is associated with intra‐abdominal infection following major hepatectomy

Rungsakulkij

Vassanasiri

Tangtawee

et al. 2019

J Hepato Biliary Pancreat

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Background Major hepatectomy is a complex surgical procedure with high morbidity. Intra-abdominal infection (IAI) is common following hepatectomy and affects treatment outcomes. This study was performed to investigate perioperative factors and determine whether the preoperative serum albumin level is associated with IAI following major hepatectomy. Methods From January 2008 to December 2018, 268 patients underwent major hepatectomy. We retrospectively analyzed demographic data and preoperative and perioperative variables. IAI was defined as organ/space surgical site infection. Risk factors for IAI were analyzed by logistic regression analysis. Results In total, 268 patients were evaluated. IAI was observed in 38 patients (14.6%). The mortality rate in the IAI group was 15.7%. Multivariate logistic analysis confirmed that the serum albumin level (odds ratio 0.91; 95% confidence interval 0.84-0.97; P = 0.03) and operative duration (odds ratio 1.50; 95% confidence interval 1.18-1.91; P < 0.01) were independent factors associated with IAI. A logistic model using the serum albumin level and operative duration to estimate the probability of IAI was analyzed. The area under the receiver operating characteristic curve for predicting IAI was 0.78. ConclusionThe serum albumin level and operative duration were independent factors predicting IAI following major hepatectomy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Preoperative serum albumin is associated with intra‐abdominal infection following major hepatectomy

Rungsakulkij

Vassanasiri

Tangtawee

et al. 2019

J Hepato Biliary Pancreat

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“…Previous studies have shown that patient outcomes are worse with prolonged surgical time. 19 The results of this systematic review should be interpreted cautiously. As described, the quality of the evidence is low, particularly…”

Section: Discussionmentioning

confidence: 98%

Systematic review of microvascular coupling devices for arterial anastomoses in free tissue transfer

Gundale

Berkovic

Entezami

et al. 2020

Laryngoscope Investig Oto

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Background Coupling devices have become commonplace in performing venous anastomoses during microvascular free tissue transfer (FTT). However, arterial anastomoses are still most commonly performed using traditional microvascular suture techniques. Objective To describe the safety and feasibility of using microvascular coupling devices for free flap arterial anastomosis. Methods A systematic review of English language literature was performed for studies that investigated the use of an arterial coupler for microvascular FTT in human patients. A comprehensive search of MEDLINE (January 1948 to August 2018), EMBASE (January 1974 to August 2018), and Web of Science was performed. Results Fifteen studies were included. All studies were retrospective case series. A combined total of 395 arterial anastomoses were attempted with a coupling device. All studies except for one used the 3M Unilink/Synovis coupling device. One study used a novel absorbable coupling device. The coupling device was aborted and converted to a suture technique in 8.4% of attempted anastomoses. Rupture of the anastomotic device was reported in only 1 patient (0.3%). Thrombosis was also infrequent at 1.9%. The quality assessment showed a high risk of bias in all studies. Conclusion In selected patients, coupling devices for arterial anastomoses have a good success rate with low rates of thrombosis based on limited quality evidence.

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“…Our results showed a longer mean operation time by 6.94 min (95% CI 5.41–8.47, P < 0.0001) in the mMV group than the mMPP group. While the causal relationship between longer operation time and increased risk of surgical site infections is well established, this marginal increase in operation time may not be adequately significant to explain the sole wound complication occurring in the mMV group . One should note that this extra 6.94 min could also be associated with a variety of administrative, patient, skin closure technique and surgeon factors within the operating room, instead of being a direct result of the technical demands of the mMV surgical approach .…”

Section: Discussionmentioning

confidence: 98%

Comparable outcomes in mini‐midvastus versus mini‐medial parapatellar approach in total knee arthroplasty: a meta‐analysis and systematic review

Onggo

Hau

2020

ANZ Journal of Surgery

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Background: Minimally invasive surgery (MIS) techniques in total knee arthroplasties (TKA) have gained popularity over conventional techniques due to benefits of hastened recovery and reduced complications. There are a variety of MIS techniques available and two most common techniques currently employed are the mini-midvastus (mMV) and minimedial parapatellar (mMPP) approaches. This meta-analysis aims to compare the clinical outcomes and peri-operative parameters between mMV and mMPP in TKA in order to determine the presence of a superior technique. Methods: A multi-database search was performed according to PRISMA guidelines. Data from studies comparing clinical outcomes and peri-operative parameters between mMV and mMPP approaches in TKA were extracted and analysed. Results: A total of five randomized controlled trials were included for analysis, consisting of 190 mMV and 189 mMPP knees. Clinically unimportant differences were noted in blood loss and surgical time between the groups (5 mL less blood loss and 7 min less surgical time in mMV, P < 0.001). There was no statistically significant difference between both groups for Knee Society Score at 1 and 2 years, range of motion at 1 and 2 years, incision length or incidence of lateral retinacular release (all non-significant, P > 0.05). Conclusion: The mMV and mMPP MIS TKA approaches have equivalent clinical outcomes. Despite a statistically significant longer operative time and higher mean blood loss in mMV than mMPP approach, clinically significant difference was not demonstrated. Both mMV and mMPP MIS techniques are reliable and safe to perform in TKA.© 2020 Royal Australasian College of Surgeons ANZ J Surg 90 (2020) 840-845ANZJSurg.com

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Prolonged operative duration is associated with complications: a systematic review and meta-analysis

Cited by 471 publications

References 98 publications

Preoperative serum albumin is associated with intra‐abdominal infection following major hepatectomy

Preoperative serum albumin is associated with intra‐abdominal infection following major hepatectomy

Systematic review of microvascular coupling devices for arterial anastomoses in free tissue transfer

Comparable outcomes in mini‐midvastus versus mini‐medial parapatellar approach in total knee arthroplasty: a meta‐analysis and systematic review

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