1.
Could post-thyroidectomy bleeding be the clue to modify the concept of postoperative drainage? A prospective randomized controlled study
Al-Qahtani AS, Abouzeid Osman T
Asian Journal of Surgery. 2017;41((5):):511-516
Abstract
BACKGROUND/OBJECTIVE To unveil the real effect of surgical drains on the outcomes of thyroidectomy for benign thyroid disorders. METHODS A prospective randomized study was conducted at Abha Private Hospital, Saudi Arabia on 108 patients suffered from benign thyroid disorders undergoing elective thyroidectomy from 1 August 2015 to 28 February 2017. Patients were allocated randomly into drainage group (A) and non-drainage group (B). The demographic data, operation (type and duration), postoperative complications, histopathological results and length of stay were assessed, documented and statistically verified to check its significance. RESULTS A total of 108 patients were enrolled in the study; 94 females and 14 males with mean age of 38.02 years, two patients developed hematoma (1.85%); one in each group and another two patients had seroma with no significant difference between both groups, the mean length of stay was significantly higher in group (A) (p = 0.001). CONCLUSION This prospective study verified that routine drainage adds no significant advantage in the prevention of post-thyroidectomy bleeding, but it prolongs hospitalization. This aids in changing the concept from the "wide" use of drains into the "wise" use in selected patients with risk factors of bleeding.
2.
Place of normovolemic hemodilution in oncologic cervicofacial and ENT surgery French
Boussofara M, Damak R, Bracco D, Ravussin P
Annales Francaises d Anesthesie et de Reanimation. 2002;21((4):):271-5.
Abstract
OBJECTIVE Evaluate the use of normovolaemic haemodilution in cervico-facial oncologic surgery. STUDY DESIGN Prospective, randomised, simple blinded study. PATIENTS AND METHODS 38 ASA I and II patients were studied: a control group (n = 21) and a haemodilution group (n = 17) in whom 5.5-8 mL.kg-1 blood were withdrawn before induction, replaced by an equivalent amount of colloids. In both groups, the transfusional strategy was to keep the haemoglobin level above 100 g.L-1 throughout the procedure and the recovery phase, using in priority the autologous blood in the haemodilution group. Blood losses during surgery were evaluated by weighing the sponges and by measuring the aspirated blood. RESULTS Demographic and anaesthetic data, and blood losses were similar. The haemoglobin levels dropped significantly in the haemodilution group (138 +/- 10 g.L-1 to 107 +/- 11 g.L-1) as well as in the control group (131 +/- 11 g.L-1 to 110 +/- 10 g.L-1). Infectious complications were slightly higher in the haemodilution group, although this difference did not reach the level of significance. CONCLUSION Normovalaemic haemodilution does not seem to be indicated in cervico-facial and ENT oncologic surgery.
3.
Autologous versus homologous transfusion in cervico-fascial oncologic and ENT surgery French
Boussofara M, Dammak R, Touazine N, Zehani S, Kaddour C, Abdallah MB, Ladgham A
Tunisie Medicale. 2001;79((3):):146-51.
Abstract
The objective was to evaluate the interest of the normovolemic hemodilution (NVH) in cervico-facial oncologic and ENT surgery. It was a prospective, randomised and simple blind study having included A(n = 17) having benefitted before induction of a blood withdrawal of 6-8 ml.kg-1, substituted by an intravenous drip of colloid. B group (n = 21). The transfusional objective having been to assure for the two groups, during operative and in postoperative periods, a rate of Hb > or = 10 g.dl-1 and a rate of Ht > or = 30%. The two groups were comparable for the demographic and anesthetic characteristics, and the blood losses during operative period. A variation significantly more important between before and postoperative hemoglobin has been objectified in the group A. The infectious morbidity was significantly more elevated in the group A (23.5% versus 4%). The cost was distinctly more elevated in the hemodiluted group. The NVH doesn't seem to be an indication of choice in the cervico-facial and ENT oncologic surgery.
4.
Role of acute normovolemic hemodilution in treating retinal venous occlusions . French
Poupard P, Eledjam JJ, Dupeyron G, Saissi G, Bloise L, Arnaud B, d'Athis F
Annales Francaises d Anesthesie et de Reanimation. 1986;5((3):):229-33.
Abstract
The supposed state of retinal venous occlusions by a thrombus has led to the use of diverse antithrombotic treatments (heparin, fibrinolytic agents). This theory being considered at the moment as controversial, haemorheological theories being more particularly favoured, other treatments are proposed in an attempt to better retinal microcirculation, and this by changing the blood viscosity parameters. The study reported here compared the effects on recovery of visual acuity of retinal venous occlusion patients of anticoagulant treatment alone, haemodilution alone, or both together. After initial ophthalmic assessment, twenty-five patients were randomly assigned to one of three groups: group I (n = 5; mean age 62 +/- 14 yr) received heparin for 21 days, followed by antivitamin K drugs for a further 30 days; group II (n = 10; mean age 54 +/- 16 yr) were acutely hemodiluted with 40,000 daltons molecular weight dextran, bringing the haematocrit to between 0.25 and 0.30; on day 2, the same anticoagulant treatment as in group I was associated; group III (n = 10; mean age 58 +/- 18 yr) were only hemodiluted. The hemodiluted state was maintained for 21 days. A biological assessment was carried out for the three groups on days 1, 2, 7, 14, 21 and 30 (haematocrit, fibrinogen level, platelet count, kaolin-cephalin time, heparin level). The evolution of visual acuity was assessed on days 7, 14, 21, 30, 60 and 90. Mean visual acuity was assessed on days 7, 14, 21, 30, 60 and 90. Mean visual acuity was virtually the same for the three groups on day 0.(ABSTRACT TRUNCATED AT 250 WORDS)