ABSTRACT
The results of perioperative decontamination in a series of 136 patients presenting diseases of the colon and rectum are evaluated. Of the total 74 are subjected to operation according to schedule, and 62 are operated on an emergency basis. Perioperatively, metronidazole plus a cephalosporin antibiotic (cephazolin, cephalothin or cephamandol) are administered. Primary anastomoses are done in 32 cases operated according to schedule, and in fourteen patients operated in the emergency room. Insufficiency of the anastomosis is recorded in 3.5 per cent in the former group, and in 15 per cent in the latter group (p > 0.05). Operative wound suppuration occurs in 5.4 per cent against 13 per cent (p > 0.05), with lethality amounting to 1.3 per cent and 19 per cent, respectively (p < 0.001). Postoperative pneumonia is registered in 4 per cent of those operated on schedule and in 9.6 per cent of those operated by urgency (p > 0.05). In either group there is not a single case of operative wound dehiscence. In colorectal operations antibacterial prophylaxis applied perioperatively proves effective in combating systemic and local inflammatory complications.
Subject(s)
Anti-Infective Agents/therapeutic use , Antibiotic Prophylaxis/methods , Cephalosporins/therapeutic use , Colorectal Surgery/methods , Metronidazole/therapeutic use , Aged , Cause of Death , Drug Therapy, Combination , Elective Surgical Procedures , Emergencies , Female , Humans , Intestinal Diseases/mortality , Intestinal Diseases/surgery , Intestine, Large/surgery , Male , Middle Aged , Rectal Diseases/mortality , Rectal Diseases/surgeryABSTRACT
The treatment results in 312 patients with cholelithiasis, covering the period 1989 to 1993, are retrospectively analyzed. Overall postoperative lethality amounts to 4.4 per cent. The obtained results are fully comparable in terms of both missed concrements left behind within the extrahepatic bile ducts, and in terms of postoperative complications, associated with the indications for choledochotomy. This is attributed to the therapeutic approach algorithm adopted with respect to the indications for intraoperative cholangiography and choledochotomy.
Subject(s)
Cholelithiasis/surgery , Acute Disease , Aged , Bulgaria/epidemiology , Cholangiography , Cholecystectomy , Cholecystostomy , Cholelithiasis/complications , Cholelithiasis/diagnostic imaging , Cholelithiasis/mortality , Chronic Disease , Humans , Intraoperative Care , Middle Aged , Retrospective StudiesABSTRACT
A total of 208 patients with diseases of the extremities, 56 of whom with diabetes mellitus, were included in the study. Septicemia developed in 6 patients, in 4 of them being caused by anaerobic pathogens. The following surgical interventions were performed: 193 incisions, 32 amputations of varying extent and 15 large-scale necrotomies. The case fatality rate was 1.44 per cent. To achieve superior therapeutic results and a better life for patients with diabetes mellitus, it is necessary to change the former approach to their long-term medical surveillance.
