RESUMO
PURPOSE: Iatrogenic enterotomy (IE) during laparoscopic ventral/incisional hernia repair (LIVHR) is reported to be associated with poorer surgical outcomes. We report our experience with diagnosis, management and complications in patients who had IE during LIVHR at our tertiary referral institute between 1994 and 2011. METHODS: We retrospectively reviewed prospectively collected data of 2,346 patients who underwent LIVHR from 1994 to 2011. We identified 33 patients who had IE during LIVHR. All surgical procedures were performed by five consultants and fellows under supervision who followed a standardized operative protocol. Patients were followed up for 6 months to evaluate morbidity, mortality, additional surgical procedures, unplanned readmissions and hospital stay. RESULTS: Mortality occurred in 2 patients (6 %). Complications occurred in 16 patients (48.5 %). Median hospital stay was 3 days (2-36). Unplanned readmission was required in 6 patients (18 %). In 18 patients, (55 %) additional surgical procedures were required within 6 months of LIVHR. In 5 patients, the enterotomy was recognized postoperatively. These patients had worst outcomes [mortality 40 %, additional surgical procedures were required in all patients (100 %) and median hospital stay was 12 days (range 7-36)]. CONCLUSION: Iatrogenic enterotomy is a serious complication during LIVHR. IE is associated with mortality, morbidity, additional surgical procedures, unplanned readmissions and prolonged hospital stay. In patients where IE was recognized postoperatively, the prognosis was worst.
Assuntos
Hérnia Ventral/cirurgia , Herniorrafia , Intestinos/lesões , Complicações Intraoperatórias , Laparoscopia , Feminino , Herniorrafia/efeitos adversos , Herniorrafia/métodos , Herniorrafia/estatística & dados numéricos , Humanos , Doença Iatrogênica , Índia , Complicações Intraoperatórias/mortalidade , Complicações Intraoperatórias/fisiopatologia , Complicações Intraoperatórias/cirurgia , Laparoscopia/efeitos adversos , Laparoscopia/métodos , Laparoscopia/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Mortalidade , Readmissão do Paciente/estatística & dados numéricos , Reoperação/métodos , Reoperação/estatística & dados numéricos , Ruptura/mortalidade , Ruptura/fisiopatologia , Ruptura/cirurgia , Resultado do TratamentoRESUMO
The polarographic behaviour of three o-hydroxyketoximes, CH(3)C(6)H(3)(OH)CRNOH, where R CH(3), C(2)H(5) and C(3)H(7), has been studied in 5% ethanolic medium, with potassium chloride as supporting electrolyte. A single four-electron reduction wave is obtained which diminishes with increase in pH, being replaced by a new wave in alkaline media. A trough is formed on the limiting-current plateau at higher negative potentials. A mechanism has been proposed for the reduction at the dropping mercury electrode.