Surgery postoperative complications

Bucher P, Mermillod B, Morel P, Soravia C Does mechanical bowel preparation have a role in preventing postoperative complications in elective colorectal surgery Swiss Med Wkly 2004 134 69-74. 

DJ Cole, SE Ettinghausen, HI Pass, DN Danforth, MW Linhan, CW Myers, MR Cooper, WF Sindelar. Postoperative complications in patients receiving suramin therapy. Surgery 116 90-95, 1994. 

In the absence of other pathology, the patient s vision should be fully correctable within a few weeks after cataract surgery. Vision that is initially clear after cataract extraction but then deteriorates is suggestive of a postoperative complication, such as capsular opacification, bullous keratopathy, CME, or retinal detachment. 

Iodine is are primarily used to induce a euthyroid state before surgery. It increases vascularity and increase the density of the thyroid gland, which decreases postoperative complications. 

Heparin may prevent postoperative fibrin formation in eyes undergoing surgery for complications of proliferative diabetic retinopathy, proliferative vitreoretino-pathy, and glaucoma filtration surgery. 

Preoperative score is a quantitative characteristic which strives for determination of hazards of the patient before surgery. Since the most frequent postoperative complications are cardiorespiratory problems, which are also fi equent causes of deaths, some systems focus just on prediction of these hazards. 

Complications of sex reassignment surgery are well known. Early postoperative complications are haem-orrage or haematoma, infection, rectovaginal, peri-... 

Besides evaluation of penile blood supply to the penis, MDCT can be indicated to evaluate large postoperative fluid collections and complications of urethral surgery such as diverticula, fistulas and postoperative strictures (Chou et al. 2005). Also prosthesis malfunction can be investigated in patients who are not candidates for magnetic resonance imaging. Moreover, in patients with penile and urethral malignancies, CT is often used after the operation to evaluate the pelvis in suspicious postoperative complications extending into the perineum and into the pelvis, such as fistulas and inflammation. Also tumor recurrence and pelvic lymphadenopathies can be evaluated effectively. 

Despite the recent development of microsurgical techniques, intraocular surgery can still fail because of postoperative complications, such as fibrin formation and proliferative vitreoretinopathy (PVR). Fibrin formation tends to be more severe in eyes with increased vascular permeability after vitrectomy in endophthalmitis, proliferative diabetic retinopathy... 

PDT has been used frequently as an adjuvant to surgery in an attempt to clean up the remaining cancer cells in the operative bed. Biel reported on five patients with recurrent infiltrating squamous cell carcinoma — all who had failed previous surgery, radiation therapy, and chemotherapy. Patients received 2 mg/kg Photofrin followed 2 days later by surgery and PDT at 50 J/cm. He reported no postoperative complications. With a follow-up of 18 to 30 months, only one patient had recurred in an area outside the surgical and PDT field. 

Engquist, A., Backer, O. G. and Jarnum, S. (1974) Incidence of postoperative complications in patients subjected to surgery under steroid covet. Acta chir. scand., 140, 343. 

Subtotal thyroidectomy is indicated in patients with very large goiters and thyroid malignancies and those who do not respond or cannot tolerate other therapies. Patients must be euthyroid prior to surgery, and patients often are administered iodide preoperatively to reduce gland vascularity. The overall surgical complication rate is 2.7%. Postoperative hypothyroidism occurs in 10% of patients who undergo subtotal thyroidectomy. 

A 52-year-old man was admitted to the hospital for abdominal surgery. He developed complications postoperatively and was intubated 6 days ago. The nurses note an increase in the amount and purulence of his sputum. Attempts yesterday and today to wean the patient off the ventilator have failed. He is sedated but does respond to commands. His temperature is 38.4°C, his blood pressure is 120/84 mm Hg, and his white blood cell (WBC) count is 14.2/mm3 with a cell differential of 76% neutrophils, 4% bands, 16% lymphocytes, and 4% monocytes. 

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