• Title/Summary/Keyword: outpatient surgery

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Application of Vacuum-Assisted Closure Device in Management of Postpneumonectomy Empyema

  • Sohn, Suk Ho;Kang, Chang Hyun;Choi, Se Hoon;Kim, Young Tae
    • Journal of Chest Surgery
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    • v.46 no.2
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    • pp.153-155
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    • 2013
  • A 57-year-old man was diagnosed with lung cancer and underwent pneumonectomy and mediastinal lymph node dissection. He was discharged without acute complications, but on a regular outpatient follow-up, he was readmitted with postpneumonectomy empyema. He was successfully treated with a vacuum-assisted closure device and for 1 year period of outpatient follow-up, there was no recurrence of empyema or lung cancer.

Overnight hospital stay and/or extended recovery period may allow long-duration oral and maxillofacial surgeries in the operating room of a dental hospital in an outpatient setting: a single-center experience

  • Uzumcugil, Filiz;Yilbas, Aysun Ankay;Akca, Basak;Ozkaragoz, Demet Basak;Adiloglu, Selen;Tuz, Hifzi Hakan;Kanbak, Meral
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.46 no.2
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    • pp.125-132
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    • 2020
  • Objectives: The requirement for overnight hospital stay should be considered preoperatively according to patient-related factors, type of surgery, and anesthetic management plan. In this study, we aimed to define the major factors that influence consideration of overnight hospital stay in patients undergoing oral and maxillofacial (OMF) surgery in an operating room (OR) of a dental hospital in an outpatient setting. Materials and Methods: The records of patients who underwent oral procedures under general anesthesia between 2014-2017 were reviewed. Results: A total of 821 patients underwent oral procedures under general anesthesia; 631 of them underwent OMF surgery in the OR of a dental hospital, and 174 of these patients were hospitalized for overnight stay. There was no significant difference in the number of patients with comorbidities between the outpatient and hospitalized patient groups (P=0.389). The duration of surgery was longer in the hospitalized patient group (105.25±57.48 vs 189.62±82.03 minutes; P<0.001). Double-jaw (n=15; 310.00±54.21 minutes) and iliac crest grafting surgeries (n=59; 211.86±61.02 minutes) had the longest durations. Patients who underwent iliac crest grafting had the highest rates of hospitalization (79%). The overall recovery period was longer in outpatients (119.40±41.60 vs 149.83±52.04; P<0.001). Conclusion: Duration of surgery was the main determinant in considering whether a patient required overnight hospital stay. However, patients with an American Society of Anesthesiology physical status score <3 may be scheduled for OMF surgery in the OR of a dental hospital in an outpatient setting regardless of duration of surgery if overnight hospital stay is planned or an extended recovery period is provided until patients meet the discharge criteria.

A MULTICENTER RETROSPECTIVE STUDY OF OUTPATIENT INTRAVENOUS SEDATION FOR DENTAL TREATMENTS (치과 치료를 위한 외래 정주진정 법에 대한 다기관 후향적 임상연구)

  • Jung, Se-Hwa;Baik, Sang-Hyun;Roh, Hyun-Ki;Kang, Na-Ra;Im, Jae-Jung;Lee, Byung-Ha;Jeon, Jae-Yoon;Hwang, Kyung-Gyun;Shim, Kwang-Sup;Park, Chang-Joo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.5
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    • pp.394-400
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    • 2009
  • Purpose : On outpatient facilities, our sedation protocol focuses on the intermittent bolus injections of midazolam intravenously, according to patient's and operator's needs during the dental treatment. This multicenter retrospective study was aimed to prove the efficiency and safety of our sedation protocol. Patients and Methods : In three centers using the same outpatient sedation protocol for dental treatment (Division of Oral and Maxillofacial Surgery/Department of Dentistry in Hanyang University Medical Center, S-plant Dental Hospital. and Grand Oral and Maxillofacial Surgery), total 937 patients had various dental treatments under intravenous conscious sedations with independent patient monitoring from March 2006 to March 2009. By reviewing charts, we analyzed the results of sedation and dental treatment, retrospectively. Results : Our sedation protocol had no severe postoperative complications requiring admission. while showing good compatibility with almost all dental treatments, with acceptable satisfaction of both patients and operators. Conclusion : We assure that our sedation protocol can be used efficiently and safely on routine outpatient basis. We also hope that this study will provide the concrete concepts to common dental practitioners, who desire to perform sedation for dental treatment.

Anesthetic considerations for a patient with myasthenia gravis undergoing deep sedation in an outpatient oral surgery setting

  • Prabhu, Shamit S.;Khan, Saad A.;Doudnikoff, Alexander L.;Reebye, Uday N.
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.19 no.1
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    • pp.67-72
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    • 2019
  • Myasthenia gravis (MG) is a neuromuscular autoimmune disorder which clinically presents as muscular weakness and fatigue due to autoantibody formation against acetylcholine receptors (AChR), leading to their subsequent destruction. Due to the neuromuscular implications of MG, certain considerations must be taken into account when providing anesthesia to MG patients. In the following case report, we have outlined procedural considerations for the anesthetic management of a patient with MG undergoing deep sedation for an elective oral surgery in an outpatient setting, as well as a discussion of relevant literature.

The Effects of Information Service Program by Media on Anxiety and Educational Satisfaction in Patients with Cataract Surgery (시청각매체를 이용한 정보제공 프로그램이 백내장 수술 환자의 불안과 교육만족도에 미치는 효과)

  • Oh, Yun Hee;Choi, Eun Joung
    • Journal of Korean Clinical Nursing Research
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    • v.22 no.3
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    • pp.305-313
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    • 2016
  • Purpose: The purpose of this research was to identify the effects of providing an information service program by media on preoperative anxiety and postoperative educational satisfaction in patients with cataract surgery. Methods: For this study 52 patients who visited the ophthalmology clinic at P Hospital in B metropolitan city and who were scheduled to undergo one-day cataract surgery under local anesthesia were recruited. The 52 patients were assigned to the experimental group (25) or the control group (27). This study was conducted from August 27, 2015 to May 29, 2016. Results: Following the provision of cataract surgery related information service by media, the experimental group had a lower mean score for anxiety and higher mean score for educational satisfaction compared to the control group of patients. Conclusion: Results indicate that information service program by media "Goodbye Cataract" is useful educational materials for cataract patients in outpatient department and outpatient operating rooms.

Posterior Interosseous Nerve Palsy Caused by a Ganglion of the Arcade of Frohse

  • Lee, Seung Jin;Hyun, Yoon Suk;Baek, Seung Ha;Seo, Ji Hyun;Kim, Hyun Ho
    • Clinics in Shoulder and Elbow
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    • v.21 no.4
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    • pp.252-255
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    • 2018
  • A 51-year-old male who is right-handed visited the outpatient for right fingers-drop. The patient's fingers, including thumb, were not extended on metacarpophalangeal joint. The active motion of the right wrist was available. The electromyography and nerve conduction velocity study were consistent with the posterior interosseous neuropathy. Further evaluation was done with the magnetic resonance imaging for finding the space-occupying lesion or any possible soft tissue lesion around the radial nerve pathway. On magnetic resonance imaging, the ganglion cyst, which was about 1.8 cm in diameter, was observed on the proximal part of the superficial layer of the supinator muscle (Arcade of Frohse). The surgical excision was done on the base of ganglion cyst at the base of stalk of cyst which looked to be connected with proximal radioulnar joint capsule. The palsy had completely resolved when the patient was observed on the outpatient department a month after the operation.

Computerized Outpatient's Prescription using Personal Computer and Local Area Network (PC 및 LAN을 이용한 외래처방 전달 시스템)

  • Kim, Won-Ky;Kim, Nam-Hyun;Huh, Jae-Man;Chang, Byung-Chul;Kim, Ji-Hyue
    • Proceedings of the KOSOMBE Conference
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    • v.1992 no.05
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    • pp.152-154
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    • 1992
  • We computerized outpatient's prescription using personal computer and local area network(LAN). The information and history of patient which is stored in the HOST computer is transfered to the local file server via emulatort & LAN. Then, the computerized outpatient's prescription which is made in each examination room is transfered to the admission of discharge office and pharmacy via LAN. In the admission of discharge office, drug charge is automatically calculated, and the prescription and envelope is printed out automatically in the pharmacy. Using this system, the patient takes the drug faster than before, eventually we improve medical service. Also, this system manage hospital works and administration effectively.

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Dental Local Anesthetic Techniques for Minor Operations at Outpatient Clinic (외래소수술시 적용하는 치과국소마취 술식들)

  • Kim, Uk-Kyu
    • The Journal of the Korean dental association
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    • v.56 no.1
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    • pp.49-57
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    • 2018
  • The most widely used method of pain control in dental practice is to block the pathway of painful impulses by local anesthesia. For a maximum effect of pain control at outpatient minor operation, regional anesthesia including nerve block must be performed. This issue includes various dental local anesthetic techniques on mandible, maxilla and considerations for selection of dental local anesthetics according to patient's age, duration of operation. Additionally, current conscious sedation technique combined with local anesthesia will be introduced for control of patient's anxiousness. Based on patient's general condition, severity of operation, local anesthesia sometimes must be changed into general anesthesia to avoid failure of dental practice. The exact choice of anesthetic techniques for minor operations at dental outpatient clinic must not be underestimated for complete success of pain control.

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Clinical outcome of ultrasound-guided atelocollagen injection for patients with partial rotator cuff tear in an outpatient clinic: a preliminary study

  • Chae, Sang Hoon;Won, Jae Yeon;Yoo, Jae Chul
    • Clinics in Shoulder and Elbow
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    • v.23 no.2
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    • pp.80-85
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    • 2020
  • Background: Atelocollagen has been studied for restoration of rotator cuff tendon. In this study, we attempted to evaluate the clinical outcome of ultrasound-guided atelocollagen injection in an outpatient clinic for patients with partial rotator cuff tear. Methods: We recruited 42 outpatients who visited our hospital from May 2019 to September 2019. Atelocollagen injection was performed in patients with partial rotator cuff tear diagnosed by magnetic resonance imaging and ultrasound. American Shoulder and Elbow Surgeons (ASES), Constant, Korean Shoulder Score (KSS) and Simple Shoulder Test (SST) scores, and range of motion were assessed before injection and after 2 months. Statistically, we analyzed the clinical results using the Wilcoxon signed-rank test. Results: Finally, 15 patients were enrolled for analysis. There was no significant difference between pre- and post-injection in terms of range of motion, ASES (57.0 vs. 60.4), Constant (56.4 vs. 58.9), KSS (64.6 vs. 68.5), and pain-visual analog scale (4.2 vs. 3.7), except function-visual analog scale (F-VAS; 6.3 vs. 7.1) and SST (6.6 vs. 6.9). A significant difference was found in SST (P=0.046) and F-VAS (P=0.009). According to the ultrasound results at 2 months, we found hyperechoic materials in three of seven patients. The most common complication of atelocollagen injection was post-injection pain (53%, 8/15). Conclusions: Ultrasound-guided atelocollagen injection for partial rotator cuff tear showed no significant change in terms of clinical outcomes, except for F-vas and SST score. Tendon regeneration was not clear due to the remnants of atelocollagen present at 2-month follow-up ultrasound. There seems to be alarming post-injection pain for 2 to 3 days in the patients who received atelocollagen injection in an outpatient clinic.

Does Simultaneous Computed Tomography and Quantitative Computed Tomography Show Better Prescription Rate than Dual-energy X-ray Absorptiometry for Osteoporotic Hip Fracture?

  • Ko, Jae Han;Lim, Suhan;Lee, Young Han;Yang, Ick Hwan;Kam, Jin Hwa;Park, Kwan Kyu
    • Hip & pelvis
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    • v.30 no.4
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    • pp.233-240
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    • 2018
  • Purpose: This study aimed to evaluate the efficacy of simultaneous computed tomography (CT) and quantitative CT (QCT) in patients with osteoporotic hip fracture (OHF) by analyzing the osteoporosis detection rate and physician prescription rate in comparison with those of conventional dual-energy X-ray absorptiometry (DXA). Materials and Methods: This study included consecutive patients older than 65 years who underwent internal fixation or hip arthroplasty for OHF between February and May 2015. The patients were assigned to either the QCT (47 patients) or DXA group (51 patients). The patients in the QCT group underwent QCT with hip CT, whereas those in the DXA group underwent DXA after surgery, before discharge, or in the outpatient clinic. In both groups, the patients received osteoporosis medication according to their QCT or DXA results. The osteoporosis evaluation rate and prescription rate were determined at discharge, postoperative (PO) day 2, PO day 6, and PO week 12 during an outpatient clinic visit. Results: The osteoporosis evaluation rate at PO week 12 was 70.6% (36 of 51 patients) in the DXA group and 100% in the QCT group (P<0.01). The prescription rates of osteoporosis medication at discharge were 70.2% and 29.4% (P<0.001) and the cumulative prescription rates at PO week 12 were 87.2% and 60.8% (P=0.003) in the QCT and DXA groups, respectively. Conclusion: Simultaneous CT and QCT significantly increased the evaluation and prescription rates in patients with OHF and may enable appropriate and consistent prescription of osteoporosis medication, which may eventually lead to patients' medication compliance.