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Surgical Aspects Of Fever
Published in Benedict Isaac, Serge Kernbaum, Michael Burke, Unexplained Fever, 2019
Jona Stadler, Hartley Stern, Jack M. Baron
Fever following surgery can be due to infectious or noninfectious causes, as shown in Table 1. One should approach the patient with postoperative fever by making the diagnosis as quickly as possible, using history, physical examination and appropriate laboratory tests. Indiscriminate use of antibiotics without a clear indication should be condemned because (a) operative site infection requires mechanical drainage, not antibiotics, as primary treatment and (b) antibiotics are inappropriate for noninfectious causes.
Perioperative care of the pediatric and adolescent gynecology patient
Published in Joseph S. Sanfilippo, Eduardo Lara-Torre, Veronica Gomez-Lobo, Sanfilippo's Textbook of Pediatric and Adolescent GynecologySecond Edition, 2019
Geri D. Hewitt, Mary E. Fallat
Patients with obstructive anomalies causing hematometra may develop perioperative fever, but there is no evidence that prolonged antimicrobial treatment after surgical correction is helpful in prevention of postoperative infection. Fever could be associated with inadequate drainage. Regardless, if fever occurs, the patient should be evaluated in the routine manner for postoperative fever and treatment with broad-spectrum antibiotics considered until cultures return. Further research in this area is needed, as there is no literature to guide treatment.
Systemic Physical Condition
Published in A. Sahib El-Radhi, Paediatric Symptom and Sign Sorter, 2019
Postoperative fever is defined as a temperature greater than 38°C on two consecutive postoperative days, or 39°C on any postoperative day. Fever during the postoperative period is common, occurring in 25%–50% of cases. The magnitude of fever is correlated with the extent of the surgery, i.e. minor surgery is rarely associated with fever. Early postoperative fever (within 48 hours postoperatively) is often caused by the trauma of the surgery. Infection is the cause of fever in about 10%–25% of febrile postoperative patients, usually occurring after 48 hours. Fever usually lasts longer than 2 days (unless treated with antibiotics) tends to be higher than 39°C, and is associated with ill appearance.
Efficacy of one-surgeon basketing technique for stone extraction during flexible ureteroscopy for urolithiasis
Published in Arab Journal of Urology, 2021
Go Anan, Kazunori Hattori, Shingo Hatakeyama, Chikara Ohyama, Makoto Sato
The patients’ results details are presented in Table 2. The median operative time was 74 min. The median stone fragmentation time was 15 min and the median stone retrieval time was 30 min. The SFR was 91% at 1 month postoperatively. The SFR was 87% for kidney stones and 94% for ureteral stones (P = 0.29). During the one-surgeon basketing none of the patients had poor visibility due to haematuria. Also, none of the patients required an assistant during the stone retrieval process. The median length of postoperative stay was 1 day. Four patients had postoperative emergency visits due to stone-related pain (two) and macrohaematuria (two). Complications related to stone retrieval were identified in two patients (2%); two patients had Clavien–Dindo Grade IIIa ureteral injury caused by the basket device. Considering total intraoperative complications, ureteral injury occurred in five patients (5%), with the degree of injury ranging between Clavien–Dindo Grades II and IIIa. Postoperative fever was recorded in five patients (5%). In this study, the stone components were calcium oxalate in 84% of cases, calcium phosphate in 10%, and uric acid in 6%.
Evaluation of the optimal laparoscopic method for benign ovarian mass extraction: a transumbilical route using a bag made from a surgical glove versus a lateral transabdominal route employing a standard endobag
Published in Journal of Obstetrics and Gynaecology, 2020
Kemal Güngördük, Osman Aşıcıoğlu, Varol Gülseren, İsa Aykut Özdemir, Mustafa Kocaer, İlker Çakır, Mehmet Gökçü, Muzaffer Sancı
A total of 109 women undergoing laparoscopic surgery at three centres to remove benign adnexal masses were retrospectively evaluated between January 2014 and September 2017. Masses were removed via the TU route in 57 women and via the LTA route in 52. All of the operations were performed by senior consultants experienced in terms of both TU and LTA retrieval, with the aid of trainees and nurses. All of the patients underwent an ultrasound investigation prior to surgery to evaluate mass morphology and size. Patients with suspected malignancies, deep infiltrating endometriosis, indications for concomitant hysterectomy, and a possible requirement for myomectomy were excluded. We recorded the body mass index (BMI); parity; ovarian mass size; perioperative and postoperative complications; requirements for additional postoperative analgesic drugs; postoperative incisional pain scores assessed using a 10 cm visual analogue scale (VAS) at 1, 3, 12, and 24 h after surgery; estimated blood loss (mL); time to discharge; and the procedure type. A postoperative fever was defined as a body temperature over 37 °C twice over a 15-min interval, and a temperature of 38 °C in the first 24 h after surgery.
Patients with true mixed growth hormone and prolactin-secreting pituitary adenoma: a case series of 12 patients
Published in British Journal of Neurosurgery, 2020
Daqiq Gulbadin, Zhiwei Li, Muhammad Shahbaz, Zeeshan Farhaj, Arzoo Shabbir, Qichao Qi, Kuanxiao Tang, Shilei Ni, Lei Sun
The surgical outcomes, postoperative complications and follow up are listed in (Table 3). The average surgical time was 125 minutes (range 70–225 min). The mean hospital stay was 10 days (range 7–15 days) and mean follow up duration was 53.5 months (range 12–101 months). Postoperative fever was noted in one of 12 patients. Other postoperative complications such as meningitis, cerebrospinal fluid leakage, bleeding, and hypopituitarism23 were not seen. Remission was observed in eight patients (66.7%). During follow-up, two patients (16.7%) had recurrence with mild elevation of hormone levels; One patient’s (case 8) relapse GH was 6.4 ng/ml (normal range 0.13–5.22 ng/ml), IGF-1 was 293.4 ng/ml (normal range up to 266 ng/ml) and PRL was 369.2 ng/ml (normal range 2.56–18.1 ng/ml); Another patient’s (case 12) relapse IGF-1 was 272 ng/ml (normal up to 266 ng/ml), PRL was 126.0 ng/ml (normal range 2.6–18.1 ng/ml) and GH level was 3.75 ng/ml (normal range 0.13–5.22 ng/ml). They were both managed with bromocriptine 2.5 mg three times daily. Two patients died for reasons unrelated to surgery; one patient (case 5) had a stroke and another (case 6) had a myocardial infarction (Figure 3).