ABSTRACT
AIM: Despite the laparoscopic right hemicolectomy has been validated by many randomized prospective trials, clear evidences on the validity of the totally mini-invasive technique, namely, through intracorporeal anastomosis, are still lacking. The aim of this study was the assessment of short-term outcome within three months from laparoscopic right colectomy with intra- or extra-corporeal anastomosis. METHODS: With no exclusion, all patients undergoing laparoscopic right hemicolectomy at our institution have been enrolled in this study. Group A included patients undergoing laparoscopic right hemicolectomy with extracorporeal anastomosis (LAC) and Group B, included patients undergoing laparoscopic right hemicolectomy with intracorporeal anastomosis (TLC). Patients' data, surgery details, results of postoperative period and histological tests have been prospectively recorded in a database and analysed. RESULTS: Between December 2006 and December 2008, 45 patients underwent right hemicolectomy, 21 with extracorporeal anastomosis and 24 had intracorporeal ones. As to patients' characteristics and histopathological results there are no difference between the groups. Anastomotic dehiscence occurred one in group A and one in group B (P>0.05). Both patients underwent reoperation. We recorded 6 postoperative ileus with vomiting in the LAC group and only 1 in the TLC group (P<0.05). The incidence of Non-Surgical Site Complications (NSSC) was of 4.54% in LAC group and 8.33% in TLC group (P>0.05). Hospitalization was of 5 days for both groups. CONCLUSION: In conclusion, we believe that this technique is feasible in terms of safety; it doesn't significatively affect the length of surgical procedure and guarantees maintenance of oncological radicality standards of reference. Besides it significatively improves quality of the post-operative period.
Subject(s)
Colectomy/methods , Laparoscopy/methods , Adult , Aged , Aged, 80 and over , Anastomosis, Surgical/methods , Colon/surgery , Feasibility Studies , Female , Humans , Ileum/surgery , Ileus/epidemiology , Ileus/etiology , Incidence , Male , Middle Aged , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Postoperative Nausea and Vomiting/epidemiology , Postoperative Nausea and Vomiting/etiology , Reoperation , Surgical Wound DehiscenceABSTRACT
A study was undertaken to determine the resources available in Italian hospitals for the control of nosocomial infections and the factors favouring a successful approach. During January-May 2000 a questionnaire about infection control was sent to the hospital health director of all Italian National Health System hospitals treating acute patients and with more than 3500 admissions in 1999. An active programme was defined as a hospital infection control committee (HICC) meeting at least four times in 1999, the presence of a doctor with infection control responsibilities, a nurse employed in infection control and at least one surveillance activity and one infection control guideline issued or updated in the past two years. There was a response rate of 87.5% (463/529). Almost fifteen percent (69/463) of hospitals had an active programme for Infection Control and 76.2% (353/463) had a HICC. Seventy-one percent (330/463) of the hospitals had a hospital infection control physician and 53% (250/463) had infection control nurses. Fifty-two percent (242/463) reported at least one surveillance activity and 70.8% (328/463) had issued or updated at least one guidance document in the last two years. The presence of regional policies [odds ratio (OR) 8.7], operative groups (OR 4.2), at least one full-time nurse (OR 4.6) and a hospital annual plan which specified infection control (OR 2.1) were statistically associated with an active programme in the multivariate analysis.
Subject(s)
Cross Infection/prevention & control , Infection Control/organization & administration , Organizational Policy , Hospital Bed Capacity , Humans , Infection Control Practitioners/supply & distribution , Italy , Logistic Models , Multivariate Analysis , Population SurveillanceSubject(s)
BCG Vaccine , Mycobacterium bovis , Tuberculosis/prevention & control , Adolescent , Child , Child, Preschool , Drug Resistance, Microbial , Humans , Isoniazid , ItalySubject(s)
BCG Vaccine , Isoniazid , Mycobacterium bovis , Tuberculin Test , Tuberculosis/immunology , Drug Resistance, Microbial , Humans , ItalyABSTRACT
The utilization of Disability-Adjusted Life Years (DALYs), provides a comprehensive assessment of the health of the insured workers. We report here on the estimation of DALYs lost due to injuries in our insured population. The study population consisted of 1.406.843 insured workers of Asociación Chilena de Seguridad: 910.932 males and 495.902 females. There were 165.494 work related injuries with an overall annual incidence of 117.6 injuries per 1.00 workers. The age group that accounted for the highest injury rate in males was the 15-29 year old age group (104.2 per 1.000 workers). The main cuses of injuries in both sexes were Exposure to Inanimate Mechanical Forces (53.6 percent) and Falls (29.6 percent). 132 died in the study year from injuries sustained at work, an occupational fatal injury rate of 9.4 per 1000.000 (13.9 in males vs 1.0 in females). male workers had a workplace mortality rate 13.8 times the rate of female workers. In the year 2000, the 110.073 work-related injuries accounted by 4.450 Disability Adjusted Life years lost. This figure represents a loss of 316 DALY per 1000.000 workers: the DALY rate ratio of male to female was 8.5. There were 3.965 Years of Life Lost due to Premature Mortality in our insured population