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Fulltext Unilateral visual loss after spine surgery in the prone position for extradural haematoma in a healthy young man

Ooi EI, Ahem A, Zahidin AZ, Bastion ML

BMJ Case Rep, 2013;2013.
PMID: 24334521 DOI: 10.1136/bcr-2013-200632

This case reports a patient who developed central retinal artery occlusion following spinal surgery in the prone position. When placed in this position, especially as a result of malposition of the head, the patient may develop external compression of the eye which leads to central retinal artery occlusion. Therefore, a special precaution must be given for adequate eye protection during prolonged prone-positioned spine surgery.

Matched MeSH terms: Postoperative Complications/pathology
Mandibulotomy: an analysis of its morbidities

Nabil S, Nazimi AJ, Nordin R, Hariri F, Mohamad Yunus MR, Zulkiflee AB

Int J Oral Maxillofac Surg, 2018 Dec;47(12):1511-1518.
PMID: 30837061 DOI: 10.1016/j.ijom.2018.05.020

The mandibulotomy is a procedure that was developed to improve access in tumour resection. This study aimed to investigate the complications associated with mandibulotomy and analyze factors that could affect the risks of developing these complications. The hospital records of all patients who underwent a mandibulotomy as part of their tumour ablative surgery at two major centres in Malaysia were reviewed retrospectively. Demographic, clinical, and complications data were recorded and analyzed. Early postoperative complications occurred in 46.5% of the patients and post-radiation therapy complications in 16.1%. Wound dehiscence (27.9%) and inferior alveolar nerve injury (25.6%) were the common early postoperative complications. Dental injuries (9.7%) and plate exposure/infection (9.7%) were the common post-radiation therapy complications. Furthermore, inferior alveolar nerve injury and early abscess formation were significantly associated with the site of the mandibulotomy. The T-stage of a tumour but not the site of mandibulotomy was significantly associated with tumour margin clearance. Mandibulotomy does pose an added risk of complications for a patient undergoing tumour surgery. The benefits of mandibulotomy in terms of gaining margin clearance could not be proven in this study. The site of mandibulotomy appears to increase the risk of developing an inferior alveolar nerve injury.

Matched MeSH terms: Postoperative Complications/pathology
Pre-operative psoas muscle index, a surrogate for sarcopenia; as a predictor of post-esophagectomy complications

Yunrong T, Jin WW, Mahendran HA, Koon YB, Jahit S, Kamaruddin MA, et al.

Dis Esophagus, 2024 Apr 02;37(4).
PMID: 38163959 DOI: 10.1093/dote/doad072

BACKGROUND: Esophagectomy is the standard of care for curative esophageal cancer. However, it is associated with significant morbidity and mortality. Esophageal cancer is known to negatively affect the nutritional status of patients and many manifest cancer sarcopenia. At present, measures of sarcopenia involve complex and often subjective measurements. We assess whether the Psoas Muscle Index (PMI); an inexpensive, simple, validated method used to diagnose sarcopenia, can be used to predict adverse outcomes in patients after curative esophagectomy.
METHODS: Multi-centre, retrospective cohort between 2010-2020, involving all consecutive patients undergoing curative esophagectomy for esophageal cancer in University Malaya Medical Centre, Sungai Buloh Hospital, and Sultanah Aminah Hospital. The cut-off value differentiating low and normal PMI is defined as 443mm2/m2 in males and 326326 mm2/m2 in females. Complications were recorded using the Clavien-Dindo Scale.
RESULTS: There was no statistical correlation between PMI and major post-esophagectomy complications (p-value: 0.495). However, complication profile was different, and patients with low PMIs had higher 30-day mortality (21.7%) when compared with patients with normal PMI (8.1%) (p-value: 0.048).
CONCLUSIONS: Although PMI did not significantly predict post-esophagectomy complications, low PMI correlates with higher 30-day mortality, reflecting a lower tolerance for complications among these patients. PMI is a useful, inexpensive tool to identify sarcopenia and aids the patient selection process. This alerts healthcare professionals to institute intensive physiotherapy and nutritional optimization prior to esophagectomy.

Matched MeSH terms: Postoperative Complications/pathology
Effect of heparin-surface-modified poly(methyl methacrylate) intraocular lenses on the postoperative inflammation in an Asian population

Lai YK, Fan RF

J Cataract Refract Surg, 1996;22 Suppl 1:830-4.
PMID: 9279680

PURPOSE: To compare the efficacy of heparin-surface-modified (HSM), poly(methyl methacrylate) (PMMA) posterior chamber intraocular lenses (IOLs) with that of unmodified PMMA IOLs in reducing postoperative complications caused by inflammatory reactions after extracapsular cataract extraction in an Asian population.
SETTING: Departments of Ophthalmology, University of Malaya, Kuala Lumpur, Malaysia, and Tan Tock Seng Hospital, Singapore.
METHODS: In a randomized, double-blind study performed at two centers, 51 patients received an HSM PMMA lens and 48, an unmodified PMMA IOL. Cell and pigment deposits were evaluated by slitlamp at 1 to 6 days, 2 to 3 weeks, and 3 to 6 months postoperatively.
RESULTS: Significantly more eyes with unmodified IOLs had inflammatory cell deposits than those with HSM IOLs at 3 to 6 months (P < .001) and 12 to 14 months (P = .018) postoperatively. The HSM group also had significantly fewer cell deposits per patient at these two follow-ups. Significantly more eyes in the non-HSM group had pigment deposits 3 to 6 months after surgery (P = .049). One year postoperatively, about 85% of patients in both groups had a best corrected visual acuity of 0.5 or better.
CONCLUSION: Heparin surface modification significantly reduced the inflammatory response to PMMA IOLs in an Asian population for at least 12 to 14 months.

Matched MeSH terms: Postoperative Complications/pathology
Postoperative death in a patient with unrecognized arrhythmogenic right ventricular dysplasia syndrome

Toh KW, Nadesan K, Sie MY, Vijeyasingam R, Tan PS

Anesth Analg, 2004 Aug;99(2):350-2, table of contents.
PMID: 15271703

Arrhythmogenic right ventricular dysplasia is an inherited disease causing fatty replacement of heart tissue. This disease often presents as T-wave inversion in the anterior leads of the electrocardiogram (ECG) with life-threatening ventricular arrhythmias. In older patients, progressive right and left ventricular failure can develop. This is a case report of postoperative death occurring in a 59-yr-old woman with undiagnosed arrhythmogenic right ventricular dysplasia after hepatic cystectomy. The patient had T-wave inversion in the inferior ECG leads and no history of arrhythmias. During general anesthesia, cardiovascular collapse occurred in the absence of arrhythmias that was unresponsive to resuscitation.

Matched MeSH terms: Postoperative Complications/pathology
Fulltext Changes following nipple areolar complex reconstruction and tattooing resembling a recurrent Paget's disease of the breast

Hanafiah M, Alhabshi SM, Mahin AH

BMJ Case Rep, 2013;2013.
PMID: 24165504 DOI: 10.1136/bcr-2013-201281
Matched MeSH terms: Postoperative Complications/pathology