McDonough McDowell (columnfear38)

In the univariate analysis, the statistically significant risk factors for early leaks were preoperative neutrophil to lymphocyte ratio > 5 and peripheral blood platelet count, while late leaks were associated with coronary artery disease; however, in the multivariate analysis, these factors were not statistically significant. <br><b>Conclusions</b> The risk factors for severe postoperative complications were neutrophil to lymphocyte ratio > 5, advanced age of the patients and coronary artery disease. TAS-102 The different risk factors for early and late anastomotic leaks after anterior resection may indicate their different aetiologies.<b>Introduction</b> The nose is the central and probably the most important organ of the face. In view of the three-dimensional shape and variety of tissues, reconstructive surgery after tumor resection in this anatomical region requires the surgeon's knowledge of anatomy. <br><b>Materials and Method</b> In the years 2010-2019, 48 patients were treated in the Oncological and Reconstructive Surgery Clinic for extended nasal tumors, which required the use of free microvascular flaps after resection for functional and aesthetic supply of anatomical structures of the nose. <br><b>Results</b> In 48 patients, a total of 92 free microvascular flaps were used for nasal reconstruction including radial forearm free flap in 24 patients, radial forearm free flap with radial bone in 14 patients, auricular free flap in 16 patients, radial forearm free flap in combination with auricle free flap in 7 patients, double auricular free flap in 6 patients, radial forearm free flap in combination with double auricular free flap in 4 patients. Total necrosis of the free flap was noted in 4 cases, partial in 6 patients. <br><b>Conclusions</b> The presented surgical techniques using microvascular free flaps constitute a recognized method of treatment and should be used in everyday surgeon practice. The results demonstrated in this article allow to obtain optimal functional and aesthetic effects. Postpartum haemorrhage is a major cause of maternal mortality and morbidity, commonly due to uterine atony. Prophylactic oxytocin use during Caesarean section is recommended; patients with a high risk of postpartum haemorrhage may require additional uterotonics or procedures. Carbetocin is a long-acting analogue of oxytocin which has shown beneficial results, compared with oxytocin. This study compared the requirement for additional uterotonics or procedures between at-risk women who underwent carbetocin infusion and those who underwent oxytocin infusion. This retrospective cohort study included women at increased risk of postpartum haemorrhage after Caesarean section for various indications in a public hospital. Women who received carbetocin infusion and women who received oxytocin infusion were compared, stratified by Caesarean section timing (elective or emergency). The primary outcome was the requirement for additional uterotonic agents or procedures. Secondary outcomes included total blood loss, operating time, rate of postpartum haemorrhage, need for blood transfusion, and need for hysterectomy. Of 1236 women included in the study, 752 received oxytocin first and 484 received carbetocin first. The two groups had comparable blood loss, operating time, rate of postpartum haemorrhage, requirement for additional uterotonics or procedures, need for blood transfusion, and need for hysterectomy. There was a reduction in the requirement for additional uterotonics or procedures, and in the rate of postpartum haemorrhage for women with major placenta praevia or with multiple pregnancies, following receipt of carbetocin first. Compared with oxytocin, carbetocin can reduce the requirement for additional uterotonics or procedures in selected high-risk patient groups. Compared with oxytocin, carbe