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Perioperative mortality has been defined as any death, regardless of cause, occurring within 30 days after surgery in or out of the hospital. [1] Globally, 4.2 million people are estimated to die within 30 days of surgery each year. [2]
The same tests are again given post-operatively to determine the extent and duration of the decline for POCD. "A project examining adults 55 and older who have major non-cardiac surgeries is finding that 'upward of 30 percent of patients is testing significantly worse than their baseline 3 months later ' ".
Of the 578 patients who died, 404 (69.9 percent) did so between 24 hours and 30 days following surgery (high 74.2 percent, middle 68.8 percent, low 60.5 percent). Patient safety factors were suggested to play an important role, with use of the WHO Surgical Safety Checklist associated with reduced mortality at 30 days.
There are a number of advantages to the patient with laparoscopic surgery versus an open procedure. These include: Reduced hemorrhaging, which reduces the chance of needing a blood transfusion. [12] [13] Smaller incision, which reduces pain and shortens recovery time, as well as resulting in less post-operative scarring. [13] [14] [15]
One of the most common post-operative complications associated with an appendectomy is the development of a surgical site infection (SSI). [20] Signs and symptoms indicative of a superficial SSI are redness, swelling, and tenderness surrounding the incision and are most likely to arise on post-operative day 4 or 5.
Post herniorrhaphy pain syndrome, or inguinodynia is pain or discomfort lasting greater than 3 months after surgery of inguinal hernia. Randomized trials of laparoscopic vs open inguinal hernia repair have demonstrated similar recurrence rates with the use of mesh and have identified that chronic groin pain (>10%) surpasses recurrence (<2%) and is an important measure of success.
Laparoscopic surgery has a reduced risk for creating adhesions. [11] Steps may be taken during surgery to help prevent adhesions such as handling tissues and organs gently, using starch-free and latex-free gloves, not allowing tissues to dry out, and shortening surgery time.
The overall rate of complications during the 30 days following surgery ranges from 7% for laparoscopic procedures to 14.5% for operations through open incisions. One study on mortality revealed a 0% mortality rate out of 401 laparoscopic cases, and 0.6% out of 955 open procedures.
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