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Introduction: Using registry analyses, a large number of influencing factors on the perioperative outcome of groin hernia repair has been identified. The interactions between several influencing factors and differences in the influencing value have to date been inadequately investigated. Methods: This retrospective analysis of prospectively collected data from the Herniamed Registry included all fully documented cases with minimum age of 16 years and groin hernia repair. Patients were assigned to the risk groups unilateral, bilateral, recurrent and emergency groin hernia repair. Multivariable analysis was performed to investigate the influence of confirmatory defined patient- and procedure-related characteristics on the outcome parameters intraoperative, postoperative general and postoperative surgical complications, complication-related reoperation and total perioperative complications. Results: A highly significantly unfavorable association with the total perioperative complication rate was identified for emergency groin hernia repair, scrotal hernia, anticoagulant medication and coagulopathy. A significantly unfavorable relation with the total perioperative complication rate was found for recurrence procedure, bilateral repair, high age, ASA score III/IV, femoral hernia, antithrombotic medication, smoking, COPD and corticosteroid medication. A significantly favorable correlation with the total perioperative complication rate was observed for the laparo-endoscopic techniques, smaller defects, female gender, normal weight and medial hernia. Conclusion: Both the number of potential influencing factors and their influencing value on the perioperative outcome should be considered when estimating the individual risk of a patient with groin hernia repair. [ABSTRACT FROM AUTHOR]

Introduction: Details of surgical and general complications for patients with cervical spondylotic myelopathy (CSM) are still uncertain. The purpose of this study was to describe surgeries and their complications among Japanese patients with CSM. Methods: The Japanese Society for Spine Surgery and Related Research performed a nationwide survey on spine surgery and complications in 2011. Data of patients with 2,961 CSM >40 years old were included. The clinicopathological variables were basic demographic and clinical information, surgical information, and surgical and general complications. To examine the influence of age, variables were compared among three age groups: patients 40-64 (n=1,123), 65-74 (n=966), and 75 (n=872) years of age. Results: The study included 1,970 males and 991 females and the mean age was 64.3 years old. There were 168 anterior (5.7%) and 2,770 posterior (94.2%) approach surgeries. The vast majority of patients with CSM were treated using the posterior approach, 89.4% of whom had decompression surgery only. Anterior surgeries were more common in the younger age group, but posterior surgeries were equally distributed. The incidence of total complications including surgical/general complications was similar for the anterior (16/168; 9.5%) and posterior (295/2,770; 10.6%) approaches. No patient died on the operating table, but four patients (0.1%) died within one month after surgery. No association was detected between complications and age, comorbidity, and other surgical factors. The incidence of complications was similar for the different age groups. However general complications were predominantly observed in the older group and those who had instrumented surgery. Conclusions: The results indicate that the indication and surgical performance for patients with CSM is favorable in Japan, despite the super-aging population. Few serious complications were reported in this study. However, more detailed informed consent about surgical and, in particular, general complications is necessary for the older patients with CSM.

Despite the growing understanding of the pathophysiological processes in the perioperative period and significant advancements in surgical techniques, operative treatment for gastric cancer remains a challenge for surgeons, especially because the primary procedure of total or nearly total gastrectomy must at times be extended by the resection of other organs. The aim of the study was to asses the influence of concomitant splenectomy in patients undergoing curative surgery for gastric cancer on postoperative complications. Material and methods. The study population consisted of 258 patients who underwent surgical treatment for gastric cancer with the intention to treat. The study assessed the influence of extending the surgical intervention by splenectomy on postoperative complications, both general and surgical, including the most severe of these, i.e. oesophago-gastric anastomotic leakage, duodenal stump leakage and peritoneal fluid infections. Results. Among the 258 gastric cancer patients receiving curative surgical treatment, the most common simultaneous intervention was splenectomy: 42/258 (16.3%), which was also accompanied by partial pancreatectomy in 8 cases. The number of surgical postoperative complications, major and minor, was similar in both subgroups: with and without splenectomy. Minor general complications, such as pyrexia with no clinically apparent reason, atelectasis, pneumonia and pleural effusion were statistically significantly more common in the subgroup with splenectomy (p=0.0001). Conclusion. Splenectomy performed concomitantly with gastrectomy for gastric cancer increases the risk of minor general complications. However, it does not increase the risk of severe surgical complications, such as oesophago-intestinal anastomotic leakage and does not increase the risk of death [ABSTRACT FROM AUTHOR]