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Complications
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Preventing and Managing Surgical Complications: Perspectives from Surgeons
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Preventing and Managing Surgical Complications: Perspectives from Surgeons

A special issue of Complications (ISSN 2813-4966).

Deadline for manuscript submissions: 30 April 2025 | Viewed by 5677

Special Issue Editor

Dr. Luis Felipe Cabrera-Vargas

E-Mail Website
Guest Editor
Vascular and Endovascular Surgeon, Department of Surgery, Fundación Santa Fe de Bogotá, Bogota, Colombia
Interests: aorta surgery; vascular trauma; acute care surgery; limb salvage; endovascular surgery; robotic surgery; artificial intelligence in surgery

Special Issue Information

Dear Colleagues,

“Every surgeon carries within himself a small cemetery, where from time to time he goes to pray—a place of bitterness and regret, where he must look for an explanation for his failures”, René Leriche once said. Complications in general surgery and its supra-specialties are devastating for the surgeon and, of course, for the patient. We must encourage a rise in the reporting and publication of our perioperative complications to improve our outcomes, help other surgeons around the world avoid complications, and advise them on how to approach these outcomes. For this reason, this Special Issue, titled “Preventing and Managing Surgical Complications: Perspectives from Surgeons”, will serve as a vital opportunity for helping surgeons achieve this goal.

Best regards,

Dr. Luis Felipe Cabrera-Vargas
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Complications is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1000 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • complications
  • surgery
  • acute care
  • vascular
  • general
  • breast
  • cancer
  • colorectal
  • gastrointestinal and abdominal wall hernia

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Published Papers (7 papers)

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4 pages, 937 KiB  
Case Report
Management of Postoperative Left-Sided Chylothorax Using Indocyanine Green Fluorescence-Guided VATS
by Luigi Lione, Alberto Busetto, Alessandro Bonis, Vincenzo Verzeletti, Eleonora Faccioli, Giovanni Comacchio, Giorgio Cannone, Michele Battistel, Alessandro Rebusso, Samuele Nicotra and Federico Rea
Complications 2024, 1(3), 79-82; https://doi.org/10.3390/complications1030012 - 29 Nov 2024
Viewed by 217
Abstract
Chylothorax is a rare complication occurring after cardio-thoracic surgical procedures. This condition presents challenges for diagnosis and treatment. Operative ductal ligation is the method of choice for relapsing or refractory cases, and it can be performed through the aid of IGC injection for [...] Read more.
Chylothorax is a rare complication occurring after cardio-thoracic surgical procedures. This condition presents challenges for diagnosis and treatment. Operative ductal ligation is the method of choice for relapsing or refractory cases, and it can be performed through the aid of IGC injection for the identification of chylous leakage. Our report presents the use of ICG fluorescence during VATS to successfully identify and treat a left-sided post-surgical chylothorax. The patient underwent a pulmonary wedge resection for a suspect malignant lesion and developed chylous leakage in the early postoperative period. On postoperative day 7, the patient underwent a revision thoracoscopy for hemostasis and thoracic duct ligation. ICG injections were performed through bilateral inguinal lymph nodes and approximately 15 min after we performed the re-thoracoscopy with effective identification and ligation of the chyle leakage. ICG fluorescence-guided VATS is a valuable and effective method for managing postoperative chylothorax, especially for left-sided leaks. Full article
(This article belongs to the Special Issue Preventing and Managing Surgical Complications: Perspectives from Surgeons)
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11 pages, 3135 KiB  
Systematic Review
Pigtail Catheter Compared to Formal Intercostal Catheter for the Management of Isolated Traumatic Pneumothorax: A Systematic Review and Meta-Analysis
by Khang Duy Ricky Le, Annie Jiao Wang, Karim Sadik, Kaylah Fink and Shasha Haycock
Complications 2024, 1(3), 68-78; https://doi.org/10.3390/complications1030011 - 8 Nov 2024
Viewed by 465
Abstract
(1) Background: The optimal management approach for adults with traumatic pneumothorax without haemothorax remains an area of debate. Specifically, there is lack of consensus as to whether insertion of a pigtail catheter is superior to a formal intercostal catheter in improving complication rates. [...] Read more.
(1) Background: The optimal management approach for adults with traumatic pneumothorax without haemothorax remains an area of debate. Specifically, there is lack of consensus as to whether insertion of a pigtail catheter is superior to a formal intercostal catheter in improving complication rates. (2) Methods: Medline, EMBASE, Cochrane Central, and the World Health Organisation International Clinical Trials Registry Platform databases were systematically searched for studies evaluating pigtail catheters compared to formal intercostal catheters for the management of traumatic pneumothorax. Investigative outcomes of interest included pain, duration management, failure, need for formal thoracoscopic surgery, need for supplemental oxygen, length of stay, infection and overall total complications. (3) Results: Three studies evaluating 280 patients were included in this analysis. There was no significant difference in total complications, rates of failure, length of stay or duration of management between pigtail catheters and formal intercostal catheters. This evidence was based on studies of low to moderate risk of bias with poor control for confounding factors. (4) Conclusions: This systematic review and meta-analysis demonstrates lack of evidence to suggest pigtail catheters are superior to formal intercostal catheter for traumatic pneumothorax. These findings may reflect a true absence of effect between either approach for this patient cohort or non-committal findings in light of limitations of the underlying evidence. Further prospective trials with larger sample sizes and control for confounders are required to validate the outcomes between these two modalities of treatment. Full article
(This article belongs to the Special Issue Preventing and Managing Surgical Complications: Perspectives from Surgeons)
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7 pages, 836 KiB  
Case Report
Successful Management of Gastric Leakage Post Gastric Sleeve by Gastric Bypass Conversion
by Manuela Jaramillo Vásquez, Hernando Thorne Vélez, Isaac Mendoza Morales and Andrés Hanssen Londoño
Complications 2024, 1(3), 61-67; https://doi.org/10.3390/complications1030010 - 4 Nov 2024
Viewed by 414
Abstract
Gastric leak represents one of the most common, serious and challenging complications in bariatric procedures, and it is caused by both ischemic and mechanical failure. The management of these leaks remains controversial. In this clinical case, we describe the occurrence of a gastric [...] Read more.
Gastric leak represents one of the most common, serious and challenging complications in bariatric procedures, and it is caused by both ischemic and mechanical failure. The management of these leaks remains controversial. In this clinical case, we describe the occurrence of a gastric leak after a gastric sleeve, which was successfully treated by gastric bypass using a laparoscopic technique. Full article
(This article belongs to the Special Issue Preventing and Managing Surgical Complications: Perspectives from Surgeons)
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8 pages, 4971 KiB  
Case Report
When Nature Strikes Back: Understanding Intestinal Perforations Caused by Vegetable and Animal Bodies
by Santiago Andrés Suárez-Gómez, Valentina Velasco-Muñoz and Fernando Escobar-Castañeda
Complications 2024, 1(3), 43-50; https://doi.org/10.3390/complications1030008 - 24 Sep 2024
Viewed by 525
Abstract
Foreign body intestinal perforation is a critical and potentially life-threatening condition that presents significant diagnostic challenges, especially in rural populations who are often distant from healthcare facilities and lack access to necessary resources. In these settings, the surgical approach is further complicated by [...] Read more.
Foreign body intestinal perforation is a critical and potentially life-threatening condition that presents significant diagnostic challenges, especially in rural populations who are often distant from healthcare facilities and lack access to necessary resources. In these settings, the surgical approach is further complicated by prolonged diagnostic times and delayed access to appropriate care. This article presents a series of cases involving patients with foreign body intestinal perforation of both vegetable and animal origin. Among these cases, one patient died due to delayed voluntary treatment, and another presented without leukocytosis, further complicating the diagnosis. Socioeconomic barriers made follow-up challenging in most cases, negatively impacting patient outcomes. This study details patient characteristics, surgical approaches, and outcomes. Community education, improved infrastructure, and greater awareness among healthcare providers are essential to improving outcomes, particularly in rural areas where healthcare delivery is more challenging and intensified efforts are required to enhance patient care and quality of life. Full article
(This article belongs to the Special Issue Preventing and Managing Surgical Complications: Perspectives from Surgeons)
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6 pages, 3392 KiB  
Case Report
Staged Hybrid Treatment of Acute Type B Complicated Aortic and External Iliac Artery Dissection and Femoral Occlusion after Transcatheter Aortic Valve Implantation
by Hernando Thorne-Vélez, Axel Tolstano Gleiser, Isaac Mendoza Morales, Ana Maria Thorne-Velez, Natalia Penaloza Barrios, Manuela Jaramillo Vasquez and William Daza Reatiga
Complications 2024, 1(2), 37-42; https://doi.org/10.3390/complications1020007 - 26 Aug 2024
Viewed by 867
Abstract
Percutaneous aortic valve replacement (TAVI) has become the treatment of choice for elderly patients with severe aortic valve stenosis because of its less invasive nature compared to surgery. As TAVI is increasingly offered, issues such as vascular lesions, access site problems, paravalvular leaks, [...] Read more.
Percutaneous aortic valve replacement (TAVI) has become the treatment of choice for elderly patients with severe aortic valve stenosis because of its less invasive nature compared to surgery. As TAVI is increasingly offered, issues such as vascular lesions, access site problems, paravalvular leaks, and aortic dissection (AD) are a few associated complications, needing consideration. AD after TAVI is rare but serious, occurring in 0.2% to 0.3% of cases, with both intraprocedural and late cases reported. This case study concerns a 68-year-old woman who developed Stanford B AD, external iliac artery dissection, and right common femoral artery occlusion after TAVI. Treatment included the stenting of the iliac and common femoral arteries, followed by a staged procedure: debranching, thoracic endovascular aortic repair (TEVAR), and endovascular aneurysm repair (EVAR), with satisfactory results. This case underscores the importance of vigilance in the management of TAVI-related complications to optimize patient care and outcomes. Full article
(This article belongs to the Special Issue Preventing and Managing Surgical Complications: Perspectives from Surgeons)
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5 pages, 1690 KiB  
Case Report
Postoperative Intestinal Intussusception in Polytraumatized Adult Patient: A Case Report
by Claudia Viviana Jaimes González, María José Pereira Velásquez, Juan Pablo Unigarro Villota and Adriana Patricia Mora Lozada
Complications 2024, 1(2), 32-36; https://doi.org/10.3390/complications1020006 - 17 Jul 2024
Viewed by 916
Abstract
Background: Intestinal intussusception is defined as the invagination of one segment of the intestine into the lumen of an adjacent intestinal segment, resulting in the mechanical intestinal obstruction of multifactorial origin with a high risk of morbidity and mortality. It is a rare [...] Read more.
Background: Intestinal intussusception is defined as the invagination of one segment of the intestine into the lumen of an adjacent intestinal segment, resulting in the mechanical intestinal obstruction of multifactorial origin with a high risk of morbidity and mortality. It is a rare pathology in adults with a nonspecific clinical presentation. We present the case of a 26-year-old male patient who was admitted postoperatively after multiple extra institutional surgical interventions due to polytrauma secondary to a work-related accident that caused high-impact trauma by a solids mixer. However, he was referred to our institution due to suspected vascular trauma in the right femoral artery. During his hospital stay, he developed intolerance to oral intake associated with pain, abdominal distension, and persistent emetic episodes despite medical management. Consequently, an abdominal CT scan with double contrast was requested, revealing intestinal intussusception secondary to intestinal adhesions, which required new surgical management with a favorable resolution; Discussion: Intussusception in the adult population is rare and is primarily caused by an identifiable structural lesion. It is one of the most challenging pathologies in terms of diagnosis and management due to its nonspecific presentation. However, when postoperative symptoms indicating intestinal obstruction appear, a computed tomography scan is considered the imaging modality of choice for diagnosing intussusception in adults; Conclusions: The development of postoperative peritoneal adhesions is a common cause of intestinal obstruction that can lead to complications such as intestinal intussusception, requiring additional interventions. Therefore, it is vital to identify their presence to reduce morbidity and mortality. Full article
(This article belongs to the Special Issue Preventing and Managing Surgical Complications: Perspectives from Surgeons)
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8 pages, 1853 KiB  
Case Report
Aortic Endograft Infections: A Race against Time
by Santiago Andrés Suárez-Gómez, Esteban Portilla-Rojas, María Fernanda Rodríguez, Natalia Velásquez-Solarte, Sara Restrepo, Luis Felipe Cabrera-Vargas, Nicolas Forero and Marcos Tarazona
Complications 2024, 1(1), 24-31; https://doi.org/10.3390/complications1010005 - 21 Jun 2024
Viewed by 1399
Abstract
Abdominal aortic aneurysms (AAAs) are a highly asymptomatic vascular pathology with an increasing risk of rupture, leading to high mortality. Upon detection, treatment primarily involves lifestyle changes to slow the growth rate. Aneurysm rupture requires immediate surgical intervention due to its high mortality. [...] Read more.
Abdominal aortic aneurysms (AAAs) are a highly asymptomatic vascular pathology with an increasing risk of rupture, leading to high mortality. Upon detection, treatment primarily involves lifestyle changes to slow the growth rate. Aneurysm rupture requires immediate surgical intervention due to its high mortality. Endovascular aneurysm repair (EVAR) is a common treatment option, involving stent placement at the aneurysm site. However, the stent is a foreign body; therefore, it is susceptible to immune response and infection. This case series presents patients with infected endovascular stents following a diagnosis of abdominal infrarenal aortic aneurysm and EVAR. The patients’ follow-ups revealed varying prognoses, complications, and treatments post-infection. These findings are compared with outcomes reported in the medical literature. Preventing aortic stent graft infection through proper aseptic techniques is crucial. This practice reduces patient complications, shortens inpatient hospice stays, and, most importantly, enhances patient quality of life. Full article
(This article belongs to the Special Issue Preventing and Managing Surgical Complications: Perspectives from Surgeons)
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Planned Papers

The below list represents only planned manuscripts. Some of these manuscripts have not been received by the Editorial Office yet. Papers submitted to MDPI journals are subject to peer-review.

Title: Surgical treatment of pressure sores in spinal cord injury patients: incidence of Surgical Complications and tips for prevention and management
Authors: Luca Negosanti; Siriana Landi; Micaela Battilana; Rossella Sgarzani
Affiliation: Montecatone Rehabilitation Institute, Imola, Italy
Abstract: Background: People with spinal cord injury/disorder are at high risk of pressure injury formation, and ,in advanced cases, surgery is mandatory. These patients present specific clinical aspects to consider in order to reduce the risk of complications. Methods: A retrospective analysis of complications on 520 patients treated for pressure injuries at a tertiary rehabilitation hospital in Italy was conducted. A specific protocol of treatment, flap selection and complication prevention methods based on a multidisciplinary approach was developed. All the specific clinical aspects of the patient must be taken into consideration and treated to optimize the results and reduce complication rates. On the other hand complications may anyway occur and specific treatment of complications are described. Results: The reported results show a low rate of complications compared to the literature, furthermore complications treatment protocols allow to further reduce overall insuccess rate. Conclusions: Multidisciplinary team approach and specific protocols for patient’s management allow to reduce complication ratesin the surgical treatment of pressure injuries in spinal cord injury patients, furthermore specific treatment protocols for complications allow to implement final success rate.

Title: Horner’s Syndrome after Central Venous Catheter Insertion: A Case Report.
Author: O'Connor
Highlights: Central venous catheters are often used for administration of total parenteral nutrition. Horner's Syndrome is a rare but recognized complication of central venous catheter insertion. Awareness of presentation enables early diagnosis and treatment. A CT angiogram of the neck is necessary to investigate damage to the carotid artery.

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