No abstract

Sepsis is one of the most dangerous post-operative complications. Recently, Monocyte Distribution Width (MDW), a blood test parameter able to measure morphological changes in monocytes, has been proposed and investigated as a new promising biomarker of sepsis. The aim of our study was to evaluate if MDW can be influenced by surgery to better understand if it could be use as a sepsis marker. All clinical and laboratories data were collected of all patients admitted from April to August 2021 to the Unit of Urology of our Department for elective kidney and ureteral stones surgery. The blood samples collected to evaluate MDW of each patient were analyzed on the UniCel DxH 900 analyzer (Beckman Coulter, Inc., USA), with an MDW value of 23 considered as significative value. Times of collection of blood samples were before surgery (BS), after surgery (AS) and at discharge time (DT) In all 66 patients enrolled in this study, while White Blood Cells (WBC) significantly increased after surgery (BS:7.95x109/L vs AS:11.4x109/L; p<0.001) with a trend to normalization at discharge (AS:11.40x109/L vs DT:9.90x109/L; p:0.021), there were no statistically significative differences for MDW (BS:17.6 vs AS:18.1; p:1) before and after surgery, as well comparing before surgery and at the time of discharge (BS:17.6 vs DT:18.5; p:0.237). In conclusion, MDW is not affected by surgical procedures and is easily measurable when compared to other biomarkers, considering that is part of a routine CBC. For these reasons, MDW could be a valid, cost-effective and fast biomarker to predict the risk of post-operative sepsis in elective surgery

No abstract

The surgeon administered laparoscopic TAP block is a safe pain management tool. Studies compared laparoscopic guided TAP block with ultrasound-guided TAP block and reported no discernible differences in the efficacy of pain management following general surgical procedures. Direct visualization of the administration site minimizes complications such as iatrogenic visceral injury by the needle or administration of the local anesthetic in the wrong plane. In addition, the surgeon-administered block also potentially reduces the additional time taken to set up an ultrasound guided TAP block which requires an anesthesiologist and an ultrasound machine.