Risks and Benefits for NTUH HC Feature Medicine| Health education| NTUH Hsin-Chu Branch

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更新日期：2024-04-29

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Education Video Education Documents Risks and Benefits for NTUH HC Feature Medicine

Cardiac Catheterization

Surgical/Medical Procedure Benefits:

Establishing a definitive diagnosis
Assessing cardiac function
Performing therapeutic interventions using cardiac catheterization techniques, such as percutaneous transluminal coronary angioplasty (PTCA) and stenting, or percutaneous transluminal mitral valvuloplasty (PTMV)

Surgical/Medical Procedure Risks:
Risks and complications: Death, myocardial infarction, stroke, arrhythmias, vascular injury, need for emergency surgery, cardiac rupture, adverse reactions to contrast agents, heart failure, and others.
The probability and severity of complications vary depending on the patient's baseline cardiac function, the severity of the disease, and the type of invasive diagnostic or therapeutic procedure being performed. However, due to the proficiency of physicians' techniques and the advancement of medical device technology, the occurrence of complications has been minimized.

Postoperative Care Instructions:

Patients who underwent the examination through the groin should remain in bed for at least 12 hours. Activities such as eating, urinating, and moving should be done in bed. If the examination was performed through the elbow or wrist, you can get out of bed after two hours.
Apply pressure to the wound site using a compression bandage for 4 to 6 hours. If you need to remain in bed during this period, you can change positions or perform horizontal movements. However, the limb with the wound should be kept straight and not bent to prevent bleeding from the wound.
If you experience any discomfort or notice numbness or increased warmth at the extremities or around the wound, please notify the healthcare personnel immediately.
It is essential to have someone present with you when you first get out of bed.
On the day after the examination, the nursing staff will change the dressing for your wound. The wound will be small, like a needle prick, and it should be kept clean and dry. If there are occasional bruises around the wound, please inform the doctor for reassurance. The bruising on the skin should gradually fade within two to three weeks, and any slight discomfort at the wound site should also resolve during this period.

Thoracic Surgery

Benefits of the procedure:
Thoracic surgery can remove the lesions within the chest. The benefits and likelihood of successful treatment vary depending on the type of surgery, and some examples are as follows:
Thoracic surgery for pneumothorax is expected to reduce recurrence rate by 20%.；
Thoracic surgery for early-stage lung cancer can achieve a 5-year survival rate of up to 90%.；
Esophageal cancer surgery performed with thoracoscopy can increase the postoperative extubation success rate to 90%.

Risks of the procedure:
Surgical Risks: Complications and unexpected situations that may occur during or after surgery.
Anesthesia:
General anesthesia will be administered during the surgery, and postoperative pain management will involve self-controlled analgesia or oral and injectable pain medication. Common anesthesia-related issues include nausea, vomiting, generalized soreness, throat discomfort, and hoarseness. Occasionally, dental and lip injuries may occur. Severe complications such as respiratory distress, stroke, or myocardial infarction are rare and typically occur in patients with poor preoperative lung function, advanced age, obesity, smoking, heart disease, diabetes, kidney disease, hypertension, and other significant medical conditions.
General surgical risks:
Some complications can occur in all types of surgeries, including thoracic surgery. These complications may include lung infections, deep vein thrombosis with a small risk of pulmonary embolism, and insufficient blood flow leading to stroke or cardiac ischemia.
Specific risks associated with thoracic surgery may include:

Bleeding
Impaired respiratory function
Persistent air leak and subcutaneous emphysema
Chylothorax (leakage of lymphatic fluid into the chest)
Pulmonary edema and pulmonary hypertension
Gastrointestinal injury and leakage
Pleural effusion and empyema (accumulation of pus in the chest cavity)
Poor wound healing or infection, among others.

According to our experience, the occurrence rates of the those mentioned complications are approximately 5-20%, and the mortality rate within thirty days is around 1-2%. Pre-existing poor lung function, other organ diseases, smoking, and advanced age increase the chances of experiencing complications. Some severe complications can potentially lead to death.

Postoperative Care Instructions:
The primary concern is to maintain a clear airway. Based on the principle that early postoperative activity helps reduce postoperative complications, we will encourage patients to actively practice deep breathing, perform effective coughing, and even engage in early ambulation to prevent lower limb venous thrombosis, pulmonary complications, and muscle adhesions. If you experience any breathing difficulties, excessive drowsiness, abnormal sounds, or any discomfort, please notify the healthcare staff.

C. Joint Replacement - Example of Knee Replacement Surgery

Surgical/Medical Procedure Benefits:
General Surgical Risks:

Medical institutions and healthcare professionals will make every effort to treat and perform surgery on patients. However, surgery is not guaranteed to be successful, and unexpected complications, including death, may occur. If you have any questions, feel free to discuss them with your physician.
Under general anesthesia, there is a small possibility of partial collapse and dysfunction of the lungs, increasing the risk of chest infection.
There is a possibility of vascular or fat embolism in the limbs, accompanied by pain and swelling. Blood clots formed may dislodge and travel to the lungs, causing life-threatening conditions. However, this is not a common occurrence. High-risk patients may receive prophylactic treatment with antithrombotic medications, which may increase the risk of bleeding.
Due to the stress endured, there is a risk of cardiac events, stroke, and stress-related gastrointestinal bleeding.

Surgical Risks:

Although the probability is extremely low, there is still a possibility of injuring peripheral nerves or blood vessels during treatment and surgery, resulting in limb paralysis or tissue ischemic damage. In severe cases, amputation may be necessary.
Surgical site infection is possible and is related to the patient's constitution and wound management. The reported infection rate for primary knee joint replacement is approximately 1-4%.
Insufficient rehabilitation post-surgery may lead to the possibility of joint stiffness.
If degeneration affects other joint surfaces, total joint replacement may still be required.

Postoperative Care Instructions:

It is normal for the surgical site to be red and swollen. Healthcare professionals may provide ice or heat therapy depending on the situation. If there is no severe pain, rehabilitation exercises can be performed.
To restore normal joint movement and achieve the goal of joint function, it is important to cooperate with healthcare professionals and perform the exercises taught before surgery as soon as possible to shorten the recovery time.
If there is swelling in the lower limb, elevate the affected limb to promote blood circulation and reduce swelling.

Da Vinci Surgery - Example of Uterine Fibroid Removal Surgery

Surgical/Medical Procedure Benefits:
Advantages of Myomectomy: Preservation of the uterus and fertility
There is a 30% chance of fibroid recurrence after the surgery, and some patients may still require a hysterectomy.
Surgical Success Rate: Approximately 90% or higher, but the rate of disease remission varies depending on the severity of the condition and individual factors.

Risks and Complications of the Procedure:

Bleeding and coagulation disorders
Infection and pelvic inflammatory disease
Injury to the gastrointestinal tract
Damage to the urinary tract
Nerve damage
Risks associated with blood transfusion.
Abdominal hernia, wound dehiscence, necrotizing fasciitis, pelvic abscess, and other complications

Postoperative Care Instructions:

There will be some small incisions of approximately 2 centimeters on the abdomen. After recovering from anesthesia and returning to the room, you can adopt a semi-sitting position to relax the abdomen and alleviate pain.
Early mobilization within 8 hours after surgery promotes gastrointestinal motility, accelerates bowel gas evacuation, prevents abdominal distention, and reduces the time required for passing gas and having bowel movements.
Temporary fasting or dietary restrictions may be necessary postoperatively. Please follow the instructions provided by the nursing staff.

Health Check-up

Benefits: Our hospital's health check-up services, including general physical examinations, free adult and senior citizen check-ups, on-site company check-ups, and occupational disease clinics, offer several advantages.
Health Check-up allow individuals to assess their health status, detect chronic diseases, and receive lifestyle recommendations. These recommendations cover areas such as maintaining a balanced diet, adjusting daily habits, engaging in regular exercise, promoting a positive mindset, and addressing harmful behaviors like smoking, betel nut chewing, or excessive alcohol consumption.
Benefits of undergoing a colonoscopy, as an example of this procedure:

Diagnostic biopsy: It allows for the confirmation of the nature of lesions or abnormalities.
Polyp removal or mucosal resection: Larger polyps or mucosal lesions can be removed using endoscopic techniques, serving both diagnostic and therapeutic purposes.
Hemostasis: In case of bleeding, various methods such as local injection, electrocautery, argon plasma coagulation, or hemostatic clips can be employed to achieve hemostasis.
Lesion marking: With the assistance of endoscopy, marker dye can be injected near gastrointestinal lesions to facilitate future monitoring or surgical localization. Possible complications include infection and abdominal pain, occurring at a rate of approximately 0.2%-0.4%.
Success rate of the procedure: With few exceptions such as patient intolerance, anatomical abnormalities, incomplete preparation, or significant intraoperative changes in vital signs, the success rate is nearly 100%. If the procedure cannot be completed, alternative diagnostic measures should be considered.

Risks of the procedure:
Generally, colonoscopy is considered a safe examination, but a small number of patients may experience symptoms such as bloating, abdominal pain, bleeding, or perforation. However, the probability of these complications is less than one percent.

Health checkup Instructions:

Before the examination: Follow the instructions given by the physician regarding bowel preparation and medication usage.
During the examination: Follow the instructions of the nursing staff. The medication may be administered to slow down intestinal movement and facilitate the examination. Some patients may experience temporary discomfort such as dry mouth or blurred vision. Patients with glaucoma or enlarged prostate may experience increased eye pressure or difficulty urinating.
After the examination:

If you experience bloating or discomfort, it is advised to engage in physical activity to promote flatus passage. Follow the doctor's instructions regarding resuming eating after the examination. If any treatments such as biopsy, polyp removal, or hemostasis were performed, follow the prescribed diet.
If any procedures such as biopsy or polyp removal were performed, a follow-up visit may be required to review the results. Minimal bleeding may occur, so continue to monitor the situation. If bleeding persists, abdominal pain intensifies, black stools occur, or fever develops, seek prompt medical attention.

Due to the variability of patients' conditions, all the information provided above is for reference only. Patients should always follow the instructions and guidance of healthcare professionals.

Data Maintainer：CIH Ms.Lee