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Updated: Feb 5, 2026

Endoscopic Cholesteatoma Surgery

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Published on: January 19, 2022

Urologic Surgery with Multisystem Comorbidities: A Case Report.

Upendra Maddineni¹, Eric F Worrall², Erik A Baker¹

¹Department of Anesthesiology, McGuire Veterans Administration Medical Center, Richmond, VA, USA.

The American Journal of Case Reports

|September 2, 2018

Summary

This summary is machine-generated.

Enhanced perioperative protocols, initially for colorectal surgery, show promise in improving outcomes for complex patients. This case report details a successful open nephrectomy in a patient with hereditary hemorrhagic telangiectasia, highlighting the potential of these protocols in high-risk surgical candidates.

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Area of Science:

Surgical protocols
Perioperative care
Multisystemic disorders

Background:

Enhanced perioperative protocols, originating in colorectal surgery, are increasingly adopted across surgical disciplines to optimize patient outcomes.
Key components include patient education, liberalized oral intake, no routine bowel preparation, multimodal analgesia, judicious IV hydration, early extubation, and early ambulation.

Observation:

This case report details the successful management of a patient with hereditary hemorrhagic telangiectasia (HHT), a rare autosomal dominant disorder.
The patient presented with multisystem involvement, including pulmonary, cardiac, hematologic, gastrointestinal, renal, oncologic, and hepatic comorbidities.
The patient underwent an open nephrectomy.

Findings:

The patient experienced a successful outcome following open nephrectomy.
This suggests that enhanced perioperative protocols can be effectively applied even in patients with significant comorbidities and rare genetic disorders.

Implications:

Further prospective and retrospective studies are warranted to validate the use of these enhanced perioperative protocols in high-risk surgical populations.
These findings may guide the development of tailored perioperative strategies for patients with complex medical histories and rare diseases.