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Indian Journal of Clinical and Experimental Ophthalmology


Prediction of severity of intraoperative haemorrhage during external dacryocystorhinostomy upon body- type (physique) rating - a pioneering study


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Author Details: Parthasarathi Roy, Asim Chakrabarti

Volume : 2

Issue : 4

Online ISSN : 2395-1451

Print ISSN : 2395-1443

Article First Page : 360

Article End Page : 364


Abstract

Background and Objectives: One of the most common complications of external dacryocystorhinostomy (DCR) is haemorrhage. Intraoperative haemorrhage not only hinders the procedures but also delays the operation and unfavourably affects the outcome. In spite of best efforts bleeding do occur. However while some patients bleed heavily during operation, some patients remain exceedingly dry. The objective of this study is to find out whether body-type (endo/meso/ecto-morph) has any co-relation with the severity of intraoperative haemorrhage in dacryocystorhinostomy operation.
Design: Prospective Study.
Methods: Twenty two consecutive patients who underwent DCR by single surgeon(PR) in preceeding two years were included in this study. Each patient’s height and weight were recorded and ectomorphy rating was calculated by the formula given by Heath and Carter. Intraoperative haemorrhage was measured in each case by recording the amount of blood collected in the suction container.
Results: Of twenty two patients, fourteen (63.63%) were female and eight (36.36%) were male, with a mean age of 33.04 years (age range: 17–48 years). 9 (Nine) patients were operated on right eye and 13 (Thirteen) were on left eye. The duration for surgery ranged from 30 to 115 min, with a mean of 72.72 min. The amount of intraoperative bleeding ranged between 3 and 18ml (9.09+/- 4.95 ml). In five patients (22.72%), there was severe intraoperative bleeding (>15 mL). The ectomorphy rating of twenty two patients ranged from 0.1 to 7.23 (2.26+/-1.75) and the Height/Weight1/3 ranged from 37.50 to 48.93 (42.04+/-2.62). Patients with ectomorphy ratings were divided into two groups, namely ectomorphy rating <1.5 (EcR <1.5) and ectomorphy rating > 1.5 (EcR > 1.5), and intraoperative bleeding was categorised under "Severe"(>15 ml) and "Mild & Moderate" (< 15 ml). Severe (>15 ml) intraoperative bleeding was found in 22.72% in (EcR <1.5) versus 0% in (EcR > 1.5) group (P < 0.0500).
Conclusion: Preoperative ectomorphy rating of patient’s physique, obtainable from a simple height/weight ratio is a predictor of severity of intra-operative haemorrhage in DCR operation.

Keywords:
Dacryocystorhinostomy, Ectomorphy rating, Heath-Carter Somatotype, Intraoperative Haemorrhage