Presurgical guidelines

This article discusses soft tissue tumors of the ankle and foot region in adults, including tumors of the joints, and also briefly addresses tumor-simulating lesions. We offer general recommendations and describe specific aspects of common entities in that region, such as typical imaging appearance, therapeutic strategies, and posttherapeutic considerations. Focal masses and diffuse swelling are common in the foot and ankle region; most of them are non-neoplastic. Some of the tumors, such as plantar fibromatosis, tenosynovial giant cell tumor, synovial chondromatosis, or schwannoma, have a very typical appearance on magnetic resonance imaging...

Because of an increased risk of local recurrence following surgical treatment of lentigo maligna (melanoma) (LM/LMM), the optimal surgical technique is still a matter of debate. We aimed to evaluate the effect of different surgical techniques and reflectance confocal microscopy (RCM) on local recurrence and survival outcomes. We searched MEDLINE, Embase, and PubMed databases through May 20th , 2022. Randomized and observational studies with ≥10 lesions were eligible for inclusion. Bias assessment was performed using the Methodological Index for Non-Randomized Studies instrument...

BACKGROUND: The novel concept of immersive 3D augmented reality (AR) surgical navigation has recently been introduced in the medical field. This method allows surgeons to directly focus on the surgical objective without having to look at a separate monitor. In the dental field, the recently developed AR-assisted dental implant navigation system (AR navigation), which uses innovative image technology to directly visualize and track a presurgical plan over an actual surgical site, has attracted great interest...

The aim of this study was to evaluate the efficacy of presurgical interventions for promoting smoking cessation in terms of achieving smoking abstinence and reducing surgical complication rates. A systematic review of randomized clinical trials (RCTs) published from March 2009 to April 2021 was performed following the PRISMA guidelines. References were found in MEDLINE (via PubMed), Web of Science (WOS), and Cumulative Index to Nursing and Allied Health Literature (CINAHL). RCTs comparing the efficacy of a smoking cessation program directed at an intervention group (IG) versus the usual intervention or another directed at a control group (CG) were included...

OBJECTIVE: To determine how augmented reality (AR) has been applied to the field of otology/neurotology, examine trends and gaps in research, and provide an assessment of the future potential of this technology within surgical practice and education. DATA SOURCES: PubMed, EMBASE, and Cochrane Library were assessed from their inceptions through October 2022. A manual bibliography search was also conducted. REVIEW METHODS: A scoping review was conducted and reported according to PRISMA-ScR guidelines...

This study evaluates a novel, simple bone health screening protocol composed of patient sex, age, fracture history, and FRAX risk to identify total knee arthroplasty patients for preoperative DXA. Findings supported effectiveness, with sensitivity of 1.00 (CI 0.92-1.00) and specificity of 0.54 (CI 0.41-0.68) when evaluating for clinical osteoporosis. PURPOSE: Bone health optimization is a process where osteoporotic patients are identified, evaluated via modalities such as dual-energy X-ray absorptiometry (DXA), and treated when indicated...

BACKGROUND: Early or emergency laparoscopic cholecystectomy (LC) was recommended in the 2018 Tokyo Guidelines for patients with mild to moderate acute cholecystitis (AC). Although surgical difficulty is frequently encountered during these surgeries, risk factors for predicting surgical difficulties have not been fully investigated, especially based on computed tomography (CT) findings. MATERIALS AND METHODS: We investigated 72 patients who underwent emergency LC with mild (n=45) to moderate (n=27) AC...

OBJECTIVE: Presurgical long-term video-EEG monitoring (LT-VEEG) is an important part of the presurgical evaluation in patients with focal epilepsy. Multiple seizures need to be recorded, often in limited time and with the need to taper anti-seizure medication (ASM). The aim of this study was to systematically study the yield – in terms of success – and risks associated with presurgical LT-VEEG, and to identify all previously reported contributing variables. METHODS: A systematic review of the databases of PubMed Medline, Embase, Cochrane Central, and the Cochrane Database of Systematic Reviews were searched following the Preferred Reporting Items for Systematic Reviews (PRISMA) guideline...

Transsphenoidal surgery is the first-line treatment for acromegaly. However, several factors can modify surgical remission rates, such as the initial hormone levels, the size and invasiveness of the tumor, and the degree of experience of the surgeon. Physicians treating patients with acromegaly should thus consider how to improve surgical remission rates. As stated in recent guidelines, the major point is to consider that any patient with acromegaly should be referred to an expert neurosurgeon to maximize the chances of surgical sure...

RATIONALE AND OBJECTIVES: Noninvasive diagnostic imaging of subclavian artery (SCA) and internal thoracic artery (ITA) is crucial to the patients planning to use ITA for coronary artery bypass grafting (CABG). The guidelines have not yet provided guidance on screening high-risk groups. The present study aimed to evaluate the contribution of ultrasonography in the assessment of SCA and ITA, especially for the patients referred for CABG who planned to use ITA graft. MATERIALS AND METHODS: Patients diagnosed with multivessel coronary heart disease were enrolled and some of them planned CABG...

Importance: More than 1 in 5 patients do not experience improved physical function after total knee arthroplasty (TKA). Identification of factors associated with physical function may be warranted to improve outcomes in these patients. Objective: To identify preoperative and intraoperative factors associated with physical function at 12 months after TKA in a systematic review and meta-analysis. Data Sources: Data from January 2000 to October 2021 were searched in Medline, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, and Physiotherapy Evidence Database (PEDro)...

Semiology describes the evolution of symptoms and signs during epileptic seizures and contributes to the evaluation of individuals with focal drug-resistant epilepsy for curative resection. Semiology varies in complexity from elementary sensorimotor seizures arising from primary cortex to complex behaviours and automatisms emerging from distributed cerebral networks. Detailed semiology interpreted by expert epileptologists may point towards the likely site of seizure onset, but this process is subjective. No study has captured the variances in semiological localizing values in a data-driven manner to allow objective and probabilistic determinations of implicated networks and nodes...

Orthodontic therapy is often necessary to facilitate successful oral and maxillofacial surgery. Orthodontics can be combined with surgery to help attain optimal skeletal correction, ideal dentofacial esthetics, and long-term occlusal function. This article presents a summary of important considerations in surgical orthodontics supported by available scientific literature. Suggestions and special considerations for different phases ranging from case diagnosis, to presurgical orthodontic preparation, to postsurgical orthodontic management, and long-term retention are presented...

OBJECTIVE: The management of surgeries in patients with hemophilia is  complex and requires adequate clotting factor adjustment to avoid bleeding  complications and excessive factor consumption. The aim of this systematic  review is to analyze the pharmacokinetic studies published on surgery in  hemophilic patients, the methodologies used, the main pharmacokinetic covariates applied, and the recommendations made by clinical guidelines. METHOD: A structured search was performed in Pubmed, the Cochrane Library,  and the Database of Abstracts of Reviews of Effects using the search terms  hemophilia (or haemophilia), surgery and pharmacokinetics (or PK)...

Objective: To qualitatively explore the approach of pediatric epilepsy providers when counseling regarding surgical options for epilepsy, presenting risks and benefits of surgery, overcoming resistance to surgery, and fostering shared decision making with patients and families. Methods: We conducted in-depth interviews with 11 academic clinicians (5- neurologists, 5- epileptologists, 1- neurosurgeon) from a Level 4 pediatric epilepsy center to explore how physicians communicate and pursue surgical decision-making...

BACKGROUND: Recent reports on challenges in resuscitation care at hospitals severely affected by the novel coronavirus disease 2019 (COVID-19) pandemic raise questions about how the pandemic affected outcomes for in-hospital cardiac arrest throughout the United States. METHODS: Within Get With The Guidelines-Resuscitation, we conducted a retrospective cohort study to compare in-hospital cardiac arrest survival during the presurge (January 1-February 29), surge (March 1-May 15) and immediate postsurge (May 16-June 30) periods in 2020 compared to 2015 to 2019...

Well-managed orthodontic therapy is vital to the success of oral and maxillofacial surgery, helping to facilitate optimal skeletal correction along with ideal dentofacial esthetics and long-term occlusal function. In the treatment of skeletally mature patients with dentofacial deformities, orthodontics often needs to be combined with oral and maxillofacial surgery to correct transverse, vertical, and sagittal skeletal discrepancies and facial asymmetries that affect function and facial esthetics. Supported by published literature, this article presents a detailed discussion of key considerations for the management of orthodontic/orthognathic surgery cases...

BACKGROUND: The growing resistance of bacteria to antimicrobial medicines is a global issue and a direct threat to human health. Despite this, antibiotic prophylaxis is often still routinely used in dental implant surgery to prevent bacterial infection and early implant failure, despite unclear benefits. There is a lack of sufficient evidence to formulate clear clinical guidelines and therefore there is a need for well-designed, large-scale randomized controlled trials to determine the effect of antibiotic prophylaxis...

How clinicians perform pre-surgical psychological evaluations (PSPE) for bariatric surgery remains variable across institutions. Bariatric PSPE guidelines state that self-report measures should be incorporated in the PSPE procedure, yet only 50-60% of PSPEs utilize patient self-report measures. Previous studies describing the presurgical psychological evaluation report a range of measures, however a gold standard in PSPE has yet to be agreed upon. Given this gap in how a presurgical psychological evaluation for bariatric patients is defined, incorporating more objective measures into this process may help clinicians identify specific areas in which a patient is struggling and benefit from additional psychosocial support...

Wilms tumor is the most common primary renal malignancy in pediatric age group, however, is rare in adults accounting for 0.5% of all adult renal malignancies. The histopathology is similar in both age groups, however the prognosis in adults is poor with tumor being at advanced stage at presentation with increased incidence of metastasis. Due to rare occurrence in adults and lack of differentiating clinical and imaging features its diagnosis is delayed or often misdiagnosed as adult renal cell cancer. Pre surgical or early post-surgical chemotherapy has shown significantly better surgical outcome and survival rate, however, delayed or misdiagnosis precludes or delays the chemotherapy...