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https://www.readbyqxmd.com/read/28092334/is-enhanced-recovery-the-new-standard-of-care-in-microsurgical-breast-reconstruction
#1
Anoushka Afonso, Sabine Oskar, Kay See Tan, Joseph J Disa, Babak J Mehrara, Jihan Ceyhan, Joseph H Dayan
BACKGROUND: Enhanced recovery pathways (ERPs) have been shown to aid in patient recovery and improve outcomes in many surgical settings. At present, there is limited data available regarding the use and feasibility of ERPs for patients undergoing microsurgical breast reconstruction. We sought to assess patient outcomes before and after the introduction of an ERP that was adopted by multiple surgeons at a single cancer center. METHODS: A multidisciplinary ERP was developed for patients undergoing deep inferior epigastric perforator (DIEP) or muscle-sparing free transverse rectus abdominis myocutaneous (TRAM) flap breast reconstruction...
January 12, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28092065/impact-of-celecoxib-on-inflammation-during-cancer-surgery-a-randomized-clinical-trial
#2
Jonathan G Hiller, Shienny Sampurno, Rosemary Millen, Niketh Kuruvilla, Kwok M Ho, Rob Ramsay, Bernhard Riedel
PURPOSE: During cancer surgery, prostaglandin-mediated inflammation may promote and activate micrometastatic disease with a consequent increase in long-term cancer recurrence. Cyclooxygenase-2 inhibitors, known to have anti-proliferative properties, may offset such perioperative perturbation. We investigated the effectiveness of these agents to minimize inflammatory changes during cancer surgery. METHODS: Following ethics approval, 32 patients who were to undergo major intracavity cancer surgery were enrolled in this prospective, randomized, clinical trial...
January 13, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28091815/quantitative-validation-of-sensory-mapping-in-persistent-postherniorrhaphy-inguinal-pain-patients-undergoing-triple-neurectomy
#3
M F Bjurström, R Álvarez, A L Nicol, R Olmstead, P K Amid, D C Chen
PURPOSE: Neurectomy of the inguinal nerves may be considered for selected refractory cases of chronic postherniorrhaphy inguinal pain (CPIP). There is to date a paucity of easily applicable clinical tools to identify neuropathic pain and examine the neurosensory effects of remedial surgery. The present quantitative sensory testing (QST) pilot study evaluates a sensory mapping technique. METHODS: Longitudinal (preoperative, immediate postoperative, and late postoperative) dermatomal sensory mapping and a comprehensive QST protocol were conducted in CPIP patients with unilateral, predominantly neuropathic inguinodynia presenting for triple neurectomy (n = 13)...
January 13, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28091439/is-epineurectomy-necessary-in-the-surgical-management-of-carpal-tunnel-syndrome
#4
U Tiftikci, S Serbest
BACKGROUND: In this study, it was aimed to determine whether median nerve epineurectomy is beneficial in the surgical management of carpal tunnel syndrome (CTS). MATERIALS AND METHODS: The study enrolled 72 patients including 34 patients without epineurectomy (Group A) and 38 patients with epineurectomy (Group B). Surgery was performed in patients with severe electrodiagnostic CTS findings, CTS duration >1 year and flattening along with hypervascularization in median nerve...
February 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28091438/caudal-analgesia-for-herniotomy-comparative-evaluation-of-two-dose-schemes-of-bupivacaine
#5
D D Akpoduado, C O Imarengiaye, N P Edomwonyi
OBJECTIVE: There is currently a wide range of volume schemes for bupivacaine caudal anesthesia. This study evaluated the quality of caudal analgesia achieved with a dosing scheme of 0.75 ml/kg compared with 0.5 ml/kg of 0.25% plain bupivacaine for herniotomy. METHODS: After the institutional approval, American Society of Anesthesiologists I-II patients aged between 1 and 6 years scheduled for unilateral inguinal herniotomy with consenting parents/guardian were recruited...
February 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28090500/a-comparison-of-postoperative-pain-after-conventional-open-thyroidectomy-and-single-incision-gasless-endoscopic-transaxillary-thyroidectomy-a-single-institute-prospective-study
#6
Jung Bong Kang, Eun Young Kim, Yong Lai Park, Chan Heun Park, Ji-Sup Yun
PURPOSE: The aim of this study was to compare postoperative pain between single-incision, gasless, endoscopic transaxillary thyroidectomy (SET), and conventional open thyroidectomy. METHODS: From March to December 2015, patients with thyroid disease underwent total thyroidectomy or lobectomy. Patient's clinical and pathological characteristics, postoperative pain score using visual analog scale (VAS) were compared between the 2 groups. The primary endpoint was postoperative pain evaluated by VAS score and postoperative analgesic use...
January 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28090460/efficacy-and-safety-of-dienogest-in-patients-with-endometriosis-a-single-center-observational-study-over-12-months
#7
So Yun Park, Sung Hoon Kim, Hee Dong Chae, Chung-Hoon Kim, Byung Moon Kang
OBJECTIVE: To evaluate the efficacy and safety of dienogest treatment in patients who had received dienogest for 12 months or more to treat endometriosis. METHODS: We analyzed the clinical data of 188 women with endometriosis who had been treated with 2 mg of dienogest once a day for 12 months or more at a single institute. We evaluated changes in endometriosis-associated pain and endometrioma size, recurrence rate, and adverse events following dienogest administration...
December 2016: Clinical and Experimental Reproductive Medicine
https://www.readbyqxmd.com/read/28089825/clinical-and-radiographic-outcome-of-revision-surgery-of-total-elbow-prosthesis-midterm-results-in-19-cases
#8
Jetske Viveen, Ante Prkic, Koen L M Koenraadt, Izaäk F Kodde, Bertram The, Denise Eygendaal
BACKGROUND: The aim of this study is to report on the midterm outcomes and complications of revision surgery of total elbow arthroplasty. METHODS: All patients who had undergone total elbow arthroplasty revision surgery between 2009 and 2014 with semiconstrained total elbow prostheses were prospectively enrolled in the study. Records were reviewed for demographic data; baseline measurements; and several follow-up assessments including the Mayo Elbow Performance Score (MEPS), visual analog scale (VAS) score for pain, Oxford Elbow Score, range of motion, satisfaction, and radiographs...
January 13, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28089812/clinical-manifestations-and-outcomes-in-surgically-managed-gartner-duct-cysts-1
#9
Adela G Cope, Shannon Laughlin-Tommaso, Abimbola Famuyide, John B Gebhart, Matthew R Hopkins, Daniel M Breitkopf
STUDY OBJECTIVE: Gartner duct cysts (GDC) are rare embryological remnants of the mesonephric duct with the majority of cases discovered incidentally in asymptomatic patients. The largest prior published series evaluating surgical management of GDC included 4 patients. The present study aims to determine the manifestations and outcomes of surgically managed patients with GDC with important implications for surveillance, monitoring, and management of patients. DESIGN: Retrospective chart review DESIGN: Classification: Canadian Task Force Classification III SETTING: Tertiary care center PATIENTS: All women diagnosed with GDC from 1/1994-4/2014 at our institution were identified...
January 12, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28089666/mini-open-oblique-lumbar-interbody-fusion-olif-approach-for-multi-level-discectomy-and-fusion-involving-l5-s1-preliminary-experience
#10
Fahed Zairi, Tarek P Sunna, Harrison J Westwick, Alexander G Weil, Zhi Wang, Ghassan Boubez, Daniel Shedid
STUDY DESIGN: Technical description and single institution retrospective case series OBJECTIVE: Evaluate technical feasibility and evaluate complications of mini open retroperitoneal oblique lumbar interbody fusion (OLIF) at the L5-S1 level. SUMMARY OF BACKGROUND: The mini open retroperitoneal oblique lumbar interbody fusion (OLIF) approach was first described in 2012 as a surgical approach to achieve spinal fusion while limiting invasiveness of the exposure to the anterior lumbar spine...
January 12, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28089468/obtain-a-outcome-benefits-of-tranexamic-acid-in-hip-arthroplasty-a%C3%A2-randomized-double-blinded-controlled-trial
#11
Andrew Fraval, Peter Effeney, Lena Fiddelaers, Belinda Smith, Ben Towell, Phong Tran
BACKGROUND: We examined whether the blood conserving effect of tranexamic acid (TXA) in total hip arthroplasty using the direct anterior approach, translates to an effect on functional outcomes in the perioperative period. METHODS: We conducted a single-center, randomized, double-blinded, placebo-controlled trial. One hundred one patients were randomized to receive either TXA or an equivalent volume of normal saline. The primary outcome measure was thigh swelling...
December 8, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28089256/a-comparative-analysis-of-work-related-outcomes-after-humeral-hemiarthroplasty-and-reverse-total-shoulder-arthroplasty
#12
Daniel J Hurwit, Joseph N Liu, Grant H Garcia, Gregory Mahony, Hao-Hua Wu, David M Dines, Russell F Warren, Lawrence V Gulotta
BACKGROUND: The return to work of young patients undergoing shoulder arthroplasty is increasingly important. Whereas studies have shown superior outcomes of reverse total shoulder arthroplasty (RTSA) compared with humeral hemiarthroplasty (HHA), no prior literature has compared RTSA with HHA in regard to return to work. METHODS: A retrospective review of a prospectively collected shoulder arthroplasty registry was performed to analyze all patients who underwent RTSA or HHA at a single institution...
January 11, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28089187/effect-of-periarticular-morphine-injection-for-total-knee-arthroplasty-a-randomized-double-blind-trial
#13
Kentaro Iwakiri, Yoshito Minami, Yoichi Ohta, Akio Kobayashi
BACKGROUND: The periarticular multimodal cocktail injection including morphine is currently commonly used to treat postoperative pain after total knee arthroplasty (TKA). Despite its analgesic effect, it is frequently reported to cause nausea and vomiting, which are adverse effects of opioids. This study aimed to assess the efficacy of morphine as a component of a multimodal cocktail injection for providing postoperative analgesia and alleviating swelling in patients who underwent TKA...
December 27, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28089127/mini-invasive-treatment-for-brachymetatarsia-of-the-fourth-ray-in-females-percutaneous-osteotomy-with-mini-burr-and-external-fixation-a-case-series
#14
Federico Fusini, Francesco Langella, Ottorino Catani, Fabrizio Sergio, Fabio Zanchini
Brachymetatarsia is a rare disease defined by metatarsal shortening and characterized by aesthetic dissatisfaction with or without pain. The aim of our study was to evaluate the outcomes of fourth ray brachymetatarsia treated with percutaneous osteotomy using a mini-burr and gradual lengthening with external fixation. A total of 7 females were recruited for the study; 6 (85.71%) of whom had a bilateral deformity, for a total of 13 feet affected by fourth ray brachymetatarsia. Percutaneous diaphysis osteotomy with a mini-burr followed by metatarsal elongation was performed...
January 6, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28088956/-thoracic-paravertebral-block-in-the-pacu-for-immediate-postoperative-pain-relief-after-video-assisted-thoracoscopic-surgery
#15
F Liu, J Zhang, H K Zhang, Y Q Zhao, P Liang, Y X Zuo
Objective: To investigate the effectiveness and safety of the thoracic paravertebral block(TPVB) in the post postanesthesia care unit(PACU) for patients suffered moderate to severe pain after Video-Assisted Thoracoscopic Surgery(VATS). Methods: 78 atients who complained moderate to severe pain on arrival to PACU after VATS were randomly assigned into two groups: thoracic paravertebral block treatment group(P group) and sufentanil treatment group(S group). The VAS Pain score at rest and movement, heart rate, blood pressure, and pulse oximetry 1 hour after treatment and duration of patients staying in the PACU after treatment were recorded...
January 10, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28088941/fracture-union-in-percutaneous-kirschner-wire-fixation-in-paediatric-tibial-shaft-fractures
#16
Ramji Lal Sahu, Rajni Ranjan
PURPOSE: To evaluate the efficacy of intramedullary Kirschner wires for the treatment of unstable tibial shaft fractures in children. METHODS: This prospective study was conducted at the Department of Orthopaedic Surgery in Maharishi Markandeshwar Medical College from June 2005 to June 2010. Sixty-six children having closed fracture of the tibial shaft with a mean age of 7.7 years (range, 2-14 years) were recruited from emergency and outpatient department. They were treated with percutaneous intramedullary Kirschner wires...
December 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28088799/use-of-spinal-cord-diffusion-tensor-imaging-to-quantify-neural-ablation-and-evaluate-outcome-after-percutaneous-cordotomy-for-intractable-cancer-pain
#17
Aditya Vedantam, Ping Hou, T Linda Chi, Patrick M Dougherty, Kenneth R Hess, Ashwin Viswanathan
BACKGROUND: Up to 20% of patients experience only partial pain relief after percutaneous cordotomy for cancer pain. OBJECTIVE: To determine whether diffusion tensor imaging (DTI) can quantify neural ablation and help evaluate early postoperative outcomes after cordotomy. METHODS: Patients undergoing percutaneous CT-guided cordotomy for intractable cancer pain were prospectively studied. Pre- and postoperative assessment was made using the visual analog scale (VAS) on pain and the pain severity scores of the Brief Pain Inventory Short Form...
January 14, 2017: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/28088107/gaas-laser-therapy-reestablishes-the-morphology-of-the-nmj-and-nachrs-after-injury-due-to-bupivacaine
#18
Cristiane Neves Alessi Pissulin, Paula Aiello Tomé de Souza Castro, Flávio Codina, Carina Guidi Pinto, Ivan Jose Vechetti-Junior, Selma Maria Michelin Matheus
BACKGROUND: Local anesthetics are used to relieve pre- and postoperative pain, acting on both sodium channels and nicotinic acetylcholine receptors (nAChR) at the neuromuscular junction (NMJ). Bupivacaine acts as a non-competitive antagonist and has limitations, such as myotoxicity, neurotoxicity, and inflammation. Low-level laser therapy (LLLT) has anti-inflammatory, regenerative, and analgesic effects. The aim of the present study was to evaluate the effects of a gallium arsenide laser (GaAs) on the morphology of the NMJ and nAChRs after application of bupivacaine in the sternomastoid muscle...
December 22, 2016: Journal of Photochemistry and Photobiology. B, Biology
https://www.readbyqxmd.com/read/28087435/postmyelotomy-closure-of-spinal-cord-zip-lock-technique-an-initial-experience
#19
Daljit Singh, Shaam Bodeliwala, Hukum Singh, Anita Jagetia, Amit Mittal
Proper closure of the pia matter is necessary to restore the normal anatomy and prevent postoperative painful dysesthesia after excision of intramedullary spinal cord tumor. Two methods of closure of the pia have been described: welding technique and conventional suturing. Here, we report our initial experience with a new "pial press" or "zip-lock" technique for pial closure where pial layers are simply held together and plunged into each other with small micro tooth forceps. Advantages of the technique over other techniques are its less chances of suture related complications or trauma to the posterior column and simplicity of the technique...
January 10, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28087356/long-term-sensitivity-and-patient-reported-functionality-of-the-neoclitoris-after-gender-reassignment-surgery
#20
Hannes Sigurjónsson, Caroline Möllermark, Johan Rinder, Filip Farnebo, T Kalle Lundgren
INTRODUCTION: A cornerstone of treating gender dysphoria for transgender women is gender reassignment surgery (GRS) encompassing vaginoplasty and clitoroplasty. The neoclitoris is harvested as a flap with a neurovascular pedicle from the proximal dorsal part of the glans penis. Few long-term follow-ups exist on postoperative sensation and patient-reported sexual functionality of the neoclitoris. AIM: To examine the sensitivity of the neoclitoris and its relation to orgasm and sexual function at least 1 year after GRS...
January 10, 2017: Journal of Sexual Medicine
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