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patient safety in surgery

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https://www.readbyqxmd.com/read/29351704/safety-of-cold-snare-polypectomy-for-duodenal-adenomas-in-familial-adenomatous-polyposis-a-prospective-exploratory-study
#1
Kenta Hamada, Yoji Takeuchi, Hideki Ishikawa, Yasumasa Ezoe, Masamichi Arao, Sho Suzuki, Taro Iwatsubo, Minoru Kato, Yusuke Tonai, Satoki Shichijo, Yasushi Yamasaki, Noriko Matsuura, Hiroko Nakahira, Takashi Kanesaka, Sachiko Yamamoto, Tomofumi Akasaka, Noboru Hanaoka, Koji Higashino, Noriya Uedo, Ryu Ishihara, Hiroyuki Okada, Hiroyasu Iishi
BACKGROUND:  Cold snare polypectomy (CSP) to remove multiple duodenal adenomas (MDAs) in patients with familial adenomatous polyposis (FAP) could be an effective and less invasive method than more extensive surgery. The aim of the present study was to determine the safety of this procedure. METHODS:  This prospective exploratory study included 10 consecutive patients with FAP and MDAs who underwent CSP for as many as 50 duodenal adenomas. The primary outcome was the incidence of severe adverse events...
January 19, 2018: Endoscopy
https://www.readbyqxmd.com/read/29351677/use-of-risk-model-for-assessment-of-residents-perception-of-complexity-of-surgical-steps-example-of-modular-component-steps-of-lumbar-spinal-fusion-surgery
#2
Jeffrey S Raskin, Jesse J Liu, Katherine Holste, Sarah Brown, Fran Hardaway, Priscilla Pang, Ahmed M Raslan
BACKGROUND: Quality improvement projects increasingly emphasize standardization of surgical work flow to optimize operative room efficiency. Removing special cause variability resulting from nonsurgical waste is an obvious target; however, resident surgical education must be maintained, even in the setting of process improvement. OBJECTIVE: To describe the impact of resident-identified "risky" or "uncomfortable" procedural steps on operative time during transforaminal lumbar interbody fusion (TLIF)...
February 1, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29351675/quality-in-spine-surgery
#3
Christopher Graves, Scott Meyer, John Knightly, Steven Glassman
Health care is expensive in the United States. There is an increasing focus on value rather than volume. Accurately measuring quality is a critically important step in determining value of care delivered. This article discusses the trials and techniques of measuring quality in spine surgery. A detailed analysis of advantages and disadvantages of various measures of quality, including process measurements, patient-reported outcome measurements, and safety measurements is included-from a historical perspective through modern practice...
February 1, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29351114/sexual-and-reproductive-issues-and-inflammatory-bowel-disease-a-neglected-topic-in-men
#4
Mariangela Allocca, Daniela Gilardi, Gionata Fiorino, Federica Furfaro, Laurent Peyrin-Biroulet, Silvio Danese
There has been considerable literature on sexual issues in women with inflammatory bowel disease (IBD), but relatively little attention has been paid to these aspects in men. To review the available literature and to provide the best management of sexual and reproductive issues in male patients with IBD. The scientific literature on sexual and reproductive issues in men with IBD was reviewed. Several factors, including surgical and medication treatments, disease activity, lifestyle, and psychological factors, may play a role in the development of infertility and sexual dysfunction and may negatively impact pregnancy outcomes...
January 18, 2018: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29350371/fundus-first-technique-and-partial-cholecystectomy-for-difficult-laparoscopic-cholecystectomies
#5
İsmail Cem Sormaz, Yiğit Soytaş, Ali Fuat Kaan Gök, İlker Özgür, Levent Avtan
BACKGROUND: This study aims to evaluate the impact of conversion from retrograde dissection to fundus-first technique (FF) or laparoscopic partial cholecystectomy (LPC) on complication rates, operation time, and duration of hospitalization. METHODS: The medical records of 210 consecutive patients who underwent laparoscopic cholecystectomy between January 2010 and December 2014 were retrospectively evaluated. All laparoscopic cholecystectomies were initiated with retrograde dissection (RD)...
January 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29349694/endoscopic-ultrasound-guided-rendezvous-technique-for-failed-biliary-cannulation-in-benign-and-resectable-malignant-biliary-disorders
#6
Hideyuki Shiomi, Kentaro Yamao, Noriyuki Hoki, Takeshi Hisa, Takeshi Ogura, Kosuke Minaga, Atsuhiro Masuda, Kazuya Matsumoto, Hironari Kato, Hideki Kamada, Daisuke Goto, Hajime Imai, Mamoru Takenaka, Chishio Noguchi, Hidefumi Nishikiori, Yasutaka Chiba, Hiromu Kutsumi, Masayuki Kitano
BACKGROUND: Endoscopic ultrasound-guided rendezvous technique (EUS-RV) has emerged as an effective salvage method for unsuccessful biliary cannulation. However, its application for benign and resectable malignant biliary disorders has not been fully evaluated. AIMS: To assess the efficacy and safety of EUS-RV for benign and resectable malignant biliary disorders. METHODS: This was a multicenter prospective study from 12 Japanese referral centers...
January 18, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29349541/per-oral-endoscopic-myotomy-early-experience-and-safety-of-a-multispecialty-approach
#7
Evgeny V Arshava, Raffaele J Marchigiani, Henning Gerke, Rami El Abiad, Ronald J Weigel, Kalpaj R Parekh, John Keech
BACKGROUND: Per oral endoscopic myotomy (POEM) has gained increasing popularity for treating achalasia. A multidisciplinary approach may allow safe and early adoption of POEM into clinical practice. MATERIALS AND METHODS: We performed a retrospective review of our initial POEM cases. All procedures were performed by a team of interventional gastroenterologist and thoracic surgeon. We analyzed demographics, comorbidities, achalasia subtypes, length of hospital stay, duration of surgery, morbidity, mortality, length of myotomy, preoperative and postoperative Eckardt scores...
January 18, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29349483/surgical-outcomes-of-primary-versus-post-neoadjuvant-chemotherapy-breast-conservation-surgery-a-comparative-study-from-a-developing-country
#8
Gaurav Agarwal, Chaitra Sonthineni, Sabaretnam Mayilvaganan, Anjali Mishra, Punita Lal, Vinita Agrawal
INTRODUCTION: In India and other developing countries, breast conservation surgery (BCS) rates in breast cancer patients are low due to advanced disease at presentation and misconceptions about BCS outcomes. Many patients presenting with large or locally advanced breast cancers (LABC) can be offered post-neoadjuvant chemotherapy (NACT) BCS, safety of which is not as well established as that of primary BCS. This retrospective study compared pathological and surgical outcome parameters in patients undergoing primary and post-NACT BCS...
January 18, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29346827/efficacy-and-complications-of-submucosal-tunneling-endoscopic-resection-for-upper-gastrointestinal-submucosal-tumors-and-exploration-for-influencing-factors
#9
Shunzhe Song, Xu Wang, Shen Zhang, Yanxia Li, Xiaonan Zhang, Xufang Chu
BACKGROUND:  Submucosal tunneling endoscopic resection (STER) has emerged as a feasible technique for resecting upper gastrointestinal (GI) tract submucosal tumors (SMTs) through natural orifice transluminal endoscopic surgery. STER reduces the risk of postoperative perforation and abdominal infections and promotes rapid wound healing. The aim of this meta-analysis was to evaluate the safety and efficacy of STER for small (≤ 3.5 cm) upper GI SMTs and explore the potential factors influencing STER's efficacy and complication rate...
January 18, 2018: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/29346570/implementation-status-of-morbidity-and-mortality-conferences-in-swiss-hospitals-a-national-cross-sectional-survey-study
#10
Isabelle Praplan-Rudaz, Yvonne Pfeiffer, David L B Schwappach
Objective: To determine the implementation status and current practice of morbidity and mortality conferences (M&MCs) in Switzerland. Design: A national cross-sectional online survey was conducted in spring 2017. The questionnaire focused on overall goals, structure and procedures of hospital M&MCs. Further topics included satisfaction, perceived effectiveness and support requirements. Setting: A total of 913 chief physicians of surgery and internal medicine, and specialist fields of obstetrics and gynaecology, anaesthesiology and intensive care from Swiss acute care hospitals were invited to the survey...
January 16, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29346507/activity-and-safety-of-afatinib-in-a-window-pre-operative-eortc-study-in-patients-with-squamous-cell-carcinoma-of-the-head-and-neck-scchn
#11
J P Machiels, P Bossi, J Menis, M Lia, C Fortpied, Y Liu, R Lhommel, M Lemort, S Schmitz, S Canevari, L De Cecco, M Guzzo, R Bianchi, P Quattrone, F Crippa, T Duprez, Y Lalami, M Quiriny, N de Saint Aubain, P M Clement, R Coropciuc, E Hauben, L F Licitra
Background: To investigate the activity and safety of afatinib in the pre-operative treatment of squamous cell carcinoma of the head and neck (SCCHN). Patients and methods: This study was an open-label, randomized, multicenter, phase II window of opportunity trial. Treatment-naïve SCCHN patients selected for primary curative surgery were randomized (5:1 ratio) to receive afatinib during 14 days (day -15 until day -1) before surgery (day 0) or no treatment. Tumor biopsies, 2-[fluorine-18]-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET), and magnetic resonance imaging (MRI) were performed at diagnosis and just before surgery...
January 15, 2018: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/29345686/reversal-agents-for-non-vitamin-k-antagonist-oral-anticoagulants
#12
REVIEW
Jerrold H Levy, James Douketis, Jeffrey I Weitz
The non-vitamin K antagonist oral anticoagulants (NOACs) include dabigatran, which inhibits thrombin, and apixaban, betrixaban, edoxaban, and rivaroxaban, which inhibit coagulation factor Xa. Although clinical studies of NOACs were conducted without antidotes, patient outcomes with major bleeding when receiving NOACs were no worse than those in patients treated with a vitamin K antagonist. Nonetheless, in patients with life-threatening bleeding or requiring urgent surgery, the capacity for rapid NOAC reversal is likely to increase patient safety...
January 18, 2018: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/29344822/novel-oral-anticoagulants-in-the-preoperative-period-a-meta-analysis
#13
Hua He, Bingbing Ke, Yan Li, Fuheng Han, Xiaodong Li, Yujie Zeng
The purpose of this study is to evaluate the efficacy and safety of novel oral anticoagulant (NOAC) versus warfarin therapy in patients undergoing different operations. We performed a systematic review of MEDLINE, EMBASE, Cochrane Controlled Trials Register, and reports presented at scientific meetings. The efficacy and safety of NOACs during the perioperative period was compared to that using warfarin. Of the 2652 studies initially reviewed, we identified 9 that included 15,880 patients for the meta-analysis...
January 17, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29344622/barriers-to-and-facilitators-of-implementing-enhanced-recovery-pathways-using-an-implementation-framework-a-systematic-review
#14
Alexander B Stone, Christina T Yuan, Michael A Rosen, Michael C Grant, Lauren E Benishek, Elizabeth Hanahan, Lisa H Lubomski, Clifford Ko, Elizabeth C Wick
Importance: Enhanced recovery pathways (ERPs) have the potential to reduce length of hospital stay, costs, and complications following surgery but can be challenging to implement. Objective: To examine the body of literature on ERPs to assess how authors describe barriers and facilitators of ERP implementation and identify, in aggregate, the best practices that should be considered utilizing the Consolidated Framework for Implementation Research (CFIR) to extract these elements and summarize common barriers and facilitators according to its 5 major domains: (1) intervention characteristics, (2) inner setting, (3) outer setting, (4) characteristics of the individuals, and (5) the process of implementation...
January 17, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29343287/percutaneous-kyphoplasty-for-the-treatment-of-very-severe-osteoporotic-vertebral-compression-fractures-with-spinal-canal-compromise
#15
Heng Wang, Zongyu Zhang, Yijie Liu, Weimin Jiang
BACKGROUND: Very severe osteoporotic vertebral compression fractures (vsOVCFs) are osteoporotic vertebral compression fractures with vertebral body collapse to less than one third of their original height. Few data are available about the use of percutaneous kyphoplasty (PKP) in treating vsOVCFs with spinal canal compromise. The aim of this study was to evaluate the safety and efficacy of percutaneous kyphoplasty (PKP) for the treatment of vsOVCFs with spinal canal compromise. METHODS: Thirty-five patients who suffered vsOVCFs with spinal canal compromise but without neurological deficits were treated by PKP between January 2009 and October 2014...
January 17, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29343282/investigation-of-perioperative-safety-and-clinical-results-of-one-stage-bilateral-total-knee-arthroplasty-in-selected-low-risk-patients
#16
Hirotaka Mutsuzaki, Arata Watanabe, Tetsuya Komatsuzaki, Tomonori Kinugasa, Kotaro Ikeda
BACKGROUND: An increased perioperative complication rate has been a concern with one-stage bilateral total knee arthroplasty (TKA). The purpose of this study was to retrospectively investigate the perioperative safety and clinical results of one-stage bilateral TKA in selected low-risk patients. METHODS: Sixty-seven patients who received one-stage bilateral TKAs for osteoarthritis who were American Society of Anesthesiology (ASA) class 1 or 2 were included in this study...
January 17, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29341967/new-modalities-for-the-administration-of-inhaled-nitric-oxide-in-intensive-care-units-after-cardiac-surgery-or-for-neonatal-indications-a-prospective-observational-study
#17
Philippe Gaudard, Claudio Barbanti, Bertrand Rozec, Philippe Mauriat, Mimoun M'rini, Gilles Cambonie, Jean Michel Liet, Claude Girard, Pierre Louis Leger, Ziad Assaf, Pierre Damas, Gauthier Loron, Laurent Lecourt, Julien Amour, Philippe Pouard
BACKGROUND: Nitric oxide (NO) has a well-known efficacy in pulmonary hypertension (PH), with wide use for 20 years in many countries. The objective of this study was to describe the current use of NO in real life and the gap with the guidelines. METHODS: This is a multicenter, prospective, observational study on inhaled NO administered through an integrated delivery and monitoring device and indicated for PH according to the market authorizations. The characteristics of NO therapy and ventilation modes were observed...
January 16, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29340826/single-port-laparoscopic-surgery-in-uncomplicated-acute-appendicitis-a-randomized-controlled-trial
#18
Byung Mo Kang, Sung Il Choi, Bum-Soo Kim, Suk-Hwan Lee
BACKGROUND: Single-port laparoscopic surgery (SPLS) is an alternative, minimally invasive surgical approach for managing appendicitis. The aim of this randomized trial was to evaluate the safety and efficacy of SPLS in uncomplicated appendicitis. METHODS: Between December 2009 and November 2010, 194 patients with radiologically diagnosed acute appendicitis were randomly allocated to undergo either SPLS or multiport laparoscopic surgery (MPLS). Patients with intraoperative findings of perforated appendicitis were excluded from the analysis...
January 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29340825/laparoscopic-surgery-in-colon-cancer-patients-treated-with-chronic-anti-thrombotic-therapy
#19
Hiroaki Nozawa, Takahide Shinagawa, Kazushige Kawai, Keisuke Hata, Toshiaki Tanaka, Takeshi Nishikawa, Kensuke Otani, Kazuhito Sasaki, Manabu Kaneko, Shigenobu Emoto, Koji Murono
BACKGROUND: Anti-thrombotic medications are commonly used for the treatment and prevention of cardiovascular diseases. Laparoscopic resection of colon cancer has generally been accepted with favorable outcomes being reported in randomized control trials. However, the safety and efficacy of laparoscopic surgery for colon cancer patients receiving chronic anti-thrombotic therapy (AT) remain unclear. METHODS: We identified 951 patients who underwent elective resection for colon cancer between 2009 and 2016 from our database...
January 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29340816/expanding-indications-of-robotic-thyroidectomy
#20
Se Hyun Paek, Kyung Ho Kang, Sung Jun Park
BACKGROUND: Robotic thyroidectomy has many advantages with comparable oncologic safety over conventional open surgery in low-risk differentiated thyroid cancer cases. However, there have been few reports on the outcomes of patients who have been treated with robotic thyroidectomy for more advanced thyroid cancer. The aim of this study was to investigate the validity of expanding indications of robotic thyroidectomy for more advanced thyroid cancer. METHODS: The data of 80 patients with thyroid cancer who underwent robotic total thyroidectomy between January 2013 and December 2014 performed by a single surgeon at Chung-Ang University Hospital were retrospectively reviewed...
January 16, 2018: Surgical Endoscopy
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