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patient safety in surgery

Shaoyun Zhang, Bin Xu, Qiang Huang, Huan Yao, Jinwei Xie, Fuxing Pei
There is no consensus as to whether drainage tube should be used and how long it should remain in use after primary total knee arthroplasty (TKA). As fast-track (FT) program has been implemented in TKA, whether drainage tube could be removed early, and the ideal timing for removal after FT primary TKA has been a new topic. The purpose of this prospective cohort study was to evaluate the safety and feasibility of early removal of drainage tube when FT program was implemented in primary TKA. A total of 101 patients undergoing FT primary TKA were prospectively allocated into three groups...
October 24, 2016: Journal of Knee Surgery
R-C Zhao, W Han, J Han, J Yu, J Guo, J-L Fu, Z Li, R-Z Zhao
OBJECTIVE: To study the efficacy and safety of radiofrequency catheter ablation (RFCA) in patients with different forms of atrial fibrillation. PATIENTS AND METHODS: By retrospective analysis, we summarize 720 cases, where patients diagnosed with atrial fibrillation in our hospital were treated with RFCA from February 2010 to October 2014. Among the cases, 425 were diagnosed with paroxysmal atrial fibrillation and 295 with non-paroxysmal atrial fibrillation (including persistent atrial fibrillation and permanent atrial fibrillation)...
October 2016: European Review for Medical and Pharmacological Sciences
R M Paredes Esteban, J I Garrido Pérez, A Ruiz Palomino, G Guerrero Peña, F Vázquez Rueda, M J Berenguer García, R Miñarro Del Moral, M Tejedor Fernández
OBJECTIVES: In 2014 our department starts to apply the PatientSafety Strategic in Pediatric Surgery. Our aim is to describe the results obtained. METHODS: For the measurement of adverse events (AE) we used a modification of the Global Trigger Tool of the Institute for Healthcare Improvement. Population analysed: patients undergoing surgery with hospitalization. On a monthly basis, audits of the medical records of 12 patients discharged in the prior week of the assessment were performed...
April 20, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
J Gómez-Chacón Villalba, L Rodríguez Caraballo, A Marco Macián, V Segarra Llido, J J Vila Carbó
AIMS: To describe our experience using Minimally Invasive Surgery (MIS) techniques in tertiary center with specific oncological pediatric surgery unit. METHODS: Retrospective review of patients undergoing MIS techniques in pediatric oncology surgery unit between January 2011 and December 2014. MIS procedures were considered made by both techniques such as laparoscopy and thoracoscopy with both diagnostic and therapeutic intent. RESULTS: 4 procedures were diagnostic and the rest were therapeutic: During the study, 56 procedures were performed by MIS...
April 20, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
Dong Hoon Suh, Miseon Kim, Hak Jae Kim, Kyung Hun Lee, Jae Weon Kim
In 2015, fourteen topics were selected as major research advances in gynecologic oncology. For ovarian cancer, high-level evidence for annual screening with multimodal strategy which could reduce ovarian cancer deaths was reported. The best preventive strategies with current status of evidence level were also summarized. Final report of chemotherapy or upfront surgery (CHORUS) trial of neoadjuvant chemotherapy in advanced stage ovarian cancer and individualized therapy based on gene characteristics followed...
November 2016: Journal of Gynecologic Oncology
S G Mistry, D R Strachan, E L Loney
BACKGROUND: Functional endoscopic sinus surgery is recognised to have a significant complication profile (e.g. blindness, cerebrospinal fluid leak and intracranial sepsis). Pre-operative computed tomography imaging is considered mandatory for surgical planning to reduce intra-operative risk. A radiological report is the 'gold standard' in image interpretation; however, because of a lack of otolaryngological or radiological guidance, its contents may be variable. By surveying practising otolaryngologists, this study aimed to provide some guidance which may be used by radiologists to produce more surgically relevant radiological reports...
October 2016: Journal of Laryngology and Otology
Ambrose J Huang, Stijn A Bos, Martin Torriani, F Joseph Simeone, Connie Y Chang, Stuart R Pomerantz, Miriam A Bredella
OBJECTIVE: To evaluate the therapeutic value, safety, and long-term clinical outcomes of percutaneous lumbar facet synovial cyst (LFSC) rupture. MATERIALS AND METHODS: Our study was institutional review board (IRB)-approved and Health Insurance Portability and Accountability Act (HIPAA)-compliant. The study group comprised 71 patients (44 women, mean age: 65 ± 17 years) who underwent CT- or fluoroscopy-guided percutaneous LFSC rupture. The technical success of LFSC rupture, the long-term clinical outcome, including repeat procedures or surgery, and imaging findings on MRI and CT were recorded...
October 22, 2016: Skeletal Radiology
Adele Sandra Budiansky, Michael P Margarson, Naveen Eipe
Increasing numbers of patients with morbid obesity are presenting for surgery, and their acute pain management requires an evidence-based clinical update. The objective of this study was to complete a literature review for acute pain management in morbid obesity and provide an evidence-based clinical update with recommendations. Using standardized search terms, in March 2015, we completed a literature search to determine evidence for different acute pain pharmacologic modalities in morbid obesity. For each modality, the highest level of evidence was ascertained, and recommendations for each pharmacologic modality are presented...
September 19, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Zoran Bjelanovic, Miroljub Draskovic, Milic Veljovic, Ivan Lekovic, Menelaos Karanikolas, Dusica Stamenkovic
INTRODUCTION: This prospective, observational study evaluated transanal dearterialization (THD) efficacy and safety in grade 2-4 hemorrhoids (HD). METHODS: THD was performed under sedation-locoregional anesthesia in 402 outpatients. Patients had follow-up evaluation 3 days, 2 weeks, 1, 6 and 12 months postoperatively. RESULTS: Mean patient age was 46.4 (range 20-85) years. A total of 268 patients (66.6%) were male. Sixteen patients (4.0%) had grade 2 HD, 210 (52...
October 19, 2016: Cirugía Española
Cecilia Nilsson, Jette Led Sorensen, Lars Konge, Mikkel Westen, Morten Stadeager, Bent Ottesen, Flemming Bjerrum
BACKGROUND: Inexperienced operating assistants are often tasked with the important role of handling camera navigation during laparoscopic surgery. Incorrect handling can lead to poor visualization, increased operating time, and frustration for the operating surgeon-all of which can compromise patient safety. The objectives of this trial were to examine how to train laparoscopic camera navigation and to explore the transfer of skills to the operating room. MATERIALS AND METHODS: A randomized, single-center superiority trial with three groups: The first group practiced simulation-based camera navigation tasks (camera group), the second group practiced performing a simulation-based cholecystectomy (procedure group), and the third group received no training (control group)...
October 21, 2016: Surgical Endoscopy
Ricarda Lechner, David Putzer, Michael Liebensteiner, Christian Bach, Martin Thaler
PURPOSE: Bone graft substitutes have been successfully used in posterolateral lumbar fusion, anterior cervical fusion and animal studies. This study has been conducted to assess the safety and efficacy of β-tricalcium phosphate (β-TCP) in instrumented anterior lumbar interbody fusion (ALIF) procedure. METHODS: In a prospective clinical study, ALIF cages were prefilled with β-TCP and additionally fixated with posterior pedicle screw. Computed tomography (CT) and X-rays were performed one year after surgery...
October 21, 2016: International Orthopaedics
J E Slotta, U Kopsch, M Ghadimi, O Kollmar
BACKGROUND: Acute appendicitis is a common disease which requires immediate surgical treatment of the focus of inflammation. So far there are no reliable data on how much time can pass between hospitalization, indications for surgery and initiating surgery without an increased risk of morbidity and mortality for the patient. OBJECTIVE: The aim of this study was to investigate how much time can lapse between admission and initiation of surgery for acute appendicitis while still providing patient safety and no increase in complication rates...
October 21, 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Henry A Pitt, Amy J Goldberg, Abhijit S Pathak, Jonathan A Shinefeld, Sally M Hinkle, Selwyn O Rogers, Verdi J DiSesa, Larry R Kaiser
BACKGROUND: Survival of surgical inpatients is a key quality metric. Patient, surgeon, and system factors all contribute to inpatient mortality, and sophisticated risk adjustment is required to assess outcomes. When the mortality of general surgery patients was determined to be high at a safety-net hospital, a comprehensive approach was undertaken to improve patient survival. METHODS: General surgical service line mortality was measured in the database of the University HealthSystem Consortium from January 2013 through June 2015...
October 18, 2016: Surgery
Kathryn L Kreicher, Jeremy S Bordeaux
Importance: Cutaneous surgery is performed by otolaryngologists, plastic surgeons, oculoplastic surgeons, dermatologic surgeons, and some primary care physicians. Practice gaps exist among cutaneous surgeons, as do differences in how different physicians approach preoperative, intraoperative, and postoperative decision-making. Objective: To present the newest and best evidence to close common practice gaps in cutaneous surgery. Evidence Review: We performed a detailed search of peer-reviewed publications that were identified through a search of PubMed/MEDLINE (January 1, 2000, through June 30, 2016) using the literature search terms "cutaneous surgery," "Mohs micrographic surgery," "plastic surgery," in combination with "safety," "cost," "anesthesia," "anti-coagulation," "bleeding," "pain," "analgesia," "anxiety," or "infection," among others...
October 20, 2016: JAMA Facial Plastic Surgery
Melissa Pilewskie, Cristina Olcese, Sujata Patil, Kimberly J Van Zee
BACKGROUND: Identifying DCIS patients at low risk for disease progression could obviate need for standard therapy. The LORIS (surgery versus active monitoring for low-risk DCIS) trial is studying the safety of monitoring low-risk DCIS, although ipsilateral breast tumor recurrence (IBTR) rates in patients meeting enrollment criteria after complete surgical excision are unknown. METHODS: Women with pure DCIS treated with breast-conserving surgery (BCS) with/without radiation therapy (RT) from 1/1996-1/2011 were included from a prospectively maintained database...
October 20, 2016: Annals of Surgical Oncology
(no author information available yet)
BACKGROUND: Significant safety concerns remain surrounding the use of nonsteroidal anti-inflammatory drugs (NSAIDs) following gastrointestinal surgery, leading to wide variation in their use. This study aimed to determine the safety profile of NSAIDs after major gastrointestinal surgery. METHODS: Consecutive patients undergoing elective or emergency abdominal surgery with a minimum one-night stay during a 3-month study period were eligible for inclusion. The administration of any NSAID within 3 days following surgery was the main independent variable...
October 20, 2016: World Journal of Surgery
David James Osborn, Andy J Martinez, James R Jezior
OBJECTIVE: To assess the efficacy and safety of circumferential cremasteric lysis in the treatment of adult symptomatic retractile testicles. MATERIAL AND METHODS: Retrospective chart review of all patients who had undergone circumferential cremasteric lysis at a single institution by a single surgeon between January 2010 and December 2011. We evaluated etiology, pre- and post-operative pain intensity, post-operative pain alleviation and any surgical complications...
October 17, 2016: Urology
Mariusz Kowalewski, Pietro Giorgio Malvindi, Piotr Suwalski, Giuseppe Maria Raffa, Wojciech Pawliszak, Damian Perlinski, Magdalena Ewa Kowalkowska, Janusz Kowalewski, Thierry Carrel, Lech Anisimowicz
Controversies remain on the increased rate of neurological events after small thoracotomy mitral valve surgery attributed to endoaortic balloon occlusion (EABO). Systematic literature search of databases identified 17 studies enrolling 6,643 patients comparing safety and effectiveness of EABO versus transthoracic clamp. In a meta-analysis, there was no difference in occurrence of cerebrovascular events, all-cause mortality, and kidney injury. EABO was associated with a significantly higher risk of iatrogenic aortic dissection (0...
October 17, 2016: Annals of Thoracic Surgery
Marcello Migliore, Alessandra Criscione, Damiano Calvo, Francesco Borrata, Marco Nardini, Paola Di Masi, Mariapia Gangemi, Francesco Scalieri
Several studies have demonstrated that for complex surgical procedures, surgeons who treat more patients have better outcomes than their lower-volume counterparts. The aim of this paper is to review the experience with video-assisted thoracic surgery (VATS) lobectomies in our small thoracic unit (group A), to understand whether our short-term results were different to the outcomes obtained by the same surgeon previously working in a high-volume unit (group B). Twenty six patients underwent VATS lobectomy. Hospital stay was on average 4...
October 21, 2016: Future Oncology
Jay A Harolds
An important way to improve outcomes after colorectal surgery is to follow the recommendations of the enhanced recovery pathway after surgery (ERAS). The ERAS guidelines are recommendations that address certain aspects of what should be done before surgery, in the operating room, and following surgery. There is a substantial fall in complications and a decrease in the length of stay for the patient if the recommendations are followed. Elements of the ERAS program are now being adopted for other surgical procedures besides colorectal surgery...
October 19, 2016: Clinical Nuclear Medicine
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