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https://www.readbyqxmd.com/read/29346829/intraoperative-seizures-in-awake-craniotomy-for-perirolandic-glioma-resections-that-undergo-cortical-mapping
#1
Chikezie Ikechukwu Eseonu, Jordina Rincon-Torroella, Young M Lee, Karim ReFaey, Punita Tripathi, Alfredo Quinones-Hinojosa
BACKGROUND:  Perirolandic motor area gliomas present invasive eloquent region tumors within the precentral gyrus that are difficult to resect without causing neurologic deficits. STUDY AIMS:  This study evaluates the role of awake craniotomy and motor mapping on neurologic outcome and extent of resection (EOR) of tumor in the perirolandic motor region. It also analyzes preoperative risk factors for intraoperative seizures. METHODS:  We evaluated 57 patients who underwent an awake craniotomy for a perirolandic motor area eloquent region glioma...
January 18, 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/29346684/comparing-cortical-trajectory-transforaminal-lumbar-interbody-fusions-against-pedicle-trajectory-transforaminal-lumbar-interbody-fusions-and-posterolateral-fusions-a-retrospective-cohort-study-of-90-day-outcomes
#2
James G Malcolm, Michael K Moore, Falgun H Choksh, Faiz U Ahmad, Daniel Refai
BACKGROUND: The cortical screw (CS) trajectory for pedicle screw placement is believed to require a smaller incision and less tissue dissection resulting in lower blood loss and faster healing; however, this has not yet been confirmed in clinical studies. OBJECTIVE: To compare CS transforaminal lumbar interbody fusions (TLIF), traditional pedicle screw (TPS) trajectory TLIFs, and posterolateral fusion (PLF) without interbody for differences in operative characteristics and complications...
January 13, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29346608/on-demand-intraoperative-3-dimensional-printing-of-custom-cranioplastic-prostheses
#3
Alexander I Evins, John Dutton, Sayem S Imam, Amal O Dadi, Tao Xu, Du Cheng, Philip E Stieg, Antonio Bernardo
BACKGROUND: Currently, implantation of patient-specific cranial prostheses requires reoperation after a period for design and formulation by a third-party manufacturer. Recently, 3-dimensional (3D) printing via fused deposition modeling has demonstrated increased ease of use, rapid production time, and significantly reduced costs, enabling expanded potential for surgical application. Three-dimensional printing may allow neurosurgeons to remove bone, perform a rapid intraoperative scan of the opening, and 3D print custom cranioplastic prostheses during the remainder of the procedure...
January 13, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29344622/barriers-to-and-facilitators-of-implementing-enhanced-recovery-pathways-using-an-implementation-framework-a-systematic-review
#4
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/29343915/impact-of-learning-curve-on-the-perioperative-outcomes-following-robot-assisted-partial-nephrectomy-for-renal-tumors
#5
Brendan Hermenigildo Dias, Mohammed Shahid Ali, Shiv Dubey, Srinivas Arkalgud Krishnaswamy, Amrith Raj Rao, Deepak Dubey
Introduction: Robot-assisted partial nephrectomy (RAPN) is an established, minimally invasive technique to treat patients with renal masses. The aim of this study was to assess the learning curve (LC) of RAPN, evaluate its impact on perioperative outcomes following RAPN and to study the role of surgeon experience in achieving "trifecta" outcomes following RAPN. Methods: We prospectively analyzed the clinical and pathological outcomes of 108 consecutive patients who underwent RAPN for renal tumors from January 2012 to December 2016 by a laparoscopy trained surgeon with no prior robotic experience...
January 2018: Indian Journal of Urology: IJU: Journal of the Urological Society of India
https://www.readbyqxmd.com/read/29343913/comparison-of-renal-padua-and-c-index-scoring-systems-in-predicting-perioperative-outcomes-after-nephron-sparing-surgery
#6
Aditya P Sharma, Ravimohan Suryanarayana Mavuduru, Girdhar Singh Bora, Sudheer K Devana, Kiruthika Palani, Anupam Lal, Nandita Kakkar, Shrawan K Singh, Arup K Mandal
Introduction and Objective: The RENAL, PADUA and centrality index (C-index) nephrometry scoring systems (SS) have been individually evaluated for their role in predicting trifecta outcomes after nephron-sparing surgery (NSS). However, there is little data on their comparative superiority. The present study was designed to evaluate the predictive value of three SS and to assess interobserver reliability. Materials and Methods: Fifty patients undergoing NSS at our center between January 2014 and April 2016 were included in the study...
January 2018: Indian Journal of Urology: IJU: Journal of the Urological Society of India
https://www.readbyqxmd.com/read/29343449/the-comparative-efficacy-and-safety-of-topical-and-intravenous-tranexamic-acid-for-reducing-perioperative-blood-loss-in-total-knee-arthroplasty-a-randomized-controlled-non-inferiority-trial
#7
Jefferson George, Krishna Kiran Eachempati, Koushik Narayan Subramanyam, A V Gurava Reddy
BACKGROUND: Total Knee Arthroplasty (TKA) can be associated with significant perioperative blood loss and blood transfusions. This is a prospective randomised non-inferiority trial comparing intraarticular (IA) and intravenous (IV) routes of administering Tranexamic acid (TXA) with regard to efficacy and safety. METHODS: A total of 113 patients who underwent primary unilateral TKA from January to June 2017 randomly received either 1.5g TXA in 100mL normal saline solution (IA group, n=58) or 10mg/kg TXA (IV group, n=55) at 10min before the tourniquet inflation and at tourniquet release...
January 14, 2018: Knee
https://www.readbyqxmd.com/read/29343302/does-previous-abdominal-surgery-adversely-affect-perioperative-and-oncologic-outcomes-of-laparoscopic-radical-cystectomy
#8
Xiaosong Wei, Jinjin Lu, Khurram Mutahir Siddiqui, Fan Li, Qianyuan Zhuang, Weimin Yang, Zhiquan Hu, Zhong Chen, Xiaodong Song, Shaogang Wang, Zhangqun Ye
BACKGROUND: Laparoscopic radical cystectomy (LRC) has been shown to have less estimated blood loss (EBL), transfusion rate, narcotic analgesic requirement, earlier return of bowel function, and shorter hospital stay. The aim of this study was to investigate the feasibility, peri-operative and oncologic outcomes of laparoscopic radical cystectomy (LRC) in patients with previous abdominal surgery (PAS). METHODS: We retrospectively reviewed 243 patients undergoing open radical cystectomy (ORC) or LRC with bilateral pelvic lymph node dissection and urinary diversion or cutaneous ureterostomy at a single center from January 2010 to December 2015...
January 17, 2018: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29342431/comparison-of-access-type-on-perioperative-outcomes-after-endovascular-aortic-aneurysm-repair
#9
Jeffrey J Siracuse, Alik Farber, Jeffrey A Kalish, Douglas W Jones, Denis Rybin, Gheorghe Doros, Salvatore T Scali, Marc L Schermerhorn
OBJECTIVE: Endovascular aneurysm repair (EVAR) can be performed through percutaneous or surgical access. Our goal was to assess the difference in perioperative outcomes based on access type in a real-world setting. METHODS: The Vascular Quality Initiative (VQI) database was queried for EVAR. Univariable analysis and multivariable analysis were used to determine the independent effect of access type. RESULTS: There were 8340 (64%) and 4747 (36%) EVAR procedures performed through percutaneous and surgical access (3395 [72%] transverse and 1352 [28%] vertical incisions)...
January 13, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29342066/resident-participation-in-fixation-of-intertrochanteric-hip-fractures-analysis-of-the-nsqip-database
#10
Alexander L Neuwirth, Russell N Stitzlein, Madalyn G Neuwirth, Rachel K Kelz, Samir Mehta
BACKGROUND: Future generations of orthopaedic surgeons must continue to be trained in the surgical management of hip fractures. This study assesses the effect of resident participation on outcomes for the treatment of intertrochanteric hip fractures. METHODS: The National Surgical Quality Improvement Program (NSQIP) database (2010 to 2013) was queried for intertrochanteric hip fractures (International Classification of Diseases, 9th Revision, Clinical Modification [ICD-9-CM] code 820...
January 17, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29341963/role-of-the-anesthesiologist-intensivist-outside-the-icu-opportunity-to-add-value-for-the-hospital-or-an-unnecessary-distraction
#11
Suzanne Bennett, Erin Grawe, Courtney Jones, Sean A Josephs, Maggie Mechlin, William E Hurford
PURPOSE OF REVIEW: Given the extremely expensive nature of critical care medicine, it seems logical that intensivists should play an active role in designing efficient systems of care. The true value of intensivists, however, is not well defined. RECENT FINDINGS: Anesthesiologists have taken key roles in improving patient safety in the operating room. Anesthesia-related mortality rates have decreased from 20 deaths per 100 000 anesthetics in the early 1980s to less than one death per 100 000 currently...
January 15, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29341506/impact-of-preoperative-anemia-on-outcomes-in-patients-undergoing-curative-resection-for-gastric-cancer-a-single-institution-retrospective-analysis-of-2163-chinese-patients
#12
Xuechao Liu, Haibo Qiu, Yuying Huang, Dazhi Xu, Wei Li, Yuanfang Li, Yingbo Chen, Zhiwei Zhou, Xiaowei Sun
We sought to evaluate whether preoperative anemia was an important determinant of survival in gastric cancer (GC). A single institution cohort of 2163 GC patients who underwent curative resection were retrospectively analyzed. Anemia was defined as a preoperative hemoglobin level <120 g/L in males and <110 g/L in females. Overall survival (OS) was analyzed using the Kaplan-Meier method, and a multivariate Cox proportional hazards model was performed to identify the independent prognostic factor. Anemic patients had a poorer OS compared with nonanemic patients after resection for tumor-nodes-metastasis (TNM) stage III tumors (5-year OS rate: 32...
January 17, 2018: Cancer Medicine
https://www.readbyqxmd.com/read/29341336/identification-of-perioperative-pulmonary-aspiration-in-children-using-quality-assurance-and-hospital-administrative-billing-data
#13
Lisa Eisler, Grace Huang, Ka-Eun M Lee, Jennifer A Busse, Ming Sun, Albert Y Lin, Lena S Sun, Caleb Ing
BACKGROUND: Perioperative aspiration is a rare but potentially devastating complication, occurring in 1-10 per 10 000 anesthetics based on studies of quality assurance databases. Quality assurance reporting is known to underestimate the incidence of adverse outcomes, but few large studies use supplementary data sources. This study aims to identify the incidence of and risk factors for perioperative aspiration in children using quality assurance data supplemented by administrative billing records, and to examine the utility of billing data as a supplementary data source...
January 17, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29341066/cerebral-near-infrared-spectroscopy-nirs-for-perioperative-monitoring-of-brain-oxygenation-in-children-and-adults
#14
REVIEW
Yun Yu, Kaiying Zhang, Ling Zhang, Huantao Zong, Lingzhong Meng, Ruquan Han
BACKGROUND: Various techniques have been employed for the early detection of perioperative cerebral ischaemia and hypoxia. Cerebral near-infrared spectroscopy (NIRS) is increasingly used in this clinical scenario to monitor brain oxygenation. However, it is unknown whether perioperative cerebral NIRS monitoring and the subsequent treatment strategies are of benefit to patients. OBJECTIVES: To assess the effects of perioperative cerebral NIRS monitoring and corresponding treatment strategies in adults and children, compared with blinded or no cerebral oxygenation monitoring, or cerebral oxygenation monitoring based on non-NIRS technologies, on the detection of cerebral oxygen desaturation events (CDEs), neurological outcomes, non-neurological outcomes and socioeconomic impact (including cost of hospitalization and length of hospital stay)...
January 17, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29340829/trends-and-surgical-outcomes-of-laparoscopic-versus-open-pyloromyotomy
#15
William C Kethman, Alex H S Harris, Mary T Hawn, James K Wall
BACKGROUND: Hypertrophic pyloric stenosis (HPS) is one of the most common pediatric illnesses necessitating surgical intervention. Controversy remains over the optimal surgical approach between laparoscopic pyloromyotomy (LP) and open pyloromyotomy (OP). LP has gained acceptance for management of HPS in an era of expanding minimal access surgical approaches to pediatric conditions. Several studies suggest advantages of LP over OP; however, selection bias and small sample sizes remain a concern...
January 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29339545/perioperative-implementation-of-noninvasive-positive-airway-pressure-therapies
#16
REVIEW
David R Hillman, Carla R Jungquist, Dennis Auckley
Noninvasively applied positive airway pressure therapy (PAP) is available in 3 basic modes: continuous positive airway pressure (CPAP), bi-level positive airway pressure (BPAP), and adaptive servo-ventilation. These are in widespread use in home and hospital settings to treat a variety of disorders of ventilation or gas exchange, including obstructive sleep apnea, sleep-related hypoventilation, periodic breathing, acute and chronic hypercapnic respiratory failure, and acute respiratory failure. They are increasingly being used perioperatively to prevent or treat upper airway obstruction, hypoventilation, and periodic breathing, and they have been found to improve postoperative outcomes in the case of obstructive sleep apnea...
January 16, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29338923/minimally-invasive-hysterectomy-surgery-rates-for-endometrial-cancer-performed-at-national-comprehensive-cancer-network-nccn-centers
#17
Jennifer Bergstrom, Alessia Aloisi, Shannon Armbruster, Ting-Tai Yen, Jvan Casarin, Mario M Leitao, Edward J Tanner, Rayna Matsuno, Karime Kalil Machado, Sean C Dowdy, Pamela T Soliman, Stephanie L Wethington, Rebecca L Stone, Kimberly L Levinson, Amanda N Fader
OBJECTIVES: Minimally invasive surgery (MIS) is a quality measure for endometrial cancer (EC) established by the Society of Gynecologic Oncology and the American College of Surgeons. Our study objective was to assess the proportion of EC cases performed by MIS at National Comprehensive Cancer Network (NCCN) centers and evaluate perioperative outcomes. METHODS: A retrospective cohort study of women who underwent surgical treatment for EC from 2013 to 2014 was conducted at four NCCN centers...
January 12, 2018: Gynecologic Oncology
https://www.readbyqxmd.com/read/29338037/stentless-vs-stented-bioprosthesis-for-aortic-valve-replacement-a-case-matched-comparison-of-long-term-follow-up-and-subgroup-analysis-of-patients-with-native-valve-endocarditis
#18
Andreas Schaefer, Jannis Dickow, Gerhard Schoen, Sumi Westhofen, Lisa Kloss, Tarik Al-Saydali, Hermann Reichenspurner, Sebastian A Philipp, Christian Detter
BACKGROUND: Current retrospective evidence suggests similar clinical and superior hemodynamic outcomes of the Sorin Freedom Solo stentless aortic valve (SFS) (LivaNova PLC, London, UK) compared to the Carpentier Edwards Perimount stented aortic valve (CEP) (Edwards Lifesciences Inc., Irvine, California, USA). To date, no reports exist describing case-matched long-term outcomes and analysis for treatment of native valve endocarditis (NVE). METHODS: From 2004 through 2014, 77 consecutive patients (study group, 59...
2018: PloS One
https://www.readbyqxmd.com/read/29337783/s1-sacrectomy-for-re-recurrent-rectal-cancer-our-experience-with-reconstruction-using-an-expandable-vertebral-body-replacement-device
#19
Daniel Jin Keat Lee, Kelvin Yafan Wang, Peter Michael Sagar, Jake Timothy
INTRODUCTION: R0 resection is achieved by high sacrectomy for local recurrence of colorectal cancer, but significant rates of perioperative complications and long-term patient morbidity are associated with this procedure. In this report, we outline our unique experience of using an expandable cage for vertebral body reconstruction following S1 sacrectomy in a 66-year-old patient with re-recurrent rectal cancer. We aim to highlight several key steps, with a view to improving postoperative outcomes...
February 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29337771/outcomes-of-closed-versus-open-defects-after-local-excision-of-rectal-neoplasms-a-multi-institutional-matched-analysis
#20
Lawrence Lee, Ashley Althoff, Kimberley Edwards, Matthew R Albert, Sam B Atallah, Iain A Hunter, James Hill, John R T Monson
BACKGROUND: The management of the rectal wall defect after local excision of rectal neoplasms remains controversial, and the existing data are equivocal. OBJECTIVE: This study aimed to determine the effect of open versus closed defects on postoperative outcomes after local excision of rectal neoplasms. DESIGN: Data from 3 institutions were analyzed. Propensity score matching was performed in one-to-one fashion to create a balanced cohort comparing open and closed defects...
February 2018: Diseases of the Colon and Rectum
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