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https://www.readbyqxmd.com/read/29161805/robot-assisted-radical-cystectomy-with-totally-intracorporeal-urinary-diversion-initial-single-surgeon-s-experience-after-a-modified-modular-training
#1
Angelo Porreca, Francesco Chessa, Daniele Romagnoli, Antonio Salvaggio, Angelo Cafarelli, Marco Borghesi, Lorenzo Bianchi, Matteo Dandrea, Daniele D'Agostino, Donato Dente, Emanuele Cappa, Peter Wiklund, Eugenio Brunocilla, Riccardo Schiavina
BACKGROUND: To report the perioperative and early functional outcomes of patients undergoing Robot-assisted radical cystectomy (RARC) with totally intracorporeal urinary diversion performed by a single surgeon after a modified modular training. METHODS: The surgeon (A.P.) attained a 30-days modified modular training at a referring Centre mentored by a worldwide-recognized robotic surgeon (P.W.). The training program consisted of: a) e-learning based on 10 hours of theoretical lessons made by the mentor; b) video-session concerning the different steps of the procedure, c) step-by-step in vivo modular training...
November 21, 2017: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
https://www.readbyqxmd.com/read/29161402/fit-for-surgery-perspectives-on-preoperative-exercise-testing-and-training
#2
K Richardson, D Z H Levett, S Jack, M P W Grocott
There is a consistent relationship between physical activity, physical fitness, and health across almost all clinical contexts, including the perioperative setting. Physiological measurements obtained during physical exercise may be used to infer the risk of adverse outcome after major surgery. In particular, data obtained from perioperative cardiopulmonary exercise testing have an expanding role in perioperative care. Such information may be used to inform a variety of changes in clinical practice, including interventions that may reduce the risk of perioperative adverse events...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29161397/abdominal-aortic-aneurysm-repair-in-the-united-kingdom-an-exemplar-for-the-role-of-anaesthetists-in-perioperative-medicine
#3
S J Howell
The past two decades have seen an increasing recognition that the delivery of safe surgery with low complication rates and good long-term outcomes is a team endeavour embracing the whole patient care pathway. The key role of the anaesthetist in managing the patient through the surgical process is widely understood and has driven the emergence of perioperative medicine. In parallel with these developments there has been a sea change in the organisation of the care of patients presenting for elective abdominal aortic aneurysm (AAA) repair...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29159840/cognitive-outcomes-after-transcatheter-aortic-valve-implantation-a-metaanalysis
#4
Maisha M Khan, Nathan Herrmann, Damien Gallagher, Dov Gandell, Stephen E Fremes, Harindra C Wijeysundera, Sam Radhakrishnan, Yue Ran Sun, Krista L Lanctôt
OBJECTIVES: To quantitatively summarize changes in cognitive performance in individuals with severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI). DESIGN: Metaanalysis. PARTICIPANTS: Individuals undergoing TAVI (N = 1,065 (48.5% male) from 18 studies, average age ≥80). MEASUREMENTS: The MEDLINE, EMBASE, and Cochrane Central databases were searched for original peer-reviewed reports assessing cognitive performance using standardized cognitive tests before and after TAVI...
November 21, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29159751/septal-and-turbinate-surgery-is-overnight-essential
#5
Ana Sousa Menezes, Joana R Guimarães, Miguel Breda, Vicente Vieira, Luís Dias
INTRODUCTION: The performance of septoplasty and turbinate surgery in an outpatient basis is an increasingly established practice, although is still a controversial topic. METHODS: Retrospective analysis of 227 patients who underwent septoplasty ± inferior and/or middle turbinoplasty. Demographic, clinical, surgical, and anesthetic data were collected. Our primary outcomes were rates of perioperative complications, prolongation of hospital stay (PHS), unexpected hospital revisits (UHR), or readmissions within 30 days of surgery...
November 20, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29159166/laparoscopic-and-robotic-surgeries-for-patients-with-colorectal-cancer-who-have-had-a-previous-abdominal-surgery
#6
Soeun Park, Jeonghyun Kang, Eun Jung Park, Seung Hyuk Baik, Kang Young Lee
Purpose: The impact of previous abdominal surgery (PAS) on surgical outcomes from laparoscopic and robot surgeries is inconclusive. This study aimed to investigate the impact of PAS on perioperative outcomes from laparoscopic and robotic colorectal surgeries. Methods: From March 2007 to February 2014, a total of 612 and 238 patients underwent laparoscopic and robotic surgeries, respectively. Patients were divided into 3 groups: those who did not have a PAS (NPAS), those who had a major PAS, and those who had a minor PAS...
October 2017: Annals of Coloproctology
https://www.readbyqxmd.com/read/29158975/assessment-of-perioperative-stress-in-colorectal-cancer-by-use-of-in-vitro-cell-models-a-systematic-review
#7
Tove Kirkegaard, Mikail Gögenur, Ismail Gögenur
Background: The perioperative period is important for patient outcome. Colorectal cancer surgery can lead to metastatic disease due to release of disseminated tumor cells and the induction of surgical stress response. To explore the overall effects on surgically-induced changes in serum composition, in vitro model systems are useful. Methods: A systematic search in PubMed and EMBASE was performed to identify studies describing in vitro models used to investigate cancer cell growth/proliferation, cell migration, cell invasion and cell death of serum taken pre- and postoperatively from patients undergoing colorectal tumor resection...
2017: PeerJ
https://www.readbyqxmd.com/read/29158591/surgical-oncology-for-gliomas-the-state-of-the-art
#8
REVIEW
Nader Sanai, Mitchel S Berger
Surgical resection remains the mainstay of treatment for patients with glioma of any grade. Maximal resection of the tumour is central to achieving long-term disease control; however, the relationship between the extent of glioma resection and actual clinical benefit for the patient is predicated on the balance between cytoreduction and neurological morbidity. For the neurosurgical oncologist, the clinical rationale for undertaking increasingly extensive resections has gained traction. In parallel, novel surgical techniques and technologies have been developed that help improve patient outcomes...
November 21, 2017: Nature Reviews. Clinical Oncology
https://www.readbyqxmd.com/read/29158173/standardized-and-simplified-retroperitoneal-lymph-node-dissection-during-retroperitoneal-laparoscopic-radical-nephroureterectomy-for-urothelial-carcinoma-of-the-upper-ureter-or-renal-pelvis-en-bloc-resection-technique
#9
Toru Kanno, Go Kobori, Masashi Kubota, Satoshi Funada, Takao Haitani, Takashi Okada, Yoshihito Higashi, Seiji Moroi, Hitoshi Yamada
OBJECTIVE To describe our en-bloc technique of retroperitoneal lymph node dissection (RPLND) during retroperitoneal laparoscopic radical nephroureterectomy (RNU) for upper urinary tract urothelial carcinoma (UTUC) and evaluate perioperative outcomes. METHODS From 2002 to 2015, 114 patients with UTUC located at the pelvis and/or upper or middle ureter underwent retroperitoneal laparoscopic RNU at two institutions. Performance of RPLND began in February 2009. The template of RPLND included the renal hilar and para-aortic lymph nodes (left side) and the renal hilar, paracaval, retrocaval, and intra-aortocaval lymph nodes (right side)...
November 17, 2017: Urology
https://www.readbyqxmd.com/read/29157723/implantable-cardioverter-defibrillator-therapy-in-hypertrophic-cardiomyopathy-a-simple-substudy
#10
Mate Vamos, Jeff S Healey, Jia Wang, Stuart J Connolly, Philippe Mabo, Lieselot VanErven, Josef Kautzner, Michael Glikson, Jorg Neuzner, Gilles O'Hara, Xavier Vinolas, Frederik Gadler, Stefan H Hohnloser
BACKGROUND: Patients with hypertrophic cardiomyopathy (HCM) are considered to be at high risk for elevated defibrillation thresholds, peri-procedural complications, and failed appropriate shocks. OBJECTIVE: To determine the value of defibrillation testing in HCM patients undergoing ICD implantation. METHODS: Defibrillation thresholds, perioperative complications, and long-term outcomes were compared between patients with HCM, and those with ischemic or dilated cardiomyopathy (ICM/DCM) enrolled in the SIMPLE trial...
November 17, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29157682/outcomes-of-thoracic-endovascular-aortic-repair-for-chronic-aortic-dissections
#11
Allan M Conway, Khalil Qato, Laurie R Mondry, Guillaume J Stoffels, Gary Giangola, Alfio Carroccio
BACKGROUND: Open surgical repair remains the "gold standard" treatment for chronic type B aortic dissection (cTBD) with aneurysm. Thoracic endovascular aortic repair (TEVAR) has gained popularity in recent years for the treatment of thoracic aortic diseases, including cTBD. We assessed the effectiveness of TEVAR in the treatment of cTBD using the Vascular Quality Initiative (VQI) database. METHODS: The VQI registry identified 4713 patients treated with TEVAR from July 2010 to November 2015, including 125 repairs for cTBD...
November 17, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29157110/risk-factors-and-clinical-outcomes-of-delirium-in-osteoporotic-hip-fractures
#12
Joon Yub Kim, Jeong Hyun Yoo, Eugene Kim, Ki Bum Kwon, Byeong-Ryong Han, Yongun Cho, Jai Hyung Park
PURPOSE: This study is performed to identify risk factors for delirium in osteoporotic hip fractures and to evaluate the hospitalization cost and clinical outcomes of delirium in osteoporotic hip. METHODS: A total of 221 patients with osteoporotic hip fractures were assessed for eligibility between 2010 and 2014. Among them, 37 patients with delirium were allocated into the delirium group (group D) and 37 patients without delirium were allocated into the non-delirium group (group ND) by matching demographic factors...
September 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/29156839/the-benefit-of-immunonutrition-in-patients-undergoing-hepatectomy-a-systematic-review-and-meta-analysis
#13
Chengshuo Zhang, Baomin Chen, Ao Jiao, Feng Li, Bowen Wang, Ning Sun, Jialin Zhang
Perioperative immunonutrition in liver resection remains doubtful. A systematic review and meta-analysis was conducted to compare postoperative outcomes between patients undergoing hepatectomy who received perioperative immunonutrition and those who did not.A PubMed, Embase, Cochrane Central Register of Controlled Trials, and Web of Knowledge database search was performed to retrieve all of the randomized controlled trials (RCTs) evaluating the value of perioperative immunonutrition in patients undergoing hepatectomy until the end of September 2016...
October 17, 2017: Oncotarget
https://www.readbyqxmd.com/read/29156482/-how-to-reduce-the-rate-of-postoperative-complications-in-frail-patients
#14
Rudolf Mörgeli, Tobias Wollersheim, Claudia Spies, Felix Balzer, Susanne Koch, Sascha Treskatsch
Frail patients are more prone to develop complications during and after surgery. As the syndrome becomes more common, recognition and special management of frail patients in the perioperative setting is becoming crucial to improve short- and long-term outcomes. Based on current literature and guidelines, we present a compilation of strategies that could be employed to reduce postoperative complication rates in frail patients. Due to their impaired response to stressors, potential perioperative hazards to frail patients are identified and discussed...
November 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29156481/-why-and-how-should-i-assess-frailty-a-guide-for-the-preoperative-anesthesia-clinic
#15
Oliver Birkelbach, Rudolf Mörgeli, Felix Balzer, Maria Olbert, Sascha Treskatsch, Rainer Kiefmann, Ursula Müller-Werdan, Anett Reisshauer, Christine Schwedtke, Bruno Neuner, Claudia Spies
Introduction: Frailty is a condition of decreased physiological reserves seen in approx. one third of elderly anesthesiological patients, and affecting many aspects of treatment as well as outcome. Although there are over 60 measurement instruments, frailty assessment is still poorly implemented. Understanding why and how to assess frailty is key to its implementation in preoperative anesthesia clinics. Method: After presenting the impact of perioperative frailty and the benefits of an early diagnosis on health related quality of life, we present an overview of the most important tools that can be used in the preoperative frailty assessment...
November 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29156184/bariatric-surgery-for-obesity
#16
REVIEW
Carel W le Roux, Helen M Heneghan
In this review, the authors discuss the indications for and the published outcomes of commonly performed bariatric procedures, including weight loss, perioperative morbidity and mortality, late complications, as well as the impact of bariatric surgery on comorbidities, cardiovascular risk, and mortality. They also briefly discuss the mechanisms by which bariatric/metabolic surgery causes such significant weight loss and health gain.
January 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29156053/propensity-matched-analysis-of-outcomes-after-mitral-valve-surgery-between-trainees-and-consultants-institutional-report
#17
Vito D Bruno, Pierpaolo Chivasso, Amna Hayat, Roberto Marsico, Umberto Benedetto, Massimo Caputo, Raimondo Ascione, Gianni D Angelini, Franco Ciulli, Hunaid A Vohra
OBJECTIVES: We aimed to determine whether early outcomes and long-term survival after mitral valve surgery performed by trainee residents are equivalent in terms of safety and efficacy when compared with consultant surgeons. METHODS: Between January 2000 and December 2015, a total of 1742 patients who underwent mitral valve surgery were identified. Of these, 1622 operations were performed by consultants (Group I) and 120 operations were performed by trainees (Group II)...
November 16, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29155935/early-and-late-outcomes-of-open-repair-for-dissecting-aneurysms-of-the-descending-or-thoraco-abdominal-aorta
#18
Atsushi Omura, Kenji Minatoya, Jiro Matsuo, Yosuke Inoue, Yoshimasa Seike, Kyokun Uehara, Hiroaki Sasaki, Hitoshi Matsuda, Junjiro Kobayashi
OBJECTIVES: Although open repair is the standard surgical option for dissecting descending thoracic aneurysms (DTAs) and thoraco-abdominal aorta aneurysms (TAAAs), it remains a significant challenge with considerable perioperative morbidity and mortality. We retrospectively analysed early and late outcomes of open repair for these aortic aneurysms. METHODS: Early and late outcomes were investigated for 223 consecutive patients who underwent open repair for dissecting DTA or TAAA between January 2003 and December 2014 (mean age 55 ± 16 years)...
October 9, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29155341/outpatient-elective-posterior-lumbar-fusions-appear-to-be-safely-considered-for-appropriately-selected-patients
#19
Patawut Bovonratwet, Taylor D Ottesen, Raj J Gala, Daniel R Rubio, Nathaniel T Ondeck, Ryan P McLynn, Jonathan N Grauer
BACKGROUND CONTEXT: There has been growing interest in performing posterior lumbar fusions (PLFs) in the outpatient setting to optimize patient satisfaction and reduce cost. Although still done in only a small percentage of cases, this has been more possible due to advances in surgical techniques and anesthesia. However, data on the perioperative course of outpatient compared to inpatient PLF in a large sample size is scarce. PURPOSE: To compare perioperative complications between outpatient and inpatient PLF in the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database...
November 16, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29155340/ambulatory-anterior-cervical-discectomy-and-fusion-is-associated-with-a-higher-risk-of-revision-surgery-and-perioperative-complications-an-analysis-of-a-large-nationwide-database
#20
Armin Arshi, Christopher Wang, Howard Y Park, Gideon W Blumstein, Zorica Buser, Jeffrey C Wang, Arya N Shamie, Don Y Park
BACKGROUND CONTEXT: With the changing landscape of healthcare, outpatient spine surgery is being more commonly performed to reduce cost and improve efficiency. Anterior cervical discectomy and fusion (ACDF) is one of the most common spine surgeries performed and demand is expected to increase with an aging population. PURPOSE: To determine the nationwide trends and relative complication rates associated with outpatient ACDF. STUDY DESIGN/SETTING: Large-scale retrospective case control study PATIENT SAMPLE: Humana-insured patients who underwent 1-2 level ACDF as either outpatients or inpatients from 2011-2016 OUTCOME MEASURES: Incidence and adjusted odds ratio (OR) of postoperative medical and surgical complications within one year of the index surgery METHODS: A retrospective review was performed of the PearlDiver® Humana insurance records database to identify patients undergoing 1-2 level ACDF (CPT-22551 AND ICD-9-816...
November 16, 2017: Spine Journal: Official Journal of the North American Spine Society
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