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indications of transfusion in surgery

M J Young, M Elmussareh, T Morrison, J R Wilson
Introduction Transurethral resection of the prostate (TURP) is considered the gold standard surgical treatment for lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia. The number of TURPs performed has declined significantly over the last three decades owing to pharmaceutical therapy. TURP data from a single institution for the years 1990, 2000 and 2010 were compared to assess the difference in performance. Methods A retrospective analysis was undertaken of all patients who underwent TURP between January and December 2010...
March 15, 2018: Annals of the Royal College of Surgeons of England
Zachary A Hamilton, Robert G Uzzo, Alessandro Larcher, Brian R Lane, Benjamin Ristau, Umberto Capitanio, Stephen Ryan, Sumi Dey, Andres Correa, Madhumitha Reddy, James A Proudfoot, Ryan Nasseri, Kendrick Yim, Sabrina Noyes, Ahmet Bindayi, Francesco Montorsi, Ithaar H Derweesh
BACKGROUND: We compared renal functional outcomes of robotic (RPN) and open partial nephrectomy (OPN) in patients with chronic kidney disease (CKD), a definite indication for nephron-sparing surgery. METHODS: A multicenter retrospective analysis of OPN and RPN in patients with baseline ≥ CKD Stage III [estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 ] was performed. Primary outcome was change in eGFR (ΔeGFR, mL/min/1.73 m2 ) between preoperative and last follow-up with respect to RENAL nephrometry score group [simple (4-6), intermediate (7-9), complex (10-12)]...
March 12, 2018: World Journal of Urology
José Ramón Ausó-Pérez, Gloria María Rodríguez-Blanes
BACKGROUND: Synovial proliferation is a rather frequent intraoperative finding during the surgery of a total knee replacement. The aim of this study is to asses whether the standard procedure of a synovectomy results in changes in blood loss and in the need for transfusion in the immediate postoperative time after the total knee replacement. METHODS: A prospective cohort study was performed with 120 patients undergoing total knee replacement (60 with synovectomy and 60 without it)...
March 9, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Adina Kleinerüschkamp, Patrick Meybohm, Niels Straub, Kai Zacharowski, Suma Choorapoikayil
BACKGROUND: Patient blood management (PBM) is a multidisciplinary concept focused on the management of anaemia, minimisation of iatrogenic blood loss and rational use of allogeneic blood products. The aims of this study were: (i) to analyse post-operative outcome in patients with liberal vs restrictive exposure to allogeneic blood products and (ii) to evaluate the cost-effectiveness of PBM in patients undergoing surgery. MATERIALS AND METHODS: A systematic literature review and meta-analysis were performed to compare post-operative complications in predominantly non-transfused patients (restrictive transfusion group) and patients who received one to three units of red blood cells (liberal transfusion group)...
February 16, 2018: Blood Transfusion, Trasfusione del Sangue
Hiroyuki Kanao, Yoichi Aoki, Tsuyoshi Hisa, Nobuhiro Takeshima
OBJECTIVE: Patients in whom laterally recurrent cervical carcinoma develops in the previously irradiated pelvis are usually abandoned because the resectability rate is low, and the 5-year survival rate is close to zero when complete margin-negative resection is not achieved [1]. Höckel described laterally extended endopelvic resection (LEER) as an approach in which the line of resection extends to the pelvic sidewall [2]. Complete margin-negative resection (R0 resection) was achieved in all 100 patients who underwent LEER for laterally recurrent cervical carcinoma, and 5-year survival was very good at 62%...
March 3, 2018: Gynecologic Oncology
Alka Anilkumar, D M Vasudevan, Mahesh Kappanayil, K R Sundaram, R Krishna Kumar, Sheela Nampoothiri
BACKGROUND AND OBJECTIVES: The 22q11 deletion syndrome is associated with a wide spectrum of phenotypic features, hence clinical diagnosis is difficult. Individuals with this syndrome are found to have a risk of developing transfusion associated graft-versus-host reaction, if they are given nonirradiated blood. Our aim was to elucidate whether chromosome 22q11 deletion in children with syndromic conotruncal heart defects is associated with platelet abnormality. MATERIALS AND METHODS: The genetic analysis was performed by standard cytogenetic and Fluorescence in situ hybridization technique...
March 5, 2018: Congenital Heart Disease
Dorota Radkowiak, Anna Zychowicz, Anna Lasek, Michał Wysocki, Piotr Major, Michał Pędziwiatr, Piotr Budzyński, Jan Kulawik, Andrzej Budzyński
BACKGROUND: Laparoscopic splenectomy (LS) has become the gold standard in elective spleen surgery. Although it is considered relatively safe, treatment results vary depending on a hospital's profile and the experience of the surgeon and center. We would like to present experience of a high-volume referral center with minimally invasive operations of the spleen. MATERIAL AND METHODS: The retrospective cohort study included consecutive patients undergoing laparoscopic splenectomy in tertiary referral surgical center in 1998-2017...
February 23, 2018: International Journal of Surgery
Martin W W Janssen, Johannes Linxweiler, Ines Philipps, Zentia Bütow, Stefan Siemer, Michael Stöckle, Carsten-Henning Ohlmann
BACKGROUND: Kidney autotransplantation (KAT) is the ultimate approach for nephron-sparing surgery. It is a rarely used method in renal tumor surgery today as minimal invasive and open techniques for nephron-sparing surgery improve constantly. In this publication, the complication rate and the long-term functional and oncological outcome at a single center are analyzed. METHODS: A prospectively constructed database of patients with renal tumors who underwent renal surgery was retrospectively analyzed to identify patients with KAT and describe surgical and oncological outcomes and to obtain long-term follow-up...
February 20, 2018: World Journal of Surgical Oncology
Edwin R Faulconer, Bernardino C Branco, Melissa N Loja, Kevin Grayson, James Sampson, Timothy C Fabian, John B Holcomb, Thomas Scalea, David Skarupa, Kenji Inaba, Nathaniel Poulin, Todd E Rasmussen, Joseph J Dubose
BACKGROUND: Vascular trauma data have been submitted to the American Association for the Surgery of Trauma PROspective Observational Vascular Injury Trial (PROOVIT) database since 2013. We present data to describe current use of endovascular surgery in vascular trauma. METHODS: Registry data from March 2013 to December 2016 were reviewed. All trauma patients who had an injury to a named artery, except the forearm and lower leg, were included. Arteries were grouped into anatomic regions and by compressible and noncompressible region for analysis...
March 2018: Journal of Trauma and Acute Care Surgery
Sedat Oner, Ahsen Karagozlu Akgul, Murat Demirbas, Efe Onen, Murat Aydos, Abdullah Erdogan
INTRODUCTION: Upper pole access in percutaneous nephrolithotomy (PCNL) provides a straight tract to the ureter, resulting in easier placement of a guidewire to the ureter, good exposure of the pelvis, calices, and upper ureter, and comfortable manipulations. However, despite these benefits, upper pole access is usually avoided because of the risk of chest complications in both pediatric and adult patients. OBJECTIVE: We aimed to evaluate the safety and morbidity of single upper pole access in pediatric patients undergoing PCNL...
February 2, 2018: Journal of Pediatric Urology
Paula Ferrada, Rachael A Callcut, David J Skarupa, Therese M Duane, Alberto Garcia, Kenji Inaba, Desmond Khor, Vincent Anto, Jason Sperry, David Turay, Rachel M Nygaard, Martin A Schreiber, Toby Enniss, Michelle McNutt, Herb Phelan, Kira Smith, Forrest O Moore, Irene Tabas, Joseph Dubose
Background: The traditional sequence of trauma care: Airway, Breathing, Circulation (ABC) has been practiced for many years. It became the standard of care despite the lack of scientific evidence. We hypothesized that patients in hypovolemic shock would have comparable outcomes with initiation of bleeding treatment (transfusion) prior to intubation (CAB), compared to those patients treated with the traditional ABC sequence. Methods: This study was sponsored by the American Association for the Surgery of Trauma multicenter trials committee...
2018: World Journal of Emergency Surgery: WJES
George Tolis, Philip J Spencer, Jordan P Bloom, Serguei Melnitchouk, David A D'Alessandro, Mauricio A Villavicencio, Thoralf M Sundt
OBJECTIVE: Teaching the next generation operative cardiac surgery while maintaining the highest level of patient care is an ever-increasing challenge given the growing proportion of patients with multiple comorbidities, the loss of more straightforward cases to percutaneous interventions, and the pressure of public reporting. No study to date has compared the outcomes of similar cases performed entirely ("skin-to-skin") by the resident with those performed entirely by the staff to confirm the safety of this practice...
February 10, 2018: Journal of Thoracic and Cardiovascular Surgery
Amudan J Srinivasan, Kyle Kausch, Collin Inglut, Alan Gray, Matthew Landrigan, Jessica L Poisson, Jacob N Schroder, Ian J Welsby
OBJECTIVE: Erythrocyte storage induces a non-physiological increase in hemoglobin-oxygen affinity (quantified by low p50, the oxygen tension at 50% hemoglobin saturation), which can be restored through biochemical rejuvenation. The objective was to mathematically model the impact of transfusing up to three standard allogeneic units or rejuvenated units on oxygen delivery (DO 2 ) and oxygen consumption (VO 2 ). METHODS: Oxygen dissociation curves were generated from AS-1 RBC leukoreduced units (n = 7) before and after rejuvenation following manufacturer's instructions...
February 9, 2018: Seminars in Thoracic and Cardiovascular Surgery
A Royo-Aznar, D Moro-Valdezate, J Martín-Arévalo, V Pla-Martí, S García-Botello, E Espín-Basany, A Espí-Macías
AIM: Hartmann's procedure (HP) is common. However restoration of intestinal continuity is not so frequent. The aim of this study was to determine predictive factors which might influence outcomes following reversal of Hartmann's procedure. METHOD: All consecutive patients that underwent elective and emergency HP in a single institution between January 1999 and December 2014 were included. Data concerning patient, disease and treatment features were collected. Univariate and multivariate binary logistic regression model were used to determine prognostic factors...
February 11, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Slavenka Straus, Ilirijana Haxhibeqiri-Karabdic, Sanja Granov Grabovica, Nermir Granov
Background: Postoperative bleeding in patients who underwent elective coronary artery bypass surgery (CABG) may increase due to preoperative anticoagulant therapy indicative of their disease - acute coronary syndrome or implanted coronary artery stent. Increased bleeding in many cases requires the use of blood and blood derivatives, and sometimes even reoperation. Their use poses the risk of complications, may extend the hospitalization. Methods: Our observation retrospective study included 131 patients, 41 treated with aspirin and 90 treated with aspirin and clopidogrel...
February 2018: Medical Archives
Candice M Baldeo, Candido E Rivera, Han W Tun, Prakash Vishnu
von Willebrand disease (VWD) is a common bleeding disorder caused by defective or low levels of von Willebrand factor (VWF). Although most cases of VWD are caused by genetic mutations, some are acquired due to various disease states. In managing VWD, the aim is to normalize plasma levels of both VWF and factor VIII (FVIII), as this aids in hemostasis. Desmopressin usually corrects VWF level in type 1 VWD by inducing the release of endogenous VWF. In cases where desmopressin is ineffective or cannot be used, transfusion of virally inactivated, plasma-derived VWF/FVIII concentrate or infusion of recombinant VWF (Vonvendi) is indicated...
2018: Journal of Blood Medicine
Jianxi Zhu, Yong Zhu, Pengfei Lei, Min Zeng, Weiping Su, Yihe Hu
BACKGROUND: Hip osteoarthritis is one of the most prevalent musculoskeletal degenerative diseases in elderly. Total hip arthroplasty (THA) is the most effective surgical treatment for end stage hip osteoarthritis. Tranexamic acid (TA) is a potent drug to reduce surgical blood loss in surgery, therefore, as a potential drug for application in THA. OBJECTIVES: To identify the combined efficacy of TA administration in THA. A meta-analysis including 25 randomized controlled trials was conducted for generating synthesized effects...
December 2017: Medicine (Baltimore)
Gildardo Cortés-Julián, Luis C Valencia, Silviano Ríos-Pascual, Marco A de la Rosa-Abarroa, Enrique Guzmán-de Alba
Background Infectious lung cavities are a common entity for the respiratory physician. Sometimes these lesions require surgical treatment, but surgery is challenging, and complications are common. Methods Patients with infectious lung cavities amenable to surgical treatment were included in a case-control study. The control group included patients with no complications. The cases group comprised patients with any of the following complications up to 90 days after surgery: death, persistence of hemoptysis, empyema, operative blood loss > 500 mL, vascular lesion requiring repair, massive transfusion (>5 units of packed red blood cells per 48 h) or reoperation for bleeding, postoperative mechanical ventilation, intensive care unit stay > 48 h, prolonged air leak, and persistent atelectasis...
January 1, 2018: Asian Cardiovascular & Thoracic Annals
Chao Jiang, Yan Zhao, Bin Feng, Jiliang Zhai, Yanyan Bian, Guixing Qiu, Xisheng Weng
To investigate the safety, cost-effectiveness, and clinical outcomes of simultaneous bilateral total knee arthroplasty (TKA) in hemophilic arthropathy (HA), the requirements for transfusions, complications, costs, hospital stays, Hospital for Special Surgery (HSS) knee scores, knee range of motion (ROM) and revision rates were compared between simultaneous bilateral and unilateral TKA in HA patients. A total of 36 patients and 54 knees were included. Compared to the unilateral group, the bilateral group did not require more transfusions (2...
January 25, 2018: Scientific Reports
Mariano Tamura Vieira Gomes, Andréa Maria Novaes Machado, Sérgio Podgaec, Gustavo Anderman Silva Barison
OBJECTIVE: This article presents the first series of robotic single-port hysterectomy cases performed at a hospital in Brazil. METHODS: From November 2014 to October 2016, 11 patients were indicated to undergo, and nine of them were submitted to single-port hysterectomy using da Vinci Single-Site® platform. However, in two patients, due to multiple previous abdominal surgeries, large uterine volume, and/or a uterus with no mobility, a pneumoperitoneum was performed with a Verres needle, and the pelvic cavity was assessed using a 5mm optics endoscope...
October 2017: Einstein
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