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https://www.readbyqxmd.com/read/28544520/safety-and-perioperative-adverse-events-in-pediatric-endoscopic-sinus-surgery-an-acs-nsqip-p-analysis
#1
Christopher R Roxbury, Lilun Li, Daniel Rhee, Kris R Jatana, Rahul K Shah, Emily F Boss
INTRODUCTION: This study describes safety outcomes of pediatric endoscopic sinus surgery (ESS) to identify risk factors for 30-day postoperative adverse events using the National Surgical Quality Improvement Program-Pediatric (NSQIP-P) database. METHODS: We performed a retrospective cohort study involving patients in the 2012-2015 NSQIP-P database who underwent ESS. Predictors included demographics, comorbidities and surgical acuity. Outcomes included 30-day complications, reoperations, and readmissions...
May 23, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28544490/evaluation-of-outcomes-of-suction-drainage-in-patients-with-haemophilic-arthropathy-undergoing-total-knee-arthroplasty
#2
S M J Mortazavi, M A Firoozabadi, A Najafi, P Mansouri
INTRODUCTION: Closed suction drainage has been extensively applied for orthopaedic procedures for the sake of avoiding fluid collections around the wound at the operated limb. AIM: We believed that without application of suction drainage after total knee arthroplasty (TKA), the risk of infection and haematoma formation will not increase while the need for blood transfusion because of decreased blood loss will be lesser. METHODS: In a prospective randomized clinical trial from April 2010 to April 2014, 176 patients with haemophilia who underwent TKA were included...
May 24, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28544292/perioperative-adverse-events-in-patients-on-continued-anticoagulation-undergoing-photoselective-vaporisation-of-the-prostate-with-the-180-w-greenlight-lithium-triborate-laser
#3
Georgia L Knapp, Venu Chalasani, Henry H Woo
OBJECTIVES: To compare perioperative factors and adverse events (AEs) in men undergoing photoselective vaporisation of the prostate (PVP) with or without continued anticoagulation therapy. PATIENTS AND METHODS: Retrospective review of a PVP database of men treated with the 180-W lithium triborate (LBO) laser from 2010 to 2016. Of 373 men, 59 underwent PVP with continued anticoagulant therapy, which was defined as treatment with heparin, warfarin, clopidogrel, dipyridamol or new oral anticoagulant drugs...
May 2017: BJU International
https://www.readbyqxmd.com/read/28542848/change-of-transfusion-and-treatment-paradigm-in-major-trauma-patients
#4
P Stein, A Kaserer, K Sprengel, G A Wanner, B Seifert, O M Theusinger, D R Spahn
Trauma promotes trauma-induced coagulopathy, which requires urgent treatment with fixed-ratio transfusions of red blood cells, fresh frozen plasma and platelet concentrates, or goal-directed administration of coagulation factors based on viscoelastic testing. This retrospective observational study compared two time periods before (2005-2007) and after (2012-2014) the implementation of changes in trauma management protocols which included: use of goal-directed coagulation management; admission of patients to designated trauma centres; whole-body computed tomography scanning on admission; damage control surgery; permissive hypotension; restrictive fluid resuscitation; and administration of tranexamic acid...
May 23, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28542107/efficacy-and-safety-of-topical-use-of-tranexamic-acid-in-reducing-blood-loss-during-primary-lumbar-spinal-surgery-a-retrospective-case-control-study
#5
Zhinan Ren, Shugang Li, Lin Sheng, Qianyu Zhuang, Zheng Li, Derong Xu, Xin Chen, Pengxiang Jiang, Xiao Zhang
STUDY DESIGN: A retrospective case-control study. OBJECTIVE: To compare postoperative blood loss, amount of allogeneic blood transfusion, removal time of drainage tube, length of hospital stay, and complications associated with tranexamic acid. SUMMARY OF BACKGROUND DATA: Spinal fusion surgery can be associated with significant blood loss. To the best of our knowledge, very few published studies exist reporting the effect of topical use of tranexamic acid (tTXA) on decreasing the blood loss in patients undergoing posterior lumbar spinal fusions...
May 25, 2017: Spine
https://www.readbyqxmd.com/read/28541862/nonoperative-management-of-the-damaged-spleen-a-community-surgeon-looks-back
#6
Mark L Walker
Blunt spleen injury is usually managed nonoperatively. An 8-year retrospective analysis by one community surgeon was done to provide an overview of the role of CT, angiography, and transfusion in the management algorithm. A total of 2750 patients were screened and 125 patients were identified with spleen injury. Of these 125 patients, 72 were managed without surgery. These were young (mean age 32 ± 16 years) patients with mean Injury Severity Score of 16 ± 8. Angiography was used in 14 patients. These patients received more blood (5 ± 6 vs 2 ± units of packed red blood cells) than their nonangiogram counterparts...
May 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28541859/emergency-cholecystectomy-for-patients-on-antiplatelet-therapy
#7
Keiichi Akahoshi, Takanori Ochiai, Ayumi Takaoka, Takuya Kitamura, Daisuke Ban, Atsushi Kudo, Shinji Tanaka, Minoru Tanabe
The use of antiplatelet therapy (APT) and/or anticoagulant therapy (ACT) continues to increase due to the aging population. Because the management of patients with acute cholecystitis receiving APT/ACT is still unclear, surgeons are sometimes faced with the difficult decision to delay surgery. We aimed to analyze characteristics and surgical risks of patients who underwent emergency cholecystectomy for acute cholecystitis without discontinuing APT. We conducted a retrospective review of 113 patients between 2006 and 2014...
May 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28540777/acute-kidney-injury-in-ovarian-cancer-patients-undergoing-cytoreductive-surgery-and-hyperthermic-intra-peritoneal-chemotherapy
#8
Eliza I-Lin Sin, Claramae Shulyn Chia, Grace Hwei Ching Tan, Khee Chee Soo, Melissa Ching-Ching Teo
BACKGROUND: Cytoreductive surgery and hyperthermic intra-peritoneal chemotherapy (CRS-HIPEC) prolongs survival in patients with metastatic peritoneal disease. We look at the incidence of acute kidney injury (AKI) in patients who have received cisplatin during CRS-HIPEC in the treatment of peritoneal carcinomatosis from an ovarian primary, and identify possible peri-operative risk factors. METHODS: Between 2005 and 2013, we performed CRS-HIPEC on 47 patients with ovarian primaries and peritoneal metastasis...
March 5, 2017: International Journal of Hyperthermia
https://www.readbyqxmd.com/read/28540398/transcatheter-retrieval-of-cardiovascular-foreign-bodies-in-children-a-15-year-single-centre-experience
#9
Vikram Kudumula, Oliver Stumper, Patrick Noonan, Chetan Mehta, Joseph De Giovanni, John Stickley, Rami Dhillon, Vinay Bhole
There has been a rapid increase in the practice of interventional catheter treatment of congenital heart disease. Catheter retrieval of embolized cardiac devices and other foreign bodies is essential, yet no large studies have been reported in the paediatric population. Retrospective 15-year review of all children who underwent transcatheter foreign body retrieval in a tertiary cardiac centre from January 1997 to September 2012. Transcatheter retrieval of foreign bodies from the cardiovascular system was attempted in 78 patients [median age 4 (0...
May 24, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28540112/comparison-of-postoperative-outcomes-in-elderly-patients-with-a-do-not-resuscitate-order-undergoing-elective-and-nonelective-hip-surgery
#10
Anair Beverly, Ethan Y Brovman, Richard D Urman
PURPOSE: Emergency hip surgery generally has worse outcomes than elective hip surgery, even when adjusted for patient and surgical factors. Do-not-resuscitate (DNR) status patients are typically at higher perioperative risk and undergo a narrow range of surgical procedures. We aimed to compare the outcomes after hip surgery of differing degrees of urgency in this cohort. MATERIALS AND METHODS: Using National Surgical Quality Improvement Program (NSQIP) data, we conducted univariate and multivariate analyses comparing outcomes of DNR status patients after emergency and nonemergency hip surgery (2007-2013)...
June 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28540073/viscoelastic-testing-inside-and-beyond-the-operating-room
#11
REVIEW
Liang Shen, Sheida Tabaie, Natalia Ivascu
Hemorrhage is a major contributor to morbidity and mortality during the perioperative period. Current methods of diagnosing coagulopathy have various limitations including long laboratory runtimes, lack of information on specific abnormalities of the coagulation cascade, lack of in vivo applicability, and lack of ability to guide the transfusion of blood products. Viscoelastic testing offers a promising solution to many of these problems. The two most-studied systems, thromboelastography (TEG) and rotational thromboelastometry (ROTEM), offer similar graphical and numerical representations of the initiation, formation, and lysis of clot...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28538384/efficacy-and-safety-of-intravenous-tranexamic-acid-administration-in-patients-undergoing-hip-fracture-surgery-for-hemostasis-a-meta-analysis
#12
Pei Zhang, Jinshan He, Yongchao Fang, Pengtao Chen, Yuan Liang, Jingcheng Wang
BACKGROUND: Patients undergoing hip fracture surgery frequently require blood transfusion. Tranexamic acid (TXA) has been widely used to decrease blood loss and transfusion rates in joint replacement surgery. Therefore, we conducted a meta-analysis to evaluate efficacy and safety of intravenous TXA administration in patients suffering from hip fractures. METHODS: Electronic databases were searched before December 2016 by 2 independent reviewers, including Cochrane Library, EMBASE, PubMed, Web of Science, the Chinese Biomedical Literature database, and the China National Knowledge Infrastructure databases...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28537970/neuraxial-and-combined-neuraxial-general-anesthesia-compared-to-general-anesthesia-for-major-truncal-and-lower-limb-surgery-a-systematic-review-and-meta-analysis
#13
Lauren M Smith, Crispiana Cozowicz, Yoshiaki Uda, Stavros G Memtsoudis, Michael J Barrington
Neuraxial anesthesia may improve perioperative outcomes when compared to general anesthesia; however, this is controversial. We performed a systematic review and meta-analysis using randomized controlled trials and population-based observational studies identified in MEDLINE, PubMed, and EMBASE from 2010 to May 31, 2016. Studies were included for adult patients undergoing major surgery of the trunk and lower extremity that reported: 30-day mortality (primary outcome), cardiopulmonary morbidity, surgical site infection, thromboembolic events, blood transfusion, and resource use...
May 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28537938/should-all-massively-transfused-patients-be-treated-equally-an-analysis-of-massive-transfusion-ratios-in-the-nontrauma-setting
#14
Eric W Etchill, Sara P Myers, Lauren M McDaniel, Matthew R Rosengart, Jay S Raval, Darrell J Triulzi, Andrew B Peitzman, Jason L Sperry, Matthew D Neal
OBJECTIVES: Although balanced resuscitation has become integrated into massive transfusion practice, there is a paucity of evidence supporting the delivery of high ratios of plasma and platelet to RBCs in the nontrauma setting. This study investigated the administration of blood component ratios in the massively transfused nontrauma demographic. DESIGN: Retrospective analysis of a prospective, observational cohort of massively bleeding patients. SETTING: Surgical and critically ill patients at a tertiary medical center between 2011 and 2015...
May 23, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28537454/transfusion-requirements-in-elective-cardiopulmonary-bypass-surgery-patients-predictive-value-of-multiplate-and-thromboelastography-teg-platelet-mapping-assay
#15
Praleene Sivapalan, Anne Caroline Bäck, Sisse Rye Ostrowski, Hanne Berg Ravn, Pär Ingemar Johansson
Managing haemostasis in patients undergoing cardiopulmonary bypass (CPB) surgery remains a challenge. There is no established laboratory test to predict transfusion requirements in cardiac surgery. We investigated whether preoperative Thromboelastography (TEG) with Platelet Mapping Assay (PMA) or Multiple Electrode Aggrometry (MEA) could predict transfusion requirements in patients undergoing elective coronary artery bypass grafting (CABG) or combined CABG with aortic or mitral valve replacement. We prospectively investigated 199 patients undergoing elective CABG or combined procedures...
May 24, 2017: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/28537438/comparison-of-surgical-outcomes-between-resection-and-enucleation-in-robot-assisted-laparoscopic-partial-nephrectomy-for-renal-tumors-according-to-the-surface-intermediate-base-margin-score-a-propensity-score-matched-study
#16
Toshio Takagi, Tsunenori Kondo, Hidekazu Tachibana, Junpei Iizuka, Kenji Omae, Kazuhiko Yoshida, Hirohito Kobayashi, Masayoshi Okumi, Hideki Ishida, Kazunari Tanabe
Objective To compare the surgical outcomes between resection and enucleation in robot-assisted laparoscopic partial nephrectomy (RAPN) based on the Surface-Intermediate-Base margin score (SIB score). Patients and Methods This study included 282 patients who underwent RAPN between 2014 and 2016. SIB score was macroscopically evaluated immediately after the surgery. We divided the patients into the following two groups: enucleation (SIB score, 1-2) and resection (SIB score, 3-5). To minimize selection bias between the two surgical methods, patient variables were adjusted by 1:1 propensity score matching...
May 24, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28535237/effect-of-intravenous-ferric-carboxymaltose-on-hemoglobin-response-among-patients-with-acute-isovolemic-anemia-following-gastrectomy-the-fairy-randomized-clinical-trial
#17
Young-Woo Kim, Jae-Moon Bae, Young-Kyu Park, Han-Kwang Yang, Wansik Yu, Jeong Hwan Yook, Sung Hoon Noh, Mira Han, Keun Won Ryu, Tae Sung Sohn, Hyuk-Joon Lee, Oh Kyoung Kwon, Seung Yeob Ryu, Jun-Ho Lee, Sung Kim, Hong Man Yoon, Bang Wool Eom, Min-Gew Choi, Beom Su Kim, Oh Jeong, Yun-Suhk Suh, Moon-Won Yoo, In Seob Lee, Mi Ran Jung, Ji Yeong An, Hyoung-Il Kim, Youngsook Kim, Hannah Yang, Byung-Ho Nam
Importance: Acute isovolemic anemia occurs when blood loss is replaced with fluid. It is often observed after surgery and negatively influences short-term and long-term outcomes. Objective: To evaluate the efficacy and safety of ferric carboxymaltose to treat acute isovolemic anemia following gastrectomy. Design, Setting, and Participants: The FAIRY trial was a patient-blinded, randomized, phase 3, placebo-controlled, 12-week study conducted between February 4, 2013, and December 15, 2015, in 7 centers across the Republic of Korea...
May 23, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28535202/clinical-implications-of-hypothermic-ventricular-fibrillation-versus-beating-heart-technique-during-cardiopulmonary-bypass-for-pulmonary-valve-replacement-in-patients-with-repaired-tetralogy-of-fallot
#18
Ji-Hyun Lee, Ji-Eun Lee, Jungho Shin, In-Kyung Song, Hee-Soo Kim, Chong-Sung Kim, Woong-Han Kim, Jin-Tae Kim
OBJECTIVES: This study aimed to compare the effects of hypothermic ventricular fibrillation and beating-heart techniques during cardiopulmonary bypass (CPB) on postoperative outcomes after simple pulmonary valve replacement in patients with repaired tetralogy of Fallot (TOF). METHODS: We retrospectively reviewed the data of 47 patients with repaired tetralogy of Fallot at a single institution, who received pulmonary valve replacement under the ventricular fibrillation or beating-heart technique without cardioplegic cardiac arrest during CPB between January 2005 and April 2015...
May 23, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28533072/relationship-between-transfusion-of-blood-products-and-the-incidence-of-thrombotic-complications-in-neonates-and-infants-undergoing-cardiac-surgery
#19
David Faraoni, Sirisha Emani, Erin Halpin, Rachel Bernier, Sitaram Emani, James A DiNardo, Juan C Ibla
OBJECTIVES: The authors hypothesized that transfusion of blood products in neonates and infants undergoing high-risk cardiac surgery in the absence of intraoperative coagulation monitoring increases the risk of thrombotic complications. DESIGN: Prospective observational study. SETTING: Neonates and infants undergoing cardiac surgery at a tertiary pediatric center. PARTICIPANTS: Neonates weighing >2.5 kg and infants ≤12 months of age undergoing elective cardiac surgery with cardiopulmonary bypass were included in this prospective observational study...
April 27, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28530629/-laparoendoscopic-single-site-less-ureteral-reimplantation
#20
Pedro M Cabrera Castillo, Felipe Cáceres Jiménez
OBJECTIVE: To present in detail our surgical technique and to show our initial experience with ureteral reimplantation using the transumbilical LESS approach to treat patients with ureteral stenosis secondary to various diseases and surgical complications. METHODS: We performed 7 ureteral reimplantations from February 2012, using the multichannel Richard- Wolf (KeyPort) platform placed transumbilical by a small 2-2,5 cm transversal incision. We always use a 3.5 mm minilaparoscopy accessory trocar in the right iliac fossa, that is crucial to perform the laparoscopic suturing safely for the patient and in an optimal time...
May 2017: Archivos Españoles de Urología
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