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Surgical patient safety

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https://www.readbyqxmd.com/read/29054773/microsurgical-vs-endovascular-treatments-for-blood-blister-aneurysms-of-the-internal-carotid-artery-a-retrospective-study-of-83-patients-in-a-single-center
#1
Yanming Ren, Lunxin Liu, Hong Sun, Yi Liu, Hao Li, Lu Ma, Chang-Wei Zhang, Xiao-Dong Xie, Min He, Chao You, Jin Li
BACKGROUND: Blood-blister aneurysms (BBAs) of the internal carotid artery (ICA) are challenging lesions with high morbidity and mortality. Currently, both surgical and endovascular approaches have been used to treat the BBAs; however, little is known about their safety and efficacy. OBJECTIVE: To review our experience with the treatment of BBAs and explore the optimal treatment strategy. METHODS: A total of 83 patients with BBAs were reviewed retrospectively...
October 17, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29054573/simulation-as-a-surgical-teaching-model
#2
José Luis Ruiz-Gómez, José Ignacio Martín-Parra, Mónica González-Noriega, Carlos Godofredo Redondo-Figuero, José Carlos Manuel-Palazuelos
Teaching of surgery has been affected by many factors over the last years, such as the reduction of working hours, the optimization of the use of the operating room or patient safety. Traditional teaching methodology fails to reduce the impact of these factors on surgeońs training. Simulation as a teaching model minimizes such impact, and is more effective than traditional teaching methods for integrating knowledge and clinical-surgical skills. Simulation complements clinical assistance with training, creating a safe learning environment where patient safety is not affected, and ethical or legal conflicts are avoided...
October 17, 2017: Cirugía Española
https://www.readbyqxmd.com/read/29054510/safety-and-efficiency-in-a-canadian-outpatient-gynaecological-surgical-centre
#3
Caroline E Lee, Annette Epp
OBJECTIVE: This study sought to describe safety and efficiency outcomes for patients undergoing procedures at the Women's Health Centre, an outpatient gynaecological surgical centre in Saskatoon, SK. METHODS: A retrospective chart review of surgical outpatient health records was conducted for the period of July 2014 to June 2015. Data were abstracted using a standardized data form for patient admissions during the study period. Primary outcomes of interest included procedure time, lead time (registration to discharge), complication rates, readmission rates, and reoperation rates...
October 17, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29053491/safety-and-feasibility-of-early-physical-therapy-for-patients-on-extracorporeal-membrane-oxygenator-university-of-maryland-medical-center-experience
#4
Chris L Wells, Jenny Forrester, Joshua Vogel, Raymond Rector, Ali Tabatabai, Daniel Herr
OBJECTIVES: To examine the feasibility and safety of mobilizing patients while on extracorporeal membranous oxygenation support. DESIGN: Retrospective cohort study. SETTING: Medical and Surgical ICUs in a large tertiary care hospital in the United States. PATIENTS: Adults supported on extracorporeal membranous oxygenation from January 2014 to December 2015. MEASUREMENTS AND MAIN RESULTS: We reviewed the medical records from physical therapy, perfusion, and intensivists to obtain the number and type of physical therapy interventions and discharge status; extracorporeal membranous oxygenation type and description of support, cannulation sites; and risk management details of adverse effects, if any...
October 19, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29053204/xen-45-collagen-implant-for-the-treatment-of-uveitic-glaucoma
#5
Chelvin Ca Sng, Jing Wang, Scott Hau, Hla Myint Htoon, Keith Barton
IMPORTANCE: The XEN-45 implant, a hydrophilic collagen implant which drains aqueous to the subconjunctival space, has not been investigated in the context of uveitic glaucoma. BACKGROUND: To determine the safety and efficacy of the XEN-45 collagen implant in eyes with uveitic glaucoma. DESIGN: Exploratory prospective case series PARTICIPANTS: Patients with medically uncontrolled uveitic glaucoma METHODS: Twenty four consecutive patients (mean age ± standard deviation [SD] = 45...
October 20, 2017: Clinical & Experimental Ophthalmology
https://www.readbyqxmd.com/read/29053073/chronic-subthreshold-cortical-stimulation-for-adult-drug-resistant-focal-epilepsy-safety-feasibility-and-technique
#6
Panagiotis Kerezoudis, Sanjeet S Grewal, Matthew Stead, Brian Nils Lundstrom, Jeffrey W Britton, Cheolsu Shin, Gregory D Cascino, Benjamin H Brinkmann, Gregory A Worrell, Jamie J Van Gompel
OBJECTIVE Epilepsy surgery is effective for lesional epilepsy, but it can be associated with significant morbidity when seizures originate from eloquent cortex that is resected. Here, the objective was to describe chronic subthreshold cortical stimulation and evaluate its early surgical safety profile in adult patients with epilepsy originating from seizure foci in cortex that is not amenable to resection. METHODS Adult patients with focal drug-resistant epilepsy underwent intracranial electroencephalography monitoring for evaluation of resection...
October 20, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29053070/relationship-between-patient-safety-indicator-events-and-comprehensive-stroke-center-volume-status-in-the-treatment-of-unruptured-cerebral-aneurysms
#7
Chad W Washington, L Ian Taylor, Robert J Dambrino, Paul R Clark, Gregory J Zipfel
OBJECTIVE The Agency of Healthcare Research and Quality (AHRQ) has defined Patient Safety Indicators (PSIs) for assessments in quality of inpatient care. The hypothesis of this study is that, in the treatment of unruptured cerebral aneurysms (UCAs), PSI events are less likely to occur in hospitals meeting the volume thresholds defined by The Joint Commission for Comprehensive Stroke Center (CSC) certification. METHODS Using the 2002-2011 National (Nationwide) Inpatient Sample, patients treated electively for a nonruptured cerebral aneurysm were selected...
October 20, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29052666/patients-perspectives-of-engagement-as-a-safety-strategy
#8
Chasity Burrows Walters, Elizabeth A Duthie
PURPOSE/OBJECTIVES: To describe patient engagement as a safety strategy from the perspective of hospitalized surgical patients with cancer.
. RESEARCH APPROACH: Qualitative, descriptive approach using grounded theory.
. SETTING: Memorial Sloan Kettering Cancer Center in New York, New York.
. PARTICIPANTS: 13 hospitalized surgical patients with cancer.
. METHODOLOGIC APPROACH: Grounded theory with maximum variation sampling...
November 1, 2017: Oncology Nursing Forum
https://www.readbyqxmd.com/read/29052567/interventional-bronchoscopic-therapy-in-adult-patients-with-tracheobronchial-mucoepidermoid-carcinoma
#9
Hui Chen, Jie Zhang, Xiao-Jian Qiu, Juan Wang, Ying-Hua Pei, Yu-Ling Wang
BACKGROUND: Tracheobronchial mucoepidermoid carcinoma (MEC) is a rare airway tumor in adults for which surgery is considered a first-line treatment. However, some patients already lost the best opportunity of a surgical intervention when diagnoses are confirmed, and surgery causes considerable trauma resulting in partial loss of pulmonary function. Moreover, the tumor is resistant to radiotherapy and chemotherapy. These factors make the treatment of tracheobronchial MEC challenging. This study aimed to evaluate the safety and efficacy of interventional bronchoscopic therapy in adult patients with tracheobronchial MEC...
October 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/29052338/laparoscopic-transabdominal-preperitoneal-repair-for-strangulated-inguinal-hernia
#10
Akihisa Matsuda, Masao Miyashita, Satoshi Matsumoto, Nobuyuki Sakurazawa, Youichi Kawano, Sho Kuriyama, Kumiko Sekiguchi, Fumihiko Ando, Takeshi Matsutani, Eiji Uchida
INTRODUCTION: Laparoscopic transabdominal preperitoneal repair (TAPP) is widely accepted in elective inguinal hernioplasty. However, given the scarcity of data, the feasibility and safety of TAPP in strangulated hernia cases have not yet been determined. METHODS: We retrospectively evaluated the data from a consecutive series of 33 patients who had undergone surgery for acute strangulated inguinal hernia associated with suspected visceral ischemic damage by either TAPP (TAPP group, n = 11) or conventional open hernioplasty via the anterior approach (anterior group, n = 22)...
October 19, 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/29052006/risk-factors-for-and-the-prevention-of-acute-kidney-injury-after-abdominal-surgery
#11
REVIEW
Yongbo An, Kai Shen, Yingjiang Ye
Postoperative acute kidney injury in patients undergoing abdominal surgery is not rare and often results in bad outcomes for patients. The incidence of postoperative acute kidney injury is hard to evaluate reliably due to its non-unified definitions in different studies. Risk factors for acute kidney injury specific to abdominal surgery include preoperative renal insufficiency, intraabdominal hypertension, blood transfusion, bowel preparation, perioperative dehydration, contrast agent and nephrotoxic drug use...
October 19, 2017: Surgery Today
https://www.readbyqxmd.com/read/29051968/impact-of-surgical-lighting-on-intraoperative-safety-in-low-resource-settings-a-cross-sectional-survey-of-surgical-providers
#12
Jared A Forrester, Nicholas J Boyd, J Edward F Fitzgerald, Iain H Wilson, Abebe Bekele, Thomas G Weiser
BACKGROUND: Safe surgery requires high-quality, reliable lighting of the surgical field. Little is reported on the quality or potential safety impact of surgical lighting in low-resource settings, where power failures are common and equipment and resources are limited. METHODS: Members of the Lifebox Foundation created a novel, non-mandatory, 18-item survey tool using an iterative process. This was distributed to surgical providers practicing in low-resource settings through surgical societies and mailing lists...
October 19, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29051399/the-impact-of-gallbladder-retrieval-from-an-epigastric-vs-umbilical-port-on-trocar-site-complications-a-prospective-randomized-study
#13
Cemal Kaya, Emre Bozkurt, Pinar Yazici
AIM: Port-site infection and hernias are among the most of the complications following laparoscopic cholecystectomy (LC). Although surgical technique of LC is described to obtain critical view of safety, there is still no consensus on ideal portsite for gallbladder retrieval. In this comparative study, we aimed to investigate the effects of gallbladder retrieval site on postoperative port site complications following LC. MATERIAL AND METHODS: In this prospective randomized study, 120 patients underwent LC for symptomatic gallbladder disease...
2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29050714/when-does-intraoperative-blood-loss-occur-during-pediatric-scoliosis-correction
#14
Sean Wahlquist, Montri Wongworawat, Scott Nelson
BACKGROUND: The purpose of our study was to assess the relationship between amount of blood loss and surgical stage in pediatric patients undergoing posterior spinal fusion for deformity correction to determine: (1) when the highest rate of blood loss occurred; (2) what percentage of total blood loss occurred during deformity correction and closure; and (3) how to predict remaining blood loss during a procedure. Blood loss following exposure and placement of the final pedicle screw is often underestimated, which may result in lack of sufficient blood product availability...
November 2017: Spine Deformity
https://www.readbyqxmd.com/read/29050088/-laryngeal-endoscopic-cricopharyngeal-myotomy-for-cricopharyngeal-achalasia-post-stroke
#15
J Wang, W Y Li, Y J Li, D H Yang, H Huo, X F Jin, Y Y Niu, X Tian, Z H Zhang, Y Chen, Z Q Gao
Objective: To explore the safety and validity of endoscopic cricopharyngeal myotomy in patients with cricopharyngeal achalasia. Methods: A total of 19 patients with cricopharyngeal achalasia suffered from sustained dysphagia were enrolled in this study. The patients were divided into transcervical cricopharyngeal myotomy(CPM) group and endoscopic CPM (ECPM) group. Swallowing function and complications were evaluated.SPSS7.0 software was used to analyze the data. Results: The swallowing function improved significantly in seven patients in ECPM group, and 9 patients improved in CPM group...
October 7, 2017: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/29050064/bilateral-anatomic-resection-of-the-ventral-parts-of-the-paramedian-sectors-of-the-liver-with-total-caudate-lobectomy-for-deeply-centrally-located-liver-tumors-a-new-technique-maximizing-both-oncological-and%C3%A2-surgical-safety
#16
Junichi Shindoh, Yujiro Nishioka, Masaji Hashimoto
Systematic resection of the tumor-bearing portal territory is reportedly correlated with an improved survival of patients with liver tumors, especially in hepatocellular carcinoma. Despite advances in surgical management, however, anatomic resection of deeply/centrally located tumors remains a challenging procedure not only with technical difficulty but also because of decreased hepatic functional reserve frequently observed due to underlying liver disease. In this report, we have reported a novel technique that allows a promising approach for deeply/centrally located tumors with maximizing both the surgical and oncological safety...
October 19, 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/29049708/two-staged-hybrid-ablation-of-non-paroxysmal-atrial-fibrillation-clinical-outcomes-and-functional-improvements-after-1%C3%A2-year
#17
Petr Budera, Pavel Osmancik, David Talavera, Anna Kraupnerova, Richard Fojt, Jana Zdarska, Tomas Vanek, Zbynek Straka
OBJECTIVES: Hybrid ablation of atrial fibrillation (AF) is a promising treatment strategy; however, data regarding its efficacy and safety are still limited. METHODS: Patients with non-paroxysmal AF were enrolled. First, a thoracoscopic, epicardial isolation of pulmonary veins and the left atrial posterior wall ('box lesion') was performed; a novel unipolar/bipolar radiofrequency device was used. Moreover, in 12 patients enrolled thereafter, the left atrial appendage was occluded...
July 31, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049548/multimodal-analgesia-in-outpatient-head-and-neck-surgery-a-feasibility-and-safety-study
#18
Justin Oltman, Oleg Militsakh, Mark D'Agostino, Brittany Kauffman, Robert Lindau, Andrew Coughlin, William Lydiatt, Daniel Lydiatt, Russell Smith, Aru Panwar
Importance: Perioperative analgesia strategies that rely solely on narcotics may contribute to adverse effects and concerns about opioid abuse or dependence. Multimodal analgesia protocols incorporating nonnarcotic agents may reduce the need for postoperative narcotic use. Objective: To evaluate the feasibility and safety of a multimodal analgesia protocol for outpatient head and neck surgical procedures and to identify the association of the multimodal analgesia protocol with postoperative pain perception scores and patient satisfaction...
October 19, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29049254/one-stage-posterior-approaches-for-treatment-of-thoracic-spinal-infection-transforaminal-and-costotransversectomy-compared-with-anterior-approach-with-posterior-instrumentation
#19
Fu-Cheng Kao, Tsung-Ting Tsai, Chi-Chien Niu, Po-Liang Lai, Lih-Huei Chen, Wen-Jer Chen
Treating thoracic infective spondylodiscitis with anterior surgical approaches carry a relatively high risk of perioperative and postoperative complications. Posterior approaches have been reported to result in lower complication rates than anterior procedures, but more evidence is needed to demonstrate the safety and efficacy of 1-stage posterior approaches for treating infectious thoracic spondylodiscitis.Preoperative and postoperative clinical data, of 18 patients who underwent 2 types of 1-stage posterior procedures, costotransversectomy and transforaminal thoracic interbody debridement and fusion and 7 patients who underwent anterior debridement and reconstruction with posterior instrumentation, were retrospectively assessed...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29048712/efficacy-and-safety-of-nuwiq-%C3%A2-human-cl-rhfviii-in-patients-with-severe-haemophilia-a-undergoing-surgical-procedures
#20
N Zozulya, C M Kessler, A Klukowska, M von Depka, K Hampton, C R M Hay, M Jansen, J Bichler, S Knaub, S Rangarajan
INTRODUCTION: Haemophilia A patients are at a high risk of excess bleeding during surgeries. The aim of haemostatic therapy during the perioperative period is to normalize FVIII level perioperatively and postoperatively to maintain normal haemostasis until wound healing is complete. AIMS/METHODS: To examine the efficacy of Nuwiq(®) (simoctocog alfa, human-cl rhFVIII), a 4(th) generation recombinant FVIII produced in a human cell line, for surgical prophylaxis in patients with severe haemophilia A...
October 19, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
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