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Surgical patient safety

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https://www.readbyqxmd.com/read/28820949/association-between-patient-factors-and-outcome-of-synthetic-cartilage-implant-hemiarthroplasty-vs-first-metatarsophalangeal-joint-arthrodesis-in-advanced-hallux-rigidus
#1
Andy Goldberg, Dishan Singh, Mark Glazebrook, Chris M Blundell, Gwyneth De Vries, Ian L D Le, Dominic Nielsen, M Elizabeth Pedersen, Anthony Sakellariou, Matthew Solan, Alastair S E Younger, Timothy R Daniels, Judith F Baumhauer
BACKGROUND: We evaluated data from a clinical trial of first metatarsophalangeal joint (MTPJ1) implant hemiarthroplasty and arthrodesis to determine the association between patient factors and clinical outcomes. METHODS: Patients ≥18 years with hallux rigidus grade 2, 3, or 4 were treated with synthetic cartilage implant MTPJ1 hemiarthroplasty or arthrodesis. Pain visual analog scale (VAS), Foot and Ankle Ability Measure (FAAM) sports and activities of daily living (ADL) scores, and Short Form-36 Physical Function (SF-36 PF) subscore were obtained preoperatively, and at 2, 6, 12, 24, 52, and 104 weeks postoperatively...
August 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28820303/rapid-ventricular-pacing-for-clip-reconstruction-of-complex-unruptured-intracranial-aneurysms-results-of-an-interdisciplinary-prospective-trial
#2
Juergen Konczalla, Johannes Platz, Stephan Fichtlscherer, Haitham Mutlak, Ulrich Strouhal, Volker Seifert
OBJECTIVE To date, treatment of complex unruptured intracranial aneurysms (UIAs) remains challenging. Therefore, advanced techniques are required to achieve an optimal result in treating these patients safely. In this study, the safety and efficacy of rapid ventricular pacing (RVP) to facilitate microsurgical clip reconstruction was investigated prospectively in a joined neurosurgery, anesthesiology, and cardiology study. METHODS Patients with complex UIAs were prospectively enrolled. Both the safety and efficacy of RVP were evaluated by recording cardiovascular events and outcomes of patients as well as the amount of aneurysm occlusion after the surgical clip reconstruction procedure...
August 18, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28819950/successful-eus-guided-ethanol-ablation-of-insulinoma-four-year-follow-up-case-report-and-literature-review
#3
Krzysztof Dąbkowski, Paula Gajewska, Kamila Walter, Magdalena Londzin-Olesik, Andrzej Białek, Elżbieta Andrysiak-Mammos, Beata Kos-Kudła, Teresa Starzyńska
INTRODUCTION: EUS-guided ethanol ablation of insulinoma is a new method of treatment of this neuroendocrine tumour. Ablation is recommended in patients who are poor surgical candidates or refuse surgery. We present a case of an 81-year-old female with symptomatic insulinoma, treated successfully with EUS-guided alcoholic ablation, along with a literature review including 28 other previously described cases. The effectiveness, safety of the therapy, and technical procedure-related issues are summarised...
2017: Endokrynologia Polska
https://www.readbyqxmd.com/read/28819902/ablation-therapy-for-barrett-s-esophagus-new-rules-for-changing-times
#4
REVIEW
Nour Hamade, Prateek Sharma
PURPOSE OF REVIEW: In this review, we discuss different endoscopic techniques in the eradication of Barrett's esophagus (BE) as well as some controversies in the field of treatment. RECENT FINDINGS: Patients with T1a esophageal adenocarcinoma and BE of high-grade dysplasia should undergo endoscopic ablative therapy. The most studied technique to date is radiofrequency ablation. It can be combined with endoscopic mucosal resection in cases containing nodular and flat lesions...
August 17, 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28819886/robotic-versus-laparoscopic-pancreaticoduodenectomy-a-nsqip-analysis
#5
Ibrahim Nassour, Sam C Wang, Matthew R Porembka, Adam C Yopp, Michael A Choti, Mathew M Augustine, Patricio M Polanco, John C Mansour, Rebecca M Minter
BACKGROUND: An increasing body of literature is supporting the safety of minimally invasive pancreaticoduodenectomy compared to open pancreaticoduodenectomy, but there are limited comparative studies between laparoscopic and robotic pancreaticoduodenectomy. The aim of this study was to compare the rate of postoperative 30-day overall complications between laparoscopic and robotic pancreaticoduodenectomy. METHODS: Patients who underwent laparoscopic and robotic pancreaticoduodenectomy were abstracted from the 2014-2015 pancreas-targeted American College of Surgeons National Surgical Quality Improvement Program...
August 17, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28819870/surgical-complications-of-extraspinal-tumors-in-the-cervical-spine-a-report-of-110-cases-and-literature-review
#6
WenHua Yang, Liang Jiang, XiaoGuang Liu, Feng Wei, Miao Yu, FengLiang Wu, Lei Dang, Hua Zhou, Hua Zhang, ZhongJun Liu
PURPOSE: To assess the safety of surgical intervention for extraspinal tumors in the cervical spine. METHODS: 110 consecutive patients were enrolled and followed-up at least 12 months or until death. The complication rates and risk factors were documented and analyzed. RESULTS: The quality of life in the surviving patients was significantly improved. The overall local recurrence rate was 17.3%. Twenty percent of patients developed distant metastasis...
August 17, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28818338/spinal-anesthesia-for-pediatric-urological-surgery-reducing-the-theoretic-neurotoxic-effects-of-general-anesthesia
#7
Emmett E Whitaker, Brianne Z Wiemann, Daniel G DaJusta, Seth A Alpert, Christina B Ching, Daryl J McLeod, Joseph D Tobias, Venkata R Jayanthi
BACKGROUND: Spinal anesthesia (SA) is an effective technique that has been used in children for years. With growing concern with regard to the risks of general anesthesia (GA), we developed a SA program to provide an alternative option. We present our initial experience with this program. OBJECTIVE: To implement a SA program at a large tertiary care pediatric center and assess the safety and efficacy of the technique as an alternative to GA for urologic surgery...
July 14, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28817978/transcutaneous-electrical-nerve-stimulation-tens-as-an-adjunct-for-pain-management-in-perioperative-settings-a-critical-review
#8
Mark I Johnson
Surgical procedures are ever more complex. Day-case surgical loads are increasing and the length of hospital stays are reducing. Management of pain in perioperative settings remains a challenge. Expert panels recommend a multimodal approach which is often interpreted by medical practitioners as polypharmacy. There is variability in non-pharmacological interventions offered to patients, although transcutaneous electrical nerve stimulation (TENS) has been used since the 1970s. Recommendations from expert panels are inconsistent about the use of TENS in perioperative pain settings...
August 18, 2017: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/28817820/endo-urological-techniques-for-benign-uretero-ileal-strictures-have-poor-efficacy-and-affect-renal-function
#9
Elisabeth E Fransen van de Putte, Liesbeth L de Wall, Erik van Werkhoven, Eddi A Heldeweg, Axel Bex, Henk G van der Poel, Bas W G van Rhijn, Simon Horenblas, Kees Hendricksen
INTRODUCTION: Uretero-ileal strictures (UES) following urinary diversion are therapeutically challenging. We compared the efficacy, safety and renal outcome following therapeutic endo-urological techniques (EUTs) and open surgical revision of the anastomosis (SRA) for UES. MATERIAL AND METHODS: We retrospectively analysed all EUTs and SRAs performed for UES in 2 hospitals between 1987 and 2015. Restenosis was defined as recurrent radiographically diagnosed hydronephrosis and re-intervention...
August 18, 2017: Urologia Internationalis
https://www.readbyqxmd.com/read/28816934/midterm-outcomes-of-intracranial-aneurysms-with-bleb-formation-with-densely-coiling-of-the-aneurismal-neck-or-entire-aneurysm
#10
Jun Wan, Lei Zhang, Gang Lu, Weijin Gu, Lei Huang, Liang Ge, Xiaolong Zhang, Lihua Ji, Qing Chen, Ruoyu Di, Yeqing Jiang
To evaluate whether the efficacy and safety of embolization of the aneurysmal neck were better than those of embolization of the entire aneurysm. Previous studies found that embolization of the aneurysmal neck can be used for treating ruptured intracranial aneurysm with bleb formation.In all, 163 patients with ruptured aneurysms with bleb formation who underwent endovascular embolization at the Shanghai Municipal Jing'an District Central Hospital from January 2014 to August 2015 were divided into the embolization of aneurysmal neck group (neck group; 87 cases) and embolization of entire aneurysm group (aneurysm group; 76 cases)...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28816894/the-clavicle-trial-a-multicenter-randomized-controlled-trial-comparing-operative-with-nonoperative-treatment-of-displaced-midshaft-clavicle-fractures
#11
Philip M Ahrens, Nicholas I Garlick, Julie Barber, Emily M Tims
BACKGROUND: The treatment of displaced midshaft clavicle fractures remains controversial. METHODS: We undertook a multicenter randomized controlled trial to compare effectiveness and safety between nonoperative management and ORIF (open reduction and internal fixation) for displaced midshaft clavicle fractures in adults. Three hundred and one eligible adult patients were randomized to 1 of the 2 treatment groups and followed at 6 weeks, 3 months, and 9 months after recruitment...
August 16, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28816875/controversies-in-the-management-of-geriatric-odontoid-fractures
#12
Scott C Wagner, Gregory D Schroeder, Christopher K Kepler, Alexander J Schupper, Frank Kandziora, Emiliano N Vialle, Cumhur Oner, Michael G Fehlings, Alexander R Vaccaro
Fractures of the odontoid process of C2 have become increasingly prevalent in the aging population and are typically associated with a high incidence of morbidity. Dens fractures comprise the majority of all cervical fractures in patients older than 80 years and remain the most common cervical fracture pattern in all geriatric patients. Type II odontoid fractures have been associated with limited healing potential, and both nonoperative and operative management are associated with high mortality rates. Historically, there has been some debate in the literature with regards to optimal management strategies to maximize outcomes in geriatric patients...
September 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28816276/-percutaneous-biopsy-of-the-renal-masses-under-ultrasound-a-single-center-14-years-experience
#13
Y X Zhang, X B Meng, L Yao, C J Zhang, G Song, L Cai, Z Zhang, X S Li, K Gong, S Q Li, G Z Shan, Q He, X Y Yang, Z S He, L Q Zhou
OBJECTIVE: To assess the diagnostic rate, safety and clinical application of percutaneous renal masses biopsy for advanced renal cell carcinoma patients. METHODS: In this retrospective study, we collected the data of renal masses from the patients who underwent renal masses biopsy under ultrasound from April 2001 to December 2014 in Peking University First Hospital. A total of 75 patients who were undiagnosed or diagnosed with advanced renal cell carcinoma by the imageological method were enrolled in this study...
August 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28816272/-radical-nephrectomy-and-thrombectomy-for-mayo-clinic-stage-iii-tumor-thrombus-a-surgical-technique-and-clinical-experience
#14
Z Liu, L L Ma, X J Tian, G L Wang, X F Hou, S D Zhang, S H Deng
OBJECTIVE: To evaluate the effectiveness and safety of radical nephrectomy and inferior vena cava thrombectomy in the treatment of patients with Mayo III tumor thrombus, and to introduce our experience and surgical technique. METHODS: The clinical data of 8 patients with Mayo III tumor thrombus from October 2014 to September 2016 were analyzed retrospectively. Of the 8 patients, 3 were male and 5 were female. The average age was (50.8±18.7) years (18 to 77 years)...
August 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28816011/lessons-learnt-from-incidents-involving-the-airway-and-breathing-reported-from-australasian-emergency-departments
#15
Carmel Crock, Kim Hansen, Toby Fogg, Angela Cahill, Anita Deakin, William B Runciman
OBJECTIVE: To review incident reports relating to problems encountered during the ED management of patients with 'airway or breathing' problems, with the aim of finding and highlighting common themes within these rare events, and making recommendations to further improve patient safety in the areas in which deficiencies have been identified. METHODS: Thematic analysis of 36 incidents reported from Australasian EDs, which were related to problems with airway and breathing...
August 16, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28815880/immunogenicity-efficacy-and-safety-of-nuwiq-%C3%A2-human-cl-rhfviii-in-previously-untreated-patients-with-severe-haemophilia-a-interim-results-from-the-nuprotect-study
#16
R J Liesner, M Abashidze, O Aleinikova, C Altisent, M J Belletrutti, A Borel-Derlon, M Carcao, H Chambost, A K C Chan, L Dubey, J Ducore, N A Fouzia, M Gattens, Y Gruel, B Guillet, N Kavardakova, M El Khorassani, A Klukowska, T Lambert, S Lohade, M Sigaud, V Turea, J K M Wu, V Vdovin, A Pavlova, M Jansen, L Belyanskaya, O Walter, S Knaub, E J Neufeld
INTRODUCTION: Nuwiq(®) (Human-cl rhFVIII) is a fourth generation recombinant FVIII, produced in a human cell line, without chemical modification or protein fusion. No inhibitors developed in studies with Nuwiq(®) in 201 previously treated patients with haemophilia A (HA). The immunogenicity, efficacy and safety of Nuwiq(®) in previously untreated patients (PUPs) with severe HA are being assessed in the ongoing NuProtect study. METHODS: The study, conducted across 38 centres worldwide, is evaluating 110 true PUPs of all ages and ethnicities enrolled for study up to 100 exposure days (EDs) or 5 years maximum...
August 16, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28815843/ilizarov-technique-and-limited-surgical-methods-for-correction-of-post-traumatic-talipes-equinovarus-in-children
#17
Xiao Jian Wang, Feng Chang, Yunxing Su, Bin Chen, Jie-Fu Song, Xiao-Chun Wei, Lei Wei
BACKGROUND: The objective of this study was to evaluate the efficacy and safety of using Ilizarov invasive distraction technique combined with limited surgical operations in the treatment of post-traumatic talipes equinovarus in children. METHODS: Eighteen cases of post-traumatic deformed feet in 15 patients who received the treatment of Ilizarov frame application, limited soft-tissue release or osteotomy were selected in this study. After removal of the frame, an ankle-foot orthosis was used continuously for another 6-12 months...
August 16, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28815550/fertility-preservation-in-women-with-borderline-ovarian-tumors-how-does-it-impact-disease-outcome-a-cohort-study
#18
Limor Helpman, Assaf Yaniv, Mario E Beiner, Sarit Aviel-Ronen, Tamar Perri, Gilad Ben-Baruch, Liat Hogen Ben-David, Ariella Jakobson-Setton, Jacob Korach
INTRODUCTION: Borderline ovarian tumors are typically indolent neoplasms. Since many are diagnosed in younger women, fertility conservation is an important consideration and has been advocated based on retrospective data. The objective of this study was to identify features impacting on recurrence and survival in a series of borderline ovarian tumors, and to assess the safety of a fertility-sparing approach. MATERIAL AND METHODS: A historical cohort study of consecutive borderline ovarian tumors cases treated at a single institution over 30 years (1981-2011)...
August 16, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28815410/efficacy-and-safety-of-a-4-factor-prothrombin-complex-concentrate-for-rapid-vitamin-k-antagonist-reversal-in-japanese-patients-presenting-with-major-bleeding-or-requiring-urgent-surgical-or-invasive-procedures-a-prospective-open-label-single-arm-phase-3b-study
#19
Shigeki Kushimoto, Toshio Fukuoka, Akio Kimura, Kazunori Toyoda, Andres Brainsky, Amy Harman, Thomas Chung, Masahiro Yasaka
Rapid vitamin K antagonist (VKA) reversal is required in patients experiencing major bleeding or requiring urgent surgery. Four-factor prothrombin complex concentrate (4F-PCC; Beriplex(®)/Kcentra(®)) was shown in two large randomized controlled, international phase 3b trials to be an effective alternative to plasma for urgent VKA reversal. In the present prospective, open-label, single-arm phase 3b trial, we evaluate the efficacy and safety of 4F-PCC in Japanese patients. Eleven patients [international normalized ratio (INR) ≥2] requiring rapid VKA reversal owing to major bleeding (n = 6) or before urgent surgical/invasive procedures (n = 5) were administered 4F-PCC dosed based on INR and weight...
August 16, 2017: International Journal of Hematology
https://www.readbyqxmd.com/read/28815402/covered-esophageal-stenting-is-effective-for-symptomatic-gastric-lumen-narrowing-and-related-complications-following-laparoscopic-sleeve-gastrectomy
#20
Murad A Aburajab, Joshua B Max, Mel A Ona, Kapil Gupta, Miguel Burch, F Michael Feiz, Simon K Lo, Laith H Jamil
BACKGROUND AND STUDY AIMS: Laparoscopic sleeve gastrectomy (LSG) is gaining popularity in treating morbid obesity. Prior studies showed a 3.5% risk of gastric sleeve stenosis (GSS). There is no consensus on how to treat these patients, and the role of endoscopic therapy has been addressed in only a few studies. We aim to assess the efficacy and safety of endoscopic stenting in the management of GSS following LSG. PATIENTS AND METHODS: Retrospective data were reviewed from July 2009 to November 2013...
August 16, 2017: Digestive Diseases and Sciences
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