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Surgical patient safety

Julian C Harnoss, Isabelle Zelienka, Pascal Probst, Kathrin Grummich, Catharina Müller-Lantzsch, Jonathan M Harnoss, Alexis Ulrich, Markus W Büchler, Markus K Diener
OBJECTIVE: The aim was to investigate available evidence regarding effectiveness and safety of surgical versus conservative treatment of acute appendicitis. SUMMARY OF BACKGROUND DATA: There is ongoing debate on the merits of surgical and conservative treatment for acute appendicitis. METHODS: A systematic literature search (Cochrane Library, Medline, Embase) and hand search of retrieved reference lists up to January 2016 was conducted to identify randomized and nonrandomized studies...
October 17, 2016: Annals of Surgery
Homero Rivas, Ignacio Robles, Francisco Riquelme, Marcelo Vivanco, Julio Jiménez, Boris Marinkovic, Mario Uribe
OBJECTIVE: To evaluate a new magnetic surgical system during reduced-port laparoscopic cholecystectomy in a prospective, multicenter clinical trial. BACKGROUND: Laparoscopic instrumentation coupled by magnetic fields may enhance surgeon performance by allowing for shaft-less retraction and mobilization. The movements can be performed under direct visualization, generating different angles of traction and reducing the number of trocars to perform the procedure. This may reduce well-known associated complications of trocars, including incisional pain, scarring, infection, bowel, and vascular injuries, among others...
October 17, 2016: Annals of Surgery
Rijul S Kshirsagar, Zachariah Chandy, Hossein Mahboubi, Sunil P Verma
OBJECTIVES/HYPOTHESIS: To evaluate the impact of resident involvement during thyroid surgery on 30-day postoperative complications. STUDY DESIGN: Retrospective cohort study. METHODS: All patients who underwent thyroid surgery in 2011 were identified from the American College of Surgeons National Surgical Quality Improvement Program database. Patient demographics, perioperative details, resident involvement in surgery, and 30-day postoperative complications were extracted...
October 18, 2016: Laryngoscope
Myreille D'Astous, Allen L Ho, Arjun Pendharkar, Clara Y H Choi, Scott G Soltys, Iris C Gibbs, Armine T Tayag, Patricia A Thompson, John R Adler, Steven D Chang
Non-vestibular cranial nerve schwannomas (NVCNS) are rare lesions, representing <10 % of cranial nerve schwannomas. The optimal treatment for NVCNS is often derived from vestibular schwannomas experience. Surgical resection has been referred to as the first line treatment for those benign tumors, but significant complication rates are reported. Stereotactic radiosurgery (SRS) has arisen as a mainstay of treatment for many benign tumors, including schwanommas. We retrospectively reviewed the outcomes of NVCNS treated by SRS to characterize tumor control, symptom relief, toxicity, and the role of hypo-fractionation of SRS dose...
October 17, 2016: Journal of Neuro-oncology
Takeshi Nishikawa, Soichiro Ishihara, Keisuke Hata, Koji Murono, Koji Yasuda, Kensuke Otani, Toshiaki Tanaka, Tomomichi Kiyomatsu, Kazushige Kawai, Hiroaki Nozawa, Hironori Yamaguchi, Toshiaki Watanabe
BACKGROUND: Along with an aging society, the number of elderly patients with colorectal cancer treated with a surgical modality has gradually increased. Our purpose is to verify the safety and effectiveness of laparoscopic surgery for the treatment of colorectal cancer in elderly patients. METHODS: We compared the short-term outcomes of open versus laparoscopic surgery in patients aged 80 years or older with colorectal cancer between 2007 and 2014. RESULTS: Of 150 elderly colorectal patients, 62 patients received laparoscopic surgery, and 88 patients, open surgery...
October 17, 2016: Surgical Endoscopy
J J Jiang, H K Qing, X M Zhang, X M Zhang, W Li, C Y Shen, Q L Li, Y Jiao
OBJECTIVE: To compare total percutaneous access using preclose technique with femoral artery cut-down in endovascular aneurysm repair (EVAR) and assess the safety and feasibility of preclose technique. METHODS: In the study, 81 cases undergoing EVAR from Dec. 2011 to Nov. 2014 in Peking University People's Hospital were retrospectively reviewed. Preoperative CT angiography (CTA) showed presence of infrarenal abdominal aortic aneurysm or descending aortic aneurysm in all the cases...
October 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
Gabriel Ogaya-Pinies, Yash Kadakia, Hariharan Palayapalayam-Ganapathi, Tracey Woodlief, Cathy Jenson, Vipul Patel
BACKGROUND: One of the key factors contributing to morbidity associated with salvage radical prostatectomy is a significant vesicourethral anastomosis (VUA) disruption or postoperative tissue dehiscence in the region of the distal bladder neck that causes a large prolonged urinary leak, perineal pain, and delayed catheter removal. OBJECTIVE: To describe our surgical technique using a urinary bladder extracellular matrix (UB-ECM) scaffold incorporated into the base of the VUA and the distal bladder neck during salvage robot-assisted radical prostatectomy (sRARP) and to assess outcomes and safety...
October 14, 2016: European Urology
Daniel F Hanley, Richard E Thompson, John Muschelli, Michael Rosenblum, Nichol McBee, Karen Lane, Amanda J Bistran-Hall, Steven W Mayo, Penelope Keyl, Dheeraj Gandhi, Tim C Morgan, Natalie Ullman, W Andrew Mould, J Ricardo Carhuapoma, Carlos Kase, Wendy Ziai, Carol B Thompson, Gayane Yenokyan, Emily Huang, William C Broaddus, R Scott Graham, E Francois Aldrich, Robert Dodd, Cristanne Wijman, Jean-Louis Caron, Judy Huang, Paul Camarata, A David Mendelow, Barbara Gregson, Scott Janis, Paul Vespa, Neil Martin, Issam Awad, Mario Zuccarello
BACKGROUND: Craniotomy, according to the results from trials, does not improve functional outcome after intracerebral haemorrhage. Whether minimally invasive catheter evacuation followed by thrombolysis for clot removal is safe and can achieve a good functional outcome is not known. We investigated the safety and efficacy of alteplase, a recombinant tissue plasminogen activator, in combination with minimally invasive surgery (MIS) in patients with intracerebral haemorrhage. METHODS: MISTIE was an open-label, phase 2 trial that was done in 26 hospitals in the USA, Canada, the UK, and Germany...
November 2016: Lancet Neurology
Bin-Fei Zhang, Chao-Yuan Ge, Bo-Long Zheng, Ding-Jun Hao
OBJECTIVE: The aim of the study was to evaluate the efficacy and safety of transforaminal lumbar interbody fusion (TLIF) versus posterolateral fusion (PLF) in degenerative lumbar spondylosis. METHODS: A systematic literature review was performed to obtain randomized controlled trials (RCTs) and observational studies (OSs) of TLIF and PLF for degenerative lumbar spondylosis. Trials performed before November 2015 were retrieved from the Medline, EMBASE, Cochrane library, and Chinese databases...
October 2016: Medicine (Baltimore)
Yi-Ming Ren, Xi-Shan Wang, Zhi-Jian Wei, Bao-You Fan, Wei Lin, Xian-Hu Zhou, Shi-Qing Feng
BACKGROUND: Carpal tunnel syndrome (CTS) is a common peripheral nerve entrapment disease. Either surgical or conservative intervention for CTS patients is needed to choose. We conducted this systematic review and meta-analysis to compare the clinical efficacy, safety, and cost of surgical versus nonsurgical intervention. METHODS: The eligible studies were acquired from PubMed, Medline, Embase, Web of Science, Google, and Cochrane Library. The data were extracted by 2 of the coauthors independently and were analyzed by RevMan5...
October 2016: Medicine (Baltimore)
Cheng Sun, Heng Zhang, Zhe Zheng
PURPOSE OF REVIEW: The efficacy and safety of β-blockers in the treatment of cardiovascular diseases, such as ischemic heart disease, cardiac arrhythmias, and heart failure, have been well established for decades. In this article, we review the current opinions on the application of β-blockers for secondary prevention in patients undergoing coronary artery bypass grafting (CABG) surgery. RECENT FINDINGS: As the average age of patients treated surgically for coronary artery disease (CAD) is increasing, it is not uncommon to have candidates for CABG presenting with concomitant atrial fibrillation, heart failure or hypertension, most of which were caused by excessive activation of the adrenergic nervous system...
November 2016: Current Opinion in Cardiology
Chenglin Guo, Jiandong Mei, Chengwu Liu, Senyi Deng, Qiang Pu, Feng Lin, Lunxu Liu
BACKGROUND: Mediastinal bronchogenic cyst (MBC) is the most common primary cystic lesion of the mediastinum. This study aimed to investigate the efficacy and safety of video-assisted thoracic surgery (VATS) compared with posterolateral thoracotomy (PLT) for the treatment of MBCs in a large series. METHODS: Patients with MBCs who underwent surgical resection between August 2005 and December 2015 were identified from the electronic database of the Department of Thoracic Surgery, West China Hospital...
September 2016: Journal of Thoracic Disease
Allison Weaver, Scott Steele
Over the past few decades, robotic surgery has developed from a futuristic dream to a real, widely used technology. Today, robotic platforms are used for a range of procedures and have added a new facet to the development and implementation of minimally invasive surgeries. The potential advantages are enormous, but the current progress is impeded by high costs and limited technology. However, recent advances in haptic feedback systems and single-port surgical techniques demonstrate a clear role for robotics and are likely to improve surgical outcomes...
2016: F1000Research
Mathew Clark, Esma Birisci, Jordan E Anderson, Christina M Anliker, Micheal A Bryant, Craig Downs, Abdallah Dalabih
BACKGROUND: Current guidelines adopted by the American Academy of Pediatrics calls for prolonged fasting times before performing pediatric procedural sedation and analgesia (PSA). PSA is increasingly provided to children outside of the operating theater by sedation trained pediatric providers and does not require airway manipulation. We investigated the safety of a shorter fasting time compared to a longer and guideline compliant fasting time. We tried to identify the association between fasting time and sedation-related complications...
September 2016: Anesthesia, Essays and Researches
Radhe Sharan, Rajan Verma, Akshay Dhawan, Jugal Kumar
BACKGROUND: Ropivacaine, a newer local anesthetic, is gaining increased acceptance due to its improved safety profile over bupivacaine and lignocaine. Analgesic adjuvants have proved to be valuable in improving the quality of anesthesia and duration of analgesia. AIM: To compare the efficacy of clonidine and fentanyl as adjuvants to ropivacaine in spinal anesthesia in lower abdominal surgeries. MATERIALS AND METHODS: A randomized, double-blind control study was carried out in 100 patients who were randomly divided into two groups...
September 2016: Anesthesia, Essays and Researches
Arie S Parnham, Maarten Albersen, Varun Sahdev, Michelle Christodoulidou, Raj Nigam, Peter Malone, Alex Freeman, Asif Muneer
BACKGROUND: Penile cancer is a rare malignancy that is confined to the glans in up to four out of five cases. Although descriptions of glansectomy exist, there are no contemporary video explanations or large published single centre series. OBJECTIVE: To show the efficacy and safety of glansectomy and split-thickness skin graft (STSG) reconstruction. DESIGN, SETTING, AND PARTICIPANTS: Data were collected retrospectively for patients identified from surgical theatre diaries between February 2005 and January 2016...
October 13, 2016: European Urology
Darryn Marks, Tracy Comans, Michael Thomas, Shu Kay Ng, Shaun O'Leary, Philip G Conaghan, Paul A Scuffham, Leanne Bisset
BACKGROUND: Physiotherapists increasingly manage shoulder referrals in place of orthopaedic doctors. Better understanding the agreement between these professionals will help inform the safety, quality and potential costs of these care models. OBJECTIVE: To establish the level of agreement between a physiotherapist and an orthopaedic surgeon regarding diagnosis, management and corticosteroid injection, in a representative sample of orthopaedic shoulder referrals...
October 5, 2016: Manual Therapy
Zeinab M Alawadi, Isabel M Leal, Juan R Flores, Julie L Holihan, Blake E Henchcliffe, Thomas O Mitchell, Tien C Ko, Mike K Liang, Lillian S Kao
BACKGROUND: The purpose of this study was to identify issues important to patients in their decision-making, expectations, and satisfaction when seeking treatment for a ventral hernia. STUDY DESIGN: An exploratory qualitative study was conducted of adult patients with ventral hernias seeking care at a safety-net hospital. Two semi-structured interviews were conducted with each patient: prior to and 6 -months following surgical consultation. Interviews were audiotaped, transcribed, and coded using latent content analysis until data saturation was achieved...
October 11, 2016: Journal of the American College of Surgeons
Víctor Daniel Rosenthal, Hail M Al-Abdely, Amani Ali El-Kholy, Safa A Aziz AlKhawaja, Hakan Leblebicioglu, Yatin Mehta, Vineya Rai, Nguyen Viet Hung, Souha Sami Kanj, Mona Foda Salama, Estuardo Salgado-Yepez, Naheed Elahi, Rayo Morfin Otero, Anucha Apisarnthanarak, Braulio Matias De Carvalho, Bat Erdene Ider, Dale Fisher, Maria Carmen S G Buenaflor, Michael M Petrov, Ana Marcela Quesada-Mora, Farid Zand, Vaidotas Gurskis, Tanja Anguseva, Aamer Ikram, Daisy Aguilar de Moros, Wieslawa Duszynska, Nepomuceno Mejia, Florin George Horhat, Vladislav Belskiy, Vesna Mioljevic, Gabriela Di Silvestre, Katarina Furova, Gloria Y Ramos-Ortiz, May Osman Gamar Elanbya, Hindra Irawan Satari, Umesh Gupta, Tarek Dendane, Lul Raka, Humberto Guanche-Garcell, Bijie Hu, Denis Padgett, Kushlani Jayatilleke, Najla Ben Jaballah, Eleni Apostolopoulou, Walter Enrique Prudencio Leon, Alejandra Sepulveda-Chavez, Hector Miguel Telechea, Andrew Trotter, Carlos Alvarez-Moreno, Luis Kushner-Davalos
BACKGROUND: We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2010-December 2015 in 703 intensive care units (ICUs) in Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. METHODS: During the 6-year study period, using Centers for Disease Control and Prevention National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 861,284 patients hospitalized in INICC hospital ICUs for an aggregate of 3,506,562 days...
October 11, 2016: American Journal of Infection Control
Lyndsey S Benson, Elizabeth A Micks, Carly Ingalls, Sarah W Prager
OBJECTIVE: To evaluate the relationship between obesity and surgical abortion complications in the outpatient setting. METHODS: We conducted a retrospective cohort study of 4,968 women undergoing surgical abortion at a large outpatient clinic network from September 2012 to July 2014. We used log-binomial regression to evaluate body mass index (BMI) as an independent risk factor for first- and second-trimester abortion complications. Body mass index was analyzed as both a continuous and categorical predictor...
October 6, 2016: Obstetrics and Gynecology
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