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Surgical patient safety

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https://www.readbyqxmd.com/read/29906644/retroperitoneal-versus-open-intraperitoneal-necrosectomy-in-step-up-therapy-for-infected-necrotizing-pancreatitis-a-meta-analysis
#1
REVIEW
Yun-Bing Wang, Xiao-Li Yang, Long Chen, Zheng-Ju Chen, Chun-Mu Miao, Jin Xia
BACKGROUND: Step-up therapy is the recommended therapy for infected necrotizing pancreatitis (INP). However, the most appropriate secondary therapy for use after initial drainage has not been fully determined. This meta-analysis was designed to evaluate the efficacy and safety of retroperitoneal versus open intraperitoneal necrosectomy as part of a step-up strategy for INP. MATERIALS AND METHODS: Eight online databases were searched for randomized controlled trials (RCTs) and cohorts comparing retroperitoneal and open intraperitoneal step-up approaches for treating INP...
June 12, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29906580/posterior-lumbar-interbody-fusion-vs-dynamic-hybrid-instrumentation-a-prospective-randomised-clinical-trial
#2
C Herren, M Simons, J Bredow, S Oikonomidis, L Westermann, R Sobottke, M J Scheyerer, M Pishnamaz, P Eysel, K Zarghooni, J Franklin, J Siewe
PURPOSE: The purpose of this study was to assess the radiological and clinical outcomes following lumbar fusion intervention and to compare both, the established posterior lumbar interbody fusion (PLIF)-technique and the dynamic hybrid instrumentation ('topping off'). METHODS: In this prospective randomised trial all patients presented with degenerative changes to the lumbar spine (L2-S1) were included and randomised in two groups: patients who underwent the 360°-fusion procedure in PLIF-technique (1, control group) and those patients who underwent fusion surgery with additional hybrid instrumentation (DTO, Zimmer, Inc...
June 12, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29906490/mapping-national-surveillance-of-surgical-site-infections-ssis-to-national-needs-and-priorities-an-assessment-of-england-s-surveillance-landscape
#3
Rachael Troughton, Gabriel Birgand, Alan P Johnson, Nichola Naylor, Myriam Gharbi, Paul Aylin, Susan Hopkins, Usman Jaffer, Alison Holmes
BACKGROUND: The rise in antimicrobial resistance has highlighted the importance of surgical site infection (SSI) prevention with effective surveillance strategies playing a key role in improving patient safety. This study maps national needs and priorities for SSI surveillance against current national surveillance activity. METHODS: This study analysed SSI surveillance in NHS hospitals in England covering 23 surgical procedures. Data collected were: (i) annual number of procedures, (ii) SSI rates from national reports, (iii) national reporting requirement (mandatory, voluntary, not offered), (iv) priority ranking from a survey of 84 English NHS hospitals, (v) excess length of stay and costs from the literature...
June 12, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29906265/transcatheter-mitral-valve-in-valve-and-valve-in-ring-replacement-in-high-risk-surgical-patients-feasibility-safety-and-longitudinal-outcomes-in-a-single-center-experience
#4
Ashleigh Long, Paul Mahoney
BACKGROUND: Transcatheter mitral valve-in-valve (TMVIV) or valve-in-ring (TMVIR) replacement has shown early promise in patients deemed poor surgical candidates as a less invasive alternative to conventional reoperative mitral valve (MV) replacement. OBJECTIVE: This retrospective, single-center study reviewed the procedural outcomes of all TMVIV and TMVIR procedures between 2013-2018 at a large tertiary referral center serving the southeastern United States. An analysis of patient safety measures was also performed, with a retrospective assessment of relative procedural safety that included preoperative risk stratification and postoperative mortality predictors, operative time, average blood loss, length of hospital stay, and readmission rates...
June 15, 2018: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/29905929/beyond-classic-risk-adjustment-socioeconomic-status-and-hospital-performance-in-urologic-oncology-surgery
#5
Anobel Y Odisho, Ruth Etzioni, John L Gore
BACKGROUND: Safety-net hospitals (SNHs) care for more patients of low socioeconomic status (SES) than non-SNHs and are disproportionately punished under SES-naive Medicare readmission risk-adjustment models. This study was designed to develop a risk-adjustment framework that incorporates SES and to assess the impact on readmission rates. METHODS: California Office of Statewide Health Planning and Development data from 2007 to 2011 were used to identify patients undergoing radical cystectomy (RC) for bladder cancer (n = 3771) or partial nephrectomy (PN; n = 5556) or radical nephrectomy (RN; n = 13,136) for kidney cancer...
June 15, 2018: Cancer
https://www.readbyqxmd.com/read/29905893/s093-pneumatic-balloon-dilation-for-palliation-of-recurrent-symptoms-of-achalasia-after-esophagomyotomy
#6
Riley D Stewart, Jeffrey Hawel, Daniel French, Drew Bethune, James Ellsmere
BACKGROUND: Achalasia is a chronic disease affecting the myenteric plexus of the esophagus and lower esophageal sphincter. Treatment is aimed at palliating symptoms to improve quality of life. Treatment options for symptom relapse after esophagomyotomy include botox injection, repeat myotomy, per-oral endoscopic myotomy, or pneumatic balloon dilation (PBD). Data demonstrating the safety and efficacy of PBD for recurrence are scarce. With a lack of published data, guidelines have suggested avoiding PBD for recurrent achalasia because of concern for a high risk of perforation...
June 15, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29905633/longer-duration-of-urinary-catheterization-increases-catheter-associated-urinary-tract-infection-in-picu
#7
Kahoru Fukuoka, Mihoko Furuichi, Kenta Ito, Yoshihiko Morikawa, Ichiro Watanabe, Naoki Shimizu, Yuho Horikoshi
OBJECTIVES: Catheter-associated urinary tract infections account for 30% of healthcare-associated infections. To date, few studies have addressed pediatric catheter-associated urinary tract infection in PICUs. The aim of our study was to assess the risk of catheter-associated urinary tract infection in relation to the duration of catheterization in the PICU. DESIGN: Retrospective cohort study. SETTING: PICU at a tertiary children's hospital...
June 13, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29905624/a-modified-posterior-c1-c2-fusion-technique-for-the-management-of-traumatic-odontoid-type-ii-fractures-by-using-intraoperative-spinal-navigation-mid-term-results
#8
Basem Ishak, Till Schneider, Valerie Gimmy, Andreas W Unterberg, Karl L Kiening
OBJECTIVES: To assess mid-term safety and efficacy of a modified Goel-Harms technique for the treatment of odontoid instabilities. DESIGN: Longitudinal prospective cohort study. SETTING: Urban Level 1 Trauma Center in Southwest Germany. PATIENTS/PARTICIPANTS: Orthopaedic and neurosurgical trauma patients older than 18 years admitted for ≤ 24 hours. MAIN OUTCOME MEASUREMENTS: The outcome was evaluated with respect to neurological outcome, radiological outcome and surgical complications...
June 4, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29902932/external-snapping-hip-a-systematic-review-of-outcomes-following-surgical-intervention-external-snapping-hip-systematic-review
#9
Todd P Pierce, Jennifer Kurowicki, Kimona Issa, Antony Festa, Anthony J Scillia, Vincent K McInerney
PURPOSE: To evaluate the outcomes of surgical management for external snapping hip in terms of: (1) recurrence; (2) complications; and (3) return to pre-injury activities. METHODS: A thorough review of 4 electronic databases- EMBASE, CINAHL Plus, PubMed, and Scopus was performed to find all relevant studies for this review that were published between January 2000 and January 2017 that addressed surgical treatment for external snapping hip. The following reports were excluded: (1) non-English manuscripts; (2) n ⩽ 5; (3) clinical reviews; (4) surgical technique notes; (5) studies only analysing diagnosis; and (6) nonoperative management studies...
June 1, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29901531/safety-of-electromagnetic-navigation-bronchoscopy-in-patients-with-copd-results-from-the-navigate-study
#10
Christopher W Towe, Michael A Nead, Otis B Rickman, Erik E Folch, Sandeep J Khandhar, Yaron Perry, Philip A Linden
BACKGROUND: Electromagnetic navigation bronchoscopy (ENB) aids in the localization of lung lesions for biopsy and/or to guide fiducial or dye marking for stereotactic radiation or surgical localization. This study assessed ENB safety in patients with chronic obstructive pulmonary disease (COPD) and/or poor lung function. METHODS: NAVIGATE is a prospective, multicenter, observational study of ENB. This substudy analyzed the 1-month follow-up of the first 1000 enrolled subjects...
June 12, 2018: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/29901529/transbronchial-lung-cryobiopsy-in-the-diagnosis-of-interstitial-lung-disease-a-retrospective-single-center-experience
#11
Roy Cho, Felix Zamora, Heidi Gibson, H Erhan Dincer
BACKGROUND: Surgical lung biopsy (SLB) is the gold standard to aid diagnosis of interstitial lung disease (ILD). Complication rates are restrictive as routine approach for all patients with ILD. Transbronchial lung cryobiopsy (TBLC) is presumed to be a safe, less invasive alternative to assist multidisciplinary discussions regarding the diagnosis of ILD. Varying practice patterns and lack of consistent guidelines prohibit wide support of this technique. The purpose of this study was to evaluate safety and diagnostic yield of TBLC, with highlight of distinct technical features, in ILD...
June 12, 2018: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/29901404/risk-of-radiation-induced-cataracts-investigation-of-radiation-exposure-to-the-eye-lens-during-endourologic-procedures
#12
Josefin Hartmann, Florian A Distler, Martin Baumueller, Ewald Guni, Sascha A Pahernik, Michael Wucherer
BACKGROUND: Due to new radiobiological data, the ICRP recommends a dose limit of 20mSv per year to the eye lens. Therefore, the IAEA International Basic Safety Standard and the EU council directive 2013/59/EURATOM requires a reduction of the annual dose limit from 150mSv to 20mSv. Urologists are exposed to an elevated radiation exposure in the head region during fluoroscopic interventions, due to the commonly used overtable X-ray tubes and the rarely used radiation protection for the head...
June 14, 2018: Journal of Endourology
https://www.readbyqxmd.com/read/29900819/aquablation-versus-transurethral-resection-of-the-prostate-1-year-united-states-cohort-outcomes
#13
Veeru Kasivisvanathan, Muddassar Hussain
INTRODUCTION: The purpose of this analysis was to compare Aquablation to transurethral resection of the prostate (TURP) with respect to efficacy and safety at 1 year for the treatment of lower urinary tract symptoms related to benign prostatic hyperplasia (BPH) in the United States (U.S.) cohort from the Waterjet Ablation Therapy for Endoscopic Resection of prostate tissue (WATER) study. MATERIALS AND METHODS: WATER is a double-blinded, multicenter prospective randomized controlled trial for patients with moderate-to-severe lower urinary tract symptoms related to BPH...
June 2018: Canadian Journal of Urology
https://www.readbyqxmd.com/read/29900817/feasibility-of-same-day-discharge-after-robotic-assisted-pelvic-floor-reconstruction
#14
Jessica C Lloyd, Juan Guzman-Negron, Howard B Goldman
INTRODUCTION: Robotic surgical procedures have become more common in female pelvic reconstruction. Purported benefits of robotic assisted pelvic floor reconstruction (RAPFR) procedures include shorter hospital stay, faster recovery, lower blood loss, and decreased postoperative pain. Following RAPFR procedures, the current accepted practice is discharge after a one-night hospitalization. We assessed whether same day discharge (SDD) affects the short term safety of and patient satisfaction with robotic assisted pelvic floor reconstructive procedures, relative to those who remain hospitalized overnight...
June 2018: Canadian Journal of Urology
https://www.readbyqxmd.com/read/29900752/micro-endoscopic-discectomy-versus-percutaneous-endoscopic-surgery-for-lumbar-disk-herniation
#15
Tuerhongjiang Abudurexiti, Ling Qi, Aikeremujiang Muheremu, Aierken Amudong
Objective This study was performed to compare the effectiveness and safety of percutaneous endoscopic lumbar discectomy (PELD) versus micro-endoscopic discectomy (MED) in the treatment of patients with lumbar disk herniation. Methods In total, 216 patients treated for lumbar disk herniation in our center from January 2016 to July 2017 were prospectively divided into two groups according to the treatment received. One group was treated with PELD and the other group was treated with MED. The surgical duration, intraoperative blood loss, total hospital stay, visual analog scale (VAS) pain score, and Oswestry disability index (ODI) score before and after the surgery were compared between the groups...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29898707/comparison-of-intravenous-and-topical-tranexamic-acid-in-total-knee-arthroplasty
#16
Wenbo Wei, Shajie Dang, Dapeng Duan, Ling Wei
BACKGROUND: To investigate the clinical effectiveness of intravenous (IV) and topical tranexamic acid (TXA) in patients undergoing total knee arthroplasty (TKA) by comparing safety, efficacy and patient-reported outcomes. METHODS: In this prospective single-blind clinical trial, 64 patients were randomized into two groups (n = 32 each). The Intravenous Group was administered TXA 10 mg/kg IV (Reyong, Shandong, China) 10 min prior to tourniquet deflation. In the Topical Group, 1...
June 13, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29897836/the-safety-and-feasibility-of-the-single-port-laparoscopic-transabdominal-preperitoneal-inguinal-hernia-repair-through-retropubic-radical-prostatectomy-scar-prospective-case-series
#17
Jae Hoon Chung, Tae Hyo Kim, Ki Soo Lee, Jeong Man Cho, Kyu Shik Kim, Hong Yong Choi, Seung Wook Lee
INTRODUCTION: To avoid an additional scar, our novel single-port laparoscopic inguinal hernia repair technique that utilizes the previous prostatectomy scar was conducted. Inguinal hernia is one of the most common complications of radical prostatectomy that require surgical repair. At present, such surgical repair inevitably leaves additional scars on the abdominal wall. This case series study was performed to determine the safety and feasibility of this procedure in patients with inguinal hernia after radical prostatectomy...
June 13, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29897572/evaluation-of-complications-and-costs-during-overlapping-transsphenoidal-surgery-in-the-treatment-of-pituitary-adenoma
#18
Michael Karsy, Christian A Bowers, Jonathan Scoville, Bornali Kundu, Mohammed Atef, J Michael Gee, Jian Guan, William T Couldwell
BACKGROUND: Pituitary adenomas are among the most common primary brain tumors. Recently, overlapping surgery has been curbed in many institutions because of the suggestion there might be more significant adverse events, despite several studies showing that complication rates are equivalent. OBJECTIVE: To assess complications and costs associated with overlapping surgery during the transsphenoidal resection of pituitary adenomas. METHODS: A single-center, retrospective cohort study was performed to evaluate the cases of patients who underwent a transsphenoidal approach for pituitary tumor resection...
June 12, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29896934/a-case-report-of-combined-ultrasound-and-fluoroscopic-guided-percutaneous-radiofrequency-lesioning-of-the-obturator-and-femoral-articular-branches-in-the-treatment-of-persistent-hip-pain-in-a-pediatric-patient
#19
James S Khan, Elliot J Krane, Maureen Higgs, Scott Pritzlaff, Scott Hoffinger, Einar Ottestad
Hip denervation comprising radiofrequency lesioning of the obturator and femoral articular branches is used in adults with refractory hip pain who are not surgical candidates. Persistent hip pain infrequently occurs in pediatric patients and there is limited data on the safety and efficacy of this procedure in a pediatric population. We provide a case report of a successful ultrasound and fluoroscopic-guided hip denervation procedure in an 11-year old female with persistent right hip pain after septic arthritis refractory to conservative and surgical management strategies...
June 13, 2018: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/29896847/advanced-chronic-kidney-disease-relationship-to-outcomes-post-tavr-a-meta-analysis
#20
REVIEW
Nader Makki, Scott M Lilly
OBJECTIVE: Chronic kidney (CKD) is associated with worse outcomes in high-surgical risk patients undergoing transcatheter aortic valve replacement (TAVR). However, it is unclear whether this relationship is apparent in lower surgical risk patients. Herein we sought to analyze existing literature to assess whether or not advanced CKD is associated with increased mortality, or a greater incidence of adverse events (specifically major stroke, bleeding and vascular complications). METHODS: We searched PubMed and EMBASE (2008-2017) for relevant studies...
June 12, 2018: Clinical Cardiology
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