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Perioperative surgical home

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https://www.readbyqxmd.com/read/28733750/magnetic-surgery-first-u-s-experience-with-a-novel-device
#1
Ivy N Haskins, Andrew T Strong, Matthew T Allemang, Kalman P Bencsath, John H Rodriguez, Matthew D Kroh
INTRODUCTION: Magnet-assisted surgery is a new platform within minimally invasive surgery. The Levita™ Magnetic Surgical System, the first magnetic surgical system to receive Food and Drug Administration (FDA) approval, includes a deployable, magnetic grasper and an external magnet that is used to manipulate the grasper within the peritoneal cavity. This system is currently approved for patients undergoing laparoscopic cholecystectomy with a body mass index (BMI) between 21 and 34 kg/m(2)...
July 21, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28731875/management-of-complex-spine-surgery
#2
Massimo Lamperti, Boris Tufegdzic, Rafi Avitsian
PURPOSE OF REVIEW: The main objective of this article is to present the updated data regarding the perioperative management of patients undergoing major spine surgery in an era where the surgical techniques are changing and there is a high demand for these surgeries in older and high-risk patients. RECENT FINDINGS: Preoperative assessment and stabilization is now more structured protocol and it is based on a multidisciplinary approach to the patient. The Enhanced Recovery After Surgery (ERAS) programs and the Perioperative Surgical Home on major spine surgery are not yet fully evidence based but it seems that the use of a perioperative optimization of patients and use of a drugs' bundle is more effective than using single drugs or interventions on the postoperative pain reduction and faster recovery from surgery...
July 20, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28709946/frailty-and-sarcopenia-do-not-predict-adverse-events-in-an-elderly-population-undergoing-non-complex-primary-elective-surgery-for-degenerative-conditions-of-the-lumbar-spine
#3
Raphaële Charest-Morin, John Street, Honglin Zhang, Taren Roughead, Tamir Ailon, Michael Boyd, Marcel Dvorak, Brian Kwon, Scott Paquette, Nicolas Dea, Charles G Fisher, Alana M Flexman
BACKGROUND CONTEXT: Sarcopenia measured by normalized total psoas area (NTPA) has been shown to predict mortality and adverse events (AE) in numerous surgical populations. The relationship between sarcopenia and postoperative outcomes after surgery for degenerative spine disease (DSD) has not been investigated. PURPOSE: This study aimed to determine the relationships between sarcopenia, frailty and postoperative adverse events in the elderly DSD population. Secondary objectives were to describe the distribution and predictors of NTPA and to determine the relationship between sarcopenia, frailty and length of stay, discharge to a facility and in-hospital mortality...
July 11, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28694151/liposomal-bupivacaine-decreases-pain-following-retropubic-sling-placement-a-randomized-placebo-controlled-trial
#4
Donna Mazloomdoost, Rachel N Pauls, Erin N Hennen, Jennifer Y Yeung, Benjamin C Smith, Steven D Kleeman, Catrina C Crisp
BACKGROUND: Midurethral slings are used commonly to treat stress urinary incontinence. Pain control, however, may be a concern. Liposomal bupivacaine is a local anesthetic with slow release over 72 hours that has been demonstrated to lower pain scores and decrease narcotic use after the procedure. OBJECTIVE: The purpose of this stud was to examine the impact of liposomal bupivacaine on pain scores and narcotic consumption after retropubic midurethral sling placement...
July 8, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28673707/predictors-of-survival-functional-survival-and-hospital-readmission-in-octogenarians-after-surgical-aortic-valve-replacement
#5
Kendra Kuo, Pallav Shah, Brett Hiebert, Karin Love, Alan H Menkis, Rizwan A Manji, Rakesh C Arora
OBJECTIVE: To analyze outcomes and predictors of functional survival (personal care home admission and mortality) and hospital readmission in patients aged ≥80 years who underwent surgical aortic valve replacement (SAVR) in a Manitoba hospital. METHODS: This was a retrospective cohort study of patients aged ≥80 years who underwent SAVR with or without coronary artery bypass grafting in Manitoba between 1995 and 2014. Data from the Manitoba Adult Cardiac Surgery database and the Manitoba Centre for Health Policy were used...
May 23, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28668859/inflammatory-and-nutritional-serum-markers-as-predictors-of-peri-operative-morbidity-and-survival-in-ovarian-cancer
#6
Amanika Kumar, Michelle L Torres, William A Cliby, Kimberly R Kalli, Giorgio Bogani, Giovanni Aletti, Caroline C Nitschmann, Francesco Multinu, Amy L Weaver, Matthew S Block, Andrea Mariani
AIM: To identify preoperative nutritional and inflammatory markers that predict perioperative outcomes in patients with ovarian cancer (OC). PATIENTS AND METHODS: Fifty patients who underwent primary debulking for advanced (stage III/IV) OC were selected from a cohort of patients who underwent surgery between 2002 and 2009. We analyzed C-reactive protein (CRP), interleukin-6 (IL6) and albumin and their impact on mortality and surgical outcomes. RESULTS: Two patients were excluded since they did not have adequate measurements of CRP and IL6...
July 2017: Anticancer Research
https://www.readbyqxmd.com/read/28665804/septic-arthritis-of-the-shoulder-a-comparison-of-treatment-methods
#7
Jimmy J Jiang, Hristo I Piponov, Daniel P Mass, Jovito G Angeles, Lewis L Shi
INTRODUCTION: In-hospital outcomes were compared among patients with shoulder septic arthritis treated with arthrocentesis, open irrigation and débridement, or arthroscopic irrigation and débridement. METHODS: The Nationwide Inpatient Sample database was queried for all cases of native shoulder septic arthritis between 2002 and 2011. Patient demographics, comorbidities, and hospitalization complications were compared for the shoulder arthrocentesis (nonsurgical) and open or arthroscopic irrigation and débridement (surgical) groups...
June 29, 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28647727/patients-as-partners-in-enhanced-recovery-after-surgery-a-qualitative-patient-led-study
#8
Chelsia Gillis, Marlyn Gill, Nancy Marlett, Gail MacKean, Kathy GermAnn, Loreen Gilmour, Gregg Nelson, Tracy Wasylak, Susan Nguyen, Edamil Araujo, Sandra Zelinsky, Leah Gramlich
OBJECTIVES: Explore the experience of patients undergoing colorectal surgery within an Enhanced Recovery After Surgery (ERAS) programme. Use these experiential data to inform the development of a framework to support ongoing, meaningful patient engagement in ERAS. DESIGN: Qualitative patient-led study using focus groups and narrative interviews. Data were analysed iteratively using a Participatory Grounded Theory approach. SETTING: Five tertiary care centres in Alberta, Canada, following the ERAS programme...
June 24, 2017: BMJ Open
https://www.readbyqxmd.com/read/28643147/the-perioperative-surgical-home-improving-the-value-and-quality-of-care-in-total-joint-replacement
#9
REVIEW
George F Chimento, Leslie C Thomas
PURPOSE OF REVIEW: The perioperative surgical home (PSH) is a patient-centered, physician-led, multidisciplinary care pathway developed to deliver value-based care based on shared decision-making. Physician and hospital reimbursement will be tied to providing quality care at lower cost, and the PSH model has been used in providing care to patients undergoing lower extremity arthroplasty. The purpose of this review is to discuss the rationale, definition, development, current state, and future direction of the PSH...
June 22, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28632542/creation-and-execution-of-a-novel-anesthesia-perioperative-care-service-at-a-veterans-affairs-hospital
#10
Bret D Alvis, Adam B King, Pratik P Pandharipande, Liza M Weavind, Katelin Avila, Philip J Leisy, Muhammad Ajmal, Michael McHugh, Kirk A Keegan, David A Baker, Ann Walia, Christopher G Hughes
Physician-led perioperative surgical home models are developing as a method for improving the American health care system. These models are novel, team-based approaches that help to provide continuity of care throughout the perioperative period. Another avenue for improving care for surgical patients is the use of enhanced recovery after surgery pathways. These are well-described methods that have shown to improve perioperative outcomes. An established perioperative surgical home model can help implementation, efficiency, and adherence to enhanced recovery after surgery pathways...
June 16, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28632535/perioperative-surgical-home-evaluation-of-a-new-protocol-focused-on-a-multidisciplinary-approach-to-manage-children-undergoing-posterior-spinal-fusion-operation
#11
Eugene Kim, Brian Lee, Giovanni Cucchiaro
BACKGROUND: The concept of Perioperative Surgical Home has been gaining significant attention in surgical centers. This model is delivering and improving coordinated care in a cost-effective manner to patients undergoing surgical procedures. It starts with the decision for surgical intervention, continues to the intraoperative and postoperative periods, and follows into long-term recovery. Constant re-evaluation of outcomes and modifications of delivery provides a feedback loop for improvement...
June 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28598923/readmissions-to-different-hospitals-after-common-surgical-procedures-and-consequences-for-implementation-of-perioperative-surgical-home-programs
#12
Franklin Dexter, Richard H Epstein, Eric C Sun, David A Lubarsky, Elisabeth U Dexter
BACKGROUND: We consider whether there should be greater priority of information sharing about postacute surgical resources used: (1) at skilled nursing facilities or inpatient rehabilitation hospitals to which patients are transferred upon discharge (when applicable) versus (2) at different hospitals where readmissions occur. Obtaining and storing data electronically from these 2 sources for Perioperative Surgical Home initiatives are dissimilar; both can be challenging depending on the country and health system...
June 7, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28577163/expanding-the-circle-of-care-can-children-find-a-perioperative-surgical-home
#13
EDITORIAL
Davinia E Withington
No abstract text is available yet for this article.
June 2, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28549029/a-contemporary-approach-to-reoperative-aortic-valve-surgery-when-is-less-more
#14
Deane E Smith, Michael S Koeckert, Patrick F Vining, Elias A Zias, Eugene A Grossi, Aubrey C Galloway
OBJECTIVE: Although the benefits of minimally invasive valvular surgery are well established, the applicability of extending these techniques to reoperative aortic valve surgery is unknown. We evaluated our experience with a minimally invasive approach to this patient population. METHODS: From January 2010 to September 2015, 21 patients underwent reoperative isolated aortic valve replacement via a minimally invasive approach by a single surgeon. All patients had preoperative evaluation with computerized tomography and coronary catheterization...
May 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
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
#15
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/28521346/real-time-magnetic-resonance-imaging-guided-biopsy-using-smartframe%C3%A2-stereotaxis-in-the-setting-of-a-conventional-diagnostic-magnetic-resonance-imaging-suite
#16
Justin K Scheer, Thomas Hamelin, Leon Chang, Brian Lemkuil, Bob S Carter, Clark C Chen
BACKGROUND: Real-time magnetic resonance imaging (MRI) visualization during stereotactic needle biopsies affords several valuable benefits to the neurosurgeon, including the opportunity to visually confirm the biopsy site at the time of surgery. Until now, reported experiences with this technique have been limited to the setting of intraoperative MRI or dedicated procedural MRI suites with modified ventilation systems. OBJECTIVE: To describe our experience with 11 consecutive patients who underwent real-time MRI-guided biopsy performed using SmartFrame® stereotaxis (MRI Interventions, Irvine, California) in the setting of a conventional diagnostic MRI suite...
June 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28511972/a-matched-cohort-comparison-of-cervical-disc-arthroplasty-versus-anterior-cervical-discectomy-and-fusion-evaluating-perioperative-outcomes
#17
Pavan S Upadhyayula, John K Yue, Erik I Curtis, Reid Hoshide, Joseph D Ciacci
OBJECTIVE: Cervical disc arthroplasty (CDA) is a recent alternative to anterior cervical discectomy and fusion (ACDF) in patients suffering cervical disc herniation and degeneration. To date, a systematic analysis of their comparative advantages and risks following elective surgery remains elusive. METHODS: Adult patients undergoing elective CDA or ACDF were extracted from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database years 2011-2014...
May 13, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28504359/changing-the-paradigm-for-diagnostic-mri-in-pediatrics-don-t-hold-your-breath
#18
Melissa M Masaracchia, Michael J Tsapakos, Nancy J McNulty, Michael L Beach
Increasingly complex pediatric patients and improvements in technology warrant reevaluation of the risk associated with anesthesia for diagnostic imaging. Although magnetic resonance imaging is the imaging modality of choice for children given the potentially harmful effects of computerized tomography-associated ionizing radiation, we dare to suggest that certain patients would benefit from the liberalization of our current standard. Incorporating the use of newer computerized tomography technology may improve safety for those that are already at higher risk for adverse events...
May 15, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28501112/early-results-of-a-surgeon-led-perioperative-surgical-home
#19
Anathea C Powell, Marie S Thearle, Matthew Cusick, Dorothy Jensen Sanderson, Holly Van Lew, Candace Lee, Jennefer A Kieran
BACKGROUND: The Perioperative Surgical Home is a novel care model designed to provide patient-centered, high-quality surgical care. In 2013, we implemented POSH, a pilot Peri-Operative Surgical Home at Phoenix Indian Medical Center (PIMC), an Indian Health Service hospital, as a quality improvement project. After 2 y, we sought to quantify the impact of POSH on the quality of surgical care at PIMC. MATERIALS AND METHODS: We conducted a retrospective review of 33 surgical patients who underwent surgery at PIMC through the POSH process between 2013 and 2015 matched to 64 historical controls with similar operations...
May 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28492816/enhanced-recovery-after-surgery-program-implementation-in-2-surgical-populations-in-an-integrated-health-care-delivery-system
#20
Vincent X Liu, Efren Rosas, Judith Hwang, Eric Cain, Anne Foss-Durant, Molly Clopp, Mengfei Huang, Derrick C Lee, Alex Mustille, Patricia Kipnis, Stephen Parodi
Importance: Novel approaches to perioperative surgical care focus on optimizing nutrition, mobility, and pain management to minimize adverse events after surgical procedures. Objective: To evaluate the outcomes of an enhanced recovery after surgery (ERAS) program among 2 target populations: patients undergoing elective colorectal resection and patients undergoing emergency hip fracture repair. Design, Setting, and Participants: A pre-post difference-in-differences study before and after ERAS implementation in the target populations compared with contemporaneous surgical comparator groups (patients undergoing elective gastrointestinal surgery and emergency orthopedic surgery)...
July 19, 2017: JAMA Surgery
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