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Surgery guidelines

Lu Hong, Hui Qiu, Zijie Mei, Hui Zhang, Shaopin Liu, Hong Cao
Supra-clavicular lymph node metastasis from ovarian cancer is rare. The present study reports the unique case of a 43-years-old patient who initially presented with left supra-clavicular lymph node metastasis, and was nulliparous. According to fine-needle aspiration cytology of the metastatic left supra-clavicular lymph nodes and 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (PET/CT) scan, the patient was diagnosed with poorly differentiated serous carcinoma of ovarian cancer, stage IV...
July 2018: Oncology Letters
Arūnas Strumila, Rūta Vilija Dagilytė, Virgilijus Beiša
Background: Infantile haemangioma is the most common childhood vascular tumour, which causes great anxiety to parents and treating first-line physicians due to its proliferative nature. It accounts for a large percentage of a tertiary centre consultations, thus delaying consultation time for patients in need of immediate care. Materials and methods: Review of literature and experience of treatment and observation of infantile haemangiomas in a tertiary centre of paediatric surgery...
2018: Acta Medica Lituanica
Maria Q B Petzel, Leah Hoffman
With slowly increasing survival rates in pancreatic cancer and international consensus guidelines recommending surgical resection of premalignant lesions, survival post-pancreatic resection is increasing. With longer survival time, the significant comorbidities of such major surgery have far-reaching effects on the nutrition status of the survivor of pancreatic cancer. This review describes the many nutrition-related side effects of pancreatic surgery, including the development of pancreatic enzyme insufficiency, micronutrient deficiencies, diabetes, fatty liver, and metabolic bone disease...
October 2017: Nutrition in Clinical Practice
Motoi Uchino, Toru Mizuguchi, Hiroki Ohge, Seiji Haji, Junzo Shimizu, Yasuhiko Mohri, Chizuru Yamashita, Yuichi Kitagawa, Katsunori Suzuki, Motomu Kobayashi, Masahiro Kobayashi, Fumie Sakamoto, Masahiro Yoshida, Toshihiko Mayumi, Koichi Hirata
BACKGROUND: Antimicrobial-coated sutures have recently become well known for preventing surgical site infections (SSIs). However, the evidence and recommendations from some organizations remain controversial. Therefore, we conducted a systematic review and meta-analysis to analyze the efficacy of antimicrobial-coated sutures for preventing SSIs in digestive surgery. METHODS: We performed a systematic review of literature published from 2000 to 2017 (registered on PROSPERO, No...
June 20, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Masahide Enomoto, Takeshi Kinoshita, Yasuo Kondo, Tomoaki Suzuki, Tohru Asai
We present the case of a 61-year-old patient with a history of essential thrombocythemia (ET) who was diagnosed as having aortic valve stenosis and dilatation of his ascending aorta. His aortic valve and ascending aorta were replaced under hypothermic circulatory arrest (HCA). No clear guideline exists for preoperative, perioperative, and postoperative management of cardiac surgery using HCA for ET patients. After performing risk assessment, we prescribed preoperative aspirin therapy and postoperative care was planned as usual for cardiovascular surgery in our establishment...
June 21, 2018: Annals of Thoracic and Cardiovascular Surgery
William C Buhrman, William B Lyman, Russell C Kirks, Michael Passeri, Dionisios Vrochides
For over two decades, enhanced recovery pathways have been implemented in many surgical disciplines, most notably in colorectal surgery. Since 2001, the Enhanced Recovery After Surgery (ERAS® ) Study Group has developed a main protocol comprising 24 evidence-based core items. While these core items unite similar preoperative, intraoperative, and postoperative principles across surgical subspecialties, variations and modifications exist to these core items based on unique considerations for each surgical subspecialty...
June 20, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Anton R Kiselev, Alexey S Korotin, Olga M Posnenkova, Yulia V Popova, Mikhail D Prokhorov, Vladimir I Gridnev
Objective: In European Society of Cardiology/European Association for Cardio-Thoracic Surgery (ESC/EACTS) guidelines, six indications have been proposed for making a decision on myocardial revascularization in patients with stable coronary artery disease (CAD). Our aim was to study a discrepancy between the actual clinical situation and ESC/EACTS indications on performing the revascularization in patients with CAD in Russia. Design and setting: We used retrospective clinical data on patients with stable CAD enrolled in the 2012-2015 Russian Registry of Hypertension, Coronary Artery Disease, and Chronic Heart Failure...
June 19, 2018: International Journal for Quality in Health Care
Joon-Hyop Lee, Hee Kyung Ahn, Jae Yeon Seok, Kyu-Chan Lee, Yong Soon Chun, Yoo Seung Chung, Young Don Lee
There is little consensus on the optimal treatment approach for newly diagnosed patients. The present study aims to provide additional evidence by evaluating a series of patients diagnosed with anaplastic thyroid carcinoma (ATC) and analyzing factors related to increased survival. This was a retrospective cohort report structured according to the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) guideline. Demographics, chief complaint, history of prior thyroid cancer, stage at presentation, management modalities (surgery, chemotherapy, radiotherapy, or observation), completeness or resection, and survival period since initial diagnosis were reviewed for patients with documentation of histologic ATC diagnosis between 2003 and 2016...
June 2018: Medicine (Baltimore)
Valeriano Leite
The 2015 guidelines from the American Thyroid Association for adults with thyroid nodules and differentiated thyroid may be particularly important in minimising potential harm from overdiagnosis and overtreatment of thyroid tumours by providing more restrictive indications for biopsy of thyroid nodules, by considering active surveillance programs, as an alternative to surgery, for papillary microcarcinomas, and by recommending more conservative surgical approaches and a more judicious use of radioiodine.
April 2018: European Endocrinology
Vital Hevia, Romain Boissier, Óscar Rodríguez-Faba, Claire Fraser-Taylor, Rhana Hassan-Zakri, Enrique Lledo, Heinz Regele, Klemens Buddde, Arnaldo Figueiredo, Jonathon Olsburgh, Alberto Breda
CONTEXT: Cancer development after kidney transplant (KT) has become a major problem, and currently, it is one of the primary causes of death in this population. Urological cancers after KT such as prostate cancer (PCa) have also increased, partly due to the increasing age of recipients and prolonged survival. PCa is the second most commonly diagnosed cancer in men, accounting for 15% of all cancers. Managing localised PCa after KT remains challenging because of treating an immunosuppressed patient with a kidney graft in the pelvic cavity...
June 16, 2018: European Urology Focus
Azeem T Malik, Nikhil Jain, Thomas J Scharschmidt, Mengnai Li, Andrew H Glassman, Safdar N Khan
BACKGROUND: Surgeon volume has been identified as an important factor impacting postoperative outcome in patients undergoing orthopedic surgeries. With an absence of a detailed systematic review, we sought to collate evidence on the impact of surgeon volume on postoperative outcomes in patients undergoing primary total hip arthroplasty. METHODS: PubMed (MEDLINE) and Google Scholar databases were queried for articles using the following search criteria: ("Surgeon Volume" OR "Provider Volume" OR "Volume Outcome") AND ("THA" OR "Total hip replacement" OR "THR" OR "Total hip arthroplasty")...
May 31, 2018: Journal of Arthroplasty
Guylaine Lefebvre, Catherine Allaire, John Jeffrey, George Vilos
OBJECTIVE: To identify the indications for hysterectomy, preoperative assessment, and available alternatives required prior to hysterectomy. Patient self-reported outcomes of hysterectomy have revealed high levels of patient satisfaction. These may be maximized by careful preoperative assessment and discussion of other treatment choices. In most cases hysterectomy is performed to relieve symptoms and improve quality of life. The patient's preference regarding treatment alternatives must be considered carefully...
July 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Y R Hu, Y Y Liu, L P Liu, H Zhang
This study aimed to observe the safety and effectiveness of different dosing regimens of low molecular weight heparin in the prevention of venous thromboembolism (VTE) and to provide a guideline for the treatment of individualized VTE prophylaxisin patients with postoperative gastrointestinal tumors. Forty patients with high risk for VTE after surgery for gastrointestinal tumors treated in Hongqi Hospital of Mudanjiang Medical University in the period October 2016 to May 2017 were included in the study. The patients were randomly divided into two groups, group A that included 24 patients treated with low molecular weight heparin (LMWH) 5000 IU every 12 hours, and group B comprised of 16 patients treated with LMWH 5000IU every 24 hours...
May 2018: Journal of Biological Regulators and Homeostatic Agents
Maria Kamenova, Jonathan Rychen, Raphael Guzman, Luigi Mariani, Jehuda Soleman
Despite being widely used, ventriculoperitoneal (VP) shunt placement is a procedure often associated with complications and revision surgeries. Many neurosurgical centers routinely perform early postoperative cranial computer tomography (CT) to detect postoperative complications (e.g., catheter malposition, postoperative bleed, over-drainage). Because guidelines are lacking, our study aimed to evaluate the yield of early routine postoperative CT after shunt placement for adult hydrocephalus. We retrospectively reviewed 173 patients who underwent frontal VP shunting for various neurosurgical conditions...
2018: PloS One
P Collinet, X Fritel, C Revel-Delhom, M Ballester, P A Bolze, B Borghese, N Bornsztein, J Boujenah, T Brillac, N Chabbert-Buffet, C Chauffour, N Clary, J Cohen, C Decanter, A Denouël, G Dubernard, A Fauconnier, H Fernandez, T Gauthier, F Golfier, C Huchon, G Legendre, J Loriau, E Mathieu-d'Argent, B Merlot, J Niro, P Panel, P Paparel, C A Philip, S Ploteau, C Poncelet, B Rabischong, H Roman, C Rubod, P Santulli, M Sauvan, I Thomassin-Naggara, A Torre, J M Wattier, C Yazbeck, N Bourdel, M Canis
First-line diagnostic investigations for endometriosis are physical examination and pelvic ultrasound. The second-line investigations are: targeted pelvic examination performed by an expert clinician, transvaginal ultrasound performed by an expert physician sonographer (radiologist or gynaecologist), and pelvic MRI. Management of endometriosis is recommended when the disease has a functional impact. Recommended first-line hormonal therapies for the management of endometriosisrelated pain are combined hormonal contraceptives (CHCs) or the 52mg levonorgestrel-releasing intrauterine system (IUS)...
June 16, 2018: Journal of Gynecology Obstetrics and Human Reproduction
Pelle Gustafson, Anders Salomonsson, Per Svensson
The WHO Checklist for Safe Surgery has been in use in Swedish healthcare since 2009. Based on national and international experiences, we have developed the original checklist, with the aim to keep its strengths and remove the weaknesses. The most obvious difference is that each section of the original checklist has been split into a pure checklist and corresponding instructions. It is now also more obvious that the basis for the checklist is local guidelines/routines. It is primarily via these local guidelines/routines that local adaptations can be made...
June 19, 2018: Läkartidningen
Jake Xavier Checketts, Jared T Scott, Chase Meyer, Jarryd Horn, Jaclyn Jones, Matt Vassar
BACKGROUND: The fragility index (FI) may prove to be a powerful metric of trial robustness. The FI is the minimum number of patient events that would need to become nonevents in order to nullify a significant result. The fragility quotient (FQ) is the FI divided by the total sample size. This study evaluates the robustness of the 20% of orthopaedic clinical trials that were cited as having strong evidence in the American Academy of Orthopaedic Surgeons (AAOS) Clinical Practice Guidelines and that could be analyzed with these indices...
June 20, 2018: Journal of Bone and Joint Surgery. American Volume
Maureen K Dwyer, Christopher Damsgaard, Jason Wadibia, Gordon Wong, Damien Lazar, Eric Smith, Carl Talmo, Hany Bedair
BACKGROUND: Although 2-stage exchange arthroplasty is the most effective treatment among available strategies for managing chronic periprosthetic joint infection (PJI), rates of its success vary greatly. The purpose of our study was to examine whether objective measurements collected at the time of the diagnosis of PJI could be used to identify patients at risk of failure of 2-stage exchange. METHODS: We identified 205 patients across 4 institutions who underwent 2-stage exchange arthroplasty for the treatment of PJI following total hip or total knee arthroplasty...
June 20, 2018: Journal of Bone and Joint Surgery. American Volume
Piotr Wranicz, Bente Brokstad Herlofson, Jan F Evensen, Ulf E Kongsgaard
Introduction Trismus, or limited mouth opening, is a well-known complication of head and neck cancer and its treatment. It may be caused by tumour infiltration into the masticatory muscles or by treatment like surgery and radiotherapy. A limited mouth opening may have a negative effect on nutrition, phonation, dental hygiene and treatment, and quality of life. The severity of this complication depends on the location of the tumour, the type of reconstruction, the total radiation dose, fractionation, and treatment techniques...
December 29, 2017: Scandinavian Journal of Pain
Jan Norum, Lise Balteskard, Mette Willumstad Thomsen, Hebe Desiree Kvernmo
Rough weather conditions in the subarctic areas of Norway may influence on the risk of wrist fracture. We implemented data from the Norwegian System of Patient Injury Compensation (NPE). All claims due to wrist surgery, performed at the public hospitals in Northern Norway, during 2005-2014 were analyzed. We employed the ICD-10 classification codes S52.5 (fracture of distal end of radius) and S52.6 (fracture of distal end of radius and ulna). Treatment was defined by NCSP codes. 84 patients (0.3%) complained...
December 2018: International Journal of Circumpolar Health
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