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the association of perioperative practice

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https://www.readbyqxmd.com/read/28720378/a-novel-technique-carbon-dioxide-gas-assisted-total-peritonectomy-diaphragm-and-intestinal-meso-stripping-in-open-surgery-for-advanced-ovarian-cancer-%C3%A3-ukurova-technique
#1
Ghanim Khatib, Ahmet Baris Guzel, Umran Kucukgoz Gulec, Mehmet Ali Vardar
OBJECTIVE: Most of the ovarian cancers are diagnosed at advanced stages. As peritoneal carcinomatosis increases, especially when it extends to the diaphragm and intestinal mesos, probability of obtaining complete cytoreduction is reduced. Complete cytoreduction (residue zero: R0) is one of the main factors affecting survival [1-3]. Here we present a novel technique of stripping the peritoneal surfaces as a part of cytoreductive surgery in such cases. METHODS: A 55year-old woman diagnosed with peritoneal carcinomatosis was considered appropriate for primary cytoreduction after assessment of her thorax-abdominopelvic tomography, which revealed resectable intra-abdominal disease...
July 15, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28719527/pupillometry-guided-intraoperative-remifentanil-administration-versus-standard-practice-influences-opioid-use-a-randomized-study
#2
Nada Sabourdin, Jérôme Barrois, Nicolas Louvet, Agnès Rigouzzo, Marie-Laurence Guye, Christophe Dadure, Isabelle Constant
BACKGROUND: Pupillometry has shown promising results for assessing nociception in anesthetized patients. However, its benefits in clinical practice are not demonstrated. The aim of this prospective randomized study was to evaluate the impact of intraoperative pupillometry monitoring on perioperative opioid consumption in major gynecologic surgery. METHODS: After receiving ethics committee approval and written consent of patients, American Society of Anesthesiologists status I to II women undergoing gynecologic surgery were included in this single-blinded, prospective, parallel-arm randomized study...
August 2017: Anesthesiology
https://www.readbyqxmd.com/read/28698538/warfarin-should-not-be-used-for-thromboprohylaxis-in-elective-major-orthopaedic-surgery-a-croatian-perspective
#3
Robert Kolundžić, Marijana Šimić Jovičić, Maja Ðinkić, Tadija Petrović, Tomislav Crnković, Vladimir Trkulja
Aim To identify modes of venous thromboembolism (VTE) prophylaxis in patients undergoing elective major orthopaedic surgery (total hip or knee arthroplasty, THA/TKA) at a single university-associated hospital in Croatia. Methods A retrospective analysis of consecutive patients subjected to THA or TKA over a two-year period (2014-2015) with a focus on anticoagulation during the first 15 post-surgical days (period of highest VTE risk). Results Of 603 identified patients three (0.5%) were not anticoagulated (haemophilia) and others received perioperative doses of low molecular weight heparins (LMWH)...
August 1, 2017: Medicinski Glasnik
https://www.readbyqxmd.com/read/28696816/pre-existing-mesh-at-the-hiatus-in-revisional-surgery-does-not-result-in-increased-morbidity-a-case-control-evaluation
#4
Rana M Higgins, Max Schumm, Matthew E Bosler, Jon C Gould
BACKGROUND: Mesh is sometimes used to reinforce the hiatus during primary and reoperative fundoplication. This is a controversial practice as it is not clear that this leads to a decreased rate of failure of the hiatal closure, and concerns about morbidity related to the presence of mesh in this location exist. One of these concerns is that if reoperation is ever required (fundoplication herniates through the hiatus, for example), revisional surgery would be significantly more difficult and associated with a higher rate of morbidity than if mesh had not been placed at the hiatus in a previous procedure...
July 11, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28693817/investigation-of-perioperative-hidden-blood-loss-of-unstable-intertrochanteric-fracture-in-the-elderly-treated-with-different-intramedullary-fixations
#5
Xu Yang, Qiang Wu, Xin Wang
OBJECTIVE: Our aim was to investigate perioperative hidden blood loss (PHBL) of unstable intertrochanteric fracture (UIF) in the elderly treated with different intramedullary fixations. PATIENTS AND METHODS: 120 consecutive elderly patients with UIF treated by intramedullary nails between January 2013 and September 2016 were enrolled in the retrospective study, including 52 patients (mean age 79.6±6.3) for the Third generation Gamma Nail (TGN), 51 patients (mean age 79...
June 24, 2017: Injury
https://www.readbyqxmd.com/read/28693251/clinical-features-and-surgical-management-of-intracranial-meningiomas-in-the-elderly
#6
Junkoh Yamamoto, Mayu Takahashi, Masaru Idei, Yoshiteru Nakano, Yoshiteru Soejima, Daisuke Akiba, Takehiro Kitagawa, Kunihiro Ueta, Ryo Miyaoka, Shigeru Nishizawa
Meningioma accounts for ~25% of all primary intracranial neoplasms and the incidence increases with age. Prvios population-based studies demonstrated that the annual incidence of intracranial meningiomas was 1.2-3.1/100,000 population. In particular, the incidence of this disease among the elderly is high. Recently, increased life expectancy and greater use of diagnostic radiological imaging led to an increased incidence in the diagnosis of intracranial meningiomas, both symptomatic and asymptomatic, in the elderly...
July 2017: Oncology Letters
https://www.readbyqxmd.com/read/28692506/reduction-of-surgical-site-infections-after-cranioplasty-with-perioperative-bundle
#7
Huiquan Liu, Xinlong Dong, Yue Yin, Zixiang Chen, Jianning Zhang
BACKGROUND: Surgical site infections (SSI) are the most common complication after cranioplasty and it is associated with poor prognosis. The aim of this study was to identify the risk factors that triggered the development of SSI after cranioplasty and establish a new perioperative bundle and monitoring system to reduce SSI. METHODS: A retrospective review of a database that included all cranioplasty patients from 2001 to 2007 was carried out to determine the prevalence of infection...
July 7, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28689939/variation-in-transfusion-practices-and-the-association-with-perioperative-adverse-events-in-patients-undergoing-open-abdominal-aortic-aneurysm-repair-and-lower-extremity-arterial-bypass-in-the-vascular-quality-initiative
#8
Zachary Osborne, Kristine Hanson, Benjamin S Brooke, Marc Schermerhorn, Peter Henke, Rumi Faizer, Andres Schanzer, Philip Goodney, Thomas Bower, Randall R DeMartino
INTRODUCTION: Blood transfusions are associated with adverse events. We examined perioperative transfusion practices and associated complications following open vascular procedures nationwide in the Vascular Quality Initiative (VQI). METHODS: Adults undergoing open abdominal aortic aneurysm repair (OAR) and lower extremity arterial bypass (Bypass) within VQI (2003-2016) were identified. All emergent cases, patients with pre-operative hemoglobin<7 g/dL, pre-operative hospitalization >1 day, or a return to OR during the index hospitalization were excluded...
July 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28678071/reporting-of-perioperative-adverse-events-by-pediatric-anesthesiologists-at-a-tertiary-children-s-hospital-targeted-interventions-to-increase-the-rate-of-reporting
#9
Glyn D Williams, Matthew K Muffly, Julianne M Mendoza, Nina Wixson, Kit Leong, Rebecca E Claure
BACKGROUND: Incident reporting systems (IRSs) are important patient safety tools for identifying risks and opportunities for improvement. A major IRS limitation is underreporting of incidents. Perioperative anesthesia IRSs have been established at multiple pediatric institutions and a national pediatric anesthesia IRS for perioperative serious adverse events (SAEs) is maintained by Wake Up Safe (WUS), a patient safety organization dedicated to pediatric anesthesia quality improvement...
July 1, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28662785/guideline-implementation-minimally-invasive-surgery-part-1
#10
Annette Wasielewski
Since its inception in the early 1990s, technological developments have made minimally invasive surgery the preferred approach for many operative procedures. However, perioperative personnel have had to develop new skills and techniques to manage this technology. The advent of robotic-assisted procedures in the early 2000s added another level of complexity to the perioperative arena. The updated AORN "Guideline for minimally invasive surgery" provides guidance for creating a safe environment for patients undergoing a wide range of procedures in which complex, advanced equipment and techniques are used...
July 2017: AORN Journal
https://www.readbyqxmd.com/read/28660816/the-role-of-antimicrobial-sutures-in-preventing-surgical-site-infection
#11
D Leaper, P Wilson, O Assadian, C Edmiston, M Kiernan, A Miller, G Bond-Smith, J Yap
INTRODUCTION Healthcare associated infections (HCAIs) are falling following widespread and enforced introduction of guidelines, particularly those that have addressed antibiotic resistant pathogens such as methicillin resistant Staphylococcus aureus or emergent pathogens such as Clostridium difficile, but no such decline has been seen in the incidence of surgical site infection (SSI), either in the UK, the EU or the US. SSI is one of the HCAIs, which are all avoidable complications of a surgical patient's pathway through both nosocomial and community care...
July 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28660135/perioperative-blood-management-strategies-for-patients-undergoing-total-knee-replacement-where-do-we-stand-now
#12
REVIEW
Tzatzairis Themistoklis, Vogiatzaki Theodosia, Kazakos Konstantinos, Drosos I Georgios
Total knee replacement (TKR) is one of the most common surgeries over the last decade. Patients undergoing TKR are at high risk for postoperative anemia and furthermore for allogeneic blood transfusions (ABT). Complications associated with ABT including chills, rigor, fever, dyspnea, light-headedness should be early recognized in order to lead to a better prognosis. Therefore, perioperative blood management program should be adopted with main aim to reduce the risk of blood transfusion while maximizing hemoglobin simultaneously...
June 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28644545/robotic-versus-laparoscopic-rectal-surgery-in-high-risk-patients
#13
Jamil Ahmed, Han Cao, Sofoklis Panteleimonitis, Jim Khan, Amjad Parvaiz
AIM: Laparoscopic rectal surgery is associated with a steep learning curve and high conversion rate despite progress in equipment design and consistent practice. The robotic system has shown the advantage over laparoscopic approach due to stable three-dimensional views, improved dexterity and better ergonomics. These factors make the robotic approach more favourable for rectal surgery. The aim of this study was to compare the perioperative outcomes of laparoscopic and robotic rectal cancer surgery in high-risk patients...
June 23, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28644187/perioperative-blood-management-in-pediatric-spine-surgery
#14
Matthew E Oetgen, Jody Litrenta
Blood management strategies are integral to successful outcomes in many types of orthopaedic surgery. These strategies minimize blood loss and transfusion requirements, ultimately decreasing complications, improving outcomes, and potentially eliminating risks associated with allogeneic transfusion. Practices to achieve these goals include preoperative evaluation and optimization of hemoglobin, the use of pharmacologic agents or anesthetic methods, intraoperative techniques to improve hemostasis and cell salvage, and the use of predonated autologous blood...
July 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28633374/cohort-study-of-preoperative-blood-pressure-and-risk-of-30-day-mortality-after-elective-non-cardiac-surgery
#15
S Venkatesan, P R Myles, H J Manning, A M Mozid, C Andersson, M E Jørgensen, J G Hardman, S R Moonesinghe, P Foex, M Mythen, M P W Grocott, R D Sanders
Background: Preoperative blood pressure (BP) thresholds associated with increased postoperative mortality remain unclear. We investigated the relationship between preoperative BP and 30-day mortality after elective non-cardiac surgery. Methods: We performed a cohort study of primary care data from the UK Clinical Practice Research Datalink (2004-13). Parsimonious and fully adjusted multivariable logistic regression models, including restricted cubic splines for numerical systolic and diastolic BP, for 30-day mortality were constructed...
June 15, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28623117/open-heart-surgery-does-not-increase-the-incidence-of-ipsilateral-ischemic-stroke-in-patients-with-asymptomatic-severe-carotid-stenosis
#16
John E Castaldo, Hussam A Yacoub, Yuebing Li, Hope Kincaid, Donna Jenny
BACKGROUND AND PURPOSE: We evaluated the incidence of perioperative stroke following the institution's 2007 practice change of discontinuing combined carotid endarterectomy and open heart surgery (OHS) for patients with severe carotid stenosis. METHODS: In this retrospective cohort study, we compared 113 patients undergoing coronary artery bypass grafting, aortic valve replacement, or both from 2007 to 2011 with data collected from 2001 to 2006 from a similar group of patients...
June 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28620968/clinical-practice-guidelines-incorporating-input-from-a-patient-panel
#17
Susan M Goodman, Amy S Miller, Marat Turgunbaev, Gordon Guyatt, Adolph Yates, Bryan Springer, Jasvinder A Singh
OBJECTIVE: To describe the integral role of a Patient Panel in the development of the 2017 American College of Rheumatology (ACR)/American Association of Hip and Knee Surgeons (AAHKS) clinical practice guideline. METHODS: We convened a Panel of 11 patients with rheumatoid arthritis and juvenile idiopathic arthritis, all of whom had undergone 1 or more arthroplasties, to review the evidence and provide guidance on recommendations for the 2017 ACR/AAHKS guideline to address the perioperative management of antirheumatic medication in patients with rheumatic diseases undergoing elective total hip or total knee arthroplasty...
June 16, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28600732/time-to-initiation-of-adjuvant-chemotherapy-in-pancreas-cancer-a-multi-institutional-experience
#18
Brent T Xia, Syed A Ahmad, Ali H Al Humaidi, Dennis J Hanseman, Cecilia G Ethun, Shishir K Maithel, David A Kooby, Ahmed Salem, Clifford S Cho, Sharon M Weber, Susan J Stocker, Mark S Talamonti, David J Bentrem, Daniel E Abbott
BACKGROUND: Despite randomized trials addressing adjuvant therapy (AT) for pancreas cancer, the ideal time to initiate therapy remains undefined. Retrospective analyses of the ESPAC-3 trial demonstrated that time to initiation of AT did not impact overall survival (OS). Given the absence of confirmatory data outside of a clinical trial, we sought to determine if AT timing in routine clinical practice is associated with OS differences. METHODS: Perioperative data of pancreatectomies for ductal adenocarcinoma from five institutions (2005-2015) were assessed...
June 9, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28599967/challenging-surgical-dogma-in-the-management-of-proximal-esophageal-atresia-with-distal-tracheoesophageal-fistula-outcomes-from-the-midwest-pediatric-surgery-consortium
#19
Dave R Lal, Samir K Gadepalli, Cynthia D Downard, Daniel J Ostlie, Peter C Minneci, Ruth M Swedler, Thomas H Chelius, Laura Cassidy, Cooper T Rapp, Deborah Billmire, Steven Bruch, R Carland Burns, Katherine J Deans, Mary E Fallat, Jason D Fraser, Julia Grabowski, Ferdynand Hebel, Michael A Helmrath, Ronald B Hirschl, Rashmi Kabre, Jonathan Kohler, Matthew P Landman, Charles M Leys, Grace Z Mak, Jessica Raque, Beth Rymeski, Jacqueline M Saito, Shawn D St Peter, Daniel von Allmen, Brad W Warner, Thomas T Sato
PURPOSE: Perioperative management of infants with esophageal atresia and tracheoesophageal fistula (EA/TEF) is frequently based on surgeon experience and dogma rather than evidence-based guidelines. This study examines whether commonly perceived important aspects of practice affect outcome in a contemporary multi-institutional cohort of patients undergoing primary repair for the most common type of esophageal atresia anomaly, proximal EA with distal TEF. METHODS: The Midwest Pediatric Surgery Consortium conducted a multicenter, retrospective study examining selected outcomes on infants diagnosed with proximal EA with distal TEF who underwent primary repair over a 5-year period (2009-2014), with a minimum 1-year follow up, across 11 centers...
June 1, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28589690/perioperative-management-of-new-oral-anticoagulants-in-patients-undergoing-elective-surgery-at-a-tertiary-hospital
#20
Henry Wamala, Ian A Scott, Xenia Caney
BACKGROUND: Increasing numbers of patients receiving new oral anticoagulants (NOACs) are undergoing elective surgery. The extent to which perioperative interruption of NOAC therapy and use of bridging heparin are concordant with best evidence is uncertain. METHODS: Retrospective study of consecutive adult patients undergoing elective surgery at a tertiary hospital between January 1(st) 2014 and June 30(th) 2015 and were receiving NOACs for at least 3 months prior to surgery...
June 7, 2017: Internal Medicine Journal
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