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Safety in surgery

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https://www.readbyqxmd.com/read/28732369/efficacy-and-safety-of-accelerated-partial-breast-irradiation-a-meta-analysis-of-published-randomized-studies
#1
Gengchun Liu, Zhongyi Dong, Baqun Huang, Yuelong Liu, Yan Tang, Qing Li, Yihui Zhu
BACKGROUND AND PURPOSE: Accelerated partial breast irradiation (APBI) technology has theoretical advantages in comparison with traditional adjuvant radiation therapy (whole-breast irradiation; WBI) after breast-conserving surgery. However, published randomized controlled trials have shown inconsistent outcomes. Therefore, a comprehensive assessment of the effectiveness and safety of APBI technology is needed. RESULTS: A total of 7 studies of 7452 patients were included in this analysis...
July 13, 2017: Oncotarget
https://www.readbyqxmd.com/read/28732252/update-on-medical-treatment-of-uterine-fibroids
#2
REVIEW
Fátima Faustino, Margarida Martinho, José Reis, Fernanda Águas
OBJECTIVES: In this review paper, the pros and cons of the available pharmacological options for the treatment of uterine fibroids are explored, including oral progestogens, levonorgestrel intra-uterine device, gonadotropin-releasing hormone analogs and progesterone receptor modulators with an emphasis on ulipristal acetate. STUDY DESIGN: The choice of the appropriate therapeutic approach for uterine fibroids depends on several factors, including women's age, parity, childbearing aspirations and wish to preserve fertility, extent and severity of symptoms, size, number and location of myomas, risk of malignancy and proximity to menopause...
July 8, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28730781/feasibility-research-of-treating-advanced-gastric-carcinoma-with-laparoscopy
#3
Hailin Xi, Rui Li, Hongqiang Yang, Su Feng, Ruihao Qin
PURPOSE: To determine the feasibility and safety of treating patients with advanced gastric cancer with laparoscopy. METHODS: We retrospectively analyzed 180 patients with advanced gastric carcinoma and divided them into either the laparoscopy group (96 cases) or the laparotomy group (84 cases). RESULTS: The number of lymph nodes dissected during surgery and the surgical time were similar in both groups. The incision length, total amount of bleeding during the operation, postoperative exhaust recovery time, and the length of hospital stay were significantly improved in the laparoscopy group when compared to the laparotomy group...
March 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/28730759/surgical-treatment-for-colorectal-cancer-in-octogenarians-and-nonagenarians
#4
Young Wan Kim
Advances in surgical techniques and perioperative care have improved cancer-related outcomes. However, there are still concerns regarding the safety of octogenarian and nonagenarian patients during surgery. Clinicians may be reluctant to perform a radical resection for colorectal cancer and administer adjuvant or palliative cytotoxic chemotherapy to octogenarian and nonagenarian patients. In the elderly, setting a primary goal based on multidisciplinary team discussions prior to treatment is important. The overall treatment scheme, risks, and potential benefits should be discussed with elderly patients and their families...
May 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/28730285/an-update-on-implants-for-minimally-invasive-glaucoma-surgery-migs
#5
REVIEW
Ejaz Ansari
For several years, the gold standard for surgical treatment of glaucoma has been trabeculectomy. Although very successful at reducing intraocular pressure (IOP), there are several potential complications of trabeculectomy, including sight-threatening ones. This has stimulated much research aimed at the development of new and effective procedures to lower IOP with an enhanced safety profile. Minimally invasive glaucoma surgery (MIGS) procedures prioritise patient safety but also demonstrate efficacy in reducing IOP...
July 20, 2017: Ophthalmology and Therapy
https://www.readbyqxmd.com/read/28730276/effect-of-patient-reported-smoking-status-on-short-term-bariatric-surgery-outcomes
#6
Michael Inadomi, Rahul Iyengar, Ilana Fischer, Xing Chen, Emily Flagler, Amir A Ghaferi
INTRODUCTION: Preoperative patient screening is a major contributor to the remarkable safety of bariatric surgery. Smoking status is a modifiable patient risk factor, and smoking cessation is associated with improved outcomes in surgical patients. However, the length of smoking cessation necessary to optimize bariatric surgery patient outcomes is not yet defined. We sought to explore the relationship between patient-reported smoking status and short-term bariatric surgery outcomes. METHODS: Using prospectively collected data from the MBSC registry, we evaluated the effects of patient-reported length of tobacco abstinence on 30-day surgical outcomes...
July 20, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28729780/best-practices-for-robotic-surgery-programs
#7
Stephanie J Estes, David Goldenberg, Joshua S Winder, Ryan M Juza, Jerome R Lyn-Sue
BACKGROUND AND OBJECTIVES: Robotic surgical programs are increasing in number. Efficient methods by which to monitor and evaluate robotic surgery teams are needed. METHODS: Best practices for an academic university medical center were created and instituted in 2009 and continue to the present. These practices have led to programmatic development that has resulted in a process that effectively monitors leadership team members; attending, resident, fellow, and staff training; credentialing; safety metrics; efficiency; and case volume recommendations...
April 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28729319/accelerated-enhanced-recovery-following-minimally-invasive-colorectal-cancer-surgery-recovermi-a-study-protocol-for-a-novel-randomised-controlled-trial
#8
Brandee A Price, Brian K Bednarski, Y Nancy You, Meryna Manandhar, E Michelle Dean, Zeinab M Alawadi, B Bryce Speer, Vijaya Gottumukkala, Marla Weldon, Robert L Massey, Xuemei Wang, Wei Qiao, George J Chang
INTRODUCTION: Definitive treatment of localised colorectal cancer involves surgical resection of the primary tumour. Short-stay colectomies (eg, 23-hours) would have important implications for optimising the efficiency of inpatient care with reduced resource utilisation while improving the overall recovery experience with earlier return to normalcy. It could permit surgical treatment of colorectal cancer in a wider variety of settings, including hospital-based ambulatory surgery environments...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28729188/assessing-interest-and-barriers-for-resident-and-faculty-involvement-in-global-surgery
#9
Maija Cheung, James M Healy, Michael R Hall, Doruk Ozgediz
BACKGROUND: Multiple institutions have developed international electives and sustainable global surgery initiatives to facilitate clinical, research, and outreach opportunities with hospitals in resource-poor areas. Despite increasing interest among programs, many institutions have not successfully reached potential involvement. OBJECTIVE: This study evaluates the experiences of Yale residents and faculty, measures interest in the development of an international surgical elective, and enumerates barriers to developing or participating in these opportunities...
July 17, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28728587/minimally-invasive-unilateral-pedicle-screws-and-a-translaminar-facet-screw-fixation-and-interbody-fusion-for-treatment-of-single-segment-lower-lumbar-vertebral-disease-surgical-technique-and-preliminary-clinical-results
#10
Peng Huang, Yiguo Wang, Jiao Xu, Bo Xiao, Jianheng Liu, Luyang Che, Keya Mao
BACKGROUND: Conventional open transforaminal lumbar interbody fusion (TLIF) using unilateral pedicle screws and a translaminar facet screw has been performed for many years with good results. The outcomes of minimally invasive TLIF (MIS TLIF) are similar to the good outcomes of open TLIF, with the additional benefits of reducing iatrogenic injury, shortening hospital stays, and reducing the recovery duration. Instead of using small cuts on both sides, we performed MIS TLIF through a single cut using unilateral pedicle screws and a translaminar facet screw...
July 20, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28728489/idarucizumab-for-the-treatment-of-hemorrhage-and-dabigatran-reversal-in-patients-requiring-urgent-surgery-or-procedures
#11
Ovidiu Vornicu, Anne-Sophie Larock, Anne-Sophie Dincq, Jonathan Douxfils, Jean-Michel Dogné, François Mullier, Sarah Lessire
Idarucizumab is a specific antagonist for dabigatran etexilate (DE). The recent market authorization of idarucizumab in Europe and the USA may reassure prescribers of DE, as it can increase the safety of the emergency management of patients taking this anticoagulant. However, idarucizumab use should be limited to specific indications to avoid unnecessary risks to patients and costs to healthcare systems. Areas covered: The authors provide an overview of idarucizumab development and its pharmacokinetic and pharmacodynamic properties...
July 20, 2017: Expert Opinion on Biological Therapy
https://www.readbyqxmd.com/read/28728177/porcine-collagen-transconjunctival-wound-closure-system-for-microincisional-vitrectomy-surgery
#12
Tiffany A Chen, Peter K Kaiser, Rainer Fasching, Darius M Moshfeghi
BACKGROUND AND OBJECTIVE: Microincisional vitrectomy surgery has improved outcomes for vitrectomies; however, wound closure complications remain an important concern. The authors introduce a technique to improve transconjunctival wound closure in vitrectomy surgery. PATIENTS AND METHODS: The authors evaluated the efficacy of porcine collagen plugs on stopping leakage from sclerotomy test sites in vitro and in vivo and assessed wound site healing with histology samples...
July 1, 2017: Ophthalmic Surgery, Lasers & Imaging Retina
https://www.readbyqxmd.com/read/28727996/efficacy-and-safety-of-one-stage-posterior-hemivertebral-resection-for-unbalanced-multiple-hemivertebrae-a-more-than-2-year-follow-up
#13
Yong Huang, Ganjun Feng, Yueming Song, Limin Liu, Chunguang Zhou, Lei Wang, Zhongjie Zhou, Xi Yang
OBJECTIVE: One-stage posterior hemivertebral resection has been proven to be an effective, reliable surgical option for treating congenital scoliosis due to a single hemivertebra. To date, however, no studies of treating unbalanced multiple hemivertebrae have appeared. This study evaluated the efficacy and safety of one-stage posterior hemivertebral resection for unbalanced multiple hemivertebrae. PATIENTS AND METHODS: Altogether, we studied 15 patients with unbalanced multiple hemivertebrae who had undergone hemivertebral resection using the one-stage posterior approach with at least 2 years of follow-up...
July 12, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28727383/outcomes-of-miniaturized-percutaneous-nephrolitotomy-in-infants-single-centre-experience
#14
Eyyup Sabri Pelit, Bülent Kati, Cengiz Çanakci, Süleyman Sağir, Halil Çiftçi
OBJECTIVES: The present study was aim to evaluate the safety and efficacy of Mini-PNL to treat kidney stones in patients aged <3 years. This is the one of the largest series in the literature in this age group of patients. MATERIAL AND METHODS: From May 2012 to April 2016, the medical records of 74 infant patients who underwent mini-PNL for renal stones were reviewed retrospectively. All infants were evaluated with the plain abdominal radiograph, urinary ultrasound, noncontrast computerized tomography and/or intravenous urogram...
July 20, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28727191/anterior-pericardial-access-to-facilitate-electrophysiology-study-and-catheter-ablation-of-ventricular-arrhythmias-a-single-tertiary-center-experience
#15
Ali R Keramati, Deeptankar DeMazumder, Satish Misra, Jonathan Chrispin, Fabrizio R Assis, Chava Raghuram, Swati Dey, Hugh Calkins, Harikrishna Tandri
INTRODUCTION: Epicardial ablation is becoming an important part of management in patients with ventricular tachycardia (VT). Posterior epicardial access via the Sosa or Needle-in-Needle (NIN) approach for epicardial VT ablation is considered to be the method of choice for most electrophysiologists. Anterior epicardial access as an alternative technique has recently been proposed, but there is limited data about its safety, efficacy and the rate of immediate complications. In this study, we report our experience with anterior epicardial access between 2009 and 2016...
July 20, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28726166/safety-of-laparoscopic-distal-gastrectomy-for-gastric-cancer-when-performed-by-trainee-surgeons-with-little-experience-in-performing-open-gastrectomy
#16
Chizu Kameda, Masato Watanabe, Nobuhiro Suehara, Yusuke Watanabe, Kazuyoshi Nishihara, Toru Nakano, Masafumi Nakamura
PURPOSE: This study aimed to evaluate the surgical outcomes and clinical safety of laparoscopic distal gastrectomy (LDG) when performed by trainee surgeons with little prior experience in performing open gastrectomy, under the guidance of trainer surgeons. METHODS: From January 2008 until March 2015, 17 trainee surgeons and 5 trainer surgeons performed LDGs to treat 371 patients with clinical stage T1-T3 gastric cancer. Of these patients, 140 and 231 underwent LDG performed by trainee surgeons and trainer surgeons, respectively...
July 19, 2017: Surgery Today
https://www.readbyqxmd.com/read/28725963/robot-assisted-surgery-for-mandibular-angle-split-osteotomy-using-augmented-reality-preliminary-results-on-clinical-animal-experiment
#17
Chaozheng Zhou, Ming Zhu, Yunyong Shi, Li Lin, Gang Chai, Yan Zhang, Le Xie
Mandibular angle split osteotomy (MASO) is a procedure widely used for prominent mandibular angles. However, conventional mandibular plastic surgery is invasive and high risk. It may induce postoperative neurosensory disturbance of the inferior alveolar nerve, fractures and infection due to the complexity of the anatomical structure and the narrow surgical field of view. The success rate of MASO surgery usually depends on the clinical experience and skills of the surgeon. To evaluate the performance of inexperienced plastic surgeons conducting this surgery, a self-developed and constructed robot system based on augmented reality is used...
July 19, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28725172/an-original-and-effective-technique-to-improve-exposure-in-open-surgery
#18
E Nohuz, G Chêne
BACKGROUND: Exposure, especially when the organs are enlarged, remains one of the most important issue in open surgery. Considering this constraint appears critical in the progress of the surgical procedure. We highlight our technique which affords optimal exposure and improves manipulation and extraction of enlarged organs. RESULTS: This original and effective technique is derived from an obstetrical device used to perform an assisted vaginal delivery. It improves exposure, reduces tissue manipulation, and enhances removal of the surgical specimen during hysterectomies and myomectomies...
2017: Gynecological Surgery
https://www.readbyqxmd.com/read/28724815/efficacy-and-safety-of-intraoperative-intracameral-mydriasis-in-manual-small-incision-cataract-surgery-a-randomized-controlled-trial
#19
K Ajay, Srinivasan Saranya, Divya Dabir Sundaresh, H R Hithashree, B C Hemalatha, Malavika Krishnaswamy, Sathyendranath B Shetty
PURPOSE: The purpose of this study is to assess the efficacy and safety of intracameral mydriatic solution, as compared to preoperative topical mydriatics, in patients undergoing manual small incision cataract surgery (MSICS) under peribulbar anesthesia. To assess the sustainability of intracameral mydriasis in MSICS by monitoring pupil size at specific junctures during the surgery. METHODS: This trial recruited 127 patients, who underwent MSICS under peribulbar block...
July 2017: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/28723807/can-patients-with-femoral-neck-fracture-benefit-from-preoperative-thromboprophylaxis-a-prospective-randomized-controlled-trial
#20
Qiangqiang Li, Bingyang Dai, Jiacheng Xu, Yao Yao, Kai Song, Haojun Zhang, Dongyang Chen, Qing Jiang
BACKGROUND: The effectiveness of preoperative thromboprophylaxis remains obscure in patients with femoral neck fracture. The purpose of the current study was to investigate whether these patients benefit from preoperative thromboprophylaxis. METHODS: In this prospective, randomized controlled trial, a total of 80 patients with femoral neck fracture were randomly assigned to receive either rivaroxaban or conservative treatment before surgery. For all patients, color Doppler ultrasound of both lower extremities was performed immediately after admission...
July 2017: Medicine (Baltimore)
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