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Safety in surgery

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https://www.readbyqxmd.com/read/29793113/assessment-of-the-risk-of-antiangiogenic-agents-before-and-after-surgery
#1
REVIEW
Christina E Bailey, Alexander A Parikh
Angiogenesis plays a critical role in the growth, progression, and metastasis of numerous solid tumor types, and thus, antiangiogenic agents have been studied for many years as potential therapeutic agents. Many different antiangiogenic agents, including monoclonal antibodies and multi-targeted tyrosine kinase inhibitors (TKIs), have been approved for various oncology indications, and promising clinical activity has been demonstrated. However, some of these agents have also been associated with serious safety concerns...
May 8, 2018: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/29792835/safety-and-efficacy-of-outpatient-parotidectomy
#2
Andrea Ziegler, Gina Lazzara, Eric Thorpe
PURPOSE: Given the increasing costs of medical care, there has been a shift to outpatient elective surgeries in certain patient populations among all surgical specialties. The goal of this study was to compare the safety and efficacy of outpatient parotidectomy with traditional inpatient parotidectomy. MATERIALS AND METHODS: This is a retrospective chart review of all patients who underwent a parotidectomy at a single tertiary academic center from 2007 through 2017...
May 7, 2018: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29791711/percutaneous-edge-to-edge-transcatheter-mitral-valve-repair-current-indications-and-future-perspectives
#3
Martino Pepe, Emanuela De Cillis, Tommaso Acquaviva, Annagrazia Cecere, Pasquale D'Alessandro, Arturo Giordano, Marco Matteo Ciccone, Alessandro Santo Bortone
Mitral regurgitation (MR) is the most prevalent valvular heart disease (VHD) and represents an important cause of heart failure. Medical therapy has a limited role in improving symptoms and does not hinder the progression of valvular disease. Surgery is the treatment of choice for severe symptomatic MR; valve repair is currently the preferred surgical approach because it reduces peri-operative mortality and ensures a good medium- to long-term survival outcome. Nevertheless, a non-negligible proportion of patients with indications for surgical correction are considered to be at prohibitive perioperative risk, mainly because of old age and multiple comorbidities...
June 1, 2018: Surgical Technology International
https://www.readbyqxmd.com/read/29791696/monocenter-experience-with-532-nm-laser-photoselective-vaporization-of-the-prostate-by-greenlight-xps%C3%A2-laser-is-it-really-an-endourological-joker-card
#4
Jamil Ghahhari, Carlo D'Orta, Ambra Rizzoli, Michele Marchioni, Giulia I Primicer, Piergustavo De Francesco, Angelo Civitella, Mario Di Lecce, Pietro Castellan, Roberto Castellucci, Fabio Neri, Fabiola Raffaella Tamburro, Luca Cindolo, Luigi Schips
INTRODUCTION: In our study, we reported on our monocenter experience with GreenLight (GL) Xcelerated Performance System (XPS)™ /MoXy™ laser fiber (American Medical Systems Inc., Minnetonka, Minnesota), examining its efficacy, safety, and its ability to effectively treat lower urinary tract symptoms (LUTS) in benign prostate obstruction (BPO). We also explored and compared the three different endoscopic approaches used for GL treatment of benign prostatic hyperplasia (BPH), standard photovaporization (PVP), anatomical PVP, and GreenLight XPS™ enucleation of the prostate...
June 1, 2018: Surgical Technology International
https://www.readbyqxmd.com/read/29791030/antiepileptic-drugs-as-prophylaxis-for-postcraniotomy-seizures
#5
REVIEW
Janette Greenhalgh, Jennifer Weston, Yenal Dundar, Sarah J Nevitt, Anthony G Marson
BACKGROUND: This is an updated version of the Cochrane Review previously published in Issue 3, 2015.The incidence of seizures following supratentorial craniotomy for non-traumatic pathology has been estimated to be between 15% to 20%; however, the risk of experiencing a seizure appears to vary from 3% to 92% over a five-year period. Postoperative seizures can precipitate the development of epilepsy; seizures are most likely to occur within the first month of cranial surgery. The use of antiepileptic drugs (AEDs) administered pre- or postoperatively to prevent seizures following cranial surgery has been investigated in a number of randomised controlled trials (RCTs)...
May 23, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29790625/managing-paediatric-bleeding-disorder-patients-undergoing-surgical-procedures-leveraging-the-electronic-medical-record
#6
C Tarango, D Dahale, N Dodson, A Otte, P J Schoettker
INTRODUCTION: Individuals with bleeding disorders have a high risk of bleeding complications with surgical procedures. Careful planning and management of peri-operative treatment is vital for their safety. Yet, inter-provider communication and communication between patients/families and providers is not reliable. AIM: Our haemophilia treatment centre (HTC) created a care gap report that used the electronic medical record to inform our team when patients with bleeding disorders were scheduled for procedures...
May 23, 2018: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/29790382/towards-respiratory-gated-retrograde-intrarenal-surgery-a-prospective-randomized-controlled-study
#7
Vasileios Kourmpetis, Snir Dekalo, Tomer Nir, Nadav Levy, Yuval Bar-Yosef, Avi Beri, Ofer Yossepowitch, Mario Sofer
INTRODUCTION: We set out to investigate whether general anesthesia with low ventilation (LV, respiratory rate ≤8/min and tidal volume <500 ml) could reduce renal mobility and thereby facilitate improved retrograde intrarenal surgery (RIRS) compared to general anesthesia with standard ventilation (SV). MATERIALS AND METHODS: All 60 consecutive patients who presented for RIRS in our department from September 1, 2017 to December 31, 2017 were prospectively randomized 1:1 into one group that was selected to receive SV and another that received LV...
May 23, 2018: Journal of Endourology
https://www.readbyqxmd.com/read/29789672/comparison-of-fast-track-versus-conventional-surgery-protocol-for-patients-undergoing-robot-assisted-laparoscopic-radical-prostatectomy-a-chinese-experience
#8
Zhichao Huang, Lu Yi, Zhaohui Zhong, Liang Zhu, Hongqing Zhao, Yijian Li, Yeqi Nian, Peng Xu, Yinhuai Wang
Fast-track surgery (FTS), which includes a series of evidence-based adjustments, is expected to reduce complications, relieve surgical stress reaction, accelerate recovery, and shorten hospitalization, as well as improve safety. The aim of this study was to critically evaluate the safety and effectiveness of FTS in Chinese prostate cancer (Pca) patients who underwent robot-assisted laparoscopic prostatectomy (RALP). A retrospective analysis was performed on 73 consecutive Chinese Pca patients who underwent RALP and who were divided into two groups: conventional surgery (CS) and FTS...
May 22, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29788942/use-of-autologous-bone-marrow-stem-cell-implantation-for-osteonecrosis-of-the-knee-in-sickle-cell-disease-a-preliminary-report
#9
Gildasio Daltro, Bruno Adelmo Franco, Thiago Batista Faleiro, Davi Araujo Veiga Rosário, Paula Braga Daltro, Roberto Meyer, Vitor Fortuna
BACKGROUND: The purpose of our study was to evaluate safety, feasibility and clinical results of bone marrow mononuclear cell (BMC) implantation for early-stage osteonecrosis of the knee (OK) secondary to sickle cell disease. METHODS: Thirty-three SCD patients (45 knees) with OK treated with BMC implantation in the osteonecrotic lesion were clinically and functionally evaluated through the American Knee Society Clinical Score (KSS), Knee Functional Score (KFS) and Numeric Rating Scale (NRS) pain score...
May 22, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29788675/anti-tumor-necrosis-factor-therapy-in-intestinal-beh%C3%A3-et-s-disease
#10
REVIEW
Jihye Park, Jae Hee Cheon
Intestinal Behçet's disease is a rare, immune-mediated chronic intestinal inflammatory disease; therefore, clinical trials to optimize the management and treatment of patients are scarce. Moreover, intestinal Behçet's disease is difficult to treat and often requires surgery because of the failure of conventional medical treatment. Administration of anti-tumor necrosis factor α, a potential therapeutic strategy, is currently under active clinical investigation, and evidence of its effectiveness for both intestinal Behçet's disease and inflammatory bowel diseases has been accumulating...
May 24, 2018: Gut and Liver
https://www.readbyqxmd.com/read/29788512/adequacy-of-fixed-dose-heparin-infusions-for-venous-thromboembolism-prevention-after-microsurgical-procedures
#11
Corinne M Bertolaccini, Ann Marie B Prazak, Jayant Agarwal, Isak A Goodwin, W Bradford Rockwell, Christopher J Pannucci
BACKGROUND:  In microvascular surgery, patients often receive unfractionated heparin infusions to minimize risk for microvascular thrombosis. Patients who receive intravenous (IV) heparin are believed to have adequate prophylaxis against venous thromboembolism (VTE). Whether a fixed dose of IV heparin provides detectable levels of anticoagulation, or whether the "one size fits all" approach provides adequate prophylaxis against VTE remains unknown. This study examined the pharmacodynamics of fixed-dose heparin infusions and the effects of real-time, anti-factor Xa (aFXa) level driven heparin dose adjustments...
May 22, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29788281/a-method-for-cranial-nerve-xi-silencing-during-surgery-of-the-foramen-magnum-region-technical-case-report
#12
Derek G Southwell, Jonathan D Breshears, William R Lyon, Michael W McDermott
BACKGROUND AND IMPORTANCE: Skull base surgery involves the microdissection and intraoperative monitoring of cranial nerves, including cranial nerve XI (CN XI). Manipulation of CN XI can evoke brisk trapezius contraction, which in turn may disturb the surgical procedure and risk patient safety. Here we describe a method for temporarily silencing CN XI via direct intraoperative application of 1% lidocaine. CLINICAL PRESENTATION: A 41-yr-old woman presented with symptoms of elevated intracranial pressure and obstructive hydrocephalus secondary to a hemangioblastoma of the right cerebellar tonsil...
May 18, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29788233/autologous-haematopoietic-stem-cell-transplantation-for-crohn-s-disease-a-retrospective-survey-of-long-term-outcomes-from-the-european-society-for-blood-and-marrow-transplantation
#13
Charlotte K Brierley, Cristina Castilla-Llorente, Myriam Labopin, Manuela Badoglio, Montserrat Rovira, Elena Ricart, Daan Dierickx, Severine Vermeire, Peter Hasselblatt, Juergen Finke, Francesco Onida, Andrea Cassinotti, Jack Satsangi, Majid Kazmi, Antonio López-Sanromán, Carsten Schmidt, Dominique Farge, Simon P L Travis, Chris J Hawkey, John A Snowden
Background/Aims: Autologous haematopoietic stem cell transplantation (AHSCT) is a therapeutic option for patients with severe, treatment-refractory Crohn's disease (CD). The evidence base for AHSCT for CD is limited, with one randomised trial (ASTIC) suggesting benefit. The aim of this study was to evaluate safety and efficacy for patients undergoing AHSCT for CD in Europe outside the ASTIC trial. Methods: We identified 99 patients in the European Society for Blood and Marrow Transplantation (EBMT) registry who were eligible for inclusion...
May 18, 2018: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/29788019/robotic-thyroid-surgery-current-perspectives-and-future-considerations
#14
Patrick Aidan, Asit Arora, Balazs Lorincz, Neil Tolley, George Garas
Robotic transaxillary thyroidectomy, pioneered in South Korea, is firmly established throughout the Far East but remains controversial in Western practice. This relates to important population differences (anthropometry and culture) compounded by the smaller mean size of thyroid nodules operated on in South Korea due to a national thyroid cancer screening programme. There is now level 2 evidence (including from Western World centres) to support the safety, feasibility, and equivalence of the robotic approach to its open counterpart in terms of recurrent laryngeal nerve injury, hypoparathyroidism, haemorrhage, and oncological outcomes for differentiated thyroid cancer...
May 22, 2018: ORL; Journal for Oto-rhino-laryngology and its related Specialties
https://www.readbyqxmd.com/read/29787349/head-and-neck-cancer-patients-rates-reasons-and-risk-factors-for-30-day-unplanned-readmission
#15
Michael K Ghiam, Alexander Langerman, Zoukaa Sargi, Sarah Rohde
Objective To analyze rates, risk factors, and complications for 30-day readmission among head and neck cancer (HNC) patients. Methods Retrospective review of administrative records from Vizient (Irving, Texas) Clinical Data Base/Resource Manager on HNC patients who underwent a head and neck surgical procedure from January 2013 through September 2015 at 176 academic and community medical centers. Results Of the 18,121 patients included in the study, 2502 patients were readmitted within 30 days (13.8%). Mean time to readmission was 11 ± 8...
May 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29786128/long-term-oncologic-outcomes-of-laparoscopic-sentinel-node-navigation-surgery-in-early-gastric-cancer-a-single-center-single-arm-phase-ii-trial
#16
Do Joong Park, Young Suk Park, Sang Yong Son, Ju-Hee Lee, Hye Seung Lee, Young Soo Park, Kyoung Ho Lee, Young Hoon Kim, Kyoung Un Park, Won Woo Lee, Soyeon Ahn, Sang-Hoon Ahn, Hyung-Ho Kim
BACKGROUND: Sentinel node navigation surgery (SNNS) in early gastric cancer (EGC) is technically feasible according to previous literature, however its long-term oncologic safety has not been reported. METHODS: A single-center, single-arm, phase II trial was conducted to determine the oncologic outcomes of laparoscopic sentinel node (SN) biopsy in clinical stage T1N0M0 gastric cancer patients. Cases with positive SNs on intraoperative pathologic examination underwent conventional gastrectomy with radical lymphadenectomy (SN-positive group), whereas those with negative SNs underwent laparoendoscopic-limited gastric resections without further lymph node dissections (SN-negative group)...
May 21, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29785940/metabolic-effects-safety-and-acceptability-of-very-low-calorie-ketogenic-dietetic-scheme-on-candidates-for-bariatric-surgery
#17
Vincenzo Pilone, Salvatore Tramontano, Michele Renzulli, Mafalda Romano, Luigi Cobellis, Tiziano Berselli, Luigi Schiavo
BACKGROUND: Previous studies have demonstrated significant advantages from a preoperative dietetic regimen for candidates to bariatric procedure. OBJECTIVES: Evaluation of safety, efficacy, and acceptability of a very low-calorie ketogenic diet in patients before bariatric surgery. SETTING: University Hospital. METHODS: A standardized 30-day sequential preoperative diet regimen has been analyzed, optimizing metabolic response with gradual carbohydrate reintroduction...
March 21, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29785493/mindset-and-communication-barriers-in-the-diffusion-of-bariatric-surgery
#18
REVIEW
Daniel Gero, Bors Hulesch, Marco Bueter
PURPOSE OF REVIEW: Cumulating evidence is available to demonstrate the efficacy of bariatric surgery (BS) in achieving weight loss and optimizing comorbidities. However, currently, only a minority of eligible patients approaches bariatric centers. The underuse of BS can no longer be explained by the lack of evidence supporting its beneficial outcomes along with its favorable safety-profile, rather, by the supporting infrastructure, insurance coverage, and mindset of society, including potential patients and allied healthcare professionals...
May 21, 2018: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29785456/methylene-blue-fluorescence-of-the-ureter-during-colorectal-surgery
#19
Thomas G Barnes, Roel Hompes, Jacqueline Birks, Neil J Mortensen, Oliver Jones, Ian Lindsey, Richard Guy, Bruce George, Chris Cunningham, Trevor M Yeung
BACKGROUND: Iatrogenic ureteric injury is a serious complication of colorectal surgery. Incidence is estimated to be between 0.3 and 1.5%. Of all ureteric injuries, 9% occur during colorectal procedures. Ureteric stents are utilised as a method to reduce the risk of injury; however, these are not without risk and do not guarantee prevention of injury. Fluorescence is a safe and effective alternative for intraoperative ureteric localisation. This proof of principle study aims to assess the use of methylene blue to fluoresce the ureter during colorectal surgery...
May 21, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29785455/robotic-assisted-laparoscopic-median-arcuate-ligament-release-7-year-experience-from-a-single-tertiary-care-center
#20
Usah Khrucharoen, Yen-Yi Juo, Yas Sanaiha, Yijun Chen, Juan C Jimenez, Erik P Dutson
BACKGROUND: Despite previous reports of robotic-assisted laparoscopic release for median arcuate ligament syndrome (MALS), the safety and efficacy profile of this approach has been difficult to establish due to the rarity of this diagnostic entity. We aim to present our experience from a tertiary minimally invasive surgery referral center. METHODS: A case series was performed whereby all patients who underwent robotic-assisted MAL release from July 2010 to July 2017 at our institution were included...
May 21, 2018: Surgical Endoscopy
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