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Protocols to reduce risk in surgery

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https://www.readbyqxmd.com/read/27902493/intravenous-amisulpride-for-the-prevention-of-postoperative-nausea-and-vomiting-two-concurrent-randomized-double-blind-placebo-controlled-trials
#1
Tong J Gan, Peter Kranke, Harold S Minkowitz, Sergio D Bergese, Johann Motsch, Leopold Eberhart, David G Leiman, Timothy I Melson, Dominique Chassard, Anthony L Kovac, Keith A Candiotti, Gabriel Fox, Pierre Diemunsch
BACKGROUND: Two essentially identical, randomized, double-blind, placebo-controlled, parallel-group phase III studies evaluated the efficacy of intravenous amisulpride, a dopamine D2/D3 antagonist, in the prevention of postoperative nausea and vomiting in adult surgical patients. METHODS: Adult inpatients undergoing elective surgery during general anesthesia and having at least two of the four Apfel risk factors for postoperative nausea and vomiting were enrolled at 9 U...
November 30, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27889694/extensive-peritoneal-lavage-after-curative-gastrectomy-for-gastric-cancer-expel-study-protocol-of-an-international-multicentre-randomised-controlled-trial
#2
Guowei Kim, Elya Chen, Amy Yl Tay, Jin San Lee, Janelle Ns Phua, Asim Shabbir, Jimmy By So, Bee Choo Tai
Peritoneal recurrence after gastrectomy for gastric cancer is common and the prognosis is dismal. Recent evidence suggests that extensive peritoneal lavage with large volume of normal saline after surgery before abdominal closure can reduce the risk of peritoneal recurrence and improve overall survival. This study aims to evaluate the benefit of extensive intraoperative peritoneal lavage. This is a prospective, open-label, multicentre randomised controlled trial involving 15 international centres in China, Korea, Japan, Malaysia and Singapore...
November 25, 2016: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/27884345/wound-edge-protection-devices-in-gastrointestinal-surgery-a-meta-analysis
#3
Qiang Chen, Lei Chen, Gang Chen, Yuwei Pu, Chungen Xing
BACKGROUND: The role of wound-edge protection devices (WEPDs) in wound infection prevention is still controversial. The aim of this meta-analysis was to assess the protective efficiency of WEPDs in gastrointestinal surgery in a pooled analysis of randomized controlled trials. MATERIALS AND METHODS: A variety of sources were searched for randomized controlled trials evaluating the protective efficiency of WEPDs in gastrointestinal surgery. Subgroup analysis and meta-regressions were conducted to investigate the possible influence of the type of WEPD on the size of intervention effect...
December 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27871539/liberal-or-restrictive-fluid-management-during-elective-surgery-a-systematic-review-and-meta-analysis
#4
REVIEW
Pim B B Schol, Ivon M Terink, Marcus D Lancé, Hubertina C J Scheepers
This article reviews if a restrictive fluid management policy reduces the complication rate if compared to liberal fluid management policy during elective surgery. The PubMed database was explored by 2 independent researchers. We used the following search terms: "Blood transfusion (MESH); transfusion need; fluid therapy (MESH); permissive hypotension; fluid management; resuscitation; restrictive fluid management; liberal fluid management; elective surgery; damage control resuscitation; surgical procedures, operative (MESH); wounds (MESH); injuries (MESH); surgery; trauma patients...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27867331/the-effectiveness-of-a-systematic-algorithm-for-the-management-of-vascular-injuries-during-the-laparoscopic-surgery
#5
Carlo C Passerotti, José A Cruz, Sabrina T Reis, Marcelo T Okano, Ricardo J Duarte, Miguel Srougi, Hiep T Nguyen
OBJECTIVES: Currently, there is no standardized training protocol to teach surgeons how to deal with vascular injuries during laparoscopic procedures. The purpose of this study is to develop and evaluate the effectiveness of a standardized algorithm for managing vascular injury during laparoscopic nephrectomies. MATERIALS AND METHODS: The performance of 6 surgeons was assessed during 10 laparoscopic nephrectomies in a porcine model. During the first and tenth operations, an injury was made in the renal vein without warning the surgeon...
October 2016: Current Urology
https://www.readbyqxmd.com/read/27852286/the-carotid-and-middle-cerebral-artery-occlusion-surgery-study-cmoss-a-study-protocol-for-a-randomised-controlled-trial
#6
Yan Ma, Yuxiang Gu, Xiaoguang Tong, Jiyue Wang, Dong Kuai, Donghai Wang, Jun Ren, Lian Duan, Aili Maimaiti, Yiling Cai, Yujie Huang, Xiaojian Wang, Yi Cao, Chao You, Jiasheng Yu, Liqun Jiao, Feng Ling
BACKGROUND: Patients with symptomatic internal carotid artery (ICA) or middle cerebral artery (MCA) occlusion with haemodynamic insufficiency are at high risk for recurrent stroke when treated medically. METHODS: The Carotid or Middle cerebral artery Occlusion Surgery Study (CMOSS) trial is an ongoing, government-funded, prospective, multicentre, randomised controlled trial. The CMOSS will recruit 330 patients with symptomatic ICA or MCA occlusion (parallel design, 1:1 allocation ratio) and haemodynamic insufficiency...
November 16, 2016: Trials
https://www.readbyqxmd.com/read/27848403/reasons-for-delayed-patient-discharge-following-day-surgery-a-literature-review
#7
Alison Rae
Aim The aim of this literature review was to explore the reasons why some patients are not suitable for discharge following day surgery. Method A pragmatic, mixed-methods approach was used to undertake a critical evaluation of the literature and current practice to determine what is already known about discharge following day surgery. Thematic analysis was used to identify the main themes and issues, enabling recommendations to be made to reduce the incidence of patients unable to be discharged following day surgery...
November 9, 2016: Nursing Standard
https://www.readbyqxmd.com/read/27842579/does-occupational-therapy-reduce-the-need-for-surgery-in-carpometacarpal-osteoarthritis-protocol-for-a-randomized-controlled-trial
#8
Ingvild Kjeken, Ruth Else Mehl Eide, Åse Klokkeide, Karin Hoegh Matre, Monika Olsen, Petter Mowinckel, Øyvor Andreassen, Siri Darre, Randi Nossum
BACKGROUND: In the absence of disease-modifying interventions for hand osteoarthritis (OA), occupational therapy (OT) comprising patient education, hand exercises, assistive devices and orthoses are considered as core treatments, whereas surgery are recommended for those with severe carpometacarpal (CMC1) OA. However, even though CMC1 surgery may reduce pain and improve function, the risk of adverse effects is high, and randomized controlled trials comparing surgery with non-surgical interventions are warranted...
November 15, 2016: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/27821384/the-effectiveness-of-hand-massage-on-pain-in-critically-ill-patients-after-cardiac-surgery-a-randomized-controlled-trial-protocol
#9
Madalina Boitor, Géraldine Martorella, Andréa Maria Laizner, Christine Maheu, Céline Gélinas
BACKGROUND: Postoperative pain is common in the intensive care unit despite the administration of analgesia. Some trials suggest that massage can be effective at reducing postoperative pain in acute care units; however, its effects on pain relief in the intensive care unit and when pain severity is highest remain unknown. OBJECTIVE: The objective is to evaluate the effectiveness of hand massage on the pain intensity (primary outcome), unpleasantness and interference, muscle tension, anxiety, and vital signs of critically ill patients after cardiac surgery...
November 7, 2016: JMIR Research Protocols
https://www.readbyqxmd.com/read/27800245/chemotherapy-in-retinoblastoma-current-approaches
#10
REVIEW
Özge Yanık, Kaan Gündüz, Kıvılcım Yavuz, Nurdan Taçyıldız, Emel Ünal
Retinoblastoma (RB) is the most common childhood malignant intraocular tumor. Although enucleation and external beam radiotherapy have been historically used, today the most commonly used eye-sparing approach is chemotherapy. Chemotherapy can be used in both intraocular and extraocular RB cases. Chemotherapeutic agents may be applied in different ways, including systemic, subconjunctival, intra-arterial and intravitreal routes. The main purposes of application of systemic therapy are to reduce the tumor size for local treatment (chemoreduction), or to reduce the risk of metastasis after enucleation surgery (adjuvant therapy)...
December 2015: Turkish Journal of Ophthalmology
https://www.readbyqxmd.com/read/27766398/enhanced-recovery-program-in-high-risk-patients-undergoing-colorectal-surgery-results-from-the-perioperative-italian-society-registry
#11
Marco Braga, Nicolò Pecorelli, Marco Scatizzi, Felice Borghi, Giancarlo Missana, Danilo Radrizzani
BACKGROUND: Enhanced recovery after surgery (ERAS) pathways represent the optimal approach for patients undergoing colorectal surgery. Elderly or low physical status patients have been often excluded from ERAS pathways because considered at high risk. The aim of this study is to assess the adherence to ERAS protocol and its impact on short-term postoperative outcome in patients with different surgical risk undergoing elective colorectal resection. METHODS: Prospectively collected data entered in an electronic Italian registry specifically designed for ERAS were reviewed...
October 20, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27762436/network-meta-analysis-of-protocol-driven-care-and-laparoscopic-surgery-for-colorectal-cancer
#12
REVIEW
A C Currie, G Malietzis, J T Jenkins, T Yamada, H Ashrafian, T Athanasiou, K Okabayashi, R H Kennedy
BACKGROUND: Laparoscopic approaches and standardized recovery protocols have reduced morbidity following colorectal cancer surgery. As the optimal regimen remains inconclusive, a network meta-analysis was undertaken of treatments for the development of postoperative complications and mortality. METHODS: MEDLINE, Embase, trial registries and related reviews were searched for randomized trials comparing laparoscopic and open surgery within protocol-driven or conventional perioperative care for colorectal cancer resection, with complications as a defined endpoint...
December 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27759881/endodontic-procedures-for-retreatment-of-periapical-lesions
#13
REVIEW
Massimo Del Fabbro, Stefano Corbella, Patrick Sequeira-Byron, Igor Tsesis, Eyal Rosen, Alessandra Lolato, Silvio Taschieri
BACKGROUND: When primary root canal therapy fails, periapical lesions can be retreated with or without surgery. Root canal retreatment is a non-surgical procedure that involves removal of root canal filling materials from the tooth, followed by cleaning, shaping and obturating of the canals. Root-end resection is a surgical procedure that involves exposure of the periapical lesion through an osteotomy, surgical removal of the lesion, removal of part of the root-end tip, disinfection and, commonly, retrograde sealing or filling of the apical portion of the remaining root canal...
October 19, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27747876/chewing-gum-for-enhancing-early-recovery-of-bowel-function-after-caesarean-section
#14
REVIEW
Edna Pereira Gomes Morais, Rachel Riera, Gustavo Jm Porfírio, Cristiane R Macedo, Vivian Sarmento Vasconcelos, Alexsandra de Souza Pedrosa, Maria R Torloni
BACKGROUND: Caesarean sections (CS) are the most frequent major surgery in the world. A transient impairment of bowel motility is expected after CS. Although this usually resolves spontaneously within a few days, it can cause considerable discomfort, require symptomatic medication and delay hospital discharge, thus increasing costs. Chewing gum in the immediate postoperative period is a simple intervention that may be effective in enhancing recovery of bowel function in other types of abdominal surgeries...
October 17, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27737442/association-of-clinical-risk-factors-and-postoperative-complications-with-unplanned-hospital-readmission-after-head-and-neck-cancer-surgery
#15
Andrés M Bur, Jason A Brant, Carolyn L Mulvey, Elizabeth A Nicolli, Robert M Brody, John P Fischer, Steven B Cannady, Jason G Newman
Importance: Unplanned hospital readmission is costly and in recent years has become a focus of health care legislation intended to reduce health care expenditures. Greater understanding of which perioperative complications are associated with hospital readmission after surgery for head and neck cancer is needed to reduce unplanned readmissions. Objective: To determine which clinical risk factors and complications are associated with 30-day unplanned readmission after surgery for malignant neoplasms of the head and neck...
October 13, 2016: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/27688236/cardiac-remote-ischemic-preconditioning-prior-to-elective-vascular-surgery-cripes-a-prospective-randomized-sham-controlled-phase%C3%A2-ii-clinical-trial
#16
Santiago Garcia, Thomas S Rector, Marina Zakharova, Rebekah R Herrmann, Selcuk Adabag, Stefan Bertog, Yader Sandoval, Steve Santilli, Emmanouil S Brilakis, Edward O McFalls
BACKGROUND: Remote ischemic preconditioning (RIPC) has been shown to reduce infarct size in animal models. We hypothesized that RIPC before an elective vascular operation would reduce the incidence and amount of a postoperative rise of the cardiac troponin level. METHODS AND RESULTS: Cardiac Remote Ischemic Preconditioning Prior to Elective Vascular Surgery (CRIPES) was a prospective, randomized, sham-controlled phase 2 trial using RIPC before elective vascular procedures...
September 29, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27688031/safety-and-efficacy-of-an-enhanced-recovery-after-surgery-protocol-for-patients-undergoing-colon-cancer-surgery-a-multi-institutional-controlled-study
#17
Hirofumi Ota, Masakazu Ikenaga, Junichi Hasegawa, Kohei Murata, Yasuhiro Miyake, Tsunekazu Mizushima, Taishi Hata, Ichiro Takemasa, Hirofumi Yamamoto, Mitsugu Sekimoto, Riichiro Nezu, Yuichiro Doki, Masaki Mori
PURPOSE: The aim of this multi-institutional study was to prospectively evaluate the safety and efficacy of an enhanced recovery after surgery (ERAS) protocol for colonic surgery. METHODS: The subjects of this study were 320 patients with an American Society of Anesthesiologists (ASA) grade I or II physical status. Patients underwent elective open or laparoscopic colonic resection or high anterior resection between April 2011 and January 2014 at one of six institutions...
September 29, 2016: Surgery Today
https://www.readbyqxmd.com/read/27681381/day-case-transobturator-tapes-a-cut-and-dried-solution
#18
T Ramhendar, D Keane
BACKGROUND: The transobturator tape (TOT) has been utilized in the surgical management of SUI since 2001 when it was first described and is associated with minimal risk of trauma as its purely perineal insertion avoids entry to the retropubic space. Given its high success rate, low associated peri-operative morbidity and relative ease of insertion, it has been increasingly used as a day case procedure worldwide. AIM: This study aims to demonstrate the suitability of the transobturator tape (TOT) as a day surgery procedure in the Republic of Ireland...
September 28, 2016: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/27666443/high-proportion-of-known-abdominal-aortic-aneurysm-in-patients-with-rupture-indicates-surveillance-deficiency
#19
Sayid Zommorodi, Joy Roy, Johnny Steuer, Rebecka Hultgren
OBJECTIVE: This study assessed the proportion of previously known abdominal aortic aneurysm (AAA) in patients presenting with a ruptured AAA (rAAA) and analyzed the reasons for nontreatment at the time of the initial AAA diagnosis. METHODS: This retrospective, observational study included all patients with rAAA admitted to a hospital in the counties of Stockholm and Gotland during 2009 to 2013. The patients' records were retrospectively reviewed, with extraction of data on previously detected AAA, demographics, and mortality at 30 and 90 days...
October 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27659939/hip-capsular-closure-a-biomechanical-analysis-of-failure-torque
#20
Jorge Chahla, Jacob D Mikula, Jason M Schon, Chase S Dean, Kimi D Dahl, Travis J Menge, Eduardo Soares, Travis Lee Turnbull, Robert F LaPrade, Marc J Philippon
BACKGROUND: Hip capsulotomy is routinely performed during arthroscopic surgery to achieve adequate exposure of the joint. Iatrogenic instability can result after hip arthroscopic surgery because of capsular insufficiency, which can be avoided with effective closure of the hip capsule. There is currently no consensus in the literature regarding the optimal quantity of sutures upon capsular closure to achieve maximal stability postoperatively. PURPOSE/HYPOTHESIS: The purpose of this study was to determine the failure torques of 1-, 2-, and 3-suture constructs for hip capsular closure to resist external rotation and extension after standard anterosuperior interportal capsulotomy (12 to 3 o'clock)...
September 22, 2016: American Journal of Sports Medicine
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