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Safety protocols in surgery

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https://www.readbyqxmd.com/read/28431896/pressurized-intraperitoneal-aerosol-chemotherapy-%C3%A2-practical-aspects
#1
M Hübner, F Grass, H Teixeira-Farinha, B Pache, P Mathevet, N Demartines
INTRODUCTION: Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) has been introduced as novel treatment for peritoneal carcinomatosis. Only proper patient selection, stringent safety protocol and careful surgery allow for a secure procedure. We hereby report the essentials for safe implementation. METHODS: All consecutive procedures within 20 months after PIPAC implementation were analyzed with regards to practical and surgical aspects. Special emphasis was laid on modifications of technique and safety measures during the implementation process with systematic use of a dedicated checklist...
April 8, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28431844/health-care-associated-infections-studies-project-an-american-journal-of-infection-control-and-national-healthcare-safety-network-data-quality-collaboration
#2
Henrietta Smith, Janet E Brooks, Denise Leaptrot, Katherine Allen-Bridson, Angela Anttila, Cindy Gross, Joan N Hebden, Georganne Ryan, Eileen Scalise, Marc-Oliver Wright
This case study is part of a series centered on the Centers for Disease Control and Prevention's National Healthcare Safety Network's (NHSN) health care-associated infection (HAI) surveillance definitions. The intent of the case study series is to foster standardized application of the NHSN's HAI surveillance definitions among infection preventionists and accurate determination of HAI events. This specific case study focuses on the definitions found within the surgical site infection (SSI) protocol. It aims to reflect the real life and complex patient scenario surrounding a bloodstream infection that is secondary to an SSI and the application of the Present at the Time of Surgery event detail...
April 18, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28421732/comparison-of-absolute-fluid-restriction-versus-relative-volume-redistribution-strategy-in-low-central-venous-pressure-anesthesia-in-liver-resection-surgery-a-randomized-controlled-trial
#3
Jan Zatloukal, Richard Pradl, Jakub Kletečka, Tomáš Skalický, Václav Liška, Jan Benes
BACKGROUND: Lowering central venous pressure (CVP) can decrease blood loss during liver resection and it is associated with improved outcomes. Multiple CVP reducing maneuvers have been described, but direct comparison of their effectiveness and safety has never been performed. METHODS: Patients undergoing resections of 2 or more liver segments were equally randomized to absolute fluid restriction (AR, N = 17) or relative volume redistribution group (RR, N = 17)...
April 19, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28419357/stereoelectroencephalography-using-magnetic-resonance-angiography-for-avascular-trajectory-planning-technical-report
#4
Krasimir Minkin, Kaloyan Gabrovski, Marin Penkov, Yuri Todorov, Rositsa Tanova, Yoana Milenova, Kiril Romansky, Petia Dimova
BACKGROUND: Stereoelectroencephalography (SEEG) requires high-quality angiographic studies because avascular trajectory planning is a prerequisite for the safety of this procedure. Some epilepsy surgery groups have begun to use computed tomography angiography and magnetic resonance T1-weighted sequence with contrast enhancement for this purpose. OBJECTIVE: To present the first series of patients with avascular trajectory planning of SEEG based on magnetic resonance angiography (MRA)...
April 13, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28413867/a-study-of-adjuvant-chemoradiotherapy-with-tri-weekly-cisplatin-for-postoperative-high-risk-oral-squamous-cell-carcinoma
#5
Mitsunobu Otsuru, Yoshihide Ota, Takayuki Aoki, Masashi Sasaki, Takatugu Suzuki, Yuya Denda, Miho Takahashi, Takeshi Akiba, Akihiro Kaneko
OBJECTIVE: The aim of this study was to assess the feasibility and safety profile of concurrent chemoradiotherapy with cisplatin in Japanese patients with postoperative high-risk oral cancer. METHODS: Patients with high-risk pathological features were selected from patients with oral squamous cell carcinoma who underwent surgery at the Department of Oral and Maxillofacial Surgery, Tokai University Hospital. Patients were given adjuvant chemoradiotherapy with tri-weekly cisplatin (100 mg/m(2)) (66 Gy/33 Fr), and the treatment completion rate was examined...
April 20, 2017: Tokai Journal of Experimental and Clinical Medicine
https://www.readbyqxmd.com/read/28411889/factibility-and-security-study-of-the-pics-af%C3%A2-plug-for-the-treatment-of-cryptoglandular-anal-fistula
#6
Fernando de la Portilla, María Luisa Reyes-Díaz, María Victoría Maestre, Rosa María Jiménez-Rodríguez, Ana María García-Cabrera, José M Díaz-Pavón, Jorge Manuel Vázquez-Monchul, Juan Antonio Villanueva
INTRODUCTION: The PICS-AF™ (Curaseal Inc.) device is a new plug made of collagen that has a retention system in the internal orifice. This pilot study was designed to assess both the feasibility and safety of this plug in the treatment of trans-sphincteric anal fístulas. METHODS: A total of 44 patients (34 men), with a mean age of 54.68±7.3, with trans-sphincteric anal fístulas were included in the study; 34 of them were analyzed. All patients were examined according to a strict preoperative protocol and until 6 months after surgery...
April 12, 2017: Cirugía Española
https://www.readbyqxmd.com/read/28410886/the-autogenous-graft-versus-transport-distraction-osteogenesis-for-reconstruction-of-the-ramus-condyle-unit-a-prospective-comparative-study
#7
S Kohli, S Mohanty, S Singh, Sandeep, J Dabas, R Patel
This study aimed to compare the joint function and morphology achieved following condylar reconstruction using sternoclavicular grafts (SCG) versus transport distraction osteogenesis (TDO) in temporomandibular joint (TMJ) ankylosis patients. Twenty-two patients with TMJ ankylosis underwent TMJ reconstruction with SCG or TDO (n=11 each). Radiographic and clinical evaluations were performed at 1 week and at 1, 3, and 6 months post-surgery. Clinical criteria examined included the duration of surgery, mean postoperative mouth opening, excursive jaw movements, and pain scores...
April 11, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28395502/reirradiation-of-head-and-neck-cancer-in-the-era-of-intensity-modulated-radiotherapy-patient-selection-practical-aspects-and-current-evidence
#8
REVIEW
Yeon Sil Kim
Locoregional failure is the most frequent pattern of failure in locally advanced head and neck cancer patients and it leads to death in most of the patients. Second primary tumors occurring in the other head and neck region reach up to almost 40% of long-term survivors. Recommended and preferred retreatment option in operable patients is salvage surgical resection, reporting a 5-year overall survival of up to 40%. However, because of tumor location, extent, and underlying comorbidities, salvage surgery is often limited and compromised by incomplete resection...
March 2017: Radiation Oncology Journal
https://www.readbyqxmd.com/read/28394839/quality-and-safety-in-health-care-part-xxvi-the-adult-cardiac-surgery-database
#9
Jay A Harolds
The Adult Cardiac Surgery Database of the Society of Thoracic Surgeons has provided highly useful information in quality and safety in general thoracic surgery, including ratings of the surgeons and institutions participating in this type of surgery. The Adult Cardiac Surgery Database information is very helpful for writing guidelines and determining optimal protocols and for many research projects. This article discusses the history and current status of this database.
April 7, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28391003/surgery-alone-is-sufficient-therapy-for-children-and-adolescents-with-low-risk-synovial-sarcoma-a-joint-analysis-from-the-european-paediatric-soft-tissue-sarcoma-study-group-and-the-children-s-oncology-group
#10
Andrea Ferrari, Yueh-Yun Chi, Gian Luca De Salvo, Daniel Orbach, Bernadette Brennan, R Lor Randall, M Beth McCarville, Jennifer O Black, Rita Alaggio, Douglas S Hawkins, Gianni Bisogno, Sheri L Spunt
BACKGROUND: Multimodal risk-adapted treatment is used in paediatric protocols for synovial sarcoma (SS). Retrospective analyses suggest that low-risk SS patients can be safely treated with surgery alone, but no prospective studies have confirmed the safety of this approach. This analysis pooled data from the two prospective clinical trials to assess outcomes in SS patients treated with a surgery-only approach and to identify predictors of treatment failure. METHODS: Patients with localised SS enrolled on the European paediatric Soft tissue sarcoma Study Group (EpSSG) NRSTS2005 and on the Children Oncology Group (COG) ARST0332 trials, treated with surgery alone were eligible for this analysis...
April 6, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28378083/minor-laparoscopic-liver-resection-toward-1-day-surgery
#11
Nicola de'Angelis, Benjamin Menahem, Philippe Compagnon, Jean Claude Merle, Francesco Brunetti, Alain Luciani, Daniel Cherqui, Alexis Laurent
BACKGROUND: Technical advances in laparoscopy and enhanced recovery after surgery programs have progressively decreased the need for hospitalization. The present study aimed to explore the feasibility and safety of an early discharge protocol after minor laparoscopic liver resection (LLR). METHODS: The study sample consisted of patients with both benign and malignant hepatic lesions involving no more than two hepatic segments who underwent minor LLR and were discharged within 24 h...
April 4, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28377920/automated-weaning-from-mechanical-ventilation-after-off-pump-coronary-artery-bypass-grafting
#12
Evgenia V Fot, Natalia N Izotova, Angelika S Yudina, Aleksei A Smetkin, Vsevolod V Kuzkov, Mikhail Y Kirov
BACKGROUND: The discontinuation of mechanical ventilation after coronary surgery may prolong and significantly increase the load on intensive care unit personnel. We hypothesized that automated mode using INTELLiVENT-ASV can decrease duration of postoperative mechanical ventilation, reduce workload on medical staff, and provide safe ventilation after off-pump coronary artery bypass grafting (OPCAB). The primary endpoint of our study was to assess the duration of postoperative mechanical ventilation during different modes of weaning from respiratory support (RS) after OPCAB...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28377246/awake-surgery-for-brain-vascular-malformations-and-moyamoya-disease
#13
Rami James N Aoun, Mithun G Sattur, Chandan Krishna, Amen Gupta, Matthew E Welz, Allan D Nanney, Antoun H Koht, Matthew C Tate, Katherine H Noe, Joseph I Sirven, Barrett J Anderies, Patrick B Bolton, Terry L Trentman, Richard S Zimmerman, Kristin R Swanson, Bernard R Bendok
OBJECTIVE: While a significant amount of experience has accumulated for awake procedures for brain tumor, epilepsy and carotid surgery, its utility for intracranial neurovascular indications remains largely undefined. Awake surgery, for select neurovascular cases, offers the advantage of precise brain mapping and robust neurological monitoring during surgery for lesions in eloquent areas, avoidance of potential hemodynamic instability, and possible faster recovery. Additionally, it opens the window for perilesional epileptogenic tissue resection with potentially less risk for iatrogenic injury...
April 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28375472/enhanced-recovery-after-surgery-protocol-in-patients-undergoing-esophagectomy-for-cancer-a-single-center-experience
#14
S Giacopuzzi, J Weindelmayer, E Treppiedi, M Bencivenga, M Ceola, S Priolo, M Carlini, G de Manzoni
This article is about an emerging issue in esophageal surgery: enhanced recovery after surgery (ERAS) Few data are published in literature and its safety and feasibility is still debated. The focus of our paper is on the feasibility of an ERAS protocol for esophagectomy (including both the Ivor-Lewis and McKeown procedure) in a high volume center comparing to a standard perioperative protocol. We introduced a novelty item on this type of surgery: resume of oral feeding in the first postoperative day. We analyzed the dropout rate for each item and the postoperative morbidity...
April 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28365947/irreversible-electroporation-nanoknife%C3%A2-treatment-in-the-field-of-hepatobiliary-surgery-current-status-and-future-perspectives
#15
Georgios Kourounis, Patrick Paul Tabet, Demetrios Moris, Alexandros Papalambros, Evangelos Felekouras, Fanourios Georgiades, George Astras, Athanasios Petrou
PURPOSE: We aimed to provide an overview of current understanding on the potential use of irreversible electroporation (IRE) in the field of hepatobiliary surgery with a focus on current results in hepatic and pancreatic cancers, its limitations, and its current directions. METHODS: Through a review of the literature we have gathered the key articles and trials that are shaping our understanding of the current status of IRE and its prospective uses, and organized them in an easily understandable format showcasing the most up to date results...
January 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/28362214/a-systematic-multidisciplinary-initiative-for-reducing-the-risk-of-complications-in-adult-scoliosis-surgery
#16
Rajiv Sethi, Quinlan D Buchlak, Vijay Yanamadala, Melissa L Anderson, Eric A Baldwin, Robert S Mecklenburg, Jean-Christophe Leveque, Alicia M Edwards, Mary Shea, Lisa Ross, Karen J Wernli
OBJECTIVE Systematic multidisciplinary approaches to improving quality and safety in complex surgical care have shown promise. Complication rates from complex spine surgery range from 10% to 90% for all surgeries, and the overall mortality rate is 1%-4%. These rates suggest the need for improved perioperative complex spine surgery processes designed to minimize risk and improve quality. METHODS The Group Health Research Institute and Virginia Mason Medical Center implemented a systematic multidisciplinary protocol, the Seattle Spine Team Protocol, in 2010...
March 31, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28350685/inadequate-enoxaparin-dosing-predicts-90-day-venous-thromboembolism-risk-among-plastic-surgery-inpatients-an-examination-of-enoxaparin-pharmacodynamics
#17
Christopher J Pannucci, W Bradford Rockwell, Maureen Ghanem, Kory I Fleming, Arash Momeni, Jayant Agarwal
BACKGROUND: Evidence-based plastic surgery guidelines support the effectiveness of once-daily enoxaparin prophylaxis. Despite prophylaxis, one in 25 highest risk patients has a venous thromboembolism event. The authors examined the pharmacodynamics of standard enoxaparin doses in plastic surgery patients to examine whether patient-level factors predict enoxaparin metabolism, whether inadequate enoxaparin dose predicts downstream venous thromboembolism events, and whether a pharmacist-driven dose-adjustment protocol was effective...
April 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28347577/utility-of-ultrasound-guided-injection-of-botulinum-toxin-type-a-for-muscle-imbalance-in-children-with-obstetric-brachial-plexus-palsy-description-of-the-procedure-and-action-protocol
#18
A García Ron, R Gallardo, B Huete Hernani
INTRODUCTION: Obstetric brachial plexus palsy (OBPP) usually has a favourable prognosis. However, nearly one third of all severe cases have permanent sequelae causing a high level of disability. In this study, we explore the effectiveness of ultrasound-guided injection of botulinum toxin A (BoNT-A) and describe the procedure. PATIENTS AND METHODS: We designed a prospective, descriptive study including patients with moderate to severe OBPP who were treated between January 2010 and December 2014...
March 24, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/28336738/single-stage-osseointegrated-reconstruction-and-rehabilitation-of-lower-limb-amputees-the-osseointegration-group-of-australia-accelerated-protocol-2-ogaap-2-for-a-prospective-cohort-study
#19
Munjed Al Muderis, William Lu, Kevin Tetsworth, Belinda Bosley, Jiao Jiao Li
INTRODUCTION: Lower limb amputations have detrimental influences on the quality of life, function and body image of the affected patients. Following amputation, prolonged rehabilitation is required for patients to be fitted with traditional socket prostheses, and many patients experience symptomatic socket-residuum interface problems which lead to reduced prosthetic use and quality of life. Osseointegration has recently emerged as a novel approach for the reconstruction of amputated limbs, which overcomes many of the socket-related problems by directly attaching the prosthesis to the skeletal residuum...
March 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/28330522/passive-range-of-motion-exercise-to-enhance-growth-in-infants-following-the-norwood-procedure-a-safety-and-feasibility-trial
#20
Linda M Lambert, Felicia L Trachtenberg, Victoria L Pemberton, Janine Wood, Shelley Andreas, Robin Schlosser, Teresa Barnard, Kaitlyn Daniels, Ann T Harrington, Nicholas Dagincourt, Thomas A Miller
OBJECTIVE: The aim of this study was to evaluate the safety and feasibility of a passive range of motion exercise programme for infants with CHD. Study design This non-randomised pilot study enrolled 20 neonates following Stage I palliation for single-ventricle physiology. Trained physical therapists administered standardised 15-20-minute passive range of motion protocol, for up to 21 days or until hospital discharge. Safety assessments included vital signs measured before, during, and after the exercise as well as adverse events recorded through the pre-Stage II follow-up...
March 23, 2017: Cardiology in the Young
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