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Safety protocols in surgery

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https://www.readbyqxmd.com/read/29777454/improved-outcomes-in-394-pancreatic-cancer-resections-the-impact-of-enhanced-recovery-pathway
#1
Vandana Agarwal, Martin Jose Thomas, Riddhi Joshi, Vikram Chaudhari, Manish Bhandare, Abhishek Mitra, Ashwin deSouza, Reshma Ambulkar, Shailesh V Shrikhande
BACKGROUND: Enhanced recovery (ER) pathway reduces morbidity and accelerates recovery. It is associated with reduced postoperative stay, morbidity, and costs. Feasibility and safety of ER programme has not been studied in developing countries. The objectives were to assess compliance with Enhanced Recovery After Surgery (ERAS) elements and to assess outcomes in pancreatic surgery. METHODS: Prospective study conducted from February 2014 to December 2016, following elective pancreatic cancer surgery...
May 18, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29776768/-topical-anesthesia-without-the-use-of-an-anesthesiologist-in-adult-outpatient-cataract-surgery-assessment-of-selection-criteria-on-consultation-report-of-248-cases
#2
M Pepin, E Rineau, A Caignard, S Leruez, P Gohier
INTRODUCTION: This work aims to evaluate selection criteria used during the cataract surgery scheduling visit, to choose whether or not there will be an anesthesiologist available during the surgery, depending upon the patient's comorbidities. MATERIALS AND METHODS: Retrospective study performed in 2016 in Angers university medical center. Two groups were established on the cataract surgery scheduling visit, based on patients' comorbidities and vital signs (blood pressure, heart rate)...
May 15, 2018: Journal Français D'ophtalmologie
https://www.readbyqxmd.com/read/29766134/protocol-for-a-randomized-trial-of-the-effect-of-timing-of-cholecystectomy-during-initial-admission-for-predicted-mild-gallstone-pancreatitis-at-a-safety-net-hospital
#3
Krislynn M Mueck, Shuyan Wei, Mike K Liang, Tien C Ko, Jon E Tyson, Lillian S Kao
Background: There is evidence-based consensus for laparoscopic cholecystectomy during index admission for predicted mild gallstone pancreatitis, defined by the absence of organ failure and of local or systemic complications. However, the optimal timing for surgery within that admission is controversial. Early cholecystectomy may shorten hospital length of stay (LOS) and increase patient satisfaction. Alternatively, it may increase operative difficulty and complications resulting in readmissions...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/29765198/management-of-post-lasik-dry-eye-a-multicenter-randomized-comparison-of-a-new-multi-ingredient-artificial-tear-to-carboxymethylcellulose
#4
Avi Wallerstein, W Bruce Jackson, Jeffrey Chambers, Amir M Moezzi, Hugh Lin, Peter A Simmons
Purpose: To compare the efficacy and safety of a preservative-free, multi-ingredient formulation of carboxymethylcellulose 0.5%, hyaluronic acid 0.1%, and organic osmolytes (CMC-HA), to preservative-free carboxymethylcellulose 0.5% (CMC) in the management of postoperative signs and symptoms of dry eye following laser-assisted in situ keratomileusis (LASIK). Methods: This was a double-masked, randomized, parallel-group study conducted in 14 clinical centers in Canada and Australia...
2018: Clinical Ophthalmology
https://www.readbyqxmd.com/read/29762292/a-dedicated-satellite-trauma-orthopaedic-program-operating-room-safely-increases-capacity
#5
Peter M Waters, Brian W Yang, Doreen White, Ellen Barth, Vincent Chiang, Arielle Mizrahi-Arnaud, William Sparks
BACKGROUND: Providing high-value care for urgent orthopaedic trauma patients requires effective and timely treatment. Herein, we describe the implementation of an innovative program utilizing the operating room (OR) capacity of a satellite campus to decrease stress on a pediatric tertiary care center without jeopardizing patient safety. METHODS: In addition to the daily emergency surgical room on the main campus, a dedicated orthopaedic trauma surgery OR was established in a satellite hospital location for 3 days per week in the summer and for 2 days per week for the rest of the year...
May 16, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29754619/enhanced-recovery-after-surgery-protocols-rationale-and-components
#6
REVIEW
Kyle L Kleppe, Jacob A Greenberg
Enhanced recovery after surgery (ERAS) protocols are spreading throughout various fields in surgery. ERAS protocols involve the implementation of evidence-based elements of care that are applied throughout the entire perioperative period to facilitate optimal recovery for the patient. ERAS protocols have been associated with improvements in quality of care, patient-reported and operative outcomes, and patient safety as well as reductions in cost. Thus, ERAS protocols have led to an overall improvement in health care value for the patient and the health care system...
June 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29742708/the-effectiveness-and-safety-of-nonsurgical-integrative-interventions-for-symptomatic-lumbar-spinal-spondylolisthesis-a-randomized-controlled-multinational-multicenter-trial-protocol
#7
Kiok Kim, Yousuk Youn, Sang Ho Lee, Jung Chul Choi, Jae Eun Jung, Jaehong Kim, Wenchun Qu, Jason Eldrige, Tae-Hun Kim
BACKGROUND: Surgery is generally accepted as the main therapeutic option for symptomatic lumbar spondylolisthesis. However, new nonsurgical therapeutic options need to be explored for this population. OBJECTIVES: The objective of this study is to assess the effectiveness and safety of a 5-week Mokhuri treatment program compared with conventional nonsurgical treatments for symptomatic lumbar spondylolisthesis. METHODS: This is a study protocol for a multinational, multicenter clinical randomized controlled trial comparing the effectiveness and safety of 5 weeks of nonsurgical integrative treatments (a Mokhuri treatment program consisting of Chuna, acupuncture, and patient education) with nonsurgical conventional treatments (drugs for pain relief, epidural steroid injections, and physical therapy)...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29739540/intravenous-lidocaine
#8
REVIEW
Jean-Pierre Estebe
Lidocaine has analgesic effect and antihyperalgesic and anti-inflammatory properties, which enable its use as a general anesthetic adjuvant. Lidocaine can reduce nociception and/or cardiovascular responses to surgical stress, postoperative pain, and/or analgesic requirements. However, its mechanisms of action remain unclear, despite its different known properties. Although the exact mechanism of action remains uncertain, initial bolus followed by a continuous lidocaine infusion has clear analgesic benefits...
December 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29732665/novel-electrical-conductivity-device-for-osteotomy-preparation-for-dental-implants-placement-a-cadaver-study
#9
Adi Lorean, Noa Barer, Horia Barbu, Liran Levin
OBJECTIVES: To evaluate the accuracy, safety, and anticipation effect of a novel electrical conductivity device (SG) in maxillary osteotomy preparation for placement of dental implants. MATERIALS AND METHODS: Thirty-seven osteotomies were prepared by three operators with different levels of expertise, using the SG protocol in the maxilla of six fresh frozen cadavers. A pre-op CT measurement of the length of bone in the desired implant location was taken and compared with the final length of the osteotomy created using SG during surgery...
May 6, 2018: Clinical Implant Dentistry and related Research
https://www.readbyqxmd.com/read/29730059/nasotracheal-intubation-the-preferred-airway-in-oral-cavity-microvascular-reconstructive-surgery
#10
Jordan Gigliotti, Godwin Cheung, Omar Suhaym, Ramanakumar V Agnihotram, Michel El-Hakim, Nicholas Makhoul
PURPOSE: We aimed to describe the safety and effectiveness of nasotracheal intubation (NTI) in a cohort of patients undergoing reconstruction of oral cavity defects with free tissue transfer (FTT). MATERIALS AND METHODS: We implemented a retrospective cohort study and enrolled a sample composed of consecutive patients undergoing FTT reconstruction of oral cavity, maxillary, or mandibular defects between 2013 and 2017. These patients were all subject to a newly developed enhanced recovery-after-surgery protocol...
April 11, 2018: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29727328/short-term-outcomes-of-ambulatory-colectomy-for-157-consecutive-patients
#11
Benoit Gignoux, Marilyn Gosgnach, Thomas Lanz, Alexandre Vulliez, Marie-Cecile Blanchet, Vincent Frering, Jean-Luc Faucheron, Philippe Chasserant
OBJECTIVE: To evaluate short-term outcomes of laparoscopic colectomy for selected consecutive patients in an ambulatory setting at two institutions. BACKGROUND: Several studies showed that an enhanced recovery protocol for colorectal surgery reduces postoperative morbidity and mortality, and shortens the length of hospital stay. The development of such a program has allowed us to gradually reduce the length of stay for colorectal surgery, until ambulatory management...
May 1, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29726071/a-prospective-randomised-multi-centre-study-of-the-impact-of-ga-68-psma-pet-ct-imaging-for-staging-high-risk-prostate-cancer-prior-to-curative-intent-surgery-or-radiotherapy-propsma-study-clinical-trial-protocol
#12
Michael S Hofman, Declan G Murphy, Scott G Williams, Tatenda Nzenza, Alan Herschtal, Richard De Abreu Lourenco, Dale L Bailey, Ray Budd, Rodney J Hicks, Roslyn J Francis, Nathan Lawrentschuk
INTRODUCTION: Accurate staging of patients with prostate cancer is important for therapeutic decision making. Relapse following surgery or radiotherapy of curative intent is not uncommon and, in part, represents a failure of staging with current diagnostic imaging techniques to detect disease spread. Prostate-specific-membrane-antigen (PSMA) positron emission tomography / computed tomography (PET/CT) is a new whole body scanning technique that enables visualisation of prostate cancer with high contrast...
May 3, 2018: BJU International
https://www.readbyqxmd.com/read/29717372/combined-repeat-laparoscopy-and-transanal-endolumenal-repair-hybrid-approach-in-the-early-management-of-postoperative-colorectal-anastomotic-leaks-technique-and-outcomes
#13
William Tzu-Liang Chen, Saurabh Bansal, Tao-Wei Ke, Sheng-Chi Chang, Yu-Chun Huang, Takashi Kato, Hwei-Ming Wang, Abe Fingerhut
BACKGROUND: Few clear recommendations exist for the management of colorectal anastomotic leaks, often based on surgeon preferences or institutional protocols. The primary goal was to evaluate the feasibility and safety of the combined laparoscopic and transanal (hybrid) approach to treat postoperative colorectal anastomotic leaks. The secondary goals included comparison of outcomes following early (< 5 days after initial resection) versus late (≥ 5 days) detection of leaks...
May 1, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29704203/safety-and-efficacy-of-synchronous-robotic-surgery-for-colorectal-cancer-with-liver-metastases
#14
REVIEW
Rozana H Dwyer, Matthew J Scheidt, J Stephen Marshall, Steven S Tsoraides
Timing of resection and treatment of colorectal cancer (CRC) with liver metastases varies based on patient characteristics and center protocols. Concerns of increased morbidity and mortality (M&M) related to anesthetic time and blood loss have limited widespread adaptation of synchronous colorectal and liver resections. Furthermore, technical challenges have made minimally invasive synchronous resections less common. We present our series of synchronous robotic surgery for CRC with liver metastases. Retrospective review of prospectively collected data of patients with stage IV CRC with liver metastases treated at a tertiary center from February 2013 to June 2014...
April 27, 2018: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/29701382/institutional-protocol-for-prevention-of-tevar-related-spinal-cord-ischemia-the-first-9-cases
#15
Marina Dias-Neto, Pedro Reis, Leonor Mendes, Margarida Rodrigues, Cristina Amaral, Graça Afonso, José Fernando Teixeira
INTRODUCTION: Spinal cord ischemia (SCI) is a feared complication after endovascular correction of thoracic aortic diseases (TEVAR). The guidelines of the European Society for Vascular Surgery recommend prophylactic lumbar drainage (LD) of cerebrospinal fluid in high-risk patients undergoing TEVAR. Our institutional protocol considers as high-risk patients as: coverage of the origin of the Adamkiewicz artery (T9-T12), aortic coverage >15 cm, involvement of collaterals (treated or untreated abdominal aortic aneurysm, left subclavian artery revascularization or bilateral occlusion of the internal iliac arteries) and symptomatic SCI...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29696173/safety-and-efficacy-of-endovascular-therapy-and-gamma-knife-surgery-for-brain-arteriovenous-malformations-in-china-study-protocol-for-an-observational-clinical-trial
#16
Hengwei Jin, Xiaochuan Huo, Yuhua Jiang, Xiaolong Li, Youxiang Li
Introduction: Brain arteriovenous malformations (BAVMs) are associated with high morbidity and mortality. The treatment of BAVM remains controversial. Microinvasive treatment, including endovascular therapy and gamma knife surgery, has been the first choice in many conditions. However, the overall clinical outcome of microinvasive treatment remains unknown and a prospective trial is needed. Methods: This is a prospective, non-randomized, and multicenter observational registry clinical trial to evaluate the safety and efficacy of microinvasive treatment for BAVMs...
September 2017: Contemporary Clinical Trials Communications
https://www.readbyqxmd.com/read/29691801/a-brief-history-of-the-opioid-epidemic-and-strategies-for-pain-medicine
#17
REVIEW
Mark R Jones, Omar Viswanath, Jacquelin Peck, Alan D Kaye, Jatinder S Gill, Thomas T Simopoulos
The opioid epidemic has resulted from myriad causes and will not be solved by any simple solution. Consequent to a staggering increase in opioid-related deaths in the USA, various governmental inputs and stakeholder strategies have been proposed and implemented with varying success. This article summarizes the history of opioid use and explores the causes for the present day epidemic. Recent trends in opioid-related data demonstrate an almost fourfold increase in overdose deaths from 1999 to 2008. Tragically, opioids claimed over 64,000 lives just last year...
April 24, 2018: Pain and Therapy
https://www.readbyqxmd.com/read/29688624/introduction-of-a-laser-safety-checklist-in-the-ent-operating-theatre-our-experience-across-twenty-cases
#18
Stephen P Williams, Andrew J Kinshuck, Colin R Butler, Guri S Sandhu
The use of operating laser poses a potential risk both to the patient and to theatre staff and so it is crucial that safety protocols and procedures are followed meticulously in every case - particularly in the setting of laser surgery in the airway. All existing guidelines and standards on laser safety highlight the importance of pre-use checks relating to aspects of the theatre environment and aspects relating directly to the patient. Good communication pathways have been highlighted as crucial for fire safety within theatre...
April 24, 2018: Clinical Otolaryngology
https://www.readbyqxmd.com/read/29688510/study-protocol-early-stereotactic-gamma-knife-radiosurgery-to-residual-tumor-after-surgery-of-newly-diagnosed-glioblastoma-gamma-gbm
#19
Stefanie Brehmer, Mario Alexander Grimm, Alex Förster, Marcel Seiz-Rosenhagen, Grit Welzel, Florian Stieler, Frederik Wenz, Christoph Groden, Sabine Mai, Daniel Hänggi, Frank Anton Giordano
BACKGROUND: Glioblastoma (GBM) is the most common malignant brain tumor in adult patients. Tumor recurrence commonly occurs around the resection cavity, especially after subtotal resection (STR). Consequently, the extent of resection correlates with overall survival (OS), suggesting that depletion of postoperative tumor remnants will improve outcome. OBJECTIVE: To assess safety and efficacy of adding stereotactic radiosurgery (SRS) to the standard treatment of GBM in patients with postoperative residual tumor...
April 24, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29669701/crizotinib-in-patients-with-advanced-inoperable-inflammatory-myofibroblastic-tumours-with-and-without-anaplastic-lymphoma-kinase-gene-alterations-european-organisation-for-research-and-treatment-of-cancer-90101-create-a-multicentre-single-drug-prospective-non
#20
Patrick Schöffski, Jozef Sufliarsky, Hans Gelderblom, Jean-Yves Blay, Sandra J Strauss, Silvia Stacchiotti, Piotr Rutkowski, Lars H Lindner, Michael G Leahy, Antoine Italiano, Nicolas Isambert, Maria Debiec-Rychter, Raf Sciot, Thomas Van Cann, Sandrine Marréaud, Axelle Nzokirantevye, Sandra Collette, Agnieszka Wozniak
BACKGROUND: An inflammatory myofibroblastic tumour (IMFT) is a rare mesenchymal neoplasm characterised by anaplastic lymphoma kinase (ALK) gene rearrangements. We assessed the activity and safety of crizotinib, a tyrosine kinase inhibitor, targeting ALK in patients with advanced IMFT either with or without ALK alterations. METHODS: We did a multicentre, biomarker-driven, single-drug, non-randomised, open-label, two-stage phase 2 trial (European Organisation for Research and Treatment of Cancer 90101 CREATE) at 13 study sites (five university hospitals and eight specialty clinics) in eight European countries (Belgium, France, Germany, Italy, Netherlands, Poland, Slovakia, and the UK)...
April 12, 2018: Lancet Respiratory Medicine
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