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intraop estimated blood loss

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https://www.readbyqxmd.com/read/28072709/tranexamic-acid-reduces-perioperative-blood-loss-of-posterior-lumbar-surgery-for-stenosis-or-spondylolisthesis-a-randomized-trial
#1
Houyin Shi, Yunsheng Ou, Dianming Jiang, Zhengxue Quan, Zenghui Zhao, Yong Zhu
BACKGROUND: A prospective, randomized, double-blind, placebo-controlled study was performed. The routine usage of TA in spinal surgery is controversial. Only a few studies have focused on patients undergoing posterior lumbar surgery for stenosis or spondylolisthesis, although a large clinical cohort exists in the population. This study aimed to evaluate the effect and safety of TA in reducing perioperative blood loss in posterior lumbar surgery for stenosis or spondylolisthesis. METHODS: 100 eligible patients out of 126 were randomized to receive either a bolus dose of 30 mg/kg TA i...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28067569/optimizing-postoperative-handover-to-the-intensive-care-unit-at-a-tertiary-centre
#2
Shankar Kumar, Andrew R McKean, Andrew Ramwell, Carolyn Johnston, Susannah Leaver
BACKGROUND: Comprehensive handover of patients transferred from operating theatre to the intensive care unit is crucial in ensuring ongoing quality and safety of care. Handover in this setting poses unique challenges, yet few studies have considered or tested approaches to improve the process. A quality improvement project was undertaken to assess and improve the quality of information transfer during the handover of postoperative patients to the general intensive care unit at a tertiary centre...
January 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/28065237/predictors-for-massive-blood-loss-during-posterior-correction-of-congenital-scoliosis-in-pre-school-children-a-retrospective-observation
#3
Le Shen, Wei-Yun Chen, Wu-Tao Wang, Hao-Nan Xu, Xue-Rong Yu, Xiu-Hua Zhang, Yu-Guang Huang
Objective To investigate the predictors for massive blood loss during posterior correction of congenital scoliosis in pre-school children. Methods Totally 124 children under six years of age,who received posterior correction of congenital scoliosis,were divided into two groups according to the ratio of intraoperative blood loss (BL) and estimated blood volume (EBV). Massive blood loss was defined as BL/EBV>0.15,and minor or moderate blood loss as BL/EBV≤0.15. All the records,including demographics,intraoperative fluids,pre- or postoperative laboratory parameters,and the length of hospital stay,were compared between these two groups...
December 20, 2016: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/28061495/effectiveness-and-safety-of-tranexamic-acid-in-spinal-deformity-surgery
#4
Ho Yong Choi, Seung-Jae Hyun, Ki-Jeong Kim, Tae-Ahn Jahng, Hyun-Jib Kim
OBJECTIVE: Spinal deformity surgery has the potential risk of massive blood loss. To reduce surgical bleeding, the use of tranexamic acid (TXA) became popular in spinal surgery, recently. The purpose of this study was to determine the effectiveness of intra-operative TXA use to reduce surgical bleeding and transfusion requirements in spinal deformity surgery. METHODS: A total of 132 consecutive patients undergoing multi-level posterior spinal segmental instrumented fusion (≥5 levels) were analyzed retrospectively...
January 1, 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28061037/single-port-laparoscopic-surgery-can-be-performed-safely-and-appropriately-for-colon-cancer-short-term-results-of-a-pilot-randomized-controlled-trial
#5
Byung Mo Kang, Sun Jin Park, Kil Yeon Lee, Suk-Hwan Lee
INTRODUCTION: Single-port laparoscopic surgery (SPLS) has gained popularity due to its cosmetic benefit, and therefore, has been applied to several kinds of benign operations, such as appendectomy and cholecystectomy. The safety and suitability of SPLS for colon cancer has not been widely proved. We aimed at validating the safety, efficacy, and short-term quality of life (QOL) of SPLS compared with conventional laparoscopic surgery (CLS) in patients with colon cancer. MATERIALS AND METHODS: Between June 2010 and April 2011, a total of 62 patients with pathology-proven colon cancer were randomly allocated to two groups: SPLS and CLS...
January 6, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28058023/laparoscopic-and-endoscopic-co-operative-surgery-for-non-ampullary-duodenal-tumors
#6
Daisuke Ichikawa, Shuhei Komatsu, Osamu Dohi, Yuji Naito, Toshiyuki Kosuga, Kazuhiro Kamada, Kazuma Okamoto, Yoshito Itoh, Eigo Otsuji
AIM: To assess the safety and feasibility of laparoscopic and endoscopic co-operative surgery (LECS) for early non-ampullary duodenal tumors. METHODS: Twelve patients with a non-ampullary duodenal tumor underwent LECS at our hospital. One patient had two mucosal lesions in the duodenum. The indication for this procedure was the presence of duodenal tumors with a low risk for lymph node metastasis. In particular, the tumors included small (less than 10 mm) submucosal tumors (SMT) and epithelial mucosal tumors, such as mucosal cancers or large mucosal adenomas with malignant suspicion...
December 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28054191/central-venous-pressure-drop-after-hypovolemic-phlebotomy-is-a-strong-independent-predictor-of-intraoperative-blood-loss-during-liver-resection
#7
Andries Ryckx, Claudine Christiaens, Mathias Clarysse, Franky Vansteenkiste, Pieter Jan Steelant, Gregory Sergeant, Isabelle Parmentier, Hans Pottel, Mathieu D'Hondt
BACKGROUND: Intraoperative hypovolemic phlebotomy (HP) has been suggested to reduce central venous pressure (CVP) before hepatectomy. This study aimed to analyze the impact of CVP drop after HP on intraoperative blood loss and postoperative renal function. METHODS: A retrospective review of a prospective database including 100 consecutive patients (43 males and 57 females; mean age, 65 years; range 23-89 years) undergoing liver resection with HP was performed. The primary outcome variable was estimated blood loss (EBL), and the secondary outcome was postoperative serum creatinin (Scr)...
January 4, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28051910/transperitoneal-intravesical-technique-for-laparoscopic-ureteral-reimplantation-to-treat-terminal-ureteral-stenosis
#8
Bing-Sheng Li, Yao He, Zhi Chen, Zhao-Hui Wang, Zhi-Qiang Wen, Xiang Chen
OBJECTIVE: To describe a newly developed transperitoneal intravesical technique for laparoscopic ureteral reimplantation in patients with terminal ureteral stenosis. METHODS: Between July 2009 and May 2015, laparoscopic transperitoneal intravesical ureteral reimplantation was performed in 16 patients with terminal ureteral stenosis without vesicoureteral reflux (VUR). An incision was made in the superior bladder wall of the affected side with an electric hook. The bladder mucosa was then circumferentially cut away from the ureteral orifice to a distance of 0...
January 4, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28039700/extended-hepatectomy-using-the-bipolar-tissue-sealer-an-experimental-model-of-small-for-size-syndrome-in-pigs
#9
Antonios Athanasiou, Michael Kontos, Emmanouil Pikoulis, John Griniatsos, Apostolos Papalois, Eleftherios Spartalis, Demetrios Moris, Evangelos Felekouras, Theodoros Liakakos
PURPOSE: After liver transplantation with a small-for-size liver graft or after extensive hepatectomy for liver malignancies or other non malignant conditions with an insufficient liver volume, the survival of patients depends on liver regeneration. This study was carried out in order to create a new porcine model for the study of small-for-size syndrome (SFSS) after extensive hepatectomy. METHODS: In the present study we used 23 domestic Landrace pigs weighing 28...
November 2016: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/28034817/laparoscopic-assisted-ventriculoperitoneal-shunt-placement-in-children-under-the-age-of-1-year
#10
Jehuda Soleman, Christian A Schneider, Viktoria A Pfeifle, Peter Zimmermann, Raphael Guzman
OBJECT: To analyze the safety and feasibility of laparoscopic assisted ventriculoperitoneal shunt (VPS) insertion in children under the age of 1 year and weighing less than 5kg. METHODS: Retrospective review of children receiving laparoscopic assisted VPS. Patient characteristics, complications, operation and hospitalization time, blood loss, and conversion to the standard approach were noted and analyzed. RESULTS: Laparoscopic assisted VPS was performed in 25 children...
December 27, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28032037/surgical-apgar-score-predicts-early-complication-in-transfemoral-amputees-retrospective-study-of-170-major-amputations
#11
Christian Wied, Nicolai B Foss, Morten T Kristensen, Gitte Holm, Thomas Kallemose, Anders Troelsen
AIM: To assess whether the surgical apgar score (SAS) is a prognostic tool capable of identifying patients at risk of major complications following lower extremity amputations surgery. METHODS: This was a single-center, retrospective observational cohort study conducted between January 2013 and April 2015. All patients who had either a primary transtibial amputation (TTA) or transfemoral amputation (TFA) conducted at our institution during the study period were assessed for inclusion...
December 18, 2016: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28029219/defining-the-tipping-point-in-surgical-performance-for-laparoscopic-donor-nephrectomy-among-transplant-surgery-fellows-a-risk-adjusted-cumulative-summation-learning-curve-analysis
#12
O K Serrano, A S Bangdiwala, D M Vock, D Berglund, T B Dunn, E B Finger, T L Pruett, A J Matas, R Kandaswamy
UNOS recommends that fellowship-trained surgeons participate in 15 LDN to be considered proficient. ASTS mandates 12 LDN during abdominal transplant surgery fellowship (ATSF). We performed a retrospective intraoperative case analysis to create a risk-adjusted cumulative summation (RACUSUM) model to assess the learning curve (LC) of novice TSF (nTSF). Between January 2000 and December 2014, 30 nTSF rotated on the Organ Procurement Rotation (OPR) of our ASTS-approved ATSF. Measures of surgical performance included: 1) intraoperative time (ORT), 2) estimated blood loss (EBL), and 3) incidence of intraoperative complications (IOC)...
December 28, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/28011275/perioperative-transfusion-of-leukocyte-depleted-blood-products-in-contemporary-radical-cystectomy-cohort-does-not-adversely-impact-short-term-survival
#13
Juan J Chipollini, Dominic H Tang, Sephalie Y Patel, Rosemarie E Garcia-Getting, Scott M Gilbert, Julio M Pow-Sang, Wade J Sexton, Philippe E Spiess, Michael A Poch
OBJECTIVES: To evaluate the effect of leukoreduced-only perioperative blood transfusion (PBT) and corresponding survival outcomes in a radical cystectomy (RC) cohort of patients. METHODS: We analyzed data from 1,026 patients who underwent RC at our institution. PBT was defined as transfusion in the intraoperative or within the postoperative hospitalization period. Multivariable Cox proportional hazards analyses (MVA) were performed to measure the association between PBT, patient variables, and 3 primary endpoints: recurrence free survival (RFS), disease specific survival (DSS), and overall survival (OS)...
December 20, 2016: Urology
https://www.readbyqxmd.com/read/28011011/robotic-cholecystectomy-versus-conventional-laparoscopic-cholecystectomy-a-meta-analysis
#14
Yeqian Huang, Terence C Chua, Guy J Maddern, Jaswinder S Samra
BACKGROUND: Robotic cholecystectomy is a novel approach that offers the surgeon improved high-definition, 3-dimensional views and enhanced instrument ergonomics, which represent a technical development from previous operative platforms that include conventional and single-incision laparoscopy. This review compares its short-term outcomes with conventional laparoscopic cholecystectomy by a meta-analysis. METHODS: A literature search was conducted using the MEDLINE, EMBASE, and PubMed databases (January 1990-October 2015)...
December 20, 2016: Surgery
https://www.readbyqxmd.com/read/28004329/validation-of-the-glycemic-stress-index-in-pediatric-neurosurgical-intensive-care
#15
Marco Piastra, Alessandro Pizza, Federica Tosi, Sonia Mensi, Luca Massimi, Andrea De Bellis, Daniele G Biasucci, Ersilia Luca, Giorgio Conti, Daniele De Luca
BACKGROUND: Studies have suggested that both the degree and the duration of hyperglycemia are independent risk factors for adverse outcome both in pediatric anesthesia and in critically ill children. In a recent paper, we combined intraoperative glycemic variations and length of surgery creating a metabolic glucose-related stress index called "Glycemic Stress Index" (GSI). AIM: To validate GSI for predicting PICU stay in a population of children undergoing different major neurosurgical procedures...
December 21, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/28000025/two-novel-classification-systems-for-uterine-fibroids-and-subsequent-uterine-reconstruction-after-myomectomy
#16
Ingolf Juhasz-Böss, Peter Jungmann, Julia Radosa, Anika von Heesen, Russalina Ströder, Stephanie Juhasz-Böss, Gabriele Meyberg-Solomayer, Erich Solomayer
OBJECTIVE: Laparoscopic approaches are the gold standard surgical treatment for intramural and subserous fibroids, whereas submucosal myomas can be treated via hysteroscopy. Removal of intramural myomas often requires a subsequent reconstruction of the uterine wall that ranges from single- to multiple-layer sutures to complex reconstructions. Several classification systems are currently used to characterize uterine fibroids, all of which focus on the assessment of submucosal fibroids during hysteroscopic myomectomy...
December 20, 2016: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/27999500/benefits-of-limited-use-of-a-tourniquet-combined-with-intravenous-tranexamic-acid-during-total-knee-arthroplasty
#17
Alexander D Rosenstein, Yehuda A Michelov, Stephanie Thompson, Alan D Kaye
BACKGROUND: Blood loss during total knee arthroplasty (TKA) may require blood transfusions that are associated with increased risk, morbidity, and cost. Multiple techniques exist to reduce blood loss in TKA, including the use of a tourniquet and tranexamic acid (TXA). While multiple studies suggest that TXA is effective in reducing blood loss, the use of a tourniquet is more controversial. We studied the combined effect of TXA with a limited-use tourniquet on blood loss and complications in the setting of primary TKA...
2016: Ochsner Journal
https://www.readbyqxmd.com/read/27995543/salvage-robotic-prostatectomy-following-whole-gland-high-intensity-focused-ultrasound-with-a-sonablate-500-device-technical-feasibility-and-safety
#18
Samuel Peretsman, Jessica Brooks
High-intensity focused ultrasound (HIFU) has been used to treat localized prostate cancers. Similar to all forms of ablation, including radiation and cryoablation, there is a local persistence rate. Salvage robotic prostatectomy has been utilized but published series are multi-institutional, multi-surgeon, and do not segregate the different HIFU devices. The results are also grouped with other forms of ablation. This series describes the technical results of a single surgeon performing salvage robotic prostatectomy on only HIFU patients, and only after whole gland ablation on a Sonablate 500 device...
December 19, 2016: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/27995328/new-surgical-scoring-system-to-predict-postoperative-mortality
#19
Maho Kinoshita, Nobutada Morioka, Mariko Yabuuchi, Makoto Ozaki
PURPOSE: There is still no easy and highly useful method to comprehensively assess both preoperative and intraoperative patient statuses to predict postoperative outcomes. We attempted to develop a new scoring system that would enable a comprehensive assessment of preoperative and intraoperative patient statuses instantly at the end of anesthesia, predicting postoperative mortality. METHODS: The study included 32,555 patients who underwent surgery under general or regional anesthesia from 2008 to 2012...
December 19, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27994780/single-posterior-approach-for-en-bloc-resection-and-stabilization-for-locally-advanced-pancoast-tumors-involving-the-spine-single-centre-experience
#20
Fahed Zairi, Tarek Sunna, Moishe Liberman, Ghassan Boubez, Zhi Wang, Daniel Shedid
STUDY DESIGN: Monocentric prospective study. PURPOSE: To assess the safety and effectiveness of the posterior approach for resection of advanced Pancoast tumors. OVERVIEW OF LITERATURE: In patients with advanced Pancoast tumors invading the spine, most surgical teams consider the combined approach to be necessary for "en-bloc" resection to control visceral, vascular, and neurological structures. We report our preliminary experience with a single-stage posterior approach...
December 2016: Asian Spine Journal
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