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https://www.readbyqxmd.com/read/29278605/erector-spinae-plane-block-for-surgery-of-the-posterior-thoracic-wall-in-a-pediatric-patient
#1
Maria Alejandra Hernandez, Lucio Palazzi, Julio Lapalma, Mauricio Forero, Ki Jinn Chin
OBJECTIVE: Historically, regional anesthesia for surgery on the posterior thoracic wall has been limited to neuraxial and paravertebral nerve blocks. The erector spinae plane (ESP) block is a novel technique that anesthetizes the dorsal rami of the spinal nerves innervating the posterior thoracic wall. We report the use of the ESP block for this clinical application in a pediatric patient. CASE REPORT: A healthy 3-year-old girl was scheduled for resection of a giant paraspinal lipoma extending over the T4-T7 dermatomes...
December 22, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29241312/selective-clamping-during-laparoscopic-partial-nefrectomy-the-use-of-near-infrared-fluorescence-guidance
#2
Francesco Porpiglia, Cristian Fiori, Enrico Checcucci, Angela Pecoraro, Michele DI Dio, Riccardo Bertolo
BACKGROUND: Near infrared fluorescence (NIRF) is being investigated as a helpful tool to enhance segmental arterial clamping in robotics. Available experiences with NIRF during standard laparoscopy are anecdotal. The aim of the study was to perform a single-center feasibility and results analysis of laparoscopic partial nephrectomy (LPN) performed using NIRF-guided selective clamping. METHODS: May 2016-December 2016: 15 patients diagnosed with a renal mass suitable for nephron-sparing approach consecutively underwent LPN with NIRF-guidance technique...
December 14, 2017: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
https://www.readbyqxmd.com/read/29217899/technical-feasibility-and-short-term-outcome-of-intracorporeal-hand-sewn-esophagojejunostomy-after-laparoscopic-total-gastrectomy-our-experience
#3
Shailesh Puntambekar, Reda Badran, Hirav Parikh, Arpit Bansal, Vikrant Sharma, Mihir Chitale, Saptesh Jadhav
The purpose of this study was to demonstrate the safety and technical feasibility of intracorporeal hand-sewn esophagojejunostomy after laparoscopic total gastrectomy. Laparoscopic total gastrectomy (LTG) is a technically challenging procedure, especially for esophagojejunal anastomosis (EJA). Various techniques have been described to overcome these difficulties using staplers with variable results. We report successfully performed complete intracorporeal hand-sewn EJA after LTG. The perioperative clinical data and short-term outcomes for 30 patients who underwent LTG using hand-sewn EJA for gastric cancer between 2013 and 2015 have been retrospectively reviewed...
December 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/29198770/preoperative-enteral-access-is-not-necessary-prior-to-multimodality-treatment-of-esophageal-cancer
#4
Thomas K Jenkins, Alexandra N Lopez, George A Sarosi, Kfir Ben-David, Ryan M Thomas
BACKGROUND: Surgical enteral access prior to multimodality treatment for esophageal cancer is controversial as dysphagia is often used for feeding tube referral. We hypothesized that enteral access before neoadjuvant chemoradiation for esophageal cancer provides no benefit compared to that placed during definitive esophagectomy. METHODS: Patients undergoing esophagectomy for esophageal malignancy from 2007 - 2014 were retrospectively identified. Clinicopathologic factors were recorded including preoperative enteral access, weight change, nutritional laboratory works, and perioperative complications...
November 30, 2017: Surgery
https://www.readbyqxmd.com/read/29198259/management-of-undernutrition-and-failure-to-thrive-in-children-with-congenital-heart-disease-in-low-and-middle-income-countries
#5
Andrew C Argent, Rakhi Balachandran, Balu Vaidyanathan, Amina Khan, R Krishna Kumar
Poor growth with underweight for age, decreased length/height for age, and underweight-for-height are all relatively common in children with CHD. The underlying causes of this failure to thrive may be multifactorial, including innate growth potential, severity of cardiac disease, increased energy requirements, decreased nutritional intake, malabsorption, and poor utilisation of absorbed nutrition. These factors are particularly common and severe in low- and middle-income countries. Although nutrition should be carefully assessed in all patients, failure of growth is not a contraindication to surgical repair, and patients should receive surgical repair where indicated as soon as possible...
December 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/29167985/short-term-outcome-after-cystectomy-comparison-of-early-oral-feeding-in-an-enhanced-recovery-protocol-and-feeding-using-bengmark-nasojejunal-tube
#6
C S Voskuilen, E E Fransen van de Putte, J Bloos-van der Hulst, E van Werkhoven, W M de Blok, B W G van Rhijn, S Horenblas, R P Meijer
PURPOSE: Cystectomy for bladder cancer is associated with a high risk of postoperative complications. Standardized perioperative protocols, such as enhanced recovery after surgery (ERAS) protocols, aim to improve postoperative outcome. Postoperative feeding strategies are an important part of these protocols. In this two-centre study, we compared complications and length of hospital stay (LOS) between an ERAS protocol with early oral nutrition and a protocol with early enteral feeding with a Bengmark nasojejunal tube...
November 22, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/29135530/should-percussion-pacing-have-a-role-in-perioperative-advanced-cardiac-life-support-a-case-report
#7
Chris Giordano, Jordan Miller, Ilan Keidan
Percussion pacing involves using one's fist to repeatedly strike a patient's left sternal border in a rhythmic manner. The resulting increase in ventricular pressure can trigger myocardial depolarization and subsequent contraction. We describe the successful treatment of acute preoperative symptomatic sinus bradycardia with percussion pacing in a 63-year-old patient scheduled for placement of a gastric feeding tube after trauma involving spinal cord injury. Although no longer included in current advanced cardiovascular life support guidelines, percussion pacing may be a suitable alternative to chest compressions in multitrauma cases where the force of compressions could cause further complications...
November 9, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29104029/nasolabial-flap-improves-healing-in-medication-related-osteonecrosis-of%C3%A2-the-jaw
#8
Juliana Lemound, Thomas Muecke, Alexander-Nicolai Zeller, Jürgen Lichtenstein, André Eckardt, Nils-Claudius Gellrich
PURPOSE: Medication-related osteonecrosis of the jaw (MRONJ) is an adverse side effect of antiresorptive and antiangiogenic therapeutic agents that is difficult to treat owing to its high relapse rate. The aim of the present study was to determine whether patients with MRONJ treated using decortication and a nasolabial flap compared with those who underwent decortication with mucoperiosteal flaps have better outcomes regarding stable wound closure. MATERIALS AND METHODS: Two groups of patients with MRONJ and intraoral exposed bone were evaluated in a cohort clinical study retrospectively...
October 13, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29067620/what-is-enhanced-recovery-and-how-can-i-do-it
#9
Bradford J Kim, Thomas A Aloia
BACKGROUND: Enhanced recovery (ER) and fast-track protocols were initially implemented in the perioperative management of the surgical patient over 20 years ago. These standardized protocols are now broadly implemented across most surgical specialties for its many benefits. ER is well known for its positive effects on decreasing length of stay and complications. However, patient-centric outcomes for adequate pain control, functional recovery, costs, and overall patient experience are less considered...
January 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29046800/re-irradiation-of-locoregional-esophageal-cancer-recurrence-following-definitive-chemoradiotherapy-a-report-of-6-cases
#10
Atsuto Katano, Hideomi Yamashita, Keiichi Nakagawa
There is currently no consensus on salvage therapy for recurrent esophageal cancer. Salvage surgery is a well-established option for attaining long-term survival; however, it is associated with a high risk of perioperative morbidity and mortality. A total of 6 patients who underwent re-irradiation for recurrence of locoregional esophageal cancer following definitive chemoradiotherapy were investigated. The median interval between initial radiotherapy and re-irradiation was 17.4 months (range, 6.4-59.2 months)...
October 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/29032966/safety-and-efficacy-of-uninterrupted-perioperative-enteral-feeding-in-pediatric-burn-patients
#11
Folasade Imeokparia, Morgan Johnson, Rajan K Thakkar, Sheila Giles, Teresa Capello, Renata Fabia
INTRODUCTION: Burn injuries are a significant cause of morbidity. Early enteral nutrition has been shown to improve outcomes, however enteral nutrition is often held for procedures receiving general anesthesia. Limited data is available on uninterrupted perioperative nutrition in pediatric burn patients. METHODS: A single, American Burn Association verified burn center database was queried for patients ≤18 years of age with ≥15% total body surface area (TBSA) burn injuries who underwent surgeries with general anesthesia...
October 9, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29025295/ultrasonography-guided-percutaneous-microwave-ablation-for-large-hepatic-cavernous-hemangiomas
#12
Fangyi Liu, Xiaoling Yu, Ping Liang, Zhigang Cheng, Zhiyu Han, Jie Yu
PURPOSE: To evaluate the efficacy and safety of ultrasound-guided percutaneous microwave ablation (MWA) for large hepatic cavernous hemangiomas (HCHs) with ablation of the feeding artery and aspiration of blood from hemangioma simultaneously. MATERIALS AND METHODS: From January 2011 to December 2016, 40 patients (29 females, 11male; average age 43.25±7.65 years) with 42 giant hepatic hemangiomas (mean diameter7.02±1.55cm, range4.1-10.8 cm) were treated with image-guided percutaneous MWA with ablation of the feeding artery and aspiration of blood from hemangioma simultaneously...
October 12, 2017: International Journal of Hyperthermia
https://www.readbyqxmd.com/read/28829221/enhanced-recovery-after-surgery-in-laparoscopic-surgery
#13
Kay B Leissner, Jessica L Shanahan, Peter L Bekker, Houman Amirfarzan
BACKGROUND: As part of an effort to maximize value in the perioperative setting, a paradigm shift is underway in the way that patients are cared for preoperatively, on the day of surgery, and postoperatively-a setting collectively known as the perioperative care. Enhanced Recovery After Surgery (ERAS(®)) is an evidence-based, patient-centered team approach to delivering high-quality perioperative care to surgical patients. METHODS: This review focuses on anesthesiologists, with their unique purview of perioperative setting, who are important drivers of change in the delivery of valuable perioperative care...
September 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28822398/variability-in-perioperative-fasting-practices-negatively-impacts-nutritional-support-of-critically-ill-intubated-patients
#14
Molly J Douglas, David Ciraulo
The aim of the study was to quantify nutritional losses related to pre- and postoperative fasts in critically ill intubated patients and to explore whether shorter fasts are safe and appropriate in this population. A retrospective review of mechanically ventilated adults undergoing surgery more than 24 hours after admission to a Level I trauma center over 15 months was done, which yielded 132 procedures and 81 unique patients. Ninety per cent of preoperative periods and 43 per cent of postoperative periods were affected by nonmedical barriers to feeding...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28815075/the-feeding-route-after-esophagectomy-a-review-of-literature
#15
REVIEW
Gijs H Berkelmans, Frans van Workum, Teus J Weijs, Grard A Nieuwenhuijzen, Jelle P Ruurda, Ewout A Kouwenhoven, Marc J van Det, Camiel Rosman, Richard van Hillegersberg, Misha D Luyer
Enhanced recovery programs effectively optimize perioperative care and reduce postoperative morbidity. In esophagectomy, several components of the ERAS program are successfully introduced. However, timing and type of postoperative feeding remain a matter of debate. Adequate nutritional support is essential in patients undergoing an esophagectomy. These patients often present with weight loss and their eating pattern is strongly altered by the procedure and reconstruction. Total parenteral nutrition (TPN) is associated with severe septic complications and enteral nutrition (EN) does not increase major complications...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28777676/benefits-of-supplemental-jejunostomy-tube-feeding-during-neoadjuvant-therapy-in-patients-with-locally-advanced-potentially-resectable-esophageal-cancer
#16
Brian G A Dalton, Adam J Friedant, Stacey Su, Tiffany A P Schatz, Karen J Ruth, Walter J Scott
BACKGROUND: Standard treatment for locally advanced esophageal cancer includes neoadjuvant therapy followed by surgical resection. However, many patients experience a period of decreased oral intake during neoadjuvant treatment and are at risk for malnutrition. We hypothesize that use of jejunostomy tube (j-tube) feedings during neoadjuvant therapy in selected patients may be associated with better perioperative outcomes. METHODS: A prospectively collected database at a single institution was retrospectively analyzed...
August 4, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28774488/crystalloid-versus-colloid-fluids-for-reduction-of-postoperative-ileus-after-abdominal-operation-under-combined-general-and-epidural-anesthesia
#17
RANDOMIZED CONTROLLED TRIAL
Mohammad Reza Ghodraty, Faranak Rokhtabnak, Hossein Reza Dehghan, Alireza Pournajafian, Masoud Baghaee Vaji, Zahra Sadat Koleini, Jahan Porhomayon, Nader D Nader
BACKGROUND: The main objective of this study was to compare the effect of perioperative administration of crystalloid versus colloid solutions and its impact on reversal of ileus after resection with primary anastomosis of intestine. We hypothesized that inclusion of colloids will improve the return of intestinal motility. METHODS: In a double-blinded clinical trial, 91 the American Society of Anesthesiologists I to III patients undergoing abdominal operation for resection with anastomosis of small or large intestine were randomized to receive either lactated Ringer solution crystalloid group or 6% hydroxyethyl starch colloid group to replace intraoperative fluid loss (blood loss + third space)...
November 2017: Surgery
https://www.readbyqxmd.com/read/28767803/perioperative-care-in-bariatric-surgery-in-the-context-of-the-acerto-project-reality-versus-surgeons-assumptions-in-a-cuiab%C3%A3-hospital
#18
Jacqueline Jéssica De-Marchi, Mardem Machado De-Souza, Alberto Bicudo Salomão, José Eduardo de Aguilar Nascimento, Anyelle Almada Selleti, Erik de-Albuquerque, Katia Bezerra Veloso Mendes
Objective: to assess the level of knowledge among bariatric surgeons, about the recommendations of the ACERTO Project, correlating their assumptions on their perioperative prescriptions and the reality, according to the patients charts. Method: we conducted a prospective, longitudinal, observational study comparing the assumptions of bariatric surgeons obtained through responses on a specific questionnaire with the reality found in clinical data from the hospital records...
May 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28761868/standardizing-the-protocols-for-enhanced-recovery-from-colorectal-cancer-surgery-are-we-a-step-closer-to-ideal-recovery
#19
Mosab Shetiwy, Tamer Fady, Fayez Shahatto, Ahmed Setit
PURPOSE: Enhanced recovery protocols are being implemented into the standard of care in surgical practice. This study aimed to insert a steadfast set of elements into the perioperative care pathway to establish an improved recovery program for colorectal cancer patients. METHODS: Seventy patients planned for elective laparoscopic colorectal resection were randomized into 2 groups: conventional recovery group (n = 35) and enhanced recovery group (n = 35). The primary outcome was the length of hospital stay...
June 2017: Annals of Coloproctology
https://www.readbyqxmd.com/read/28758272/transoral-robotic-retropharyngeal-node-dissection-in-oropharyngeal-squamous-cell-carcinoma-patterns-of-metastasis-and-functional-outcomes
#20
Scott Troob, Babak Givi, Macgregor Hodgson, Alia Mowery, Neil D Gross, Peter E Andersen, Daniel Clayburgh
BACKGROUND: Assessment of the retropharyngeal lymph nodes is essential in the treatment for oropharyngeal squamous cell carcinoma (SCC). Transoral robotic retropharyngeal lymph node dissection (RPLND) may provide valuable staging information and guide selection of adjuvant therapy in a transoral robotic surgery (TORS) treatment paradigm. METHODS: Outcomes were compared between 30 patients with oropharyngeal SCC with tonsillar primaries undergoing RPLND and 37 stage-matched cases without RPLND...
July 31, 2017: Head & Neck
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