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https://www.readbyqxmd.com/read/29135530/should-percussion-pacing-have-a-role-in-perioperative-advanced-cardiac-life-support-a-case-report
#1
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
#2
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
#3
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...
October 24, 2017: 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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
https://www.readbyqxmd.com/read/28742713/does-prolonged-enteral-feeding-with-supplemental-omega-3-fatty-acids-impact-on-recovery-post-esophagectomy-results-of-a-randomized-double-blind-trial
#15
RANDOMIZED CONTROLLED TRIAL
Laura A Healy, Aoife Ryan, Suzanne L Doyle, Éadaoin Bríd Ní Bhuachalla, Samantha Cushen, Ricardo Segurado, Thomas Murphy, Narayanasamy Ravi, Claire L Donohoe, John V Reynolds
OBJECTIVE: This randomized controlled trial (RCT) hypothesized that prolonged enteral nutrition (EN) with supplemental eicosapentanoic acid (EPA), an omega-3 fatty acid with immune and anabolic properties, may impact on clinical and nutritional outcomes. BACKGROUND: Esophagectomy is associated with significant weight loss and catabolism, and negatively impacts quality of life (QL). Strategies to counter sustained catabolism have therapeutic rationale. METHODS: This multicenter, double-blind, placebo-controlled RCT was powered on a 5% difference in lean body mass (LBM) at 1 month...
November 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28656470/effectiveness-of-intervention-with-a-perioperative-multidisciplinary-support-team-for-radical-esophagectomy
#16
Yuji Akiyama, Takeshi Iwaya, Fumitaka Endo, Yoshihiro Shioi, Motoi Kumagai, Takeshi Takahara, Koki Otsuka, Hiroyuki Nitta, Keisuke Koeda, Masaru Mizuno, Yusuke Kimura, Kenji Suzuki, Akira Sasaki
PURPOSE: We aimed to evaluate the effectiveness of intervention by a perioperative multidisciplinary support team for radical esophagectomy for esophageal cancer. METHODS: We retrospectively reviewed 85 consecutive patients with esophageal cancer who underwent radical esophagectomy via right thoracotomy or thoracoscopic surgery with gastric tube reconstruction. Twenty-one patients were enrolled in the non-intervention group (group N) from May 2011 to September 2012, 31 patients in the perioperative rehabilitation group (group R) from October 2012 to April 2014, and 33 patients in the multidisciplinary support team group (group S) from May 2014 to September 2015...
December 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28653159/could-a-feeding-jejunostomy-be-integrated-into-a-standardized-preoperative-management-of-oeso-gastric-junction-adenocarcinoma
#17
Simone Manfredelli, Jean-Baptiste Delhorme, Aïna Venkatasamy, Christian Gaiddon, Cécile Brigand, Serge Rohr, Benoît Romain
PURPOSE: To evaluate the impact of a feeding jejunostomy (FJ) on the preoperative management of patients with an oesogastric adenocarcinoma (OGA). METHODS: From January 2007 to December 2014, patients with potentially resectable OGA were enrolled in a perioperative chemotherapy protocol. FJ was performed before starting perioperative treatments in patients presenting with dysphagia or with a nutritional risk index (NRI) <97.5. The patients who did not require a FJ served as a control group...
October 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28600636/results-of-a-nationwide-questionnaire-based-survey-on-nutrition-management-following-gastric-cancer-resection-in-japan
#18
Nobuyuki Shimizu, Fumihiko Hatao, Kazuhiko Fukatsu, Susumu Aikou, Yukinori Yamagata, Kazuhiko Mori, Hiroharu Yamashita, Sachiyo Nomura, Yasuyuki Seto
PURPOSE: A study was conducted to clarify the actual status of nutrition management after gastric cancer surgery in Japan and obtain basic data for optimizing perioperative nutrition management. METHODS: A questionnaire was sent to 354 hospitals with at least 50 cases of gastric cancer surgery per year. Questions included the perioperative nutrition management and length of hospital stay for patients who underwent gastric cancer surgery within three months of the survey...
December 2017: Surgery Today
https://www.readbyqxmd.com/read/28599967/challenging-surgical-dogma-in-the-management-of-proximal-esophageal-atresia-with-distal-tracheoesophageal-fistula-outcomes-from-the-midwest-pediatric-surgery-consortium
#19
Dave R Lal, Samir K Gadepalli, Cynthia D Downard, Daniel J Ostlie, Peter C Minneci, Ruth M Swedler, Thomas H Chelius, Laura Cassidy, Cooper T Rapp, Deborah Billmire, Steven Bruch, R Carland Burns, Katherine J Deans, Mary E Fallat, Jason D Fraser, Julia Grabowski, Ferdynand Hebel, Michael A Helmrath, Ronald B Hirschl, Rashmi Kabre, Jonathan Kohler, Matthew P Landman, Charles M Leys, Grace Z Mak, Jessica Raque, Beth Rymeski, Jacqueline M Saito, Shawn D St Peter, Daniel von Allmen, Brad W Warner, Thomas T Sato
PURPOSE: Perioperative management of infants with esophageal atresia and tracheoesophageal fistula (EA/TEF) is frequently based on surgeon experience and dogma rather than evidence-based guidelines. This study examines whether commonly perceived important aspects of practice affect outcome in a contemporary multi-institutional cohort of patients undergoing primary repair for the most common type of esophageal atresia anomaly, proximal EA with distal TEF. METHODS: The Midwest Pediatric Surgery Consortium conducted a multicenter, retrospective study examining selected outcomes on infants diagnosed with proximal EA with distal TEF who underwent primary repair over a 5-year period (2009-2014), with a minimum 1-year follow up, across 11 centers...
June 1, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28552157/surgical-management
#20
Michael K Morgan
Surgical management includes selection of patients for surgery, performing the technical procedure of brain arteriovenous malformation (bAVM) resection and perioperative management that maximize the chance for the best outcome. In general the Spetzler-Ponce class (SPC) can divide patients into those with good evidence that surgery is appropriate in most cases (SPC A), those in whom surgery should only be considered occasionally with highly nuanced indications (SPC C), and surgery may be appropriate having made a detailed analysis of patient (including age), clinical (including mode of presentation), and AVM characteristics (including diffuseness), and a comparative analysis of outcomes with alternate management pathways for SPC B cases...
2017: Handbook of Clinical Neurology
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