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Perioperative mortality

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https://www.readbyqxmd.com/read/28731954/laparoscopic-pancreaticoduodenectomy-a-single-team-preliminary-experience
#1
Xiaohui Duan, Bo Jiang, Lixue Zhou, Jianhui Yang, Bingzhang Tian, Huiming Wen, Xianhai Mao
OBJECTIVE: The present study aimed to describe the authors' experience and the perioperative outcome for laparoscopic pancreaticoduodenectomy (LPD). MATERIALS AND METHODS: Perioperative clinical data of 57 consecutive pancreaticoduodenectomy (PD) procedures performed from January 2014 to May 2016 in the Department of Hepatobiliary Surgery, Hunan Provincial People's Hospital were retrospectively analyzed. RESULTS: The median of operative time was 315 minutes (range, 220 to 575 min) and the median of intraoperative estimated blood loss was 200 mL (range, 100 to 550 mL)...
July 20, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28731952/open-colectomies-of-shorter-operative-time-do-not-result-in-improved-outcomes-compared-with-prolonged-laparoscopic-operations
#2
Sara L Zettervall, Ivy N Haskins, Sarah E Deery, Richard L Amdur, Paul P Lin, Khashayar Vaziri
BACKGROUND: Laparoscopic colectomies are associated with reduced perioperative morbidity and mortality compared with open surgery. Nevertheless, many surgeons continue to utilize an open surgical approach due to the perceived benefits of shorter operative times. This study aims to compare the outcomes of laparoscopic versus open colectomies of equal or shorter operative duration. METHODS: All patients undergoing elective laparoscopic or open colectomy in the American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP) were identified from the years 2005 through 2012...
July 20, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28729903/tranexamic-acid-and-trauma-induced-coagulopathy
#3
REVIEW
Takeshi Nishida, Takahiro Kinoshita, Kazuma Yamakawa
Tranexamic acid (TXA) is a synthetic derivative of the amino acid lysine that inhibits fibrinolysis by blocking the interaction of plasminogen with the lysine residues of fibrin. Historically, TXA is commonly used for reduction of blood loss in perioperative situations, while recently it has attracted attention for clinical use in the trauma field. In 2010, the Clinical Randomization of an Antifibrinolytic in Significant Hemorrhage 2 (CRASH-2) trial demonstrated that intravenous administration of TXA improved mortality significantly in trauma patients with significant bleeding...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28728783/enhanced-recovery-pathway-versus-standard-care-in-patients-undergoing-video-assisted-thoracoscopic-lobectomy
#4
Alessandro Brunelli, Caroline Thomas, Padma Dinesh, Andrew Lumb
OBJECTIVE: The objective of this study was to compare outcomes after video-assisted thoracoscopic lobectomy or segmentectomy before and after introduction of an enhanced recovery program. METHODS: Data from 600 patients undergoing video-assisted lobectomy or segmentectomy between April 2014 and January 2017 were analyzed. A comparative analysis was performed between patients undergoing operation before (365 patients) and after (235 patients) the start of the enhanced recovery program...
June 22, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28728715/robotic-lobectomy-and-segmentectomy-technical-details-and-results
#5
REVIEW
Benjamin Wei, Robert J Cerfolio
Robotic-assisted pulmonary lobectomy can be considered for patients fit for conventional lobectomy. Contraindications include prohibitive lung function or medical comorbidities, multistation N2, gross N2 disease, or evidence of N3 disease. Team training, familiarity with equipment, troubleshooting, and preparation are critical for successful robotic lobectomy. Similar to video-assisted thoracoscopic surgery (VATS) lobectomy, robotic lobectomy is associated with decreased blood loss, blood transfusion, air leak, chest tube duration, duration of stay, and mortality compared with thoracotomy...
August 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28722116/opioids-for-cancer-related-pain-in-children-and-adolescents
#6
REVIEW
Philip J Wiffen, Tess E Cooper, Anna-Karenia Anderson, Andrew L Gray, Marie-Claude Grégoire, Gustaf Ljungman, Boris Zernikow
BACKGROUND: Pain is a common feature of childhood and adolescence around the world, and for many young people, that pain is chronic. The World Health Organization (WHO) guidelines for pharmacological treatments for children's persisting pain acknowledge that pain in children is a major public health concern of high significance in most parts of the world. Views on children's pain have changed over time and relief of pain is now seen as important. In the past, pain was largely dismissed and was frequently left untreated, and it was assumed that children quickly forgot about painful experiences...
July 19, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28720229/perioperative-registered-nurses-knowledge-attitudes-behaviors-and-barriers-regarding-pressure-ulcer-prevention-in-perioperative-patients
#7
Peggy C Tallier, Patricia R Reineke, Kathy Asadoorian, John G Choonoo, Marc Campo, Christine Malmgreen-Wallen
BACKGROUND: Hospital acquired pressure ulcers have a detrimental effect on patient quality of life, morbidity, mortality, and cost to the healthcare industry. Little is known about pressure ulcer prevention in perioperative services. OBJECTIVES: The objectives of this study were to describe perioperative registered nurses (RNs) knowledge, attitudes, behaviors, and barriers about pressure ulcer prevention and to determine if knowledge and the availability of a pressure ulcer staging tool are predictors of pressure ulcer prevention behavior...
August 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28719780/venous-thromboembolic-prophylaxis-in-foot-and-ankle-surgery-a-review-of-current-literature-and-practice
#8
Martin H S Weisman, James R Holmes, Todd A Irwin, Paul G Talusan
Venous thromboembolism (VTE) is a well-known and feared complication following foot and ankle surgery, as it is a source of morbidity and mortality in the perioperative phase. The most recent CHEST guidelines recommended against the use of chemoprophylaxis and the majority of the literature has found a low incidence of VTE following foot and ankle surgery. Some authors prefer screening patients for risk factors and recommend the use of chemoprophylaxis on a case-by-case basis. Interestingly, studies that found high incidence of VTE were unable to determine a statistically significant difference between the prophylaxis and placebo groups...
August 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28719609/renal-function-following-xenon-anesthesia-for-partial-nephrectomy-an-explorative-analysis-of-a-randomized-controlled-study
#9
Ana Stevanovic, Patrick Schaefer, Mark Coburn, Rolf Rossaint, Christian Stoppe, Peter Boor, David Pfister, Axel Heidenreich, Hildegard Christ, Martin Hellmich, Astrid V Fahlenkamp
BACKGROUND: Perioperative preservation of renal function has a significant impact on morbidity and mortality in kidney surgery. Nephroprotective effects of the anesthetic xenon on ischemia-reperfusion injury were found in several experimental studies. OBJECTIVE: We aimed to explore whether xenon anesthesia can reduce renal damage in humans undergoing partial nephrectomy and to gather pilot data of possible nephroprotection in these patients. DESIGN: A prospective randomized, single-blinded, controlled study...
2017: PloS One
https://www.readbyqxmd.com/read/28719430/high-sensitivity-cardiac-troponin-t-improves-the-diagnosis-of-perioperative-mi
#10
Jamie C Brown, Eslam Samaha, Srikar Rao, Mohammad A Helwani, Andreas Duma, Frank Brown, Brian F Gage, J Philip Miller, Allan S Jaffe, Fred S Apple, Mitchell G Scott, Peter Nagele
BACKGROUND: The diagnosis of myocardial infarction (MI) after noncardiac surgery has traditionally relied on using relatively insensitive contemporary cardiac troponin (cTn) assays. We hypothesized that using a recently introduced novel high-sensitivity cTnT (hscTnT) assay would increase the detection rate of perioperative MI. METHODS: In this ancillary study of the Vitamins in Nitrous Oxide trial, readjudicated incidence rates of myocardial injury (new isolated cTn elevation) and MI were compared when diagnosed by contemporary cTnI versus hscTnT...
July 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28719134/development-and-implementation-of-a-clinical-pathway-for-cardiac-surgery-in-the-intensive-care-unit-effects-on-protocol-adherence
#11
Marion van der Kolk, Mark van den Boogaard, Corine Ter Brugge-Speelman, Jeroen Hol, Luc Noyez, Kees van Laarhoven, Hans van der Hoeven, Peter Pickkers
RATIONALE, AIMS AND OBJECTIVES: Cardiac surgery (CS) is facilitated by multiple perioperative guidelines and protocols. Use of a clinical pathway (CP) may facilitate the care of these patients. METHODS: This is a pre-post design study in the ICU of a tertiary referral centre. A CP for CS patients in the ICU was developed by ICU-nurses and enabled them to execute proactively predefined actions in accordance with and within the preset boundaries which were part of a variance report...
July 18, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28718889/veno-arterial-extracorporeal-membrane-oxygenation-support-in-patients-undergoing-aortic-surgery
#12
Zhaopeng Zhong, Chunjing Jiang, Feng Yang, Xing Hao, Jialin Xing, Hong Wang, Xiaotong Hou
Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is an option for mechanical support for patients with postcardiotomy cardiogenic shock (PCS). However, the use of VA-ECMO in patients suffering from aortic disease with PCS has not been greatly reported. This is a retrospective review of adult patients undergoing aortic surgery who received VA-ECMO support to treat refractory PCS from August 2009 to May 2016. A total of 36 patients who underwent aortic surgery with VA-ECMO support for refractory PCS were included...
July 18, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28717740/curative-intent-surgery-for-pancreatic-tumors-a-review-of-procedures-from-the-brazilian-national-health-system
#13
Lucas V Dos Santos, Marco Antonio O Lessa, João Paulo S N Lima, Benjamin Haaland, Gilberto L Lopes
PURPOSE: In Brazil, a country with major health access disparities, resource limitations make management of pancreatic cancer (PC) challenging. This study evaluated curative-intent surgery for PC in the Brazilian public health care system. METHODS: We collected data for PC surgical procedures with curative intent in Brazil's public health care system (DATASUS) and from the demographic database. Costs, lengths of stay, number of perioperative deaths, and PC deaths were analyzed for each state and then associated with population, gross domestic product (GDP) per capita, and number of procedures...
February 2017: Journal of Global Oncology
https://www.readbyqxmd.com/read/28714229/implementing-a-protocol-to-optimize-blood-use-in-a-cardiac-surgery-service-results-of-a-pre-post-analysis-and-the-impact-of-high-volume-blood-users
#14
Juan B Grau, Jacqueline H Fortier, Cyrus Kuschner, Giovanni Ferrari, Mariano E Brizzio, Alex Zapolanski, Richard E Shaw
BACKGROUND: Blood transfusions are a common and costly intervention for cardiac surgery patients. Evidence suggests that a more restrictive transfusion strategy may reduce costs and transfusion-related complications without increasing perioperative morbidity and mortality. STUDY DESIGN AND METHODS: A transfusion-limiting protocol was developed and implemented in a cardiovascular surgery unit. Over a 5-year period, data were collected on patient characteristics, procedures, utilization of blood products, morbidity, and mortality, and these were compared before and after the protocol was implemented...
July 16, 2017: Transfusion
https://www.readbyqxmd.com/read/28713061/the-extent-of-unnecessary-surgery-for-benign-rectal-polyps-in-the-netherlands
#15
L Laurien J van Nimwegen, L Leon M G Moons, J Joost M J Geesing, L Rene Arensman, M M Miangela Laclé, I Ivo A M J Broeders, P Peter P Viergever, J John N Groen, K Koen Kessels, M Thijs P Schwartz
BACKGROUND AND AIMS: Minimally invasive techniques are available to safely and efficaciously remove even the largest rectal polyps. This study aimed to investigate the magnitude of cases still referred for radical rectal surgery, the reasons for theses referrals, and to perform a re-evaluation of cases potentially suitable for endoscopic therapy. METHODS: A retrospective analysis of data from the Dutch Pathology Registry (PALGA) was performed using the records of patients who underwent major surgical treatment for a histologically proven benign rectal polyp between 2005 to 2014 in the Netherlands...
July 13, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28712961/disruption-in-non-anastomotic-section-of-an-axillofemoral-bypass-a-thorough-critical-review-of-the-literature
#16
REVIEW
S Valverde García, R Peña Cortés, J Torre Eiriz, M B García-Cenador, F S Lozano Sánchez
This work is a thorough non-systematic critical review (PubMed/Medline 1950-september 2016) of "disruption in non-anastomotic section of an axillofemoral bypass". Fourteen cases were selected (including that provided by the authors of this publication) dating from 1963 to 2016 (53 years). This type of disruption is a very unusual complication in axillofemoral bypass. The cases described reveal that this disorder is more frequent in unifemoral bypass (9 cases), in ringed PTFE (10), in blunt trauma (8) and at costal level (12) especially on the left side (8)...
July 13, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28712677/extracorporeal-membrane-oxygenation-following-lung-transplantation-indications-and-survival
#17
Michael S Mulvihill, Babatunde A Yerokun, Robert Patrick Davis, David N Ranney, Mani A Daneshmand, Matthew G Hartwig
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is employed to rescue patients with early graft dysfunction after lung transplantation (LTx). Rates of post-LTx ECMO and subsequent outcomes have been limited to single-center reports. METHODS: UNOS registry was queried for LTx recipients from March 2015 to March 2016; 2,001 recipients were identified and stratified by need for post-LTx ECMO. Logistic regression was used to determine variables associated with post-LTx ECMO...
July 1, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28711369/predicting-failure-to-rescue-after-abdominal-aortic-aneurysm-repair-in-elderly-patients
#18
Caitlin W Hicks, Anna O'Kelly, Tammam Obeid, Satinderjit Locham, Mahmoud B Malas
BACKGROUND: We aim to describe trends in failure to rescue (FTR) among elderly patients undergoing elective open aortic aneurysm repair (OAR) and endovascular aortic aneurysm repair (EVAR). MATERIALS AND METHODS: All patients aged ≥80 y recorded in the Vascular Quality Initiative database (2002-2014) undergoing nonruptured infrarenal AAA repair were included. Primary outcome was FTR, defined as percentage of deaths in patients who had a complication within 30 d of surgery...
July 12, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28711314/independent-predictors-of-the-duration-and-overall-burden-of-postoperative-delirium-after-cardiac-surgery-in-adults-an-observational-cohort-study
#19
Christian Cereghetti, Martin Siegemund, Sabine Schaedelin, Jens Fassl, Manfred D Seeberger, Friedrich S Eckstein, Luzius A Steiner, Nicolai Goettel
OBJECTIVE: Postoperative delirium (POD) is a common complication after cardiac surgery and is associated with increased patient morbidity and mortality. The objective of this study was to identify risk factors for long duration and overall burden of POD after cardiac surgery. DESIGN: One-year, single-center, retrospective, observational cohort study. SETTING: University hospital. PARTICIPANTS: Adult patients undergoing cardiac surgery with cardiopulmonary bypass in 2013...
March 31, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28709946/frailty-and-sarcopenia-do-not-predict-adverse-events-in-an-elderly-population-undergoing-non-complex-primary-elective-surgery-for-degenerative-conditions-of-the-lumbar-spine
#20
Raphaële Charest-Morin, John Street, Honglin Zhang, Taren Roughead, Tamir Ailon, Michael Boyd, Marcel Dvorak, Brian Kwon, Scott Paquette, Nicolas Dea, Charles G Fisher, Alana M Flexman
BACKGROUND CONTEXT: Sarcopenia measured by normalized total psoas area (NTPA) has been shown to predict mortality and adverse events (AE) in numerous surgical populations. The relationship between sarcopenia and postoperative outcomes after surgery for degenerative spine disease (DSD) has not been investigated. PURPOSE: This study aimed to determine the relationships between sarcopenia, frailty and postoperative adverse events in the elderly DSD population. Secondary objectives were to describe the distribution and predictors of NTPA and to determine the relationship between sarcopenia, frailty and length of stay, discharge to a facility and in-hospital mortality...
July 11, 2017: Spine Journal: Official Journal of the North American Spine Society
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