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https://www.readbyqxmd.com/read/27932888/preoperative-risk-factors-in-total-thyroidectomy-of-substernal-goiter
#1
Aldo Bove, Raffaella Maria Di Renzo, Gauro D'Urbano, Manuela Bellobono, Vincenzo D' Addetta, Alfonso Lapergola, Giuseppe Bongarzoni
The definition of substernal goiter (SG) is based on variable criteria leading to a considerable variation in the reported incidence (from 0.2% to 45%). The peri- and postoperative complications are higher in total thyroidectomy (TT) for SG than that for cervical goiter. The aim of this study was to evaluate the preoperative risk factors associated with postoperative complications. From 2002 to 2014, 142 (8.5%; 98 women and 44 men) of the 1690 patients who underwent TT had a SG. We retrospectively evaluated the following parameters: sex, age, histology, pre- and retrovascular position, recurrence, and extension beyond the carina...
2016: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/27931579/harm-and-benefits-of-salvage-transplantation-for-hepatocellular-carcinoma-an-updated-meta-analysis
#2
Q Xiong, T-T Geng, L He, H Gao
OBJECTIVE: The aim of this work was to compare salvage liver transplantation (SLT) and primary liver transplantation (PLT) in terms of the harm and benefits. METHODS: The authors searched Pubmed, Embase, and the Cochrane Library from their dates of establishment to December 2015. Based on selection and exclusion criteria, 2 researchers screened the literature independently. The meta-analysis was performed with the use of the Review Manager software. Meta-analysis of the pooled standard mean difference (SMD) and odds ratio (OR) with 95% confidence interval (CI) were calculated based on either a fixed-effects or a random-effects model...
December 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27931247/the-radical-extent-of-lymphadenectomy-d2-dissection-versus-complete-mesocolic-excision-of-laparoscopic-right-colectomy-for-right-sided-colon-cancer-relarc-trial-study-protocol-for-a-randomized-controlled-trial
#3
Jun-Yang Lu, Lai Xu, Hua-Dan Xue, Wei-Xun Zhou, Tao Xu, Hui-Zhong Qiu, Bin Wu, Guo-Le Lin, Yi Xiao
BACKGROUND: The extent of lymphadenectomy during laparoscopic right colectomy can affect the oncological outcome and the safety of surgery. The principle of complete mesocolic excision (CME) has been gradually accepted and increasingly applied by colorectal surgeons. The aim of this study is to investigate whether extended lymphadenectomy (CME) in laparoscopic colectomy could improve the oncological outcomes of patients with right-sided colon cancers, compared with D2 lymphadenectomy...
December 8, 2016: Trials
https://www.readbyqxmd.com/read/27928584/endovascular-management-of-infected-femoral-artery-pseudoaneurysms-in-high-risk-patients-a-case-series
#4
Mario D'Oria, Giada Sgorlon, Cristiano Calvagna, Francesca Zamolo, Stefano Chiarandini, Roberto Adovasio, Filippo Griselli
We report our experience with the urgent treatment of two high-risk patients with infected femoral artery pseudoaneurysms (IFAPs) with the placement of a self-expandable covered stent (SECS). In both cases, there was no perioperative mortality and the aneurysm exclusion was successful without early or late stent thrombosis/stent fracture nor acute or chronic limb ischemia or limb loss. There was no recurrence of local or systemic infection during the follow-up period. Endovascular therapy represents a feasible treatment option for IFAPs in those patients for whom the risk of open surgical repair would be prohibitive, especially under urgent circumstances...
December 7, 2016: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/27927660/effect-of-prehabilitation-in-gastro-oesophageal-adenocarcinoma-study-protocol-of-a-multicentric-randomised-control-trial-the-prehab-study
#5
Bertrand Le Roy, Bruno Pereira, Corinne Bouteloup, Frédéric Costes, Ruddy Richard, Marie Selvy, Caroline Pétorin, Johan Gagnière, Emmanuel Futier, Karem Slim, Bernard Meunier, Jean-Yves Mabrut, Christophe Mariette, Denis Pezet
INTRODUCTION: Perioperative chemotherapy is the gold standard treatment of the resectable gastro-oesophageal adenocarcinoma. However, 70% of patients cannot receive the complete sequence because of a postoperative complication or a decrease in functional and nutritional reserves. Recently, a new concept appeared in digestive surgery: prehabilitation. This interventional process consists of patient preparation, between surgical consultation and surgery, and is based on 3 components: (1) physical management, (2) nutritional care and (3) psychological care...
December 7, 2016: BMJ Open
https://www.readbyqxmd.com/read/27927246/minimally-invasive-oesophagectomy-versus-open-esophagectomy-for-resectable-esophageal-cancer-a-meta-analysis
#6
REVIEW
Waresijiang Yibulayin, Sikandaer Abulizi, Hongbo Lv, Wei Sun
BACKGROUND: Open esophagectomy (OE) is associated with significant morbidity and mortality. Minimally invasive oesophagectomy (MIO) reduces complications in resectable esophageal cancer. The aim of this study is to explore the superiority of MIO in reducing complications and in-hospital mortality than OE. METHODS: MEDLINE, Embase, Science Citation Index, Wanfang, and Wiley Online Library were thoroughly searched. Odds ratio (OR)/weighted mean difference (WMD) with a 95% confidence interval (CI) was used to assess the strength of association...
December 8, 2016: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27926555/avoiding-radical-surgery-in-elderly-patients-with-rectal-cancer-is-cost-effective
#7
Christopher Rao, Arthur Sun Myint, Thanos Athanasiou, Omar Faiz, Antony Paul Martin, Brendan Collins, Fraser McLean Smith
BACKGROUND: Radical surgery is associated with significant perioperative mortality in elderly and comorbid populations. Emerging data suggest for patients with a clinical complete response after neoadjuvant chemoradiotherapy that a watch-and-wait approach may provide equivalent survival and oncological outcomes. OBJECTIVE: The purpose of this study was to compare the cost-effectiveness of watch and wait and radical surgery for patients with rectal cancer after a clinical complete response following chemoradiotherapy...
January 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/27925393/intensive-care-unit-icu-readmission-after-major-lung-resection-prevalence-patterns-and-mortality
#8
Jae Jun Jung, Jong Ho Cho, Tae Hee Hong, Hong Kwan Kim, Yong Soo Choi, Jhingook Kim, Young Mog Shim, Jae Ill Zo
BACKGROUND: The aim of this study was to identify risk factors associated with mortality in patients re-admitted to an intensive care unit (ICU) after initial recovery from major lung resection. METHODS: We retrospectively reviewed the case records of all patients who underwent major lung resection between February 2011 and May 2013. A total of 1916 patients underwent major resection surgery for various lung diseases, 63 (3.3%) of which required ICU admission after initial recovery...
December 7, 2016: Thoracic Cancer
https://www.readbyqxmd.com/read/27919293/perioperative-statin-therapy-in-cardiac-surgery-a-meta-analysis-of-randomized-controlled-trials
#9
Alessandro Putzu, Bruno Capelli, Alessandro Belletti, Tiziano Cassina, Enrico Ferrari, Michele Gallo, Gabriele Casso, Giovanni Landoni
BACKGROUND: Several studies suggest beneficial effects of perioperative statin therapy on postoperative outcome after cardiac surgery. However, recent randomized controlled trials (RCTs) show potential detrimental effects. The objective of this systematic review is to examine the association between perioperative statin therapy and clinical outcomes in cardiac surgery patients. METHODS: Electronic databases were searched up to 1 November 2016 for RCTs of preoperative statin therapy versus placebo or no treatment in adult cardiac surgery...
December 5, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27917566/perioperative-hypothermia-in-neonatal-intensive-care-unit-patients-effectiveness-of-a-thermoregulation-intervention-and-associated-risk-factors
#10
Branden M Engorn, Stephanie L Kahntroff, Karen M Frank, Sarabdeep Singh, Helen A Harvey, Charles T Barkulis, Annika M Barnett, Olamide O Olambiwonnu, Eugenie S Heitmiller, Robert S Greenberg
BACKGROUND: Hypothermia in neonatal intensive care unit patients is associated with morbidity. Perioperative normothermia is the standard of care. AIMS: We hypothesized that a quality improvement intervention (transport protocol, transport education, ongoing monitoring) would decrease the incidence of perioperative hypothermia. Secondarily, we hypothesized that patients undergoing surgery at a postmenstrual age of <37 weeks or at a weight of <1.5 kg would be at higher risk for perioperative hypothermia...
December 5, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27916380/contemporary-outcomes-of-open-thoracoabdominal-aneurysm-repair-functional-status-is-the-strongest-predictor-of-perioperative-mortality
#11
Tammam Obeid, Caitlin W Hicks, Kanhua Yin, Isibor Arhuidese, Besma Nejim, Arman Kilic, James H Black, Mahmoud Malas
BACKGROUND: Open repair of thoracoabdominal and descending thoracic aneurysm (TAA) carries significant operative morbidity and mortality. Despite evolving operative techniques patient-level risk factors affecting mortality after open TAA repair, including patient functional status, remain to be fully understood. MATERIALS AND METHODS: We identified all open TAA repair cases in the National Surgical Quality Improvement Program database between 2005 and 2013. Multivariable logistic regression was used to evaluate the effect of patients' age, gender, race, body mass index (BMI), comorbid conditions, functional status, ASA class, smoking, rupture, descending thoracic aneurysm versus Crawford types, dissection, and preoperative: transfusion, creatinine levels, on perioperative (30-d) mortality after open TAA repair...
November 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27916348/blood-transfusion-is-an-independent-predictor-of-morbidity-and-mortality-after-hepatectomy
#12
Allison N Martin, Matthew J Kerwin, Florence E Turrentine, Todd W Bauer, Reid B Adams, George J Stukenborg, Victor M Zaydfudim
BACKGROUND: Previous studies have indicated that blood transfusion is associated with increased risk of worse outcomes among patients selected for hepatectomy. However, the independent effect of transfusion has not been confirmed. We hypothesize that blood transfusion is an independent factor that affects outcomes in patients undergoing hepatectomy. MATERIALS AND METHODS: Patients at tertiary care center who underwent hepatectomy between 2006 and 2013 were identified and linked with the American College of Surgeons National Surgical Quality Improvement Program PUF data set...
November 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27916222/acute-amiodarone-pulmonary-toxicity-after-surgical-procedures
#13
REVIEW
Jirapat Teerakanok, Pakpoom Tantrachoti, Phumpattra Chariyawong, Kenneth Nugent
Amiodarone can cause toxicity in several organs, including amiodarone-induced pulmonary toxicity which is a subacute or chronic complication. Amiodarone-induced acute respiratory distress syndrome (ARDS) in postoperative patients is a rare acute complication. The PubMed and Google Scholar databases were searched. Seven retrospective and prospective case series and 10 case reports of amiodarone-induced postoperative ARDS were reviewed. All patients received amiodarone chronically or during the perioperative period...
December 2016: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/27914765/operative-morbidity-and-survival-following-hepatectomy-for-colorectal-liver-metastasis-in-octogenarians-a-contemporary-case-matched-series
#14
Julie N Leal, Eran Sadot, Mithat Gonen, Stuart Lichtman, T Peter Kingham, Peter J Allen, Ronald P DeMatteo, William R Jarnagin, Michael I D'Angelica
BACKGROUND: Clinical outcomes of octogenarians undergoing hepatectomy for colorectal liver metastases (CRLM) are poorly characterized. The current study evaluated operative morbidity, mortality and survival outcomes among a contemporary cohort of octogenarians. METHODS: Patients undergoing their first hepatectomy for CRLM were identified from institutional databases and those ≥80 years old (y) were matched 1:1 to a group of patients <80 y. Data pertaining to surgical morbidity/mortality and survival were compared using standard statistical methods...
November 30, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27914636/open-surgical-repair-remains-the-gold-standard-for-treating-aortic-arch-pathology
#15
Vishal Khullar, Hartzell V Schaff, Joseph A Dearani, Richard C Daly, Kevin L Greason, Lyle D Joyce, Alberto Pochettino
BACKGROUND: Endovascular arch repair technology is driven in large part by the assumption that open arch operations are high-risk. We wanted to evaluate the clinical results of open arch reconstruction in the modern era in a large group practice. METHODS: From October 2003 to June 2014, 567 patients underwent aortic arch operations: hemiarch repair was performed in 429 patients (75.7%; group A), total arch repair in 129 (22.7%; group B), and patch repair in the remaining 9 (1...
November 30, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27914501/levosimendan-in-patients-with-left-ventricular-systolic-dysfunction-undergoing-cardiac-surgery-on-cardiopulmonary-bypass-rationale-and-study-design-of-the-levosimendan-in-patients-with-left-ventricular-systolic-dysfunction-undergoing-cardiac-surgery-requiring
#16
Rajendra H Mehta, Sean Van Diepen, James Meza, Paula Bokesch, Jeffrey D Leimberger, Sandra Tourt-Uhlig, Merri Swartz, Jodi Parrotta, Rachael Jankowich, Douglas Hay, Robert W Harrison, Stephen Fremes, Shaun G Goodman, John Luber, Wolfgang Toller, Matthias Heringlake, Kevin J Anstrom, Jerrold H Levy, Robert A Harrington, John H Alexander
BACKGROUND: Low cardiac output syndrome is associated with increased mortality and occurs in 3% to 14% of patients undergoing cardiac surgery on cardiopulmonary bypass (CPB). Levosimendan, a novel calcium sensitizer and KATP channel activator with inotropic, vasodilatory, and cardioprotective properties, has shown significant promise in reducing the incidence of low cardiac output syndrome and related adverse outcomes in patients undergoing cardiac surgery on CPB. METHODS: LEVO-CTS is a phase 3 randomized, controlled, multicenter study evaluating the efficacy, safety, and cost-effectiveness of levosimendan in reducing morbidity and mortality in high-risk patients with reduced left ventricular ejection fraction (≤35%) undergoing cardiac surgery on CPB...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27914358/defining-the-role-of-perioperative-statin-treatment-in-patients-after-cardiac-surgery-a-meta-analysis-and-systematic-review-of-20-randomized-controlled-trials
#17
Xin Yuan, Jianlin Du, Qi Liu, Ling Zhang
BACKGROUND: Although statin use has been indicated to prevent atrial fibrillation in previous observational and experimental trials, the issue remains inadequately and insufficiently explored. We therefore performed this meta-analysis to evaluate the effects of perioperative statin therapy on complications and short-term prognosis following cardiac surgery. METHODS: A search of the PubMed, EMBASE and the Cochrane database of controlled trials was performed from inception to June 2016 to identify relevant randomized controlled trials (RCTs)...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27909512/concomitant-left-atrial-appendage-clipping-during-minimally-invasive-mitral-valve-surgery-technically-feasible-and-safe
#18
Ashraf Alqaqa Md, Shabiah Martin Md, Aiman Hamdan Md Facc, Fayez Shamoon Md Facc, Kourosh T Asgarian DO
BACKGROUND: It is believed that most of thrombi form in the left atrial appendage (LAA)before they emboli. Different surgical and percutaneouse approaches were suggested to manage the LAA. In this study we are evaluating the safety of clipping the LAA via minithoractotomy approach. METHOD: All consecutive patients who had minimally invasive mitral valve surgery with concomitant LAA clipping between December 2012 and February 2014 were included in the study. LAA exclusion was performed using AtriClip® LAA Exclusion System (Cincinnati, Ohio, AtriCure®)...
June 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27908636/impact-of-neoadjuvant-chemotherapy-on-complications-of-minimally-invasive-radical-cystectomy
#19
D Lizée, R S Salas, E Barret, M Galiano, E Di Trapani, F Montorsi, X Cathelineau
BACKGROUND: Neoadjuvant chemotherapy (NC) before minimally invasive radical cystectomy (MIRC) is considered a standard of care in muscle-invasive bladder cancer or recurrent high-risk non-muscle-invasive bladder cancer. OBJECTIVE: To evaluate the impact of NC on morbidity and mortality after MIRC. DESIGN, SETTING, AND PARTICIPANTS: We prospectively evaluated 135 patients who underwent MIRC (laparoscopic: n=100; robotic: n=35) between 2007 and 2013 with ≥90 days of follow-up (median age: 66 year)...
November 28, 2016: Actas Urologicas Españolas
https://www.readbyqxmd.com/read/27907939/intraoperative-intermittent-blocking-of-the-common-iliac-arteries-in-cases-of-placenta-percreta-without-the-use-of-fluoroscopy
#20
S Heinze, B Filsinger, G Kastenholz, R J Schröder
Background: The number of patients with placenta accreta, percreta and increta is increasing. The morbidity and mortality are higher mostly due to hemorrhage. Therefore, new methods to reduce the risk of severe bleeding are necessary. Methods: Three patients were treated in collaboration by obstetricians, urologists, anesthesiologists, and radiologists. An MRI of the pelvis was performed and the diameters and lengths of the iliac arteries were measured to avoid fluoroscopy during the preoperative placement of catheter balloons into the iliac arteries...
December 2016: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
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