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Perioperative mortality

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https://www.readbyqxmd.com/read/29775973/safety-model-for-the-introduction-of-robotic-surgery-in-gynecology
#1
Mariano Tamura Vieira Gomes, Beatriz Taliberti da Costa Porto, Jose Pedro Parise Filho, Ana Luiz Vasconcelos, Bruna Fernanda Bottura, Renato Moretti Marques
OBJECTIVE:  To analyze the perioperative results and safety of performing gynecological surgeries using robot-assisted laparoscopy during implementation of the technique in a community hospital over a 6-year period. METHODS:  This was a retrospective observational study in which the medical records of 274 patients who underwent robotic surgery from September 2008 to December 2014 were analyzed. We evaluated age, body mass index (BMI), diagnosis, procedures performed, American Society of Anesthesiologists (ASA) classification, the presence of a proctor (experienced surgeon with at least 20 robotic cases), operative time, transfusion rate, perioperative complications, conversion rate, length of stay, referral to the intensive care unit (ICU), and mortality...
May 18, 2018: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/29774793/surgical-considerations-in-interrupted-aortic-arch
#2
Damien J LaPar, Christopher W Baird
Interrupted aortic arch (IAA) is a rare congenital anomaly with several anatomical variants and is often associated with other intracardiac and/or extracardiac congenital anomalies. Historically, associated with high early mortality, outcomes for this anomaly have improved in recent eras with advances in perioperative and anesthesia management and refinements in surgical technique. This review provides a description of surgical anatomy, anatomical classifications, and associated congenital lesions as well as an examination of the perioperative and surgical management of IAA in the contemporary surgical era...
May 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29774558/clinical-outcome-and-comparison-of-three-different-left-ventricular-assist-devices-in-a-high-risk-cohort
#3
Konstantin Zhigalov, Ahmed Mashhour, Marcin Szczechowicz, Sabreen Mkalaluh, Sergei Karagezian, Irakli Gogia, Maxim Isaev, Bakitbek K Kadyraliev, Jerry Easo, Juergen Ennker, Harald C Eichstaedt, Alexander Weymann
We present a comparison between three left ventricular assist devices (LVADs): HeartWare (HVAD) (HeartWare International Inc., Framingham, MA, USA), HeartMate II (HMII) and HeartMate III (HMIII) (Thoratec Corp., Pleasanton, CA, USA). To our knowledge, no study to date has aimed at placing these three devices in juxtaposition. Between June 2007 and June 2017, 108 consecutive patients received HMII, n = 77 (71.3%), HVAD, n = 14 (13%), or HM III, n = 17 (15.7%), for end-stage heart failure. Mean age was 63...
May 17, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29773835/levosimendan-in-patients-with-left-ventricular-dysfunction-undergoing-cardiac-surgery-a-meta-analysis-and-trial-sequential-analysis-of-randomized-trials
#4
Zhenhua Xing, Liang Tang, Pengfei Chen, Jiabing Huang, Xiaofan Peng, Xinqun Hu
Patients with left ventricular dysfunction (LVD) undergoing cardiac surgery have a high mortality rate. Levosimendan, a calcium sensitizer, improves myocardial contractility without increasing myocardial oxygen demand. It is not clear whether levosimendan can reduce mortality in cardiac surgery patients with LVD. The PubMed, Embase, and Cochrane Central databases were searched to identify randomized trials comparing levosimendan with conventional treatment in cardiac surgery patients with LVD. We derived pooled risk ratios (RRs) with random effects models...
May 17, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29773579/use-rate-and-outcome-in-bilateral-internal-thoracic-artery-grafting-insights-from-a-systematic-review-and-meta-analysis
#5
REVIEW
Mario Gaudino, Faisal Bakaeen, Umberto Benedetto, Mohamed Rahouma, Antonino Di Franco, Derrick Y Tam, Mario Iannaccone, Thomas A Schwann, Robert Habib, Marc Ruel, John D Puskas, Joseph Sabik, Leonard N Girardi, David P Taggart, Stephen E Fremes
BACKGROUND: This meta-analysis was designed to assess whether center experience affects the short- and long-term results and the relative benefits of bilateral internal thoracic artery grafting (BITA) for coronary artery bypass grafting. METHODS AND RESULTS: MEDLINE and EMBASE were searched to identify all articles reporting the outcome of BITA in patients undergoing coronary artery bypass grafting. The BITA center experience was gauged according to the percentage use of BITA in the institutional overall coronary artery bypass grafting population (%BITA)...
May 17, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29772591/-monitoring-and-modern-hemodynamic-concepts-in-cardiac-anesthesia
#6
Matthias Heringlake, Christian Schmidt, Sebastian Brandt
Patients undergoing cardiac surgery are growing older, present with more comorbidities, and are frequently scheduled for more complex and prolonged surgical procedures. Routine application of neurological as well as extended hemodynamic monitoring combined with goal-directed perioperative hemodynamic optimization, targeting optimization of systemic and cerebral oxygen balance, show promise to reduce postoperative complications and to improve mortality in this high risk population. Expert recommendations suggest to avoid synthetic colloids for fluid optimization...
May 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29772312/early-and-late-outcomes-of-endovascular-aortic-aneurysm-repair-versus-open-surgical-repair-of-an-abdominal-aortic-aneurysm-a-single-center-study
#7
Kyunghak Choi, Youngjin Han, Gi-Young Ko, Yong-Pil Cho, Tae-Won Kwon
OBJECTIVE: To compare the treatment outcomes and cost of endovascular aortic aneurysm repair (EVAR) and open surgical repair (OSR) in patients with an abdominal aortic aneurysm (AAA) at a single center. METHODS: Patients treated for an AAA at a single center between January 2007 and December 2012 were retrospectively identified and classified based on the treatment that they received (EVAR or OSR). Patient demographics, and in hospital costs were recorded. Long-term survival was calculated using the Kaplan-Meier method...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29770886/laparoscopic-extended-liver-resection-are-postoperative-outcomes-different
#8
Daniel Pietrasz, David Fuks, Daren Subar, Gianfranco Donatelli, Carlotta Ferretti, Christian Lamer, Luca Portigliotti, Marc Ward, Jane Cowan, Takeo Nomi, Marc Beaussier, Brice Gayet
BACKGROUND: Although laparoscopic major hepatectomy (LMH) is becoming increasingly common in specialized centers, data regarding laparoscopic extended major hepatectomies (LEMH) and their outcomes are limited. The aim of this study was to compare the perioperative characteristics and postoperative outcomes of LEMH to standard LMH. METHODS: All patients who underwent purely laparoscopic anatomical right or left hepatectomy and right or left trisectionectomy between February 1998 and January 2016 are enrolled...
May 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29770883/laparoscopic-liver-resection-for-large-hcc-short-and-long-term-outcomes-in-relation-to-tumor-size
#9
Giovanni Battista Levi Sandri, Gabriele Spoletini, Giovanni Vennarecci, Elisa Francone, Mohammed Abu Hilal, Giuseppe Maria Ettorre
OBJECTIVE: In this study, we aim to assess the impact of tumor size on clinical and oncological outcomes in patients undergoing laparoscopic liver resection (LLR) for hepatocellular carcinoma (HCC). BACKGROUND: LLR has been shown to be feasible, safe, and oncologically efficient. However, it has been slow to develop in patients with HCC who often suffer from chronic liver disease which represents an additional challenge for the surgeon. The experience with large HCCs is even more limited...
May 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29770291/a-review-of-the-nunn-modified-single-patch-technique-for-atrioventricular-septal-defect-repair
#10
REVIEW
Tracy R Geoffrion, Kanchana Singappuli, John S K Murala
Atrioventricular septal defect (AVSD) is a common congenital cardiac surgical problem. Over the years, younger and smaller infants are having operations for this condition before irreversible cardio pulmonary changes occur. Traditionally a single or two patch techniques have been used to repair this defect. However, in the past two decades an innovative method of modified single patch technique popularized by Dr. Graham Nunn has gained worldwide popularity. This review discusses the origin, surgical principles, technique and outcomes of this method, popularly known as Nunn or Australian technique...
April 2018: Translational Pediatrics
https://www.readbyqxmd.com/read/29766321/acute-kidney-injury-after-implantation-of-a-left-ventricular-assist-device-a-comparison-of-axial-flow-heartmate-ii-and-centrifugal-flow-heartware-hvad-devices
#11
Azeen Anjum, Chitaru Kurihara, Andre Critsinelis, Masashi Kawabori, Tadahisa Sugiura, Andrew B Civitello, Whitson B Etheridge, Reynolds M Delgado, Leo Simpson, Joggy K George, Ajith P Nair, O H Frazier, Jeffrey A Morgan
Continuous-flow left ventricular assist devices (CF-LVADs) are increasingly being used to treat advanced, refractory chronic heart failure. Herein, we sought to determine the incidence of postoperative acute kidney injury (AKI) in axial-flow (HeartMate II; HM-II) and centrifugal-flow (HVAD) CF-LVAD recipients, as well as the effect of AKI on mortality. The study cohort comprised 520 patients who received a HM-II (n = 398) or HVAD (n = 122) at our center between November 2003 and March 2016. Their records were reviewed to determine the incidence of RIFLE-defined AKI after LVAD implantation...
May 15, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29766138/risk-stratification-tools-in-emergency-general-surgery
#12
REVIEW
Joaquim Michael Havens, Alexandra B Columbus, Anupamaa J Seshadri, Carlos V R Brown, Gail T Tominaga, Nathan T Mowery, Marie Crandall
The use of risk stratification tools (RST) aids in clinical triage, decision making and quality assessment in a wide variety of medical fields. Although emergency general surgery (EGS) is characterized by a comorbid, physiologically acute patient population with disparately high rates of perioperative morbidity and mortality, few RST have been explicitly examined in this setting. We examined the available RST with the intent of identifying a tool that comprehensively reflects an EGS patients perioperative risk for death or complication...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/29764968/how-to-prevent-and-manage-radiation-induced-coronary-artery-disease
#13
REVIEW
Jason R Cuomo, Sean P Javaheri, Gyanendra K Sharma, Deepak Kapoor, Adam E Berman, Neal L Weintraub
Radiation-induced coronary heart disease (RICHD) is the second most common cause of morbidity and mortality in patients treated with radiotherapy for breast cancer, Hodgkin's lymphoma and other prevalent mediastinal malignancies. The risk of RICHD increases with radiation dose. Exposed patients may present decades after treatment with manifestations ranging from asymptomatic myocardial perfusion defects to ostial, triple-vessel disease and sudden cardiac death. RICHD is insidious, with a long latency and a tendency to remain silent late into the disease course...
May 15, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29762198/endometrial-cancer-in-the-elderly-does-age-influence-surgical-treatments-outcomes-and-prognosis
#14
Meriem Koual, Charlotte Ngo, Aude Girault, Fabrice Lécuru, Anne-Sophie Bats
OBJECTIVE: To compare clinicopathological characteristics, surgical outcomes, and survival rates for nonelderly (<75 years old) and elderly (≥75 years old) women with endometrial cancer (EC). METHODS: This retrospective study included consecutive patients who underwent surgery for EC at the gynecologic-oncologic surgery department of Hôpital Européen Georges-Pompidou (Paris, France) from January, 2002 to December, 2015. Independent-group t tests and chi-square tests were used to compare elderly and nonelderly women...
May 14, 2018: Menopause: the Journal of the North American Menopause Society
https://www.readbyqxmd.com/read/29762149/pseudoadjuvant-chemotherapy-in-resectable-metastatic-colorectal-cancer
#15
Laura Polastro, Georges El Hachem, Alain Hendlisz
PURPOSE OF REVIEW: In this article, we focus on the potential benefits and risks of chemotherapy administration before (perioperative) or after (pseudoadjuvant) a curative resection of colorectal cancer (CRC) metastases. RECENT FINDINGS: In the published evidence, there is a lack of survival benefit from peri or postoperative chemotherapy in the context of resectable metastatic CRC. However, high-risk patients may have a certain benefit when receiving a postoperative cytotoxic treatment...
May 11, 2018: Current Opinion in Oncology
https://www.readbyqxmd.com/read/29758371/comparative-cost-analysis-for-the-surgical-and-endovascular-treatment-of-ruptured-intracranial-aneurysms-in-taiwan-a-nationwide-population-based-cohort-study
#16
Jian-Han Chen, Chih-Yuan Huang, Yi-Che Lee, Kuo-Wei Wang, Po-Chou Liliang, Cheng-Loong Liang, Kang Lu, Han-Jung Chen, Yuan-Ting Sun, Hao-Kuang Wang
OBJECTIVE: Using a database that enabled longitudinal follow-up, the authors assessed the cost, outcome, complications, and readmission rate of ruptured cerebral aneurysms repaired by surgical clipping and endovascular coiling. METHODS: This study was a retrospective review of data from a series of patients who underwent surgical clipping or endovascular coiling of ruptured cerebral aneurysms between 1996 and 2013. The medical records and hospital cost data were all examined...
May 11, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29757910/ishlt-primary-graft-dysfunction-incidence-risk-factors-and-outcome-a-uk-national-study
#17
Sanjeet Singh Avtaar Singh, Nicholas R Banner, Sally Rushton, Andre R Simon, Colin Berry, Nawwar Al-Attar
BACKGROUND: Heart transplantation (HTx) remains the most effective long-term treatment for advanced heart failure. Primary graft dysfunction (PGD) continues to be a potentially life-threatening early complication. In 2014, a consensus statement released by ISHLT established diagnostic criteria for PGD. We studied the incidence of PGD across the UK. METHODS: We analysed the medical records of all adult patients who underwent heart transplantation between October 2012-October 2015 in the 6 UK heart transplant centers Preoperative donor and recipient characteristics, intraoperative details and posttransplant complications were compared between the PGD and non PGD groups using the ISHLT definition...
May 1, 2018: Transplantation
https://www.readbyqxmd.com/read/29757568/acute-kidney-injury-following-radical-cystectomy-and-urinary-diversion-predictors-and-associated-morbidity
#18
Yasser Osman, Ahmed M Harraz, Samer El-Halwagy, Mahmoud Laymon, Ahmed Mosbah, Hassan Abol-Enein, Atalla A Shaaban
INTRODUCTION: Acute kidney injury (AKI) after major surgeries is associated with significant morbidity and mortality. We aim to report incidence, predictors and associated comorbidities of AKI after radical cystectomy in a large cohort of patients. MATERIALS AND METHODS: We conducted a retrospective analysis of 1000 patients who underwent open radical cystectomy in a tertiary referral center. Perioperative serum creatinine measurements were used to define AKI according to the RIFLE criteria (as Risk, Injury and Failure)...
March 18, 2018: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/29756693/multi-parametric-functional-hemodynamic-optimization-improves-postsurgical-outcome-after-intermediate-risk-open-gastrointestinal-surgery-a-randomized-controlled-trial
#19
Pavel Szturz, Pavel Folwarczny, Roman Kula, Jan Neiser, Pavel Ševčík, Jan Benes
BACKGROUND: Perioperative goal directed therapy (pGDT) using flow monitoring has been associated with improved outcomes. However, its protocols are often based on stroke volume only: as a target for fluid loading, inotropic support and vasopresors (via mathematical coupling of systemic vascular resistance). In this trial, we have tested the multi- parametric pGDT protocol based on esophageal Doppler variables (corrected flow time, peak velocity) in intermediate-to-high risk patients undergoing gastrointestinal surgery...
May 11, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29756676/impact-of-serious-mental-illness-on-surgical-patient-outcomes
#20
Kate E McBride, Michael J Solomon, Jane M Young, Daniel Steffens, Tim J Lambert, Nick Glozier, Paul G Bannon
BACKGROUND: People with comorbid mental illness have poorer health status and disparate access to healthcare. Several studies internationally have reported mixed findings regarding the association between mental illness and surgical patient outcomes. This study examines the surgical outcomes in people with decompensated serious mental illness (SMI) within the setting of the Australian universal healthcare system. METHODS: Retrospective cohort study involving elective overnight surgical patients aged 18 years and above who attended a large public tertiary referral hospital in Sydney, Australia, between 2010 and 2014...
May 14, 2018: ANZ Journal of Surgery
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