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https://www.readbyqxmd.com/read/29346168/a-new-robot-assisted-billroth-i-reconstruction-details-of-the-technique-and-early-results
#1
Graziano Ceccarelli, Luigi Marano, Massimo Codacci-Pisanelli, Enrico Andolfi, Alessia Biancafarina, Massimiliano Fabozzi, Stefano Caruso, Alberto Patriti
BACKGROUND: Laparoscopic surgery for gastric tumor is considered a demanding procedure because of lymph node dissection and reconstruction. Billroth-I (B-I) reconstruction after laparoscopic distal gastrectomy is commonly performed extracorporeally because of the complexity of an intracorporeal procedure. Robotic surgery overcomes some limitations of laparoscopy, allowing to reproduce the basic maneuvers of open surgery. We describe a new technique to perform robotic B-I anastomosis. METHODS: Between January 2012 and February 2015, 5 patients underwent distal gastrectomy with intracorporeal B-I-stapled anastomosis...
January 16, 2018: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/29342431/comparison-of-access-type-on-perioperative-outcomes-after-endovascular-aortic-aneurysm-repair
#2
Jeffrey J Siracuse, Alik Farber, Jeffrey A Kalish, Douglas W Jones, Denis Rybin, Gheorghe Doros, Salvatore T Scali, Marc L Schermerhorn
OBJECTIVE: Endovascular aneurysm repair (EVAR) can be performed through percutaneous or surgical access. Our goal was to assess the difference in perioperative outcomes based on access type in a real-world setting. METHODS: The Vascular Quality Initiative (VQI) database was queried for EVAR. Univariable analysis and multivariable analysis were used to determine the independent effect of access type. RESULTS: There were 8340 (64%) and 4747 (36%) EVAR procedures performed through percutaneous and surgical access (3395 [72%] transverse and 1352 [28%] vertical incisions)...
January 13, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29342066/resident-participation-in-fixation-of-intertrochanteric-hip-fractures-analysis-of-the-nsqip-database
#3
Alexander L Neuwirth, Russell N Stitzlein, Madalyn G Neuwirth, Rachel K Kelz, Samir Mehta
BACKGROUND: Future generations of orthopaedic surgeons must continue to be trained in the surgical management of hip fractures. This study assesses the effect of resident participation on outcomes for the treatment of intertrochanteric hip fractures. METHODS: The National Surgical Quality Improvement Program (NSQIP) database (2010 to 2013) was queried for intertrochanteric hip fractures (International Classification of Diseases, 9th Revision, Clinical Modification [ICD-9-CM] code 820...
January 17, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29341963/role-of-the-anesthesiologist-intensivist-outside-the-icu-opportunity-to-add-value-for-the-hospital-or-an-unnecessary-distraction
#4
Suzanne Bennett, Erin Grawe, Courtney Jones, Sean A Josephs, Maggie Mechlin, William E Hurford
PURPOSE OF REVIEW: Given the extremely expensive nature of critical care medicine, it seems logical that intensivists should play an active role in designing efficient systems of care. The true value of intensivists, however, is not well defined. RECENT FINDINGS: Anesthesiologists have taken key roles in improving patient safety in the operating room. Anesthesia-related mortality rates have decreased from 20 deaths per 100 000 anesthetics in the early 1980s to less than one death per 100 000 currently...
January 15, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29341066/cerebral-near-infrared-spectroscopy-nirs-for-perioperative-monitoring-of-brain-oxygenation-in-children-and-adults
#5
REVIEW
Yun Yu, Kaiying Zhang, Ling Zhang, Huantao Zong, Lingzhong Meng, Ruquan Han
BACKGROUND: Various techniques have been employed for the early detection of perioperative cerebral ischaemia and hypoxia. Cerebral near-infrared spectroscopy (NIRS) is increasingly used in this clinical scenario to monitor brain oxygenation. However, it is unknown whether perioperative cerebral NIRS monitoring and the subsequent treatment strategies are of benefit to patients. OBJECTIVES: To assess the effects of perioperative cerebral NIRS monitoring and corresponding treatment strategies in adults and children, compared with blinded or no cerebral oxygenation monitoring, or cerebral oxygenation monitoring based on non-NIRS technologies, on the detection of cerebral oxygen desaturation events (CDEs), neurological outcomes, non-neurological outcomes and socioeconomic impact (including cost of hospitalization and length of hospital stay)...
January 17, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29338037/stentless-vs-stented-bioprosthesis-for-aortic-valve-replacement-a-case-matched-comparison-of-long-term-follow-up-and-subgroup-analysis-of-patients-with-native-valve-endocarditis
#6
Andreas Schaefer, Jannis Dickow, Gerhard Schoen, Sumi Westhofen, Lisa Kloss, Tarik Al-Saydali, Hermann Reichenspurner, Sebastian A Philipp, Christian Detter
BACKGROUND: Current retrospective evidence suggests similar clinical and superior hemodynamic outcomes of the Sorin Freedom Solo stentless aortic valve (SFS) (LivaNova PLC, London, UK) compared to the Carpentier Edwards Perimount stented aortic valve (CEP) (Edwards Lifesciences Inc., Irvine, California, USA). To date, no reports exist describing case-matched long-term outcomes and analysis for treatment of native valve endocarditis (NVE). METHODS: From 2004 through 2014, 77 consecutive patients (study group, 59...
2018: PloS One
https://www.readbyqxmd.com/read/29336904/bypass-versus-endovascular-intervention-for-healing-ischemic-foot-wounds-secondary-to-tibial-arterial-disease
#7
Abhisekh Mohapatra, Jon C Henry, Efthimios D Avgerinos, Aureline Boitet, Rabih A Chaer, Michel S Makaroun, Steven A Leers, Eric S Hager
OBJECTIVE: Pedal (inframalleolar) bypass is a long-standing therapy for tibial arterial disease in patients with ischemic tissue loss. Endovascular tibial intervention is an appealing alternative with lower risks of perioperative mortality or complications. Our objective was to compare the effectiveness of these two treatment modalities with respect to patency and limb-related clinical outcomes. METHODS: We performed a retrospective chart review of patients presenting between 2006 and 2013 with ischemic foot wounds and infrapopliteal arterial disease who underwent a revascularization procedure (either open surgical bypass to an inframalleolar target or endovascular tibial intervention)...
January 11, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29336894/preoperative-surveillance-rectal-swab-is-associated-with-an-increased-risk-of-infectious-complications-in-pancreaticoduodenectomy-and-directs-antimicrobial-prophylaxis-an-antibiotic-stewardship-strategy
#8
Matteo De Pastena, Salvatore Paiella, Anna M Azzini, Giovanni Marchegiani, Giuseppe Malleo, Debora Ciprani, Annarita Mazzariol, Erica Secchettin, Deborah Bonamini, Clizia Gasparini, Ercole Concia, Claudio Bassi, Roberto Salvia
BACKGROUND: Despite improvements in the perioperative care, the morbidity rate after pancreaticoduodenectomy (PD) is still higher than 50%. The aim of this study was twofold: first, to assess the correlation between preoperative rectal swab (RS) and intraoperative bile cultures; to examine the impact of RS isolates on postoperative course after PD. METHODS: An observational study was conducted analyzing all consecutive PD performed from January 2015 to July 2016...
January 11, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/29336771/surgical-and-endovascular-management-of-patients-with-chronic-mesenteric-ischemia-a-single-center-experience
#9
Panagiotis Paliogiannis, Giorgio C Ginesu, Alessandro Fancellu, Aldo Pischedda, Mario Maiore, Eleonora Maiore, Antonio Pinna, Michele Barmina, Alberto Porcu
Chronic mesenteric ischemia is a rare intestinal disorder, with a potential evolution toward intestinal infraction. The choice of the appropriate treatment is currently the most crucial issue in the management of patients with chronic mesenteric ischemia. We describe our experience with 16 cases, and we discuss the current diagnostic and therapeutic approaches. A retrospective review of the clinical records was performed, and demographic, clinical, therapeutic, and prognostic data were collected. Six patients were females (37%), and the mean age was 62 years...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29336386/retrospective-study-of-complete-atrioventricular-canal-defects-anesthetic-and-perioperative-challenges
#10
Aniruddha Ramesh Janai, Wilfried Bellinghausen, Edwin Turton, Carmine Bevilacqua, Waseem Zakhary, Martin Kostelka, Farhad Bakhtiary, Joerg Hambsch, Ingo Daehnert, Florian Loeffelbein, Joerg Ender
OBJECTIVE: The objective of this study was to highlight anesthetic and perioperative management and the outcomes of infants with complete atrioventricular (AV) canal defects. DESIGN: This retrospective descriptive study included children who underwent staged and primary biventricular repair for complete AV canal defects from 1999 to 2013. SETTING: A single-center study at a university affiliated heart center. PARTICIPANTS: One hundred and fifty-seven patients with a mean age at surgery of 125 ± 56...
January 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29335389/checklist-in-colorectal-surgery-proposal-of-experts-of-the-polish-club-of-coloproctology-and-national-consultant-in-general-surgery
#11
Tomasz Banasiewicz, Łukasz Krokowicz, Piotr Richter, Adam Dziki, Piotr Krokowicz, Zbigniew Lorenc, Marek Szczepkowski, Michał Drews, Grzegorz Wallner
A checklist is a collection of information that helps reduce the risk of failure due to limitations in human memory and attention. In surgery, the first Surgical Safety Checklist (SSC), created under the supervision of WHO (World Health Organization), was established in 2007 and covers three stages related to the patient's stay in the operating theater and operation: 1. Prior to initiation (induction) of anesthesia; 2. before cutting the skin; 3. before the patient leaves the operating room Colorectal surgery is particularly at high risk for complications and relatively high mortality...
December 30, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/29334927/dexmedetomidine-prevents-acute-kidney-injury-after-adult-cardiac-surgery-a-meta-analysis-of-randomized-controlled-trials
#12
Yang Liu, Bo Sheng, Suozhu Wang, Feiping Lu, Jie Zhen, Wei Chen
BACKGROUND: Dexmedetomidine has been shown to confer direct renoprotection by stabilizing the sympathetic system, exerting anti-inflammatory effects and attenuating ischemia/reperfusion (I/R) injury in preclinical studies. Results from clinical trials of dexmedetomidine on acute kidney injury (AKI) following adult cardiac surgery are controversial. METHODS: We searched EMBASE, PubMed, and Cochrane CENTRAL databases for randomized controlled trials (RCTs) comparing the renal effect of dexmedetomidine versus placebo or other anesthetic drugs in adult patients undergoing cardiac surgery...
January 15, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29334334/mortality-after-endovascular-treatment-of-infrarenal-abdominal-aortic-aneurysms-the-newer-the-better
#13
Aspasia Tzani, Ilias P Doulamis, Ioannis Katsaros, Eirini Martinou, Dimitrios Schizas, Konstantinos P Economopoulos
Although endovascular repair of infrarenal abdominal aortic aneurysms (EVAR) presents a delicate alternative treatment for abdominal aortic aneurysms (AAA) with lower perioperative mortality, its long-term efficacy remains a matter of concern. The purpose of this study was to evaluate the currently reported mortality evidence after EVAR and to examine the possible effect of aneurysm status and the study period on mortality rates. The PubMed and Cochrane bibliographical databases were thoroughly searched for studies reporting on more than 1 000 patients with non-ruptured or ruptured infrarenal AAA, treated with EVAR from August 1991 to September 2016...
January 15, 2018: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/29333531/patient-reported-outcome-measures-prom-as-a-preoperative-assessment-tool
#14
Sunghye Kim, Pamela W Duncan, Leanne Groban, Hannah Segal, Rica Moonyeen Abbott, Jeff D Williamson
Aim of review: Patient-reported outcomes (PRO) on functional, social, and behavioral factors might be important preoperative predictors of postoperative outcomes. We conducted a literature review to explore associations of preoperative depression, socioeconomic status, social support, functional status/frailty, cognitive status, self-management skills, health literacy, and nutritional status with surgical outcomes. Methods: Two electronic data bases, including PubMed and Google Scholar, were searched linking either depression, socioeconomic status, social support, functional status/frailty, cognitive status, self-management skills, health literacy, or nutritional status with surgery, postoperative complications, or perioperative period within the past 2 decades...
November 28, 2017: Journal of anesthesia and perioperative medicine
https://www.readbyqxmd.com/read/29333076/parenchyma-sparing-hepatectomy-psh-versus-non-psh-for-bilobar-liver-metastases-of-colorectal-cancer
#15
Lidewij Spelt, Daniel Ansari, Max Swanling, Peter Holka, Roland Andersson
Background: Preoperative interventions have increased the resectability of colorectal cancer (CRC) liver metastases. This retrospective study compares outcomes after liver resection for bilobar CRC metastases between patients who underwent parenchyma-sparing hepatectomy (PSH), i.e., segmentectomies and smaller resections on both lobes, and those treated with non-PSH, i.e., hemihepatectomy plus any resection on the other lobe. Methods: A cohort of 119 patients who underwent liver resection for bilobar CRC metastases were included...
January 2018: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/29332544/the-possible-use-of-preoperative-natriuretic-peptides-for-discriminating-low-versus-moderate-high-surgical-risk-patient
#16
Luigi Vetrugno, Daniele Orso, Carola Matellon, Marilù Giaccalone, Tiziana Bove, Elena Bignami
Perioperative risk scores for patients undergoing noncardiac surgery are generally considered inaccurate, poor, or, at best, modest. We propose estimating a patient's pretest and posttest probability of cardiac morbidity and death using the preoperative scoring system plus the negative likelihood ratio from brain natriuretic peptide (BNP) or N-terminal proB-type natriuretic peptide (NT-proBNP) plasma levels. Our clinical challenge scenario showed a pretest probability of postoperative major cardiac complications with the patient risk factor as 6...
January 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29332215/heparin-coated-grafts-reduce-mortality-in-pediatric-patients-receiving-systemic-to-pulmonary-shunts
#17
Adeel Ashfaq, Mohammad S Soroya, Amit Iyengar, Myke Federman, Brian L Reemtsen
We aimed to evaluate the outcomes of systemic-to-pulmonary (SP) shunt procedures utilizing heparin-coated (HC) polytetrafluoroethylene (PTFE) vascular grafts compared to uncoated (non-HC) grafts, in order to observe any benefits in pediatric patients. Our institution switched from using non-HC grafts to HC grafts in March 2011. We conducted a retrospective review of consecutive pediatric patients receiving SP shunts from May 2008 to December 2015. Perioperative variables including baseline characteristics, morbidity, mortality, and blood product utilization were evaluated between the HC and non-HC groups...
January 13, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29331401/preoperative-dipstick-albuminuria-and-other-urine-abnormalities-predict-acute-kidney-injury-and-patient-outcomes
#18
Sehoon Park, Soojin Lee, Anna Lee, Jin Hyuk Paek, Ho Jun Chin, Ki Young Na, Dong-Wan Chae, Sejoong Kim
BACKGROUND: It is unclear whether pathologic findings on preoperative urinalysis are associated with the risk of postoperative acute kidney injury (AKI). Therefore, we performed a retrospective review to investigate this association. METHODS: We assessed the clinical significance of preoperative dipstick urinalysis in a 10-year surgery cohort from a tertiary hospital in Korea. Patients without available information on perioperative serum creatinine levels or kidney injury prior to surgery were excluded...
January 10, 2018: Surgery
https://www.readbyqxmd.com/read/29331217/the-cost-of-perioperative-complications-following-pancreaticoduodenectomy-a-systematic-review
#19
REVIEW
Jason Wang, Ronald Ma, Leonid Churilov, Paul Eleftheriou, Mehrdad Nikfarjam, Christopher Christophi, Laurence Weinberg
BACKGROUND/OBJECTIVES: Pancreaticoduodenectomy (PD), also known as a Whipple procedure, is commonly performed for a variety of benign and malignant tumours, including of the pancreatic head and surrounding structures. PD is associated with low mortality but high morbidity and costs. Our objective was to describe the financial burden of complications following pancreaticoduodenectomy. METHODS: We searched for articles using the MEDLINE, EMBASE, Cochrane and EconLit databases from the year 2000...
December 19, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/29327897/peripheral-arterial-occlusive-disease-and-perioperative-risk
#20
Peter Poredos, Pavel Poredos
Surgical procedures represent a risk for different complications which may appear during the perioperative period. Cardiac ischemic events and vascular complications are the most important causes of increased morbidity and mortality and they are much more frequent in patients with manifest cardiovascular disease. This is particularly seen in patients with peripheral arterial occlusive disease (PAD), which represents advanced atherosclerosis frequently accompanied by the presence of coronary artery disease. Therefore, patients with PAD need careful preoperative examination, including estimation of functional capacity and the presence of other co-existing atherosclerotic diseases...
January 11, 2018: International Angiology: a Journal of the International Union of Angiology
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