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Perioperative volume management

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https://www.readbyqxmd.com/read/28321971/risk-factors-for-perioperative-mortality-and-transfusion-in-sacrococcygeal-teratoma-resections
#1
Rebecca S Isserman, Olivia Nelson, Kha M Tran, Lingyu Cai, Marcia Polansky, Julia M Rosenbloom, Theodora K Goebel, Elaina E Lin
BACKGROUND: Sacrococcygeal teratomas are a common congenital tumor. Surgical resection can occur in utero, in the neonatal period, or in the postneonatal period. AIMS: We describe patient and tumor factors associated with mortality and transfusion in this population. METHODS: We did a retrospective chart review of patients who underwent sacrococcygeal teratoma resection between January 1998 and March 2016. Demographic data, transfusion data, and tumor characteristics were collected...
March 21, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28295573/therapeutic-plasma-exchange-for-perioperative-management-of-patients-with-congenital-factor-xi-deficiency
#2
Mohamed S Alsammak, Aneel A Ashrani, Jeffrey L Winters, Rajiv K Pruthi
BACKGROUND: Factor XI (FXI) deficiency (hemophilia C [HEM-C]) is a bleeding disorder with unpredictable severity that correlates poorly with FXI coagulation activity (FXI:C). It poses a perioperative hemostatic management challenge. For US patients with severe disease, fresh frozen plasma (FFP) or, in current use, thawed plasma is the most readily available option but comes with risk of volume overload. We report our experience of using therapeutic plasma exchange (TPE) as an alternative perioperative management strategy...
March 15, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/28289542/complications-after-pancreaticoduodenectomy-are-associated-with-higher-amounts-of-intra-and-postoperative-fluid-therapy-a-single-center-retrospective-cohort-study
#3
Birte Kulemann, Marianne Fritz, Torben Glatz, Goran Marjanovic, Olivia Sick, Ulrich T Hopt, Jens Hoeppner, Frank Makowiec
BACKGROUND: Perioperative mortality after pancreaticoduodenectomy has decreased significantly in high-volume centers, but morbidity remains high. Restrictive perioperative fluid management may contribute to reduced complication rates after various surgical procedures. The aim of this study was to determine whether there is a correlation between the amount of fluid administered and postoperative complications. We hypothesized that higher amounts of intra- and total fluid is associated with greater postoperative morbidity...
April 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28288777/outcomes-after-pediatric-open-laparoscopic-and-robotic-pyeloplasty-at-academic-institutions
#4
Yvonne Y Chan, Blythe Durbin-Johnson, Renea M Sturm, Eric A Kurzrock
INTRODUCTION: Patient age and hospital volume have been shown to affect perioperative outcomes after pediatric pyeloplasty. However, there are few multicenter studies that focus on outcomes at teaching hospitals, where many of the operations are performed. OBJECTIVE: The goal was to determine if surgical approach, age, case volume, or other factors influence perioperative outcomes in a large contemporary cohort. STUDY DESIGN: Using the clinical database/resource manager (CDB/RM) of the University Health-System Consortium (UHC), children who underwent open, laparoscopic, or robotic pyeloplasty from 2011 to 2014 were identified at 102 academic institutions...
February 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28260994/risk-factors-for-intraoperative-massive-transfusion-in-pediatric-liver-transplantation-a-multivariate-analysis
#5
Seok-Joon Jin, Sun-Key Kim, Seong-Soo Choi, Keum Nae Kang, Chang Joon Rhyu, Shin Hwang, Sung-Gyu Lee, Jung-Man Namgoong, Young-Kug Kim
Background: Pediatric liver transplantation (LT) is strongly associated with increased intraoperative blood transfusion requirement and postoperative morbidity and mortality. In the present study, we aimed to assess the risk factors associated with massive transfusion in pediatric LT, and examined the effect of massive transfusion on the postoperative outcomes. Methods: We enrolled pediatric patients who underwent LT between December 1994 and June 2015. Massive transfusion was defined as the administration of red blood cells ≥100% of the total blood volume during LT...
2017: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/28260992/risk-factors-associated-with-decreased-renal-function-after-hand-assisted-laparoscopic-donor-nephrectomy-a-multivariate-analysis-of-a-single-surgeon-experience
#6
Jinwook Lim, Yu-Gyeong Kong, Young-Kug Kim, Bumsik Hong
Background: Hand-assisted laparoscopic donor nephrectomy is a minimally invasive procedure for living kidney donation. The surgeon operative volume is associated with postoperative morbidity and mortality. We evaluated the risk factors associated with decreased renal function after hand-assisted laparoscopic donor nephrectomy performed by a single experienced surgeon. Methods: We included living renal donors who underwent hand-assisted laparoscopic donor nephrectomy by a single experienced surgeon between 2006 and 2013...
2017: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/28256704/a-comprehensive-guide-to-perioperative-management-and-operative-technique-for-robotic-cystectomy-with-intracorporeal-urinary-diversion
#7
Wei Shen Tan, Benjamin W Lamb, Ashwin Sridhar, Timothy P Briggs, John D Kelly
Robotic-assisted radical cystectomy (RARC) represents an evolution of open radical cystectomy (ORC) with the aim of reducing patient morbidity and improving return to normal function, whilst maintaining oncological equivalence. RARC is gaining popularity, especially in high-volume centres, although there remains a lack of level 1 evidence to demonstrate any superiority of RARC over ORC. All previously reported studies that randomised ORC and RARC have utilised a technique for RARC requiring a conversion to open surgery for urinary diversion...
February 27, 2017: Urologia
https://www.readbyqxmd.com/read/28251830/disparities-in-the-management-and-prophylaxis-of-surgical-site-infection-and-pancreatic-fistula-after-pancreatoduodenectomy
#8
Francisco Igor B Macedo, Mia Mowzoon, Janak Parikh, Sandeep A Sathyanarayana, Michael J Jacobs
BACKGROUND: Pancreatoduodenectomy (PD) carries a high morbidity. Over time, pancreatic surgeons have altered their perioperative management in efforts to reduce morbidity rates, thereby creating major technical and management variations. We aim to evaluate the practice patterns of hepato-pancreato-biliary (HPB) surgeons across multiple regions worldwide. METHODS: Between May and August 2015, an anonymous 25-item survey questionnaire was electronically distributed to IHPBA (International Hepato-Pancreato-Biliary Association) members regarding practice patterns and perioperative care of patients undergoing PD...
March 2, 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/28240466/liberal-transfusion-strategies-still-the-trend-in-burn-surgery
#9
N L Allorto, M D T Smith, D L Clarke
OBJECTIVE: Blood is a limited resource in middle-income countries such as South Africa. Transfusion is associated with complications and expense. We aimed to understand our transfusion practices in burn surgery as well as ascertain the opinion of a broader group of surgeons and anaesthetists regarding transfusion triggers in order to understand the rationale and bias that drives current transfusion practice in our setting. METHOD: Firstly, we investigated the current blood practices at our regional burn service through an audit of perioperative notes for all patients receiving packed cell transfusions in a 24-month period...
September 2016: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28197025/current-perioperative-management-of-pheochromocytomas
#10
REVIEW
Rashmi Ramachandran, Vimi Rewari
Neuroendocrine tumors which have the potential to secrete catecholamines are either associated with sympathetic adrenal (pheochromocytoma) or nonadrenal (paraganglioma) tissue. Surgical removal of these tumors is always indicated to cure and prevent cardiovascular and other organ system complications associated with catecholamine excess. Some of these tumors have malignant potential as well. The diagnosis, localization and anatomical delineation of these tumors involve measurement of catecholamines and their metabolic end products in plasma and urine, (123)I-metaiodobenzylguanidine scintigraphy, computed tomography, and/or magnetic resonance imaging...
January 2017: Indian Journal of Urology: IJU: Journal of the Urological Society of India
https://www.readbyqxmd.com/read/28153614/internal-maxillary-artery-preoperative-embolization-using-nbca-and-pushable-coils-for-temporomandibular-joint-ankylosis-surgery-technical-note
#11
Yazan J Alderazi, Darshan Shastri, John Wessel, Melvin Mathew, Tareq Kass-Hout, Shahid R Aziz, Charles J Prestigiacomo, Chirag D Gandhi
INTRODUCTION: Temporomandibular joint (TMJ) ankylosis causes disability through impaired digestion, mastication, speech and appearance. Surgical treatment increases range of motion with resultant functional improvement. However, substantial perioperative blood loss can occur, up to three liters, if the internal maxillary artery (IMAX) is injured as it traverses the ankylotic mass. Achieving hemostasis is difficult due to limited proximal IMAX access and poor visualization. Our aim is to investigate the technical feasibility and preliminary safety of preoperative IMAX embolization in patients undergoing TMJ ankylosis surgery...
January 30, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28153509/re-defining-and-contextualizing-the-hospital-volume-outcome-relationship-for-robotic-assisted-radical-prostatectomy-implications-for-centralization-of-care
#12
Boris Gershman, Sarah K Meier, Molly M Jeffery, Daniel M Moreira, Matthew K Tollefson, Simon P Kim, R Jeffrey Karnes, Nilay D Shah
PURPOSE: Robotic-assisted radical prostatectomy (RARP) has undergone rapid dissemination, driven in part by market forces, to become the most frequently employed surgical approach in the management of prostate cancer. Accordingly, a critical analysis of its volume-outcome relationship has important health policy implications. We therefore evaluated the association of hospital RARP volume with perioperative outcomes, and examined the distribution of hospital RARP volumes to contextualize the volume-outcome relationship...
January 30, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28139242/the-effect-of-perioperative-fluid-management-on-postoperative-ileus-in-rectal-cancer-patients
#13
Matthew S VandeHei, Christina M Papageorge, Matthew M Murphy, Gregory D Kennedy
BACKGROUND: Postoperative ileus is a common cause of increased morbidity and cost after operative intervention. The aim of this study was to assess how fluid type, volume, and timing may affect incidence of postoperative ileus. METHODS: A retrospective cohort study was performed on patients undergoing operative intervention for rectal cancer from 2008 to 2015 at a single institution. Univariate and multivariate analyses were used to assess the effect of type (crystalloid versus colloid), volume by quartile, and timing (perioperative versus postoperative) on rate of postoperative ileus...
January 27, 2017: Surgery
https://www.readbyqxmd.com/read/28132917/reducing-postoperative-complications-and-improving-clinical-outcome-enhanced-recovery-after-surgery-in-pancreaticoduodenectomy-a-retrospective-cohort-study
#14
Juntao Dai, Yongjian Jiang, Deliang Fu
BACKGROUND: An enhanced recovery after surgery (ERAS) programme aims to reduce the stress response to surgery and thereby accelerate recovery. The experience of implementing the ERAS programmes in pancreatoduodenectomy (PD) is relatively limited. The aim of this study was to evaluate the feasibility, safety and clinical outcomes of the ERAS programme after PD at a high-volume Chinese university referral centre. METHODS: Between September 2014 and July 2016, a retrospective analysis of 166 consecutive patients who underwent PD at a tertiary referral care center was carried out...
January 26, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28097305/enhanced-recovery-after-surgery-a-review
#15
Olle Ljungqvist, Michael Scott, Kenneth C Fearon
Importance: Enhanced Recovery After Surgery (ERAS) is a paradigm shift in perioperative care, resulting in substantial improvements in clinical outcomes and cost savings. Observations: Enhanced Recovery After Surgery is a multimodal, multidisciplinary approach to the care of the surgical patient. Enhanced Recovery After Surgery process implementation involves a team consisting of surgeons, anesthetists, an ERAS coordinator (often a nurse or a physician assistant), and staff from units that care for the surgical patient...
March 1, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28092401/randomized-clinical-trial-of-preoperative-oral-versus-intravenous-iron-in-anaemic-patients-with-colorectal-cancer
#16
B D Keeler, J A Simpson, O Ng, H Padmanabhan, M J Brookes, A G Acheson
BACKGROUND: Treatment of preoperative anaemia is recommended as part of patient blood management, aiming to minimize perioperative allogeneic red blood cell transfusion. No clear evidence exists outlining which treatment modality should be used in patients with colorectal cancer. The study aimed to compare the efficacy of preoperative intravenous and oral iron in reducing blood transfusion use in anaemic patients undergoing elective colorectal cancer surgery. METHODS: Anaemic patients with non-metastatic colorectal adenocarcinoma were recruited at least 2 weeks before surgery and randomized to receive oral (ferrous sulphate) or intravenous (ferric carboxymaltose) iron...
February 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28027816/pancreatic-anastomosis-after-pancreatoduodenectomy-a-position-statement-by-the-international-study-group-of-pancreatic-surgery-isgps
#17
REVIEW
Shailesh V Shrikhande, Masillamany Sivasanker, Charles M Vollmer, Helmut Friess, Marc G Besselink, Abe Fingerhut, Charles J Yeo, Carlos Fernandez-delCastillo, Christos Dervenis, Christoper Halloran, Dirk J Gouma, Dejan Radenkovic, Horacio J Asbun, John P Neoptolemos, Jakob R Izbicki, Keith D Lillemoe, Kevin C Conlon, Laureano Fernandez-Cruz, Marco Montorsi, Max Bockhorn, Mustapha Adham, Richard Charnley, Ross Carter, Thilo Hackert, Werner Hartwig, Yi Miao, Michael Sarr, Claudio Bassi, Markus W Büchler
BACKGROUND: Clinically relevant postoperative pancreatic fistula (grades B and C of the ISGPS definition) remains the most troublesome complication after pancreatoduodenectomy. The approach to management of the pancreatic remnant via some form of pancreatico-enteric anastomosis determines the incidence and severity of clinically relevant postoperative pancreatic fistula. Despite numerous trials comparing diverse pancreatico-enteric anastomosis techniques and other adjunctive strategies (pancreatic duct stenting, somatostatin analogues, etc), currently, there is no clear consensus regarding the ideal method of pancreatico-enteric anastomosis...
December 24, 2016: Surgery
https://www.readbyqxmd.com/read/28027231/the-lipo-body-lift-a-new-circumferential-body-contouring-technique-useful-after-bariatric-surgery
#18
Nicolas Bertheuil, Benoit Chaput, Antoine De Runz, Paul Girard, Raphael Carloni, Eric Watier
BACKGROUND: After bariatric surgery, lifting of the lower body involves a contouring technique used to achieve optimal lower trunk reconstruction. The authors describe an innovative procedure applicable after massive weight loss: the lipo-body lift method. The authors describe their experience with this novel, safe procedure. METHODS: Twenty-five abdominal body-contouring reconstructions following massive weight loss were treated by means of circumferential lipo-body lift...
January 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28018896/factors-influencing-neurodevelopment-after-cardiac-surgery-during-infancy
#19
REVIEW
Hedwig Hubertine Hövels-Gürich
Short- and long-term neurodevelopmental (ND) disabilities with negative impact on psychosocial and academic performance, quality of life, and independence in adulthood are known to be the most common sequelae for surviving children after surgery for congenital heart disease (CHD). This article reviews influences and risk factors for ND impairment. For a long time, the search for independent risk factors was focused on the perioperative period and modalities of cardiopulmonary bypass (CPB). CPB operations to ensure intraoperative vital organ perfusion and oxygen supply with or without circulatory arrest or regional cerebral perfusion bear specific risks...
2016: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28008466/perioperative-hemorrhagic-complications-after-laparoscopic-sleeve-gastrectomy-four-year-experience-of-a-bariatric-center-of-excellence
#20
Francesco De Angelis, Mohamed Abdelgawad, Mario Rizzello, Consalvo Mattia, Gianfranco Silecchia
BACKGROUND: Bleeding and gastric fistula are the most common postoperative complications after laparoscopic sleeve gastrectomy (LSG). The long stapler line represents the most frequent source of bleeding, which ranges between 0 and 20%. The aim of this retrospective study was to analyze the 4-year experience of a high-volume center with respect to the prevention and management of perioperative LSG bleeding. METHODS: The prospectively maintained database from June 2012 to June 2016 was reviewed...
December 23, 2016: Surgical Endoscopy
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