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Perioperative bleeding

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https://www.readbyqxmd.com/read/28640782/perioperative-venous-thromboembolism-a-review
#1
Ronald J Gordon, Frederick W Lombard
Venous thromboembolism (VTE) is a significant problem in the perioperative period, increasing patient morbidity, mortality, and health care costs. It is also considered the most preventable of the major postoperative complications. Despite widespread adoption of prophylaxis guidelines, it appears that morbidity from the disease has not substantially changed within the past 2 decades. It is becoming clear that current prophylaxis efforts are not sufficient. Using more potent anticoagulants may decrease the incidence of VTE, but increase the risk for bleeding and infection...
June 20, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28638798/robot-assisted-laparoscopic-vs-open-gastrectomy-for-gastric-cancer-systematic-review-and-meta-analysis
#2
Stefano Caruso, Alberto Patriti, Franco Roviello, Lorenzo De Franco, Franco Franceschini, Graziano Ceccarelli, Andrea Coratti
AIM: To evaluate the potential effectiveness of robot-assisted gastrectomy (RAG) in comparison to open gastrectomy (OG) for gastric cancer patients. METHODS: A comprehensive systematic literature search using PubMed, EMBASE, and the Cochrane Library was carried out to identify studies comparing RAG and OG in gastric cancer. Participants of any age and sex were considered for inclusion in comparative studies of the two techniques independently from type of gastrectomy...
June 10, 2017: World Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28633580/platinum-agents-and-mitomycin-c-specific-complications-in-cytoreductive-surgery-crs-and-hyperthermic-intraperitoneal-chemotherapy-hipec
#3
Grace Hwei Ching Tan, Nicholas B Shannon, Claramae Shulyn Chia, Khee Chee Soo, Melissa Ching Ching Teo
INTRODUCTION: Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have been found to prolong survival in patients with peritoneal disease but is associated with significant morbidity. We evaluate the perioperative complications and the association with the chemotherapy agent used for HIPEC. METHODS: Retrospective analysis of a prospectively collected database of CRS-HIPEC cases between April 2001 and February 2016 was performed. Patients were stratified by the chemotherapy used, and perioperative complications were compared...
June 20, 2017: International Journal of Hyperthermia
https://www.readbyqxmd.com/read/28626087/effect-of-obesity-and-underweight-status-on-perioperative-outcomes-of-congenital-heart-operations-in-children-adolescents-and-young-adults-an-analysis-of-data-from-the-society-of-thoracic-surgeons-database
#4
Michael L O'Byrne, Sunghee Kim, Christoph P Hornik, Babatunde A Yerokun, Roland A Matsouaka, Jeffrey P Jacobs, Marshall L Jacobs, Richard A Jonas
Background -Extreme BMI (either very high or very low) has been associated with increased risk of adverse perioperative outcome in adults undergoing cardiac surgery. The effect of body-mass index (BMI) on perioperative outcomes in congenital heart disease patients has not been evaluated. Methods -A multicenter retrospective cohort study was performed studying patients 10-35 years undergoing a congenital heart disease operation in the Society of Thoracic Surgeons Congenital Heart Surgery Database between 1/1/2010-12/31/2015...
June 16, 2017: Circulation
https://www.readbyqxmd.com/read/28625238/-risk-factors-of-perioperative-intra-aortic-balloon-pump-complications-in-cardiac-surgery-a-12-year-single-institution-analysis
#5
Hongyan Zhou, Yonghui Zhang, Yu Du, Fangfang Cao, Ji Wang, Li Zhao, Yu Nie, Haitao Zhang
OBJECTIVE: To investigate the incidence and risk factors of the complications in perioperative intra-aortic balloon pump (IABP) supported cardiac surgical patients. METHODS: The clinical data of adult cardiac surgery patients undergoing IABP in Fuwai Hospital from January 2005 to January 2017 were enrolled. The patients were divided into complications group and no complications group. Demographic characteristics, diagnosis, perioperative clinical parameters, IABP related data, and IABP complications (including ischemia, bleeding, vascular injury and mechanical problems) were collected...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28622377/hemostatic-function-to-regulate-perioperative-bleeding-in-patients-undergoing-spinal-surgery-a-prospective-observational-study
#6
Atsushi Kimura, Tsukasa Ohmori, Asuka Sakata, Teruaki Endo, Hirokazu Inoue, Satoshi Nishimura, Katsushi Takeshita
Although bleeding is a common complication of surgery, routine laboratory tests have been demonstrated to have a low ability to predict perioperative bleeding. Better understanding of hemostatic function during surgery would lead to identification of high-risk patients for bleeding. Here, we aimed to elucidate hemostatic mechanisms to determine perioperative bleeding. We prospectively enrolled 104 patients undergoing cervical spinal surgery without bleeding diathesis. Blood sampling was performed just before the operation...
2017: PloS One
https://www.readbyqxmd.com/read/28616279/benefits-of-a-right-anterolateral-minithoracotomy-rather-than-a-median-sternotomy-in-isolated-tricuspid-redo-procedures
#7
Aikebaier Maimaiti, Lai Wei, Ye Yang, Huan Liu, Chunsheng Wang
BACKGROUND: To compare results of tricuspid valve (TV) reoperation between incision via a right anterolateral minithoracotomy (RAMT) and median sternotomy (MS). METHODS: We performed a retrospective analysis of 49 patients who underwent isolated TV surgery as a reoperation at our institution between 2006 and 2015. Previous cardiac operations included mitral, aortic, and TV surgeries, atrial septal defect repair, and pericardiectomy. The mean age of the patients was 51...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28614174/minimally-invasive-cholecystolithotomy-to-treat-cholecystolithiasis-in-children-a-single-center-experience-with-23-cases
#8
Xiaokun Lin, Jingli Cai, Jisheng Wang, Congde Chen, Guorong He, Yijiang Han
OBJECTIVE: Minimally invasive cholecystolithotomy is recently popularized treatment that may offer advantages over laparoscopic cholecystectomy, especially in China. However, there are few reports concerning the use of this technique in the pediatric population. This report describes our initial experience with minimally invasive cholecystolithotomy using laparoscopy combined with choledochoscopy to treat cholecystolithiasis in children. MATERIALS AND METHODS: A retrospective review of 23 pediatric patients with cholecystolithiasis who underwent minimally invasive cholecystolithotomy using laparoscopy combined with choledochoscopy from January 2009 to December 2015 was performed...
June 13, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28608040/paraesophageal-hernia-repair-in-the-usa-trends-of-utilization-stratified-by-surgical-volume-and-consequent-impact-on-perioperative-outcomes
#9
Francisco Schlottmann, Paula D Strassle, Marco E Allaix, Marco G Patti
BACKGROUND: The impact of surgical volume on perioperative results after a paraesophageal hernia (PEH) repair has not yet been analyzed. We sought to characterize the trend of utilization of this procedure stratified by surgical volume in the USA, and analyze its impact on perioperative outcomes. METHODS: A retrospective population-based analysis was performed using the National Inpatient Sample for the period 2000-2013. Adult patients (≥18 years old) who underwent PEH repair were included...
June 12, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28606775/oxidized-regenerated-cellulose-fibrillar%C3%A2-reduces-risk-of-postoperative-corporal-bleeding-following-inflatable-penile-prosthesis-surgery
#10
Alexander T Rozanski, Boyd R Viers, Alexander G Liu, Nabeel A Shakir, Travis J Pagliara, Jeremy M Scott, Mary L West, Allen F Morey
OBJECTIVES: To report our initial experience with oxidized regenerated cellulose (ORC; Surgicel Fibrillar™) as a hemostatic adjunct during inflatable penile prosthesis (IPP) surgery. MATERIALS AND METHODS: Beginning in April 2016, ORC pledgets were placed within the corporotomy closures of all men undergoing IPP insertion. Perioperative characteristics and outcomes including cumulative postoperative drain output were evaluated among consecutive cases with (April 2016 to October 2016) and without ORC (December 2015 to March 2016) using an identical surgical technique by a single surgeon...
June 9, 2017: Urology
https://www.readbyqxmd.com/read/28605922/surgical-coronary-revascularization-on-pump-versus-off-pump-in-patients-with-stenosis-of-the-main-tree-of-the-left-coronary-artery-and-carotid-stenosis
#11
Edin Kabil, Bedrudin Banjanović, Emir Mujanović
OBJECTIVE: The aim of this study was to show perioperative complications of CABG procedure with and without cardiopulmonary bypass (CPB) in patients with combined coronary and carotid disease. PATIENTS AND METHODS: This retrospective survey included patients with left main stenosis greater than 50% and carotid stenosis over 50%, who had undergone CABG without carotid endarterectomy at the BH Heart Centre, from May 2009 to May 2014. The patients were divided into two groups according to the surgical method used...
May 2017: Acta Medica Academica
https://www.readbyqxmd.com/read/28602376/left-ventricular-assist-device-in-older-adults
#12
REVIEW
Chris Caraang, Gregg M Lanier, Alan Gass, Wilbert S Aronow, Chhaya Aggarwal Gupta
Left ventricular assist devices (LVADs) are an effective therapy for a growing and aging population in the background of limited donor supply. Selecting the proper patient involves assessment of indications, risk factors, scores for overall outcomes, assessment for right ventricular failure, and optimal timing of implantation. LVAD complications have a 5% to 10% perioperative mortality and complications of bleeding, thrombosis, stroke, infection, right ventricular failure, and device failure. As LVAD engineering technology evolves, so will the risk-prediction scores...
July 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/28601642/comparison-of-citrated-and-fresh-whole-blood-for-viscoelastic-coagulation-testing-during-elective-neurosurgery
#13
E Silverberg, F Tornqvist, T Kander, J Bengzon, C Solomon, J Bonnevier, U Schött
BACKGROUND: Previous viscoelastic haemostatic tests studies have often indicated a hypercoagulative test signal with citrated blood, which could influence clinical decision makings. PURPOSE: The aim of this study was to compare fresh and citrated whole blood using two non-automated viscoelastic ROTEM and Sonoclot tests. Our hypothesis was that citrated blood would demonstrate a hypercoagulative response in this setting, not tested before. METHODS: Perioperative viscoelastic coagulation changes were evaluated with a ROTEM and Sonoclot in 38 patients undergoing elective brain tumor surgery...
June 3, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28601514/does-diabetes-mellitus-impact-prognosis-after-transcatheter-aortic-valve-implantation-insights-from-a-meta-analysis
#14
Tomo Ando, Hisato Takagi, Alexandros Briasoulis, Takuya Umemoto
BACKGROUND: Diabetes mellitus (DM) is well known to increase mortality in several cardiovascular diseases. However, the prognostic impact of DM following transcatheter aortic valve implantation (TAVI) remains controversial. We sought to assess the impact of DM on perioperative (in-hospital or 30-day) complications and mid-term (≥1 year) all-cause mortality after TAVI through meta-analysis. METHODS: A comprehensive literature search of PUBMED and EMBASE was conducted through January 1st 2002 to May 15th 2016...
June 7, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28589690/perioperative-management-of-new-oral-anticoagulants-in-patients-undergoing-elective-surgery-at-a-tertiary-hospital
#15
Henry Wamala, Ian A Scott, Xenia Caney
BACKGROUND: Increasing numbers of patients receiving new oral anticoagulants (NOACs) are undergoing elective surgery. The extent to which perioperative interruption of NOAC therapy and use of bridging heparin are concordant with best evidence is uncertain. METHODS: Retrospective study of consecutive adult patients undergoing elective surgery at a tertiary hospital between January 1(st) 2014 and June 30(th) 2015 and were receiving NOACs for at least 3 months prior to surgery...
June 7, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28587360/the-value-of-sonoclot-detection-technology-to-guide-the-clinical-medication-of-the-perioperative-anticoagulation-and-antiplatelet-therapy-in-patients-with-acute-myocardial-infarction-undergoing-emergent-pci
#16
Wu-Xiao Yang, Chun-Lin Lai, Fu-Heng Chen, Ji-Rong Wang, You-Rui Ji, Dong-Xia Wang
The value of Sonoclot detection technology to guide the clinical medication of the perioperative anticoagulation and antiplatelet therapy in patients with acute myocardial infarction (AMI) undergoing emergent percutaneous coronary intervention (PCI) was estimated. One hundred and twenty-eight patients were randomly divided into control group and observation group with 64 cases in each group. Control group adopted routine blood coagulation indexes, including prothrombin time, activated partial thromboplastin time, fibrinogen and plasma thrombin time, platelet count and platelet aggregation turbidity analysis; observation group adopted Sonoclot detection technology, including activated clotting time, coagulation rate and platelet function...
June 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28582301/reducing-postoperative-bleeding-after-craniosynostosis-repair-utilizing-a-low-dose-transexamic-acid-infusion-protocol
#17
Jennifer K Hansen, Anna M Lydick, Matthew M Wyatt, Brian T Andrews
BACKGROUND: Craniosynostosis surgery is associated with large volume blood loss and the need for blood transfusion. Recently, the use of tranexamic acid (TXA) has been demonstrated to be helpful in reducing perioperative blood loss in many pediatric procedures. This study used a low-dose pharmacokinetic TXA dosing protocol and assessed its ability to limit perioperative blood loss for craniosynostosis repairs. METHODS: A retrospective chart review was conducted of pediatric craniosynostosis surgeries performed at our institution between September 2011 and December 2014...
June 2, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28582287/does-cleft-palate-width-correlate-with-veau-classification-and-outcome
#18
Robin Wu, Shayan Cheraghlou, Yassmin Parsaei, Roberto Travieso, Derek M Steinbacher
PURPOSE: Wider cleft palates are thought to be associated with increased complications and poorer outcomes following cleft palate repair. Objective cleft palate photographic measurement and assessment of complications have not been previously performed. The purpose of this study is to quantitatively characterize a series of cleft palate dimensions and to investigate possible correlations with Veau classification and intra-, peri-, and postoperative outcomes. METHODS: The analytic sample included primary cleft palate repairs performed by the senior author over a 2-year period...
June 2, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28580075/role-of-vasopressin-in-current-anesthetic-practice
#19
REVIEW
Keun Suk Park, Kyung Yeon Yoo
Arginine vasopressin (AVP), also known as antidiuretic hormone, is a peptide endogenously secreted by the posterior pituitary in response to hyperosmolar plasma or systemic hypoperfusion states. When administered intravenously, it causes an intense peripheral vasoconstriction through stimulation of V1 receptors on the vascular smooth muscle. Patients in refractory shock associated with severe sepsis, cardiogenic or vasodilatory shock, or cardiopulmonary bypass have inappropriately low plasma levels of AVP ('relative vasopressin deficiency') and supersensitivity to exogenously-administered AVP...
June 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28578084/a-novel-surgical-strategy-for-secondary-hyperparathyroidism-purge-parathyroidectomy
#20
Cheng-Xiang Shan, Nian-Cun Qiu, Si-Luo Zha, Miao-E Liu, Qiang Wang, Pei-Pei Zhu, Zhi-Peng Du, Chun-Yan Xia, Ming Qiu, Wei Zhang
OBJECTIVE: This study was intended to demonstrate the feasibility and efficacy of purge parathyroidectomy (PPTX) for patients with secondary hyperparathyroidism (SHPT). METHODS: The "seed, environment, and soil" medical hypothesis was first raised, following review of the literatures, to demonstrate the possible causes of persistence or recurrence of SHPT after parathyroidectomy. Subsequently, the novel surgical strategy of PPTX was proposed, which involves comprehensive resection of the fibro-fatty tissues, including visible or invisible parathyroid, within the region surrounded by the thyroid cartilage, bilateral carotid artery sheath, and the brachiocephalic artery...
May 31, 2017: International Journal of Surgery
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