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Perioperative bleeding

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https://www.readbyqxmd.com/read/28229197/minimally-invasive-percutaneous-nephrolithotomy-vs-standard-pcnl-for-management-of-renal-stones-in-the-flank-free-modified-supine-position-single-center-experience
#1
Ahmed Sakr, Emad Salem, Mostafa Kamel, Esam Desoky, Ahmed Ragab, Mohamed Omran, Amr Fawzi, Ashraf Shahin
To assess the safety and efficacy of minimally invasive percutaneous nephrolithotomy (mPCNL) as compared to standard PCNL (sPCNL) for management of 2-3-cm renal stones in the flank-free modified supine position. Between September 2010 and December 2013, 150 patients (168 renal units) with 2-3-cm renal stones were prospectively randomized into two treatment groups; Group A (75 patients/87 renal units) treated by mPCNL and Group B (75 patients/81 renal units) treated by sPCNL. In both groups, the patients were placed in the flank-free modified supine position...
February 22, 2017: Urolithiasis
https://www.readbyqxmd.com/read/28228885/omental-flap-transposition-for-inferior-vena-cava-filter-penetration
#2
Junji Yamaguchi, Takamichi Miyamoto, Nobuhiro Hara, Tetsuo Yamaguchi, Tomoyuki Umemoto
A 40-year-old woman presented with uterine malignancy, deep vein thrombosis, and nonmassive pulmonary embolism in both lungs. Gunter-tulip filter was inserted, because she had severe genital bleeding, which is one of the contraindications to anticoagulation therapy. Total hysterectomy was conducted and anticoagulation therapy was started afterward. The thrombus worsened perioperatively, and the filter could not be retrieved. Since there was lymph node recurrence, the second time operation was performed. During operation, the struts were found to be penetrating the inferior vena cava...
March 2017: Radiology case reports
https://www.readbyqxmd.com/read/28228199/the-efficacy-of-dextran-40-as-a-venous-thromboembolism-prophylaxis-strategy-in-cytoreductive-surgery-and-hyperthermic-intraperitoneal-chemotherapy
#3
Jason M Foster, Richard Sleightholm, Duncan Watley, Steven Wahlmeier, Asish Patel
The incidence of venous thromboembolism (VTE) in peritoneal malignancies can approach 30 to 50 per cent without prophylaxis. Prophylaxis in cytoreductive surgeries (CRS) presents a challenge to preoperative heparin-based therapy because of an increased risk of coagulopathy and potential for bleeding. Herein, we report the large series of CRS and hyperthermic intraperitoneal chemotherapy receiving dextran-40 prophylaxis. Retrospective chart review of peritoneal malignancies patients undergoing CRS at University of Nebraska Medical Center identified 69 individuals who received dextran-40 between 2010 and 2013...
February 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28226349/-prevention-and-treatment-of-complications-related-to-the-digestive-tract-reconstruction-in-laparoscopic-gastric-cancer-surgery
#4
Junsheng Peng, Shi Chen
With the development of laparoscopic techniques and equipments, laparoscopic-assisted, even total laparoscopic radical surgery for gastric cancer can be performed successfully. However, the incidence of postoperative complications is higher in the laparoscopy group as compared to the open-surgery group, which is still the barrier for the total laparoscopic radical gastrectomy. Similar to open surgery, the major complications of digestive tract reconstruction after laparoscopic radical gastrectomy are anastomotic leakage, anastomotic bleeding, anastomotic stricture and stenosis of input or output loop...
February 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28225801/perioperative-hemoglobin-area-under-the-curve-is-an-independent-predictor-of-renal-failure-after-cardiac-surgery-results-from-a-spanish-multicenter-retrospective-cohort-study
#5
Paula Duque-Sosa, Diego Martínez-Urbistondo, Gemma Echarri, Raquel Callejas, María Josefa Iribarren, Gregorio Rábago, Pablo Monedero
Perioperative anemia is an important risk factor for cardiac surgery-associated acute kidney injury (CSA-AKI). Nonetheless, the severity of the anemia and the time in the perioperative period in which the hemoglobin level should be considered as a risk factor is conflicting. The present study introduces the concept of perioperative hemoglobin area under the curve (pHb-AUC) as a surrogate marker of the evolution of perioperative hemoglobin concentration. Through a retrospective analysis of prospectively collected data, we assessed this new variable as a risk factor for the development of acute kidney injury after cardiac surgery in 966 adult patients who underwent cardiac surgery with cardiopulmonary bypass, at twenty-three academic hospitals in Spain...
2017: PloS One
https://www.readbyqxmd.com/read/28224648/impacts-of-disease-severity-on-postoperative-complications-in-children-with-sleep-disordered-breathing
#6
Kun-Tai Kang, I-Sheng Chang, Chia-Chen Tseng, Wen-Chin Weng, Tzu-Yu Hsiao, Pei-Lin Lee, Wei-Chung Hsu
OBJECTIVES/HYPOTHESIS: To investigate the effects of diseases severity on postoperative complications following adenotonsillectomy (T&A) in children with sleep-disordered breathing (SDB). STUDY DESIGN: Retrospective study. METHODS: Children aged <18 years were enrolled and underwent T&A for treating SDB. Polysomnography was used to classify the disease severity: primary snoring (apnea-hypopnea index [AHI] <1), mild (AHI = 1-5), moderate (AHI = 5-10), and severe obstructive sleep apnea [OSA] (AHI ≥10)...
February 22, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28222991/perioperative-clopidogrel-is-associated-with-increased-bleeding-and-blood-transfusion-at-the-time-of-lower-extremity-bypass
#7
Douglas W Jones, Marc L Schermerhorn, Benjamin S Brooke, Mark F Conrad, Philip P Goodney, Mark C Wyers, David H Stone
OBJECTIVE: Controversy persists surrounding the perceived bleeding risk associated with perioperative clopidogrel use in patients undergoing lower extremity bypass (LEB). The purpose of this study was to examine the LEB bleeding risk and clinical sequelae associated with clopidogrel. METHODS: All LEBs in the Vascular Quality Initiative (VQI) from 2008 to 2014 were studied. The exposure was perioperative clopidogrel. Primary outcomes were blood transfusion, estimated blood loss ≥500 mL, and reoperation for bleeding...
February 17, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28219665/comparison-of-hospital-outcome-of-transcatheter-versus-surgical-aortic-valve-replacement-in-patients-with-diabetes-mellitus-from-the-nationwide-inpatient-sample
#8
Tomo Ando, Emmanuel Akintoye, Tesfaye Telila, Alexandros Briasoulis, Hisato Takagi, David P Slovut, Theodore Schreiber, Cindy L Grines, Luis Afonso
The comparative outcomes of transcatheter aortic valve replacement (TAVR) versus surgical aortic valve replacement (SAVR) in diabetes mellitus (DM) patients are scarce. We aimed to assess and compare the outcomes of TAVR versus SAVR in DM patients using the Nationwide Inpatient Sample database from 2011 to 2013. A complete case analysis was performed for the multivariate analysis and cases with missing data were excluded. The primary end point was in-patient all-cause mortality and secondary outcomes were perioperative complications...
January 25, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28217677/delayed-hemorrhage-effect-of-local-anesthesia-with-epinephrine-in-the-loop-electrosurgical-excisional-procedure
#9
Yong Jae Lee, Yunjin Park, In Ok Lee, Jung Won Yoon, Jung Yoon Lee, Sang Wun Kim, Sunghoon Kim, Young Tae Kim, Eun Ji Nam
OBJECTIVE: The aim of this study was to investigate factors preventing delayed hemorrhage after the loop electrosurgical excisional procedure (LEEP). METHODS: Medical records of patients who underwent LEEP at one university affiliated hospital from October 2013 to January 2015 were reviewed. Patients with or without delayed hemorrhage were classified. LEEP was performed either in an operating room under general anesthesia or in a procedure room with local anesthesia in the outpatient clinic...
January 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/28214484/hybrid-operative-thrombectomy-is-noninferior-to-percutaneous-techniques-for-the-treatment-of-acute-iliofemoral-deep-venous-thrombosis
#10
Limael E Rodríguez, Aihab Aboukheir-Aboukheir, Ricardo Figueroa-Vicente, Hiram Soler-Bernardini, Guillermo Bolanos-Avila, Luis J Torruella-Bartolomei, Anthony J Comerota, Jorge L Martinez-Trabal
OBJECTIVE: Hybrid operative thrombectomy (HOT) is a novel technique for the treatment of acute iliofemoral deep venous thrombosis (IFDVT) and is an alternative to percutaneous techniques (PTs) that use thrombolytics. In this study, we compare perioperative and intermediate outcomes of HOT vs PT as interventions for early thrombus removal. METHODS: From July 2008 to May 2015, there were 71 consecutive patients who were treated with either PT (n = 31) or HOT (n = 40) for acute or subacute single-limb IFDVT...
March 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28213669/aspirin-use-prior-to-coronary-artery-bypass-grafting-surgery-a-systematic-review
#11
REVIEW
Ayman Elbadawi, Marwan Saad, Ramez Nairooz
PURPOSE OF REVIEW: Aspirin use before coronary artery bypass graft (CABG) surgery has been a puzzling question for years. Controversy existed regarding the overall benefits vs. risk of pre-operative aspirin use and was translated to conflicting guidelines from major societies. RECENT FINDINGS: Observational studies have suggested a reduced mortality with pre-operative aspirin use. A meta-analysis of randomized controlled trials showed increased risk of post-operative bleeding with aspirin, with no associated increased mortality risk...
February 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28210451/dental-management-of-patients-taking-novel-oral-anticoagulants-noas-dabigatran
#12
REVIEW
Adrian Curto, Alberto Albaladejo, Alfonso Alvarado
BACKGROUND: A new group of oral anticoagulants (dabigatran, rivaroxaban, apixaban and edoxaban) with clear advantages over classic dicoumarin oral anticoagulants (warfarin and acenocoumarol) has been developed in recent years. Patients being treated with oral anticoagulants are at higher risk for bleeding when undergoing dental treatments. MATERIAL AND METHODS: A literature search was conducted through April 2016 for publications in the ISI Web of Knowledge, PubMed and Cochrane Library using the keywords "dabigatran", "rivaroxaban", "apixaban", "edoxaban", "new oral anticoagulants", "novel oral anticoagulants", "bleeding" and "dental treatment"...
February 2017: Journal of Clinical and Experimental Dentistry
https://www.readbyqxmd.com/read/28207537/lymph-node-dissection-for-siewert-ii-esophagogastric-junction-adenocarcinoma-a-retrospective-study-of-3-surgical-procedures
#13
Xiao-Feng Duan, Jie Yue, Peng Tang, Xiao-Bin Shang, Hong-Jing Jiang, Zhen-Tao Yu
The present study was aimed to investigate the application of right thansthoracic Ivor-Lewis (IL), left transthoracic (LTT), and left thoracoabdominal (LTA) approach in Siewert type II adenocarcinoma of esophagogastric junction (AEG).The data of 196 patients with Siewert type II AEG received surgical resection in our cancer center between January 2014 and April 2016 was retrospectively analyzed. Finally, 136 patients met the inclusion criteria were enrolled in the study and divided into the IL (47 cases), LTT (51 cases), and LTA group (38 cases)...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28203535/the-state-of-robotic-cardiac-surgery-in-europe
#14
Matteo Pettinari, Emiliano Navarra, Philippe Noirhomme, Herbert Gutermann
BACKGROUND: In the past two decades, the introduction of robotic technology has facilitated minimally invasive cardiac surgery, allowing surgeons to operate endoscopically rather than through a median sternotomy. This approach has facilitated procedures for several structural heart conditions, including mitral valve repair, atrial septal defect closure and multivessel minimally invasive coronary artery bypass grafting. In this rapidly evolving field, we review the status of robotic cardiac surgery in Europe with a focus on mitral valve surgery and coronary revascularization...
January 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28194489/the-effect-of-preoperative-anemia-on-the-outcome-after-coronary-surgery
#15
Tuomas Tauriainen, Joni Koski-Vähälä, Eeva-Maija Kinnunen, Fausto Biancari
BACKGROUND: Preoperative anemia is associated with increased morbidity and mortality after cardiac surgery. Since anemia is ultimately treated with red blood cell transfusions, we investigated the independent impact of anemia and transfusion on the outcome after coronary artery bypass grafting (CABG). METHODS: This study included 2761 consecutive patients who underwent isolated CABG. Anemia was defined as hemoglobin <12.0 g/dL in women and <13.0 g/dL in men...
February 13, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28193282/preoperative-embolization-in-patients-with-metastatic-spinal-cord-compression-mandatory-or-optional
#16
Chul Gie Hong, Jae Hwan Cho, Dae Chul Suh, Chang Ju Hwang, Dong-Ho Lee, Choon Sung Lee
BACKGROUND: The contribution of preoperative embolization in reducing intraoperative blood loss and its clinical importance are unclear. So, we aimed to compare the perioperative clinical outcomes based on whether preoperative embolization was performed and assess the role and safety of preoperative embolization in metastatic spinal cord compression (MSCC) patients. METHODS: We enrolled 52 patients (men, 37; women, 15) who underwent palliative decompression for MSCC...
February 14, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28191744/endovascular-therapy-for-angio-seal-tm-related-acute-limb-ischemia-perioperative-and-long-term-results
#17
Hui Dong, Meng Peng, Xiongjing Jiang, Wuqiang Che, Yubao Zou, Bo Xu, Yuejin Yang, Runlin Gao
OBJECTIVES: To investigate the perioperative and long-term outcomes of endovascular therapy for Angio-seal(TM) -related acute limb ischemia. BACKGROUND: Currently, limited data are available on the optimal treatment strategy for Angio-seal(TM) -related acute lower limb ischemia. METHODS: The prospectively maintained patient database of our institution was retrospectively searched to identify all patients who developed acute lower limb ischemia after use of the Angio-Seal(TM) and received endovascular treatment from January 2010 to February 2016...
February 13, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28190717/perioperative-outcomes-of-infrainguinal-bypass-surgery-in-patients-with-and-without-prior-revascularization
#18
Thomas C F Bodewes, Klaas H J Ultee, Peter A Soden, Sara L Zettervall, Katie E Shean, Douglas W Jones, Frans L Moll, Marc L Schermerhorn
OBJECTIVE: Although an increasing number of patients with peripheral arterial disease undergo multiple revascularization procedures, the effect of prior interventions on outcomes remains unclear. The purpose of this study was to evaluate perioperative outcomes of bypass surgery in patients with and those without prior ipsilateral treatment. METHODS: Patients undergoing nonemergent infrainguinal bypass between 2011 and 2014 were identified in the National Surgical Quality Improvement Program Targeted Vascular module...
February 9, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28190568/predictable-factors-of-deep-venous-thrombosis-in-patients-undergoing-spine-surgery
#19
Terumasa Ikeda, Hiroshi Miyamoto, Kazuki Hashimoto, Masao Akagi
BACKGROUND: DVT is one of the major postoperative complications of joint replacement surgery of the lower extremity which can cause catastrophic complications such as pulmonary embolism. However, little is known about the incidence of DVT after spine surgery. The purpose of this study was to examine predictable factors of DVT after spine surgery. METHODS: This study included 194 patients who underwent spine surgery (104 males, 90 females, mean age 65.7 years). Postoperative DVT was detected using duplex ultrasonography (DUS)...
February 9, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28184261/dual-antiplatelet-therapy-and-non-cardiac-surgery-evolving-issues-and-anesthetic-implications
#20
REVIEW
Jong Wook Song, Sarah Soh, Jae-Kwang Shim
Dual antiplatelet therapy (DAPT) consisting of aspirin plus a P2Y12 inhibitor (clopidogrel, prasugrel, or ticagrelor) is imperative for the treatment of acute coronary syndrome, particularly during the re-endothelialization period after percutaneous coronary intervention (PCI). When patients undergo surgery during this period, the consequences of stent thrombosis are far more serious than those of bleeding complications, except in cases of intracranial surgery. The recommendations for perioperative DAPT have changed with emerging evidence regarding the improved efficacy of non-first-generation drug (everolimus, zotarolimus)-eluting stents (DES)...
February 2017: Korean Journal of Anesthesiology
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