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Emergency general surgery

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https://www.readbyqxmd.com/read/28728520/in-and-out-hospital-mortality-rate-in-surgical-patients
#1
Philippe Dony, Magali Pirson, Jean G Boogaerts
BACKGROUND: Death rates after surgery are increasingly analysed for clinical audit and quality assessment. Many studies commonly provide information only on deaths that occur during hospital stay, known as in-hospital death rates. By using hospital data set linked to death certificate registry, we recorded in- and out-hospital deaths within 30 and 60 post-operative days. METHODS: The study included all consecutive surgical procedures (denominator) under general or locoregional anaesthesia in adult patients admitted for elective or non-elective inpatient surgery...
July 20, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28727632/a-prospective-randomized-controlled-trial-comparing-quality-of-life-following-endoscopic-totally-extraperitoneal-tep-versus-open-stoppa-inguinal-hernioplasty
#2
Jitendra K Kushwaha, Loreno E Enny, Akshay Anand, Abhinav A Sonkar, Awanish Kumar, Harvinder S Pahwa
In inguinal hernia surgery, quality of life (QOL) has emerged as a striking issue. Evidence suggests better QOL of patients operated with laparoscopic procedure as compared with open anterior hernia repairs. However data are scarce with relation to open posterior repair in terms of QOL issues. A prospective randomized single-blind study from November 2014 to October 2015 including all patients who underwent elective primary endoscopic [totally extraperitoneal (TEP)] or open Stoppa inguinal hernia repair was undertaken...
July 19, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28722299/cost-and-health-care-utilization-implications-of-bariatric-surgery-versus-intensive-lifestyle-and-medical-intervention-for-type-2-diabetes
#3
Souvik Banerjee, Louis P Garrison, David R Flum, David E Arterburn
OBJECTIVE: The aim of this study was to compare the cost and health care utilization of patients with obesity and type 2 diabetes mellitus (T2DM) randomized into either Roux-en-Y gastric bypass (RYGB) surgery or an intensive lifestyle and medical intervention (ILMI). METHODS: This analysis (N = 745) is based on 2-year follow-up of a small randomized controlled trial (RCT); adult patients with obesity and T2DM were recruited between 2011 and 2012 from Kaiser Permanente Washington...
July 19, 2017: Obesity
https://www.readbyqxmd.com/read/28721690/pre-or-postoperative-interscalene-block-and-or-general-anesthesia-for-arthroscopic-shoulder-surgery-a-retrospective-observational-study
#4
Laura Bosco, Cheng Zhou, John A C Murdoch, Ryan Bicknell, Wilma M Hopman, Rachel Phelan, Vidur Shyam
PURPOSE: Arthroscopic shoulder surgery can be performed with an interscalene brachial plexus block (ISBPB) alone, ISBPB combined with general anesthesia (GA), or GA alone. Postoperative pain is typically managed with opioids; however, both GA and opioids have adverse effects which can delay discharge. This retrospective study compares the efficacy of four methods of anesthesia management for arthroscopic shoulder surgery. METHODS: Charts of all patients who underwent shoulder surgery by a single surgeon from 2012-2015 were categorized by analgesic regimen: GA only (n = 177), single-shot ISBPB only (n = 124), or pre- vs postoperative ISBPB combined with GA (ISBPB + GA [n = 72] vs GA + ISBPB [n = 52], respectively)...
July 18, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28719872/health-related-quality-of-life-in-patients-undergoing-lumbar-total-disc-replacement-a-comparison-with-the-general-population
#5
Pablo Clavel, Gheorghe Ungureanu, Ignasia Catalá, Guillermo Montes, Xavier Málaga, Moisés Ríos
OBJECTIVES: In up to half of the cases, low back pain (LBP) is thought to be related to a degeneration of the lumbar disc. Lumbar total disc replacement (LTDR) emerged as an alternative to fusion, but its use and indications are still subject to debate. The purpose of this paper was to compare Health-related Quality of life (HRQOL) in patients undergoing LTDR for one or two-level degenerative disc disease (DDD) with the paired age and gender general population values and to assess functional disability and residual pain at one year after the surgical procedure...
July 11, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28718887/operative-learning-curve-trajectory-in-a-cohort-of-surgical-trainees
#6
C Brown, T Abdelrahman, N Patel, C Thomas, M J Pollitt, W G Lewis
BACKGROUND: Certification of completion of training in general surgery in the UK requires demonstration of competence in index operations by means of three level 4 competence consultant-validated procedure-based assessments (PBAs). The aim of this study was to evaluate the trajectory of operative learning curves related to PBA performance levels for curriculum-defined indicative operations with respect to numbers performed and training time. METHODS: Logbook data from consecutive higher general surgical trainees were compared with PBA evaluations to determine the relationship between PBA performance level, operative experience, training time and indicative numbers...
July 18, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28713660/a-cross-sectional-pharmacoepidemiological-study-of-the-utilization-pattern-of-pre-anesthetic-medications-in-major-surgical-procedures-in-a-tertiary-care-hospital
#7
Madhuri Kulkarni, Anant Patil
OBJECTIVE : A study of the utilization pattern of pre-anesthetic medications in major surgical procedures. MATERIAL AND METHODS : A cross-sectional, pharmacoepidemiological study was conducted among patients undergoing surgical procedures in routine or emergency conditions under general anesthesia. The utilization of pre-anesthetic medicines in all patients was reported. RESULTS: A total of 110 patients (mean age - 42.36 years; 57.27% males) were enrolled...
June 13, 2017: Curēus
https://www.readbyqxmd.com/read/28712687/assessing-residents-readiness-for-or-autonomy-a-qualitative-descriptive-study-of-expert-surgical-teachers-best-practices
#8
Xiaodong Phoenix Chen, Amy M Sullivan, Adnan Alseidi, Gifty Kwakye, Douglas S Smink
PURPOSE: Providing resident autonomy in the operating room (OR) is one of the major challenges for surgical educators today. The purpose of this study was to explore what approaches expert surgical teachers use to assess residents' readiness for autonomy in the OR. We particularly focused on the assessments that experts make prior to conducting the surgical time-out. METHODS: We conducted semistructured in-depth interviews with expert surgical teachers from March 2016 to September 2016...
July 13, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28708753/effectiveness-of-preoperative-intranasal-dexmedetomidine-compared-with-oral-midazolam-for-the-prevention-of-emergence-delirium-in-the-pediatric-patient-undergoing-general-anesthesia-a-systematic-review
#9
James FitzSimons, Laura S Bonanno, Stephanie Pierce, Jennifer Badeaux
BACKGROUND: Emergence delirium is defined as a cognitive disturbance during emergence from general anesthesia resulting in hallucinations, delusions and confusion manifested by agitation, restlessness, involuntary physical movement and extreme flailing in bed. Postoperative emergence delirium develops in 12% to 18% of all children undergoing general anesthesia for surgery. This post-anesthetic phenomenon changes cognitive and psychomotor behavior, and puts pediatric patients and health care personnel at risk of injury...
July 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28708016/emergency-separation-of-craniopagus-twins-case-report
#10
Farideh Nejat, Zohreh Habibi, Mehrdad Goudarzi, Mahdi Souraki Azad, Ehsan Moradi, Vahid Heidari, Maliheh Kadivar, Zahra Ebrahim Soltani, Leila Kouchakzadeh
Craniopagus is a very rare congenital anomaly that tends to affect females more often than males. It is classified as partial or total. Most affected twins are either stillborn or die during the perinatal period. Those who survive birth should undergo detailed radiological evaluations soon after their condition becomes stable so that the precise anatomy of the conjoined part can be defined and surgery can be planned in detail by a multidisciplinary team. Recommendations for decreasing the risk of unsuccessful surgery include performing surgery on an elective basis after extensive preoperative radiological evaluations as well as when the twins are at an acceptable age and weight for a complex surgical separation, generally as staged procedures...
July 14, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28707046/understanding-the-post-surgical-bariatric-experiences-of-patients-two-or-more-years-after-surgery
#11
Rebecca H Liu, Jennifer D Irwin
BACKGROUND: In Canada, one year after bariatric surgery follow-up appointments become less frequent and surgical recipients must cope with weight management more independently. Up to 50% of patients experience weight regain by two years post-surgery. Understanding the lived experiences of those who have gone through the bariatric process may shed light on what is needed to support others moving forward. Therefore, the purpose of the study was to gain an understanding of the physical, psychological, social, and clinic-related experiences of individuals who have undergone bariatric surgery at least two years prior...
July 13, 2017: Quality of Life Research
https://www.readbyqxmd.com/read/28704248/low-end-tidal-carbon-dioxide-at-the-onset-of-emergent-trauma-surgery-is-associated-with-nonsurvival-a-case-series
#12
Roman Dudaryk, Danielle K Bodzin, Juliet J Ray, Craig S Jabaley, Richard R McNeer, Richard H Epstein
BACKGROUND: End-tidal carbon dioxide (EtCO2) is a valuable marker of the return of adequate circulation following cardiac arrest due to medical causes. Previously, the prognostic value of capnography in trauma has been studied among limited populations in prehospital and emergency department settings. We aimed to investigate the relationship between early intraoperative EtCO2 and nonsurvival of patients undergoing emergency surgery at a level 1 academic trauma center as a case series...
July 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28703109/comparative-analysis-of-immediate-postoperative-complications-following-total-gastrectomy
#13
Samantha McKenzie Stancu, Bogdan Popescu
INTRODUCTION: Total gastrectomy (TG), despite disrupting the continuity of the alimentary tract and accounting for significant postoperative complications, is the procedure of choice for curative resection of gastric carcinoma. The objectives of this study were to report the rate of postoperative complications following TG, to analyze adverse postoperative outcomes, and to determine which of the two techniques - the Roux-en-Y esophagojejunostomy and Omega-Braun TG, is safer. MATERIALS AND METHODS: A retrospective, observational study was conducted among patients diagnosed with gastric carcinoma who underwent TG between January 1st, 2010 and December 31st, 2012 in the Surgery Department of the Bucharest Clinical Emergency Hospital...
June 30, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28702382/epidemiology-of-pelvic-ring-fractures-and-injuries
#14
Gilberto José Cação Pereira, Erick Ribeiro Damasceno, Daniel Innocenti Dinhane, Francisco Marques Bueno, Jaqueline Bartelega Rodrigues Leite, Bruno da Costa Ancheschi
OBJECTIVE: This study evaluated the pelvic ring fractures and injuries in patients admitted to and treated at this ward between August, 2012 and January, 2014. METHODS: 66 patients were submitted to treatment protocols according to their age, gender, skin color, injury mechanism, location of the trauma, classification of their injuries, emergency intervention, associated injuries, injured side of the body, treatment, and mortality. The most relevant data were classified according to statistic procedures, such as Goodman's association test...
May 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28701933/network-efficiency-and-posterior-alpha-patterns-are-markers-of-recovery-from-general-anesthesia-a-high-density-electroencephalography-study-in-healthy-volunteers
#15
Stefanie Blain-Moraes, Vijay Tarnal, Giancarlo Vanini, Tarik Bel-Behar, Ellen Janke, Paul Picton, Goodarz Golmirzaie, Ben J A Palanca, Michael S Avidan, Max B Kelz, George A Mashour
Recent studies have investigated local oscillations, long-range connectivity, and global network patterns to identify neural changes associated with anesthetic-induced unconsciousness. These studies typically employ anesthetic protocols that either just cross the threshold of unconsciousness, or induce deep unconsciousness for a brief period of time-neither of which models general anesthesia for major surgery. To study neural patterns of unconsciousness and recovery in a clinically-relevant context, we used a realistic anesthetic regimen to induce and maintain unconsciousness in eight healthy participants for 3 h...
2017: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/28698761/vagus-nerve-stimulation
#16
REVIEW
Hakan Ekmekçi, Hülagu Kaptan
BACKGROUND: The vagus nerve stimulation (VNS) is an approach mainly used in cases of intractable epilepsy despite all the efforts. Also, its benefits have been shown in severe cases of depression resistant to typical treatment. AIM: The aim of this study was to present current knowledge of vagus nerve stimulation. MATERIAL AND METHODS: A new value has emerged just at this stage: VNS aiming the ideal treatment with new hopes. It is based on the placement of a programmable generator on the chest wall...
June 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28697289/bariatric-metabolic-surgery-a-guide-for-the-primary-care-physician
#17
Phong Ching Lee, John Dixon
BACKGROUND: Bariatric-metabolic surgery has emerged as an attractive option that offers significant and durable weight loss in the treatment of clinically severe obesity. Given the high prevalence of obesity, and growing numbers of bariatric-metabolic surgeries performed, primary care physicians increasingly encounter patients who have had, or are considering, bariatric-metabolic surgery. OBJECTIVE: The aim of this article is to provide guidance on common issues pertaining to bariatric-metabolic surgery that general practitioners (GPs) face, including patient selection, preoperative work-up, acute and long-term complications following the surgery, and long-term lifestyle and nutritional support...
2017: Australian Family Physician
https://www.readbyqxmd.com/read/28695876/impact-of-obesity-on-surgical-outcome-after-single-incision-laparoscopic-cholecystectomy
#18
Toru Obuchi, Noriaki Kameyama, Masato Tomita, Hiroaki Mitsuhashi, Ryohei Miyata, Shigeaki Baba
INTRODUCTION: Single-incision laparoscopic cholecystectomy (SILC) is widely used as a treatment option for gallbladder disease. However, obesity has been considered a relative contraindication to this approach due to more advanced technical difficulties. The aim of this report was to review our experience with SILC to evaluate the impact of body mass index (BMI) on the surgical outcome. PATIENTS AND METHODS: Between May 2009 and February 2013, 237 patients underwent SILC at our institute...
July 7, 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28695560/minimally-invasive-extracorporeal-circulation-excellent-outcome-and-life-expectancy-after-coronary-artery-bypass-grafting-surgery
#19
Bernhard Winkler, Paul Philipp Heinisch, Grzegorz Zuk, Katarzyna Zuk, Brigitta Gahl, Hans-Jörg Jenni, Alexander Kadner, Christoph Huber, Thierry Carrel
OBJECTIVE: Coronary artery bypass grafting (CABG) remains the gold standard for complex revascularisation in multivessel disease. The concept of the minimally invasive extracorporeal circulation circuit (MiECC) was introduced to minimise pathophysiological side effects of conventional extracorporeal circulation. This study presents early and long-term outcomes after CABG with use of MiECC in a single-centre consecutive patient cohort. METHODS: From 1 January 2005 to 31 December 2010, 2130 patients underwent isolated CABG with MiECC at our centre...
July 11, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28692564/is-trainee-participation-really-associated-with-adverse-outcomes-in-emergency-general-surgery
#20
Mandy Mak, Sarah Ashford-Wilson, Abdul R Hakeem, Vivek Chitre
No abstract text is available yet for this article.
August 2017: Annals of Surgery
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