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Intraoperative monitorering

R Bosc, A Fitoussi, B Hersant, T-H Dao, J-P Meningaud
Although the term augmented reality appears increasingly in published studies, the real-time, image-guided (so-called 'hands-free' and 'heads-up') surgery techniques are often confused with other virtual imaging procedures. A systematic review of the literature was conducted to classify augmented reality applications in the fields of maxillofacial surgery. Publications containing the terms 'augmented reality', 'hybrid reality', and 'surgery' were sought through a search of three medical databases, covering the years 1995-2018...
October 10, 2018: International Journal of Oral and Maxillofacial Surgery
K Iwamoto, J Iizuka, Y Hashimoto, T Kondo, T Takagi, K Hata, K Unagami, M Okumi, H Ishida, K Tanabe
OBJECTIVES: We aimed to evaluate the feasibility and efficacy of surgical prostatectomy in renal transplant recipients (RTRs). METHODS: Between January 2008 and February 2017, we identified 13 RTRs who were diagnosed with localized prostate cancer and underwent radical prostatectomy. We reviewed all available clinicopathologic data for these 13 patients. RESULTS: The median patient age was 61 years and median serum prostate-specific antigen (PSA) was 8...
October 2018: Transplantation Proceedings
Zhimin Li, Jun Gao, Tianyu Wang, Yongning Li
To investigate effects of microvascular decompression (MVD) surgical treatment on hemifacial spasm.A retrospective analysis of 320 adult patients (95 male cases, 29.7% and 225 female cases, 70.3%) with hemifacial spasm treated by surgery was conducted between February 2007 to June 2016, with an average age of 49.3 years and average disease course of 4.9 years. All the 320 cases of patients received MVD. After surgery, all patients were followed up for an average of 2.3 years. Surgical effects were evaluated based on the patients' symptoms and signs...
October 2018: Medicine (Baltimore)
Hong Fu, Kai Sun, Jun Li, Weiyi Gong, Vatche Agopian, Min Yan, Ronald W Busuttil, Randolph H Steadman, Victor W Xia
Nonselective Beta blockade (NSBB) is commonly prescribed for liver transplantation (LT) candidates, but its impact on intraoperative hemodynamics is not well understood. In this study, we investigated if preoperative NSBB was associated with severe bradycardia during LT and if severe intraoperative bradycardia was associated with 30-day mortality. Adult patients undergoing LT between 2005 and 2014 were included. Propensity matching was used to control selection bias. Intraoperative hemodynamics were compared between patients with and without preoperative NSBB...
October 12, 2018: Clinical Transplantation
Go Yoshida, Muneharu Ando, Shiro Imagama, Shigenori Kawabata, Kei Yamada, Tsukasa Kanchiku, Yasushi Fujiwara, Nobuaki Tadokoro, Masahito Takahashi, Kanichiro Wada, Naoya Yamamoto, Sho Kobayashi, Hiroki Ushirozako, Kazuyoshi Kobayashi, Akimasa Yasuda, Kenichi Shinomiya, Toshikazu Tani, Yukihiro Matsuyama
STUDY DESIGN: Prospective multicenter study OBJECTIVE.: To analyze the incidence of intraoperative spinal neuromonitoring (IONM) alerts and neurological complications, as well as to determine which interventions are most effective at preventing postoperative neurological complications following IONM alerts in high risk spinal surgeries. SUMMARY OF BACKGROUND DATA: IONM may play a role in identifying and preventing neural damage; however, few studies have clarified the outcomes of intervention after IONM alerts...
October 11, 2018: Spine
Gianluca Nazzaro, Giovanni Genovese, Athanasia Tourlaki, Emanuela Passoni, Emilio Berti, Lucia Brambilla
BACKGROUND: Intralesional vincristine is an effective treatment for Kaposi's sarcoma (KS) nodules on the skin, but there is little evidence of its action through imaging techniques. Ultrasonography can be an adjunctive tool in the diagnosis and management of KS skin lesions, but data in the literature are few. MATERIALS AND METHODS: Five patients with classic KS nodules were treated with intralesional vincristine. Ultrasonographic and color Doppler assessment were performed during vincristine injection and monitoring was repeated 1 and 3 months after the procedure...
October 12, 2018: Skin Research and Technology
Jonggeun Lee, Seogjae Lee, Su Wan Kim, Jee Won Chang
Purpose: The aim of this study is to analyze postoperative outcomes for carotid endarterectomy (CEA) in addition to the preoperative clinical characteristics related to selective shunting based on dual monitoring with stump pressure (SP) and electroencephalography (EEG). Materials and Methods: We retrospectively reviewed medical records of 70 patients who underwent CEA from March 2010 to December 2017. CEA was performed under general anesthesia and selective shunting was done if the SP was lower than 35 mmHg regardless of EEG or if intraoperative EEG showed any changes different from preoperative one regardless of SP...
September 2018: Vascular Specialist International
Masami Yuda, Katsunori Nishikawa
Recurrent laryngeal nerve (RLN) palsy can result in motility disorders of the vocal cord muscles and/or fatal respiratory complications. Procedures aimed at checking for intraoperative RLN injuries have not been established. Intraoperative nerve monitoring( IONM) informs electromyographic activity of the vocal cord muscles to a surgeon by visual and aural signals. In this chapter, we introduce methods for using IONM during esophageal cancer surgery. Since we introduced IONM, several cases in which surgeons have had difficulty visually identifying the RLN have been reported...
September 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Kazumasa Orihashi
Transesophageal echocardiography (TEE) provides real-time information on both morphology and hemodynamics without radiation exposure or contrast media, interruption of surgical procedures, or need for transferring the patient to other division, and thus can be used as intraoperative monitoring as well as diagnostic imaging. TEE is helpful for confirming the adequacy of routine surgical procedures, ruling out an occurrence of unexpected adverse events, or even navigating the manipulations of cannulae and catheters...
September 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Michael Rasmussen, Cameron Platell, Mark Jones
BACKGROUND: To develop a risk-adjustment model for unplanned return to theatre (URTT) outcomes following colorectal surgeries in Australia and New Zealand hospitals and apply top-down and bottom-up statistical process control methods for fair comparison of hospitals and surgeons' URTT rates. METHODS: We analysed URTT outcomes from hospitals contributing data to the Bi-National Colorectal Cancer Audit clinical registry between 2007 and 2016. Preoperative and intraoperative covariates were considered for risk adjustment...
October 10, 2018: ANZ Journal of Surgery
Ming Yin Lin, Andrew Dobrotwir, Orla McNally, Nadeem R Abu-Rustum, Kailash Narayan
Endometrial cancer is the most common gynecologic cancer in women today. It is surgically staged, and while surgery is the primary treatment modality, the identification of disease extent-in particular extrauterine spread-prior to surgery is important to optimize treatment decision making. Ultrasound and MRI are useful for evaluating the extent of local disease, while CT and PET are used for detecting lymph node or distant metastases. Diffusion-weighted MRI has also been used for detecting small metastatic deposits in lymph nodes and omentum...
October 2018: International Journal of Gynaecology and Obstetrics
Juying Jin, Su Min, Dan Liu, Ling Liu, Bixiao Lv
Background: Several randomized controlled trials suggest that goal-directed fluid therapy (GDFT) may result in improved postoperative outcomes. The aim of this study was to assess the clinical and financial impact of the real-life implementation of intraoperative GDFT in patients undergoing elective gastrointestinal surgery in a Chinese tertiary medical center. Methods: This Quality Improvement Program (QIP) study comprised three phases of 5, 1, and 5 months, respectively...
2018: Perioperative Medicine
Chang-Soon Lee, Jae Young Lee, Soohan Ro, Seungeun Choi, Jee Youn Moon
BACKGROUND: High-intensity focused ultrasound (HIFU) is a noninvasive thermodestructive procedure targeting internal organs with concentrated sonification energy that may cause pain. We aimed to compare the effectiveness of epidural analgesia (EA) and monitored anesthesia care (MAC) in HIFU treatment of uterine adenomyosis. MATERIALS AND METHODS: Sixty-eight patients were included in this case-control study. Thirty-seven patients underwent MAC; 31 patients underwent fluoroscope-guided epidural analgesia...
October 10, 2018: International Journal of Hyperthermia
Yehoshua N Schacham, Barak Cohen, Gausan R Bajracharya, Michael Walters, Nicole Zimmerman, Guangmei Mao, Marianne A Tanios, Daniel I Sessler
BACKGROUND: We tested the primary hypothesis that final intraoperative esophageal temperature is associated with increased odds of a composite of in-hospital all-cause mortality and myocardial injury within 7 days after noncardiac surgery. Secondary exposures were time-weighted average intraoperative temperature and area <37°C threshold. METHODS: Myocardial injury was defined by postoperative fourth-generation troponin T ≥0.03 ng/mL apparently due to cardiac ischemia...
October 8, 2018: Anesthesia and Analgesia
Paolo Pelosi, Lorenzo Ball, Marcus J Schultz
PURPOSE OF REVIEW: Timely identification of surgery patients at risk of postoperative complications is important to improve the care process, including critical care. This review discusses epidemiology and impact of postoperative complications; prediction scores used to identify surgical patients at risk of complications, and the role of critical care in the postoperative management. It also discusses how critical care may change, with respect to admission to the ICU. RECENT FINDING: Optimization of postoperative outcome, next to preoperative and intraoperative optimization, consists of using risk scores to early identify patients at risk of developing complications...
October 6, 2018: Current Opinion in Critical Care
Simone Bazurro, Lorenzo Ball, Paolo Pelosi
PURPOSE OF REVIEW: The volume of bariatric and nonbariatric surgical procedures on obese patients is dramatically increasing worldwide over the past years. In this review, we discuss the physiopathlogy of respiratory function during anesthesia in obese patients, the stratification of perioperative risk to develop intraoperative and postoperative pulmonary complications, the optimization of airway management, and perioperative ventilation, including postoperative respiratory assistance...
October 6, 2018: Current Opinion in Critical Care
Paolo Vinciguerra, Riccardo Vinciguerra, J Bradley Randleman, Ingrid Torres, Emanuela Morenghi, Fabrizio I Camesasca
PURPOSE: To report long-term outcomes of sequential customized therapeutic keratectomy for Reis-Bücklers' corneal dystrophy. METHODS: This was a retrospective review of 14 eyes of 8 patients with Reis-Bücklers' corneal dystrophy that underwent surgical peeling with a spatula of the epithelium and subepithelial membrane present in Reis-Bücklers' corneal dystrophy, with subsequent sequential customized therapeutic keratectomy featuring a multi-step approach with sequential, repeated customized excimer laser photoablations alternating with repeat intraoperative topographies to monitor and progressively reduce corneal irregularities...
October 1, 2018: Journal of Refractive Surgery
Carsten Schumacher, Hendrik Eismann, Lion Sieg, Lars Friedrich, Dirk Scheinichen, Florian W R Vondran, Kai Johanning
OBJECTIVES: Increased transfusion requirements in liver transplantation have been reported to be associated with worsened outcomes, more frequent reinterventions, and higher expenses. Anesthesiologists might counteract this through improved coagulation management. We evaluated the effects of rotational thromboelastometry on transfusion and coagulation product requirements and on outcome measurements. MATERIALS AND METHODS: Patients who were 14 years or older and who were undergoing liver transplant at Hannover Medical School between January 2005 and December 2009 were included in this retrospective analysis...
October 5, 2018: Experimental and Clinical Transplantation
T M Clough, F Alvi, H Majeed
AIMS: Total ankle arthroplasty (TAA) surgery is complex and attracts a wide variety of complications. The literature lacks consistency in reporting adverse events and complications. The aim of this article is to provide a comprehensive analysis of each of these complications from a literature review, and to compare them with rates from our Unit, to aid clinicians with the process of informed consent. PATIENTS AND METHODS: A total of 278 consecutive total ankle arthroplasties (251 patients), performed by four surgeons over a six-year period in Wrightington Hospital (Wigan, United Kingdom) were prospectively reviewed...
October 2018: Bone & Joint Journal
Yu Zhang, Jin-Wang Ding, Ling-Ying Yu, Ding-Cun Luo, Jian-Liang Sun, Zhi-Kai Lei, Zhi-Hua Wang
Primary hyperparathyroidism (PHPT) is rare during pregnancy. A case of twin pregnancy with three simultaneous parathyroid adenomas at the same time has not been reported. Multiple parathyroid lesions are difficult to diagnose, as pregnant women who insist upon continuing a pregnancy are not able to undergo 99mTc-sestamibi scintigraphy, so cases of PHPT are easily unobserved and often can have serious consequences for the patient and the fetus. Therefore, we reported a case of a 28-year-old woman mid-pregnancy with twins, who had hypercalcemia and was eventually diagnosed with twin pregnancy with PHPT due to a triple parathyroid adenoma, had good pregnancy outcomes after undergoing surgery in mid-pregnancy...
October 6, 2018: World Journal of Clinical Cases
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