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postoperative pulmonary complication

Guangxian Yang, Xicheng Deng, Yifeng Yang, Ni Yin, Jinhua Wang, Pingbo Liu
OBJECTIVES: The aim of this study is to describe an effective surgical strategy for the treatment of children with pectus excavatum (PE) and concurrent congenital heart defect (CHD). METHODS: We retrospectively reviewed the medical records of all children (n = 16) who underwent simultaneous repair of PE with concurrent CHD at the Hunan Children's Hospital from July 2007 to December 2017. Among them, 7 patients had a simple atrial septal defect (ASD); 4 patients had a simple ventricular septal defect (VSD); 3 patients had both VSD and ASD; 1 patient had VSD, ASD and patent ductus arteriosus; and 1 patient had VSD complicated by pulmonary hypertension...
December 11, 2018: Interactive Cardiovascular and Thoracic Surgery
Adel Elkbuli, Alyssa Eily, Valerie Polcz, Dessy Boneva, Paul J Spano Ii, Mark McKenney, Shaikh Hai
Background: Early operative intervention for hip fractures in the elderly is advised to reduce mortality and morbidity. Postoperative complications impose a significant burden on patient outcomes and cost of medical care. Our aim was to determine the relationship between time to surgery and postoperative complications/mortality in patients with hip fracture. Methods: This is a retrospective review of data collected from our institution's trauma registry for patients ≥65 years old with isolated hip fracture and subsequent surgery from 2015 to 2017...
2018: Trauma surgery & acute care open
Yongtao Gao, Zhi Wang, Feng Jiang, Jie Gao, Yujia Li, Siyuan Liu
OBJECTIVE: The aim of this study was to determine whether a AOI strategy on non-ventilated lung could reduce the regional and systemic proinflammatory cytokine and oxidative stress response associated with esophagectomy, and to evaluate whether AOI can be used as a novel lung protective ventilation strategy. Its impact on oxygenation after OLV, surfactant protein A, B, C (SP-A, B, C), postoperative hospital stay and postoperative pulmonary complications (PPCs) was also evaluated. METHODS: Fifty-four adults (ASA II-III) undergoing esophagectomy with OLV were enrolled in the study...
December 11, 2018: BMC Anesthesiology
Kagami Miyaji, Shohei Miyazaki, Keiichi Itatani, Norihiko Oka, Tadashi Kitamura, Tetsuya Horai
OBJECTIVES: A novel surgical strategy using haemodynamic analyses based on virtual operations with computational simulations has been introduced for complicated pulmonary stenosis. We evaluated the efficacy of this strategy. METHODS: Six patients were enrolled. Before surgery, the optimal pulmonary arteries were constructed based on computational fluid dynamics using 3-dimensional computed tomography. Energy loss (EL, mW) and wall shear stress (WSS, Pa) were calculated...
December 6, 2018: Interactive Cardiovascular and Thoracic Surgery
Jun-Shik Kim
In Western patient populations, the reported incidence of imaging-demonstrated deep vein thrombosis (DVT) after total hip arthroplasty (THA) is as high as 70% without prophylaxis. The reported rates of symptomatic pulmonary embolism (PE) after THA in recent studies range from 0.6% to 1.5%, and the risk of fatal PE ranges from 0.11% to 0.19% in the absence of prophylaxis. Predisposing factors to DVT in western patients include advanced age, previous venous insufficiency, osteoarthritis, obesity, hyperlipidemia, dietary and genetic factors...
December 2018: Hip & Pelvis
Patrick Hill, Avani Vaishnav, Blake Kushwaha, Steven McAnany, Todd Albert, Catherine Himo Gang, Sheeraz Qureshi
Objective: The purpose of this study was to evaluate factors associated with inpatient admission following 2-level cervical disc arthroplasty (CDA). A secondary aim was to compare outcomes between those treated on an inpatient versus outpatient basis. Methods: Using data from the American College of Surgeons National Surgical Quality Improvement Program database, multivariate logistic regression analysis was used to assess the independent effect of each variable on inpatient or outpatient selection for surgery...
September 9, 2018: Neurospine
Richard Templeton, Donna Greenhalgh
PURPOSE OF REVIEW: Lung resection provides the best outcome for patients with early stage lung cancer. However, lung cancer surgery carries a significant risk of perioperative complications. Patient risk may be reduced by addressing modifiable risk factors in the preoperative period. We review how this can be achieved through preoperative rehabilitation pathways. RECENT FINDINGS: Cardiorespiratory fitness is an independent predictor of survival for nonsmall cell cancer...
December 6, 2018: Current Opinion in Anaesthesiology
Theodoros Kratimenos, Constantine N Antonopoulos, Dimitrios Tomais, Panagiotis Dedeilias, Vasileios Patris, Ilias Samiotis, John Kokotsakis, Dimosthenis Farsaris, Michalis Argiriou
OBJECTIVE: The aim of the study was to present the results for patients with atherosclerotic aneurysm of the descending thoracic aorta (DTA) treated with a novel thoracic stent graft. METHODS: A single-center retrospective review of prospectively collected data was performed. We extracted demographic variables as well as atherosclerotic comorbidities and operation-related and imaging-related data from patients' medical records. We estimated technical success rate, in-hospital and 30-day mortality, and mortality at the end of follow-up as well as complication and reintervention rate in our study cohort...
October 24, 2018: Journal of Vascular Surgery
José de Jesús Rodriguez-Andoney, Viridiana Jimenez-Zamora, Eduardo Rivero-Sigarroa, José Luis Hernandez-Oropeza, Ignacio García-Juárez, Guillermo Dominguez-Cherit
A 44-year-old woman with Child-Pugh class C cirrhosis due to primary biliary cirrhosis and mild portopulmonary syndrome received a liver transplant. Her basal catheterization showed a mean pulmonary arterial pressure (mPAP) of 28 mm Hg, pulmonary artery occlusion pressure (PAOP) of 8 mm Hg, pulmonary vascular resistance (PVR) of 307 , and a cardiac output of 5.2 L/min. The echocardiogram did not reveal right ventricular dilatation (mid-diameter of 34 mm). In surgery, hemodynamic assessment showed an mPAP of 25 mm Hg, PAOP of 6 mm Hg, PVR of 262 dynes...
December 2018: Chest
Michael J Chen, Abiram Bala, James I Huddleston, Stuart B Goodman, William J Maloney, Alistair J Aaronson, Derek F Amanatullah
INTRODUCTION: While statins have been found to reduce postoperative atrial fibrillation after cardiac surgery, little is known about their use in total hip arthroplasty (THA). This study investigated if statins would similarly reduce postoperative arrhythmias in patients undergoing THA. METHODS: We queried a large Medicare and private-payer database from 2005 to 2012 and identified 12,075 patients who were on a statin prior to THA. We then age and sex matched 34,446 non-statin users who underwent THA...
December 10, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Kuei-Yen Tsai, Hsin-An Chen, Wan-Yu Wang, Ming-Te Huang
BACKGROUND: Pulmonary complications remain relatively high in morbidities that arise after liver surgery and are associated with increased length of hospital stay and higher cost. Identification of possible risk factors in this retrospective analysis may help reduce operative morbidity and achieve better outcomes. METHODS: In all, 363 consecutive patients underwent elective hepatectomies between July 2008 and November 2013 and these were identified and analyzed retrospectively...
December 5, 2018: Digestive Surgery
Krish C Dewan, Karan S Dewan, Jay J Idrees, Suparna M Navale, Brad F Rosinski, Lars G Svensson, A Marc Gillinov, Douglas R Johnston, Faisal Bakaeen, Edward G Soltesz
Importance: Persistent opioid use is currently a major health care crisis. There is a lack of knowledge regarding its prevalence and effect among patients undergoing cardiac surgery. Objective: To characterize the national population of cardiac surgery patients with opioid use disorder (OUD) and compare outcomes with the cardiac surgery population without OUD. Design, Setting, and Participants: In this retrospective population-based cohort study, more than 5...
December 5, 2018: JAMA Surgery
Zhi-Hong Lu, Hai-Long Dong, Jia-Wen Huang-Fu, Xiao-Jian Fan, Wei-Xian Zhao, Su Min, Wei Zhang, Ming-Fu Liu, Yong-Hui Wang, Li-Ni Wang, Li-Ze Xiong
BACKGROUND: Transcutaneous electric acupoint stimulation (TEAS) has shown benefits when used peri-operatively. However, the role of numbers of areas with acupoint stimulation is still unclear. Therefore, we report the protocol of a randomized controlled trial of using TEAS in elderly patients subjected to gastrointestinal surgery, and comparing dual-acupoint and single-acupoint stimulation. METHODS/DESIGN: A multicenter, randomized, controlled, three-arm design, large-scale trial is currently undergoing in four hospitals in China...
December 4, 2018: Trials
Daniel J Shubert, Kevin H Shepet, Abigail F Kerns, Michelle A Bramer
HYPOTHESIS/BACKGROUND: Iatrogenic pneumothorax is a rare but serious complication of open reduction and internal fixation (ORIF) of clavicular fractures. Many institutions use postoperative chest radiographs to evaluate for this complication despite a lack of data to support this routine practice. Due to concerns of radiation exposure and health care costs, this practice may not be necessary. This study determined the rate of iatrogenic pneumothorax after clavicular ORIF with plate fixation at a single institution over 8 years...
November 30, 2018: Journal of Shoulder and Elbow Surgery
Lucio Cagini, Gabriela Cardaioli, Marco Andolfi, Ketty Savino, Paolo Eusebi, Ilenia Corbelli, Simone Simoni, Jacopo Vannucci, Elisa Sacchini, Francesco Ripandelli, Alberto Matricardi, Francesco Puma
BACKGROUND: Patent foramen ovale (PFO) is present in up to 25% of the general population and is considered an irrelevant condition in healthy subjects. Here we sought to determine an association between the presence of an asymptomatic PFO at baseline and postoperative short-term adverse events in patients undergoing major pulmonary resection for lung cancer. As well, we evaluated for the rate of PFO after pulmonary resections. METHODS: This prospective, observational study assessed patients by transcranial doppler (TCD) with contrast at baseline and discharge...
November 30, 2018: Annals of Thoracic Surgery
Ori Barzilai, Lily McLaughlin, Eric Lis, Anne S Reiner, Mark H Bilsky, Ilya Laufer
BACKGROUND: Cancer patients experience pathological fractures and the typical poor bone quality frequently complicates stabilization. Methods for overcoming screw failure include utilization of fenestrated screws that permit the injection of bone cement into the vertebral body to augment fixation. OBJECTIVE: To evaluate the safety and efficacy of cement augmentation via fenestrated screws. METHODS: A retrospective chart review of patients with neoplastic spinal instability who underwent percutaneous instrumented stabilization with cement augmentation using fenestrated pedicle screws...
December 3, 2018: Operative Neurosurgery (Hagerstown, Md.)
E Hadzijusufovic, E Tagkalos, H Neumann, B Babic, S Heinrich, H Lang, P P Grimminger
Delayed gastric emptying (DGE) after Ivor-Lewis esophagectomy occurs postoperatively in up to 50% of the patients. This pyloric dysfunction can lead to severe secondary complications postoperatively such as early aspiration, pneumonia or may even have an impact on anastomotic healing and therefore leakage. Early detection of DGE is essential to prevent further complications. The common treatment postoperatively is endoscopic pyloric balloon dilatation (EPBD) after symptoms already occurred. In our work, we analyzed patients who received a preoperative EPBD during the routine restaging endoscopy and compared those patients to a control group to analyze if preoperative EPBD may prevent postoperative DGE and secondary additional complications...
December 1, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Sherif Assaad, Wolf B Kratzert, Albert C Perrino
PURPOSE OF REVIEW: Excessive accumulation of extravascular lung water (EVLW) resulting in pulmonary edema is the most feared complication following thoracic surgery and lung transplant. ICUs have long relied on chest radiography to monitor pulmonary status postoperatively but the increasing recognition of the limitations of bedside plain films has fueled development of newer technologies, which offer earlier detection, quantitative assessments, and can aide in preoperative screening of surgical candidates...
November 29, 2018: Current Opinion in Anaesthesiology
Daniel G French, Madelaine Plourde, Harry Henteleff, Aneil Mujoomdar, Drew Bethune
Air leaks are the most common complication after pulmonary resection. Enhanced recovery after surgery (ERAS) programs must be designed to manage parenchymal air leaks. ERAS programs should consider two components when creating protocols for air leaks: assessment and management. Accurate assessment of air leaks using traditional analogues devices, newer digital drainage systems, portable devices and chest X-rays (CXR) are reviewed. Published data suggests that digital drainage systems result in a more confident assessment of air leaks...
November 2018: Journal of Thoracic Disease
Patrick James Villeneuve
Surgical resection of lung cancer is the preferred treatment for early-stage disease in medically fit patients. The rates of postoperative pulmonary complications (PPCs) such as pneumonia, empyema and atelectasis are as high as 10% in contemporary series. A review of the literature was performed to identify the best evidence supporting interventions to identify, prevent and treat PPCs. The use of patient risk scores, appropriate choice of antibiotic prophylaxis, intraoperative ventilatory strategies, chest physiotherapy, sputum management and non-invasive ventilatory support were specifically discussed, as was the relevant supporting data...
November 2018: Journal of Thoracic Disease
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