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postoperative pulmonary complication

Raymond A Jean, Alex S Chiu, Jessica R Hoag, Justin D Blasberg, Daniel J Boffa, Frank C Detterbeck, Anthony W Kim
BACKGROUND: Readmissions after pulmonary lobectomy for lung cancer are important markers of healthcare quality for surgeons and hospitals. The implications on resources and quality are magnified when examining patients who require multiple readmissions within the perioperative period. METHODS: The Nationwide Readmission Database (NRD) between 2013 and 2014 was investigated for patients with a primary diagnosis of lung cancer who underwent pulmonary lobectomy. Using adjusted hierarchical regression models, demographic and clinical factors during the index hospitalization were investigated for associations with single and multiple readmissions during the 90-day postoperative period...
October 15, 2018: Annals of Thoracic Surgery
Chao-Shun Lin, Chien-Yu Chen, Chun-Chieh Yeh, Chi-Li Chung, Ta-Liang Chen, Chien-Chang Liao
Background: The relationship between chronic obstructive pulmonary disease (COPD) and perioperative outcomes remains incompletely understood. Our purpose is to evaluate the features of postoperative adverse outcomes for geriatric surgical patients with chronic obstructive pulmonary disease (COPD) receiving non-thoracic surgeries. Methods and procedures: We conducted a nationwide study of 15,359 COPD patients aged 65 years and older who received major non-thoracic surgeries in 2008-2013 from the Taiwan National Health Insurance Research Database...
October 18, 2018: QJM: Monthly Journal of the Association of Physicians
Alexander T Hawkins, Timothy M Geiger, Adam B King, Jonathan P Wanderer, Vikram Tiwari, Roberta L Muldoon, Molly M Ford, Roger R Dmochowski, Warren S Sandberg, Barbara Martin, M Benjamin Hopkins, Matthew D McEvoy
BACKGROUND: Perioperative care has lacked coordination and standardization. Enhanced recovery programs (ERPs) have been shown to decrease aggregate complications across surgical specialties. We hypothesize that the sustained implementation of an ERP will be associated with a decrease in a broad range of complications at the organ system level. STUDY DESIGN: Adult patients undergoing elective colorectal procedures between 1/2011 and 10/2016 were included. Patients were stratified based on exposure to a sustained ERP (7/2014-10/2016) after an 18-month wash-in period in a pre-post analysis...
October 17, 2018: Surgical Endoscopy
Brenda Nachiyunde, Louisa Lam
Cardiac surgery induces severe postoperative pain and impairment of pulmonary function, increases the length of stay (LOS) in hospital, and increases mortality and morbidity; therefore, evaluation of the evidence is needed to assess the comparative benefits of different techniques of pain management, to guide clinical practice, and to identify areas of further research. A systematic search of the Cochrane Central Register of Controlled Trials, DARE database, Joanna Briggs Institute, Google scholar, PUBMED, MEDLINE, EMBASE, Academic OneFile, SCOPUS, and Academic search premier was conducted retrieving 1875 articles...
October 2018: Annals of Cardiac Anaesthesia
Laura Sommerauer, Alois Philipp, Matthias Lubnow, Thomas Müller, Dirk Lunz, Hans-Stefan Hofmann, Michael Ried
INTRODUCTION: Patients with severe respiratory failure and veno-venous extracorporeal membrane oxygenation (vv-ECMO) often require diagnostic or therapeutic thoracic surgery. METHODS: Retrospective analysis of prospectively collected data (Regensburg ECMO Registry) on all patients requiring vv-ECMO between December 2010 and December 2016 due to acute lung failure (ALF) with diagnostic or therapeutic thoracic surgery. Endpoints were the indications for thoracic surgery as well as postoperative morbidity and in-hospital mortality...
October 15, 2018: Zentralblatt Für Chirurgie
Kisa Hyde Congo, António Tomás, Álvaro Laranjeira, Daniela Afonso, José Fragata
We report the case of 67-year old male patient who was admitted with a 2-week history of progressively worsening chest pain and dyspnea. Diagnostic investigation showed a type B aortic dissection with a retrograde intramural hematoma and bilateral pulmonary embolism. These simultaneous findings highly complicated patient management. Patient was started on anticoagulation therapy with partial resolution of pulmonary embolism after which surgical correction was performed. The patient was successfully submitted to a modified Frozen Elephant Trunk technique with a 3-branched customized Dacron tube and aortic arch replacement with E-Vita Open Plus...
January 2018: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
Carlos Branco, Gonçalo F Coutinho, Filipe Soares, Pedro E Antunes, Manuel J Antunes
BACKGROUND: Complete revascularization is the gold standard of coronary artery bypass grafting (CABG). However, the rationale for revascularization of all diseased vessels is questionable. We aimed at evaluating the impact of multiple versus single grafts in each diseased coronary territory in the long-term survival and incidence of major adverse cardiac and cerebrovascular events (MACCE). METHODS: From January/00 to November/15, 5.694 consecutive patients were submitted to isolated CABG, of whom 4...
January 2018: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
Chandler Tedder, Henry DeBell, Daniel Dix, Walter R Smith, Gerald McGwin, Ashish Shah, Sameer Naranje
Ankle arthritis is a potentially debilitating disease, with approximately 50,000 cases diagnosed annually. One treatment option for these patients is total ankle arthroplasty (TAA). This procedure has historically been performed in the inpatient setting with a 1-2-night postoperative hospital stay. Outpatient surgeries are gaining popularity due to their cost effectiveness, decreased length of hospital stay, and convenience. Therefore it is important to evaluate the safety of specific procedures in the outpatient setting compared with the inpatient setting...
October 10, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Scott R Steele, Justin T Brady, Zhun Cao, Dorothy L Baumer, Scott B Robinson, H Keri Yang, Conor P Delaney
BACKGROUND: Postoperative ileus is a significant complication after bowel resection surgeries. Alvimopan is the only US Food and Drug Administration-approved therapy for accelerating the return of bowel function after large- and small-bowel resection. OBJECTIVE: The purpose of this study was to estimate the healthcare use and in-hospital morbidities associated with on-label use of alvimopan in patients undergoing bowel resection surgeries. DESIGN: A retrospective observational propensity-matched cohort study was conducted using a large hospital administrative database...
October 11, 2018: Diseases of the Colon and Rectum
Lily V Saadat, Adam C Fields, Heather Lyu, Richard D Urman, Edward E Whang, Joel Goldberg, Ronald Bleday, Nelya Melnitchouk
BACKGROUND: The rate of unplanned reoperation for rectal cancer can provide information about surgical quality. We sought to determine factors associated with unplanned reoperation after low anterior resection and abdominoperineal resection for patients with rectal cancer and outcomes after these reoperations. METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was used to conduct this retrospective study. Patients who underwent elective low anterior resection and abdominoperineal resection for rectal cancer from 2012-2014 were identified...
October 8, 2018: Surgery
Hao Xu, Congying Guo, Yu Lu, Linyou Zhang
BACKGROUND: To summarize the clinical features of patients with pulmonary embolism after lobectomy and to explore the methods of diagnosis and treatment of pulmonary embolism after lobectomy. METHODS: The clinical data of 6 patients with pulmonary embolism after lobectomy between July 2007 and July 2017 were retrospectively analyzed. RESULTS: Of the 6 patients, 3 died within 24 h of onset and 3 patients were cured and discharged. CONCLUSIONS: Pulmonary embolism after lobectomy is a rare postoperative complication in thoracic surgery...
October 20, 2018: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
Shengjie Jing, Jianming Zhou, Qitong Lu, Xin Chu, Wei He, Jie Jiang, Xin Xue, Zhiyong Liu, Tao Xue
BACKGROUND: Pulmonary thrombosis embolism (PTE) is one of the most severe complications of perioperative radical mastectomy. Massive PTE is often accompanied by shock and hypotension which is characterized by rapid progression and high mortality. There is no standard for the treatment of these patients, which is thoracic surgery, and it is a critical issue in the thoracic surgeons. This article summarizes and analyzes the treatment of two patients with high-risk PTE at the early stage of postoperative lung cancer in our hospital...
October 20, 2018: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
Zhe Xu, Xiaoxi Fan, Shun Xu
BACKGROUND: Pulmonary embolism (PE) is one of the most severe complications after thoracic surgeries. Thus it is of great importance to learn the characteristics of acute PE after thoracic surgeries. This study summarized the clinical characteristics and experience on the diagnosis and treatment of 37 patients with postoperative acute pulmonary embolism, in order to improve its prophylaxis and management level. METHODS: We retrospectively reviewed 37 patients with postoperative acute pulmonary embolism following thoracic surgeries...
October 20, 2018: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
Hui Xu, Hu Liao, Guowei Che, Kun Zhou, Mei Yang, Lunxu Liu
BACKGROUND: The incidence of pulmonary embolism (PE) in lung cancer patients who underwent surgery increased during the perioperative period, and prophylactic anticoagulation therapy was important part of enhanced recovery after surgery (ERAS). However, the timing of preventive anticoagulation in patients with lung cancer remained controversial. This study was designed to investigate the safety and efficacy of perioperative prophylactic anticoagulation therapy for lung cancer patients...
October 20, 2018: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
Pieter C van der Sluis, Sylvia van der Horst, Anne M May, Carlo Schippers, Lodewijk A A Brosens, Hans C A Joore, Christiaan C Kroese, Nadia Haj Mohammad, Stella Mook, Frank P Vleggaar, Inne H M Borel Rinkes, Jelle P Ruurda, Richard van Hillegersberg
BACKGROUND: The standard curative treatment for patients with esophageal cancer is perioperative chemotherapy or preoperative chemoradiotherapy followed by open transthoracic esophagectomy (OTE). Robot-assisted minimally invasive thoracolaparoscopic esophagectomy (RAMIE) may reduce complications. METHODS: A single-center randomized controlled trial was conducted, assigning 112 patients with resectable intrathoracic esophageal cancer to either RAMIE or OTE. The primary endpoint was the occurrence of overall surgery-related postoperative complications (modified Clavien-Dindo classification grade 2-5)...
October 10, 2018: Annals of Surgery
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
Yuka Yamada, Takashi Yurikusa, Kohei Furukawa, Yasuhiro Tsubosa, Masahiro Niihara, Keita Mori, Seiji Asoda, Hiromasa Kawana, Yuko Kitagawa, Taneaki Nakagawa
Radical esophagectomy for thoracic esophageal cancer is invasive and frequently results in postoperative pulmonary complications. Postoperative pneumonia is the most common such complication and affects hospital mortality and survival rates. Oral care has been very effective in reducing pneumonia. In Japan, preoperative professional oral care is highly recommended. However, there are few studies on the effect of preoperative improvements in oral hygiene as a result of intervention on the incidence of postoperative pneumonia...
October 6, 2018: Keio Journal of Medicine
Özlem Sarısoy, Canan Ayabakan, Kürşad Tokel, Murat Özkan, Rıza Türköz, Sait Aşlamacı
OBJECTIVE: The follow-up results of patients operated for atrioventricular septal defect (AVSD) during 1996-2016 at Başkent University are presented. METHODS: Data obtained from hospital records consists of preoperative echocardiographic and angiographic details, age and weight at surgery, operative details, Down syndrome presence, postoperative care details, early postoperative and latest echocardiographic findings and hospitalization for reintervention. RESULTS: A total of 496 patient-files were reviewed including 314 patients (63...
October 2018: Anatolian Journal of Cardiology
Z L Bao, J Zhang
Objective: To summarize and analyze the methods of termination of pregnancy in the first and second trimester of pregnancy with severe cardiovascular disease. Methods: A retrospective analysis of 27 cases of termination of pregnancy in the first and second trimester of pregnancy in Beijing Anzhen Hospital from January 1, 2016 to December 30, 2017. All of these pregnant women were pregnancy complicated with severe cardiovascular disease in grade Ⅴ pregnancy risk. Results: (1) The age of 27 pregnant women was 22-40 years, gestational age was 6-27 weeks; cardiac function grade before induced labor was: 5 cases of grade Ⅱ, 15 cases of grade Ⅲ, 7 cases of grade Ⅳ...
September 25, 2018: Zhonghua Fu Chan Ke za Zhi
Aurélien Venara, Pascal Alfonsi, Eddy Cotte, Jérôme Loriau, Jean-François Hamel, Karem Slim
PURPOSE: Postoperative ileus (POI) occurrence within enhanced recovery programs (ERPs) has decreased. Also, intra-abdominal complications (IAC) such as anastomotic leakage (AL) generally present late. The aim was to characterize the link between POI and the other complications occurring after surgery. METHODS: This retrospective analysis of a prospective database was conducted by the Francophone Group for Enhanced Recovery after Surgery. POI was considered to be present if gastrointestinal functions had not been recovered within 3 days following surgery or if a nasogastric tube replacement was required...
October 6, 2018: International Journal of Colorectal Disease
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