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Surgery (General)

Ying-Cheng Huang, Chun-Yu Chen, Kai-Cheng Lin, Shang-Wei Yang, Yih-Wen Tarng, Wei-Ning Chang
Wide-awake local anesthesia no tourniquet (WALANT) is used for various hand surgeries, but there are no reports of its use for distal radius fractures. The authors compared perioperative variables and clinical outcomes for volar plating for distal radius fractures with WALANT vs general anesthesia with tourniquet. This retrospective study included 47 patients who presented with distal radius fractures between January 2015 and February 2017. Twenty-one underwent surgical volar plating with WALANT, and 26 underwent surgical volar plating with general anesthesia with tourniquet...
December 11, 2018: Orthopedics
Raphael M Byrne, Heather E Hoops, Daniel O Herzig, Sarah J Diamond, Kim C Lu, Karen J Brasel, V Liana Tsikitis
BACKGROUND: The Fundamentals of Endoscopic Surgery examination is required for all general surgery residents. The test modules are not available for practice before the examination; however, similar modules are commercially available. OBJECTIVE: This study aims to determine which modules are most valuable for resident training and preparation for the examination by evaluating which correlates best with experience level. DESIGN: This was a single-institution study...
November 28, 2018: Diseases of the Colon and Rectum
Sheung-Nyoung Choi, Young-Eun Jang, Ji-Hyun Lee, Eun-Hee Kim, Jin-Tae Kim, Hee-Soo Kim
BACKGROUND: Minimising rocuronium administration during paediatric surgery helps to reduce the incidence of residual muscular blockade. OBJECTIVE: To determine whether intermittent bolus injection (Bolus group) or continuous infusion (group) requires the lesser amount of rocuronium. DESIGN: A prospective, randomised, single-blind controlled trial. SETTING: A single university hospital from March to June 2017. PATIENTS: Sixty-six children undergoing general anaesthesia...
December 11, 2018: European Journal of Anaesthesiology
Yohei Nomura, Mitsunori Nakano, Brian Bush, Jing Tian, Atsushi Yamaguchi, Jeremy Walston, Rani Hasan, Kenton Zehr, Kaushik Mandal, Andrew LaFlam, Karin J Neufeld, Vidyulata Kamath, Charles W Hogue, Charles H Brown
BACKGROUND: Frailty is a geriatric syndrome thought to identify the most vulnerable older adults, and morbidity and mortality has been reported to be higher for frail patients after cardiac surgery compared to nonfrail patients. However, the cognitive consequences of frailty after cardiac surgery have not been well described. In this study, we examined the hypothesis that baseline frailty would be associated with postoperative delirium and cognitive change at 1 and 12 months after cardiac surgery...
December 11, 2018: Anesthesia and Analgesia
Ming-Hui Hung, Jin-Shing Chen, Ya-Jung Cheng
PURPOSE OF REVIEW: The current review focuses on precise anesthesia for video-assisted thoracoscopic surgery (VATS) with the goal of enhanced recovery. RECENT FINDINGS: VATS has become an established and widely used minimally invasive approach with broad implementation on a variety of thoracic operations. In the current environment of enhanced recovery protocols and cost containment, minimally invasive VATS operations suggest adoption of individualized tailored, precise anesthesia...
December 11, 2018: Current Opinion in Anaesthesiology
Bruno Della Mea Gasperin, Thamyres Zanirati, Leandro Totti Cavazzola
BACKGROUND: The increasingly intense usage of technology applied to videosurgery and the advent of robotic platforms accelerated the use of virtual models in training surgical skills. AIM: To evaluate the performance of a general surgery department's residents in a video-simulated laparoscopic cholecystectomy in order to understand whether training with virtual reality is sufficient to provide the skills that are normally acquired in hands-on experience at the operating room...
December 6, 2018: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Quan Shen, Qing-Feng Jiang, Yu-Wei Tian, Miao Yu, Jiang-Kun Jia, Huan-Zhou Xue
Aims: The aim of this study is to evaluate the therapeutic efficacy of Appleby operation for carcinoma of the body and tail of pancreas. Materials and Methods: From March 2010 to February 2015, Appleby operation was performed in 17 patients with carcinoma of the body and tail of pancreas. The values of fasting plasma blood, body weight (BW), visual analog pain intensity scale (VAS score), and the quality of life indices were evaluated before and 1 day, 1, 2, 6 weeks after surgery...
December 2018: Journal of Cancer Research and Therapeutics
Jin-Song Tong, Zhen Dong, Bin Xu, Cheng-Gang Zhang, Yu-Dong Gu
For severe cubital tunnel syndrome, patients with absent sensory nerve action potential tend to have more severe nerve damage than those without. Thus, it is speculated that such patients generally have a poor prognosis. How absent sensory nerve action potential affects surgical outcomes remains uncertain owing to a scarcity of reports and conflicting results. This retrospective study recruited one hundred and fourteen cases (88 patients with absent sensory nerve action potential and 26 patients with present sensory nerve action potential) undergoing either subcutaneous transposition or in situ decompression...
March 2019: Neural Regeneration Research
B Llombart, C Serra, C Requena, M Alsina, D Morgado-Carrasco, V Través, O Sanmartín
Sarcomas comprise a broad group of tumors, many of whose biological behavior and aggressiveness differ from one type to another. The therapeutic approach is generally multidisciplinary and often complex. Developments in surgical and oncological dermatology during the last few decades have positioned dermatologists as specialists in the diagnosis and treatment of skin cancer. The aim of this article is to review the main soft tissue sarcomas that typically affect the skin. Dermatofibrosarcoma protuberans is a low-grade malignant sarcoma...
December 2018: Actas Dermo-sifiliográficas
Dirk Zajonz, Julia Behrens, Alexander Giselher Brand, Andreas Höch, Johannes K M Fakler, Andreas Roth, Christoph Josten, Mohamed Ghanem
BACKGROUND: Hemiarthroplasty is an established treatment for femoral neck fractures (FNF) in old age; however, approximately 20-30% of patients die within 1 year after surgery. Periprosthetic joint infections (PJI) are one of the severest complications and associated with a high mortality rate. In this retrospective study of aged patients with FNF treated with hemiarthroplasty, the incidence of PJI was evaluated with respect to the influence of the delay to and timing of surgical treatment...
December 11, 2018: Der Orthopäde
John A Woller Iii, Victoria L Walsh, Chad Robichaux, Vinod H Thourani, Jesse T Jacob
Background: The use of valve surgery for infective endocarditis (IE) in end-stage renal disease (ESRD) patients may be different than in the general population. We assessed predictors of early surgery in ESRD patients with IE. Methods: We conducted a retrospective cohort study among dialysis patients with left-sided IE between 2005 and 2015. Indications for surgery were based on current endocarditis guidelines. Patients were categorized as early valve replacement surgery or delayed/no surgery...
November 2018: Open Forum Infectious Diseases
Jianqing Deng, Zhipeng Ren, Jiaxin Wen, Bo Wang, Xiaobin Hou, Zhiqiang Xue, Xiangyang Chu
Purpose: This study aimed to establish a nomogram to predict the overall survival (OS) of the general non-small-cell lung cancer (NSCLC) patients with distant metastasis. Patients and methods: We investigated Surveillance, Epidemiology, and End Results database for NSCLC patients with distant metastasis diagnosed between 2010 and 2014. Statistically significant prognostic factors were identified using uni- and multivariable Cox regression analyses. A nomogram incorporating these prognostic factors was developed and evaluated by the Harrell's concordance index (C-index), calibration plots, and risk group stratifications...
2018: Cancer Management and Research
Manish Sahni, Ashish Goel, Pankaj Pande, Kapil Kumar
Multiple gastrointestinal cancers in a single patient is a rare entity. In our study, we are showing the clinical presentation and management of these patients. A fifty-nine-year-old asthenic male (already treated case of metachronous colorectal cancer in 2008 and 2011) presented with complaints of generalized weakness and fatigue. Strong family history was present with two of his first-degree relatives having diagnosed with gastrointestinal cancer at the age < 50 years with one of them having stomach carcinoma and another with GEJ tumors...
December 2018: Indian Journal of Surgical Oncology
Katalin Kristof, Benedikt Büttner, Anna Grimm, Caspar Mewes, Bastian Schmack, Aron Frederik Popov, Michael Ghadimi, Tim Beissbarth, José Hinz, Ingo Bergmann, Ashham Mansur
OBJECTIVE: The mortality associated with sepsis remains unacceptably high, despite modern high-quality intensive care. Based on the results from previous studies, anaemia and its management in patients with sepsis appear to impact outcomes; however, the transfusion policy is still being debated, and the ideal approach may be extremely specific to the individual. This study aimed to investigate the long-term impact of anaemia requiring red blood cell (RBC) transfusion on mortality and disease severity in patients with sepsis...
December 11, 2018: BMC Research Notes
Risa Shimizu, Kae Tanaka, Yu Oikawa, Hirofumi Tomioka, Kou Kayamori, Tohru Ikeda, Takatomo Yoshioka, Arata Ebihara, Hiroyuki Harada
BACKGROUND: Epithelioid cell granuloma with caseating necrosis is a typical pathological finding in tuberculosis. While specific inflammation, including that related to tuberculosis, can induce caseating granuloma formation, there have been very few reports on the induction of caseating granuloma by non-specific inflammation. Chronic periapical periodontitis is usually related to bacterial biofilm formation as well as fungal or viral infection in the periapical lesion. However, it is difficult to eliminate these extraradicular pathogenic microbes by normal endodontic therapy alone, and more invasive surgical removal is almost always required...
December 11, 2018: Journal of Medical Case Reports
Reinhard Strametz, Martin N Bergold, Tobias Weberschock
BACKGROUND: Percutaneous dilatational tracheostomy (PDT) is one of the most common bedside surgical procedures performed in critically ill adults, on intensive care units (ICUs), who require long-term ventilation. PDT is associated with relevant life-threatening complications: Cuff rupture or accidental extubation may lead to hypoxia, aspiration or loss of airway. Puncture of the oesophagus, or creating a false passage during dilatation or replacement of the tracheostomy tube, can lead to pneumothorax or emphysema...
November 15, 2018: Cochrane Database of Systematic Reviews
Tapan D Patel, Kristen A Echanique, Candice Yip, Wayne D Hsueh, Soly Baredes, Richard Chan Woo Park, Jean Anderson Eloy
OBJECTIVES/HYPOTHESIS: The authors used the Surveillance, Epidemiology, and End Results (SEER) database to analyze epidemiological features of patients presenting with supraglottic squamous cell carcinoma (SCCa) and to evaluate treatment trends and outcomes. METHODS: The SEER database was queried for patients with supraglottic SCCa from 1973 to 2013. Information on demographics; tumor size; histologic grade; American Joint Committee on Cancer (AJCC) stage; SEER local, regional, distant stage; and treatment modality were analyzed...
December 11, 2018: Laryngoscope
Joana Gomes de Amorim, Manuel Rocha Abecasis, Filipa Maria Nogueira Lança Rodrigues
Thrombocytopenia is the most common hemostatic change in pregnancy, but severe thrombocytopenia is rare. One of the causes, immune thrombocytopenic purpura (ITP), is characterized by increased platelet destruction by immunoglobulin G (IgG) antibodies, presenting a high risk of hemorrhage for the patient, but also for the fetus, since antibodies may cross the placenta. We present the case of a 23-year-old pregnant woman with a history of Langerhans cell histiocytosis of the mandible submitted to surgery and chemotherapy when she was 10 years old, with diagnosis of ITP since then...
December 2018: Revista Brasileira de Ginecologia e Obstetrícia
Argyrios Ioannidis, Nikolaos Machairas, Christos Koutserimpas, Eleftherios Spartalis, Michael Konstantinidis, Konstantinos Konstantinidis
Robot-assisted general surgery in Greece and Cyprus coincided with a devastating financial crisis. We hereby present the evolution of the technology in this unwelcoming environment, using data provided to us by the official distributor of the Da Vinci platform in these countries.
December 8, 2018: Journal of Robotic Surgery
S Linder, G Linder, C Månsson
PURPOSE: de Garengeot's hernia is a rare entity in which the appendix is located within a femoral hernia and is almost invariably encountered incarcerated in an emergency setting with concomitant appendicitis. In the literature, there are mostly single-case reports. The purpose of the present study was to perform a review of the literature to study the incidence, pathogenesis, demographics, clinical presentation, laboratory and radiological investigations, differential diagnosis, delay in diagnosis and treatment, operative findings, surgical technique, histological findings, the postoperative course, use of antibiotics, and complications regarding de Garengeot's hernia...
December 7, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
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