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https://www.readbyqxmd.com/read/28334592/using-an-electronic-perioperative-documentation-tool-to-identify-returns-to-operating-room-ror-in-a-tertiary-care-academic-medical-center
#1
Robert R Cima, Sarah R Dhanorker, Christopher L Ostendorf, Mfonabasi Ntekpe, Raghu V Mudundi, Elizabeth B Habermann, Claude Deschamps
BACKGROUND: The metric "Unplanned returns to operating room (ROR)" is being tracked in surgical quality dashboards; 70% of unplanned RORs may be related to surgical complications. With increasing regionalization of trauma and complex surgical care at tertiary care academic centers, it is unclear if a simple ROR metric is a valid assessment of surgical quality at such centers. METHOD: A real-time electronic tool was used to identify all RORs-planned and unplanned-in a high-volume, high-complexity academic surgical practice at Mayo Clinic-Rochester within 45 days of the index operation...
March 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334545/-conservative-treatment-of-late-aortic-graft-infection
#2
Peter Baľa, Kamil Zeman, Renata Kološová, Ivo Pavlas, Dušan Kučera
Aortic graft infection is one of the most serious complications of aortovascular surgery. Diagnosis is based on clini-cal and radiologic findings. The emphasis is put on early diagnosis and its impact on prognosis of patients. The management should be individualized. The gold standard is surgical treatment with complete excision of the infected foreign material with debridement of the surrounding tissue and repair of vascular continuity by extra-anatomic bypass or in situ bypass with autologous femoral vein or cryopreserved arterial allografts...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28334471/the-clinical-applicability-of-a-daily-summary-of-patients-self-reported-postoperative-pain-a-repeated-measure-analysis
#3
Lotta Wikström, Kerstin Eriksson, Bengt Fridlund, Mats Nilsson, Kristofer Årestedt, Anders Broström
AIM AND OBJECTIVES: (I) to determine if a central tendency, median, based on patients' self-rated pain is a clinically applicable daily measure to show patients' postoperative pain on the first day after major surgery (II) and to determine the number of self-ratings required for the calculation of this measure. BACKGROUND: Perioperative pain traits in medical records are difficult to overview. The clinical applicability of a daily documented summarising measure of patients' self-rated pain scores is little explored...
March 23, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28334436/impact-of-neoadjuvant-chemoradiation-on-perioperative-outcomes-in-patients-with-rectal-cancer
#4
Brandon C Chapman, Patrick Hosokawa, William Henderson, Alessandro Paniccia, Douglas M Overbey, Wells Messersmith, Christopher Lieu, Greg V Stiegmann, Richard D Schulick, Csaba Gajdos
BACKGROUND AND OBJECTIVES: Neoadjuvant chemoradiation for rectal cancer is associated with lower local recurrence rates. The objective of this study is to assess the impact of neoadjuvant therapy on perioperative complications in patients with rectal cancer. METHODS: Using the ACS-NSQIP database (2005-2012), a propensity score was used to match 3592 patients with rectal cancer receiving neoadjuvant therapy to 3592 patients undergoing surgery alone. The association between neoadjuvant chemoradiation and perioperative outcomes was evaluated...
March 23, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28333936/adenosine-for-postoperative-analgesia-a-systematic-review-and-meta-analysis
#5
Xin Jin, Weidong Mi
PURPOSE: Perioperative infusion of adenosine has been suggested to reduce the requirement for inhalation anesthetics, without causing serious adverse effects in humans. We conducted a meta-analysis of randomized controlled trials evaluating the effect of adenosine on postoperative analgesia. METHODS: We retrieved articles in computerized searches of Scopus, Web of Science, PubMed, EMBASE, and Cochrane Library databases, up to July 2016. We used adenosine, postoperative analgesia, and postoperative pain(s) as key words, with humans, RCT, and CCT as filters...
2017: PloS One
https://www.readbyqxmd.com/read/28333865/clinical-application-of-perioperative-multimodal-analgesia
#6
Jörgen Bruhn, Gert J Scheffer, Geert-Jan van Geffen
PURPOSE OF REVIEW: The experience of intense postoperative pain remains a significant problem in perioperative medicine. The mainstay of postoperative analgetic therapy is the combination of nonopioid agents (e.g. paracetamol and NSAIDs) with strong opioids (e.g. morphine) according to the WHO analgesic ladder. But as the incidence and intensity of postoperative pain remains high, the search for and evaluation of additional concepts is ongoing. This review highlights the current trends of perioperative multimodal analgesia concepts...
March 22, 2017: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/28333315/transcutaneous-brow-shaping-a-straightforward-and-precise-method-to-lift-and-shape-the-eyebrows
#7
Mario Pelle-Ceravolo, Matteo Angelini
Background: The height of the eyebrow is less crucial aesthetically than is the relationship between the lateral and medial portions of the brow. Although various surgical procedures are effective in raising the brow, the authors maintain that transcutaneous brow shaping (TBS) is the only technique that enables precise shaping of the brow and correction of minor asymmetries. Objectives: The authors described their experiences with direct TBS alone or in conjunction with blepharoplasty and facelift...
March 16, 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/28333178/age-as-a-risk-factor-in-abdominoplasty
#8
Rafael A Couto, Gregory A Lamaris, Todd A Baker, Ahmed M Hashem, Kashyap Tadisina, Paul Durand, Steven Rueda, Susan Orra, James E Zins
Background: Recent studies reviewing large patient databases suggested that age may be an independent risk factor for abdominoplasty. However, these investigations by design considered only short-term major complications. Objectives: The purpose of this investigation was: (1) to compare the safety of abdominoplasty in an elderly and younger patient population; (2) to determine the complication rates across all spectrums: major, minor, local, and systemic; and (3) to evaluate complications occurring both short and long term...
January 20, 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/28333038/detecting-colorectal-cancer-using-electrical-impedance-spectroscopy-an-ex-vivo-feasibility-study
#9
Angela Pathiraja, Paul Ziprin, Arsam Shiraz, Reza Mirnezami, Andrew Tizzard, Brian Brown, Andreas Demosthenous, Richard H Bayford
OBJECTIVE: Colorectal cancer is the fourth most common cancer worldwide, with a lifetime risk of around 20%. Current solutions do not allow clinicians to objectively assess tissue abnormality during endoscopy and perioperatively. A solution capable of objectively assessing samples in real time could greatly improve the treatment process. A solution that can be integrated in minimally invasive diagnostics and management strategies to provide real-time point-of-care information would be greatly transformative...
March 23, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28332129/development-of-an-enhanced-recovery-after-surgery-eras-protocol-in-laparoscopic-colorectal-surgery-results-of-the-first-120-consecutive-cases-from-a-university-hospital
#10
Antonio Brescia, Federico Tomassini, Giammauro Berardi, Carola Sebastiani, Massimo Pezzatini, Anna Dall'Oglio, Giovanni Guglielmo Laracca, Fabrizio Apponi, Marcello Gasparrini
The ERAS(®) represents a dynamic culmination of upon perioperative care elements, successfully applied to different surgical specialties with shorter hospital stay and lower morbidity rates. The aim of this study is to describe the introduction of the ERAS protocol in colorectal surgery in our hospital analysing our first series. Between September 2014 and June 2016, 120 patients suffering from colorectal diseases were included in the study. Laparoscopic approach was used in all patients if not contraindicated...
March 22, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28332089/surgery-for-total-anomalous-pulmonary-venous-connection-primary-sutureless-repair-vs-conventional-repair
#11
REVIEW
Naoki Yoshimura, Kazuaki Fukahara, Akio Yamashita, Toshio Doi, Katsunori Takeuchi, Shigeyuki Yamashita, Takahiro Homma, Shigeki Yokoyama, Masaya Aoki, Yuki Ikeno
Despite recent advances in surgical technique and perioperative care, the surgical correction of total anomalous pulmonary venous connection (TAPVC) remains a challenge. The major complication and the main cause of reoperation in TAPVC surgery are the occurrence of pulmonary venous obstruction (PVO). In the 1990s, sutureless repair was introduced as a technique to relieve PVO after TAPVC repair. Following the favorable outcomes for postoperative PVO, the indications for sutureless repair as a primary operation have been expanded to include infants who have preoperative PVO or those at risk of developing PVO after the repair of TAPVC...
March 22, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28332075/roux-en-y-gastric-bypass-following-nissen-fundoplication-higher-risk-same-reward
#12
Michael D Watson, J Hunter Mehaffey, Bruce D Schirmer, Peter T Hallowell
BACKGROUND: Roux-en-Y gastric bypass (RYGB) effectively treats obesity and gastroesophageal reflux disease (GERD). As more surgeons recommend RYGB to treat GERD in patients with obesity, there are concerns about this approach in patients with previous non-bariatric foregut surgery. This study aims to evaluate the effect of previous non-bariatric foregut surgery on subsequent RYGB. METHODS: Retrospective review of 2089 patients undergoing RYGB between January 1985 and June 2015 was conducted to identify all patients with previous non-bariatric foregut surgery...
March 22, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28332058/bilateral-axillo-breast-approach-robotic-thyroidectomy-baba-rt-does-not-interfere-with-breast-image-follow-up
#13
Hyeong Won Yu, Young Jun Chai, Hyungju Kwon, Su-Jin Kim, June Young Choi, Kyu Eun Lee
BACKGROUND: Bilateral axillo-breast approach robotic thyroidectomy (BABA RT) is frequently performed and has excellent cosmetic results. However, there has been concern that subcutaneous tunneling in construction of the operation field might interfere with subsequent breast imaging. In this study, we evaluated whether BABA RT interferes with breast imaging by evaluating serial perioperative results of mammography and ultrasonography. METHODS: We selected female patients who underwent BABA RT between 2008 and 2012, and who also had mammography or ultrasonography pre- and postoperatively, and compared the results of pre- and postoperative imaging...
March 22, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28332057/the-impact-of-operative-approach-on-postoperative-complications-following-colectomy-for-colon-caner
#14
Benedetto Mungo, Christina M Papageorge, Miloslawa Stem, Daniela Molena, Anne O Lidor
BACKGROUND: Colectomy is one of the most common major abdominal procedures performed in the USA. A better understanding of risk factors and the effect of operative approach on adverse postoperative outcomes may significantly improve quality of care. METHODS: Adult patients with a primary diagnosis of colon cancer undergoing colectomy were selected from the National Surgical Quality Improvement Program 2013-2015 targeted colectomy database. Patients were stratified into five groups based on specific operative approach...
March 22, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28331851/predicting-factors-for-allogeneic-blood-transfusion-and-excessive-postoperative-blood-loss-after-single-low-dosage-intra-articular-tranexamic-acid-application-in-total-knee-replacement
#15
Paphon Sa-Ngasoongsong, Siwadol Wongsak, Noratep Kulachote, Pongsthorn Chanplakorn, Patarawan Woratanarat, Viroj Kawinwonggowit
Background. Recently, intra-articular tranexamic acid (IA-TXA) application has become a popular method for perioperative blood loss (PBL) reduction in total knee replacement (TKR). Nevertheless, through our knowledge, no previous studies had shown the correlation perioperative factors and the risk of excessive PBL or need of blood transfusion (BT) after IA-TXA. Materials and Methods. A retrospective study was conducted in patients underwent 299 primary TKRs, using IA-TXA, during 2-year period (2013-2014). Patient's characteristic and perioperative data were reviewed and collected...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28331608/american-society-for-enhanced-recovery-aser-and-perioperative-quality-initiative-poqi-joint-consensus-statement-on-measurement-to-maintain-and-improve-quality-of-enhanced-recovery-pathways-for-elective-colorectal-surgery
#16
S Ramani Moonesinghe, Michael P W Grocott, Elliott Bennett-Guerrero, Roberto Bergamaschi, Vijaya Gottumukkala, Thomas J Hopkins, Stuart McCluskey, Tong J Gan, Michael Monty G Mythen, Andrew D Shaw, Timothy E Miller
BACKGROUND: This article sets out a framework for measurement of quality of care relevant to enhanced recovery pathways (ERPs) in elective colorectal surgery. The proposed framework is based on established measurement systems and/or theories, and provides an overview of the different approaches for improving clinical monitoring, and enhancing quality improvement or research in varied settings with different levels of available resources. METHODS: Using a structure-process-outcome framework, we make recommendations for three hierarchical tiers of data collection...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/28331446/lung-transplantation-and-the-routine-use-of-cardiopulmonary-bypass-and-median-sternotomy-experience-at-the-ochsner-multi-organ-transplant-institute
#17
Michael Bates, Matthew Factor, P Eugene Parrino, Aditya Bansal, Reinaldo Rampolla, Leonardo Seoane, Jose Mena, Matthew Gaudet, William Smith, P Michael McFadden
BACKGROUND: From 1990-2005 at Ochsner Medical Center in New Orleans, LA, cardiopulmonary bypass (CPB) was used only when necessary during lung transplantation surgeries. Ochsner's lung transplant program was closed for more than 4 years after Hurricane Katrina, and since the program's reestablishment in 2010, the majority of lung transplantation surgeries have been performed with the patient on CPB and with a median sternotomy incision. The purpose of this study was to compare the outcomes of the CPB and non-CPB groups...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28331362/anesthesia-for-the-patient-undergoing-total-knee-replacement-current-status-and-future-prospects
#18
REVIEW
Zachary A Turnbull, Dahniel Sastow, Gregory P Giambrone, Tiffany Tedore
Total knee arthroplasty (TKA) has become one of the most common orthopedic surgical procedures performed nationally. As the population and surgical techniques for TKAs have evolved over time, so have the anesthesia and analgesia used for these procedures. General anesthesia has been the dominant form of anesthesia utilized for TKA in the past, but regional anesthetic techniques are on the rise. Multiple studies have shown the potential for regional anesthesia to improve patient outcomes, such as a decrease in intraoperative blood loss, length of stay, and patient mortality...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28331287/does-remifentanil-attenuate-renal-ischemia-reperfusion-injury-better-than-dexmedetomidine-in-rat-kidney
#19
E Erkılıç, E Kesimci, F Alaybeyoğlu, I Kılınç, R Tural, A Yazgan, T Gümüş, A Sepici Dinçel, E G Dumlu, O Kanbak
BACKGROUND: Ischemia-reperfusion (I/R) injury is a common cause of patient morbidity and mortality in the perioperative period. Patients undergoing long-lasting, abdominal, and urogenital surgeries with risk factors such as advanced age, peripheral artery disease, diabetes mellitus, renovascular disease, and congestive heart failure are candidates for acute kidney injury (AKI) due to impaired renal perfusion and decreased functional renal reserve. Pharmacological agents with multiple functions and anti-oxidative and anti-inflammation properties may be promising preventative strategies for AKI...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28331173/laparoscopic-gastrectomy-with-enhanced-recovery-after-surgery-protocol-single-center-experience
#20
Magdalena Pisarska, Michał Pędziwiatr, Piotr Major, Michał Kisielewski, Marcin Migaczewski, Mateusz Rubinkiewicz, Piotr Budzyński, Krzysztof Przęczek, Anna Zub-Pokrowiecka, Andrzej Budzyński
BACKGROUND Surgery remains the mainstay of gastric cancer treatment. It is, however, associated with a relatively high risk of perioperative complications. The use of laparoscopy and the Enhanced Recovery After Surgery (ERAS) protocol allows clinicians to limit surgically induced trauma, thus improving recovery and reducing the number of complications. The aim of the study is to present clinical outcomes of patients with gastric cancer undergoing laparoscopic gastrectomy combined with the ERAS protocol. MATERIAL AND METHODS Fifty-three (21 female/32 male) patients who underwent elective laparoscopic total gastrectomy due to cancer were prospectively analyzed...
March 23, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
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