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https://www.readbyqxmd.com/read/28215039/impact-of-surgical-experience-on-management-and-outcome-of-pancreatic-surgery-performed-in-high-and-low-volume-centers
#1
Marco Stella, Massimiliano Bissolati, Daniele Gentile, Alessandro Arriciati
Pancreaticoduodenectomy (PD) is one of the procedures in general surgery with the highest rate of life-threatening complications. The positive impact of the volume-outcome ratio on outcomes and mortality in pancreatic surgery (PS) has led to policy-level efforts toward centralization of care for PS that is currently under evaluation by some Regional Health Services. The role of the surgeon's experience and training is still under debate. The aim of this paper is to compare the outcomes of PS by the same surgeon in a high volume (HV) and in a low volume (LV) hospital to assess whether a specific training in PS could outdo the benefits of hospital volume...
February 18, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28214574/minimally-invasive-versus-open-approach-for-cystectomy-trends-in-the-utilization-and-demographic-or-clinical-predictors-using-the-national-cancer-database-ncdb
#2
Andrew G Bachman, Alexander A Parker, Marshall D Shaw, Brian W Cross, Kelly L Stratton, Michael S Cookson, Sanjay G Patel
OBJECTIVES: To examine temporal national trends of operative approach for cystectomy and identify demographic or clinical predictive factors that influence choice of approach. METHODS: We performed a retrospective cohort study of patients who underwent cystectomy for bladder cancer between 2010 and 2013 using the National Cancer Database (NCDB). Approach was stratified by open vs. minimally invasive (robotic or laparoscopic). Univariate Pearson chi-square and multivariate logistic regression analysis was used to assess relationships between demographic and hospital factors and the receipt of minimally invasive or open surgical approach...
February 15, 2017: Urology
https://www.readbyqxmd.com/read/28214508/surgical-management-of-pericardial-diseases
#3
REVIEW
Douglas R Johnston
Disease of the pericardium represents a relatively rare indication for cardiac surgery, and there exist no widely accepted guidelines for surgical management. As such, the surgical approach to the pericardium has relied largely on institutional experience with a slow evolution based on published studies. In particular, management of pericardial constriction has varied widely from surgeon to surgeon and institution to institution, in large part due to a perception of inherent high risk to the procedure. This review covers the current practice of surgery for disease of the pericardium, with particular focus on the evolution of indications for pericardiectomy, new applications in inflammatory or relapsing pericarditis, and the progressive refinement in surgical technique and operative planning which have led to significantly improved outcomes in experienced centers...
January 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/28214487/radiofrequency-ablation-with-concomitant-stab-phlebectomy-increases-risk-of-endovenous-heat-induced-thrombosis
#4
Caitlin W Hicks, Sandra R DiBrito, J Trent Magruder, M Libby Weaver, Cathy Barenski, Jennifer A Heller
OBJECTIVE: Endovenous heat-induced thrombosis (EHIT) is a well-documented phenomenon that follows endovenous ablation, but the treatment, surveillance, and risk factors for EHIT have yet to be comprehensively elucidated. We sought to identify characteristics that may put patients at higher risk for development of EHIT after radiofrequency ablation (RFA) for the treatment of symptomatic superficial venous insufficiency. METHODS: A retrospective review was performed of all consecutive patients undergoing treatment with RFA to the great saphenous vein by a single surgeon from July 2013 through October 2015...
March 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28214463/bridging-the-gap-in-peripheral-nerve-repair
#5
Donato Perretta, Steven Green
Peripheral nerve injuries following trauma present an ongoing challenge to the hand surgeon. This review presents an overview of the topic with a historical perspective. Nerve anatomy and nerve injury classifications are discussed followed by a description of the biology of nerve regeneration. Methods used to bridge gaps in peripheral nerve repair are discussed in detail with a critical appraisal of the most recent literature. Recommendations for surgical treatment are formulated based on evidence-based medicine...
January 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28214462/the-arthroscopic-latarjet-a-bony-solution-for-a-bony-injury
#6
David Ding, Robert Meislin
Treatment of shoulder instability has greatly evolved over the past century. Open capsulolabral repairs and bony augmentation procedures have slowly been replaced with arthroscopy. As arthroscopy and arthroscopic instruments have improved, surgeons have gravitated toward more minimally invasive procedures. The open Latarjet procedure has been historically very successful in preventing recurrent shoulder dislocation. While there is a steep learning curve, the arthroscopic Latarjet procedure as developed by Lafosse in 2007 can be effective in preventing shoulder instability in patients with significant bone loss of up to 30%...
January 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28214460/managing-acetabular-defects-in-total-hip-arthroplasty
#7
Brian Park, Frank Liporace, Scott Marwin
With the aging population and rising incidence of primary total joint arthroplasty has come the increasing incidence of revision total hip arthroplasties. One challenge in revision total hip arthroplasty is dealing with acetabular defects. The orthopaedic surgeon who chooses to take on these challenges requires a proper method for the evaluation of these defects as well as an evidence-based treatment algorithm. Initial assessment requires appropriate use and interpretation of imaging modalities such as x-rays and computed tomography...
January 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28214280/current-guidelines-do-not-sufficiently-discriminate-venous-thromboembolism-risk-in-urology
#8
Kristen McAlpine, Rodney H Breau, Ranjeeta Mallick, Sonya Cnossen, Ilias Cagiannos, Christopher Morash, Marc Carrier, Luke T Lavallée
PURPOSE: Venous thromboembolism (VTE) is the leading cause of noncancer death following major cancer surgery. Current thromboprophylaxis guidelines do not address procedure-specific risk of venous thromboembolism for urological patients. This project was created to determine the risk and timing of VTE after major urological surgery and to evaluate if surgical procedure was an independent risk factor for VTE after adjusting for previously established risk factors. MATERIAL AND METHODS: The American College of Surgeons׳ National Surgical Quality Improvement Program was used to create a cohort of patients who received major abdominal or pelvic urologic surgery between 2006 and 2014...
February 14, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28214257/a-comparison-of-two-dosing-regimens-of-asa-following-total-hip-and-knee-arthroplasties
#9
Michael J Feldstein, Sara L Low, Antonia F Chen, Laura A Woodward, William J Hozack
BACKGROUND: The purpose of this study was to compare short-term side effects of aspirin (ASA) 325 mg vs ASA 81 mg orally twice daily (PO BID) when used as thromboembolic prophylaxis following primary total joint arthroplasty. METHODS: A 1-year prospective cohort study was performed on 643 primary unilateral total joint arthroplasty patients operated on by a single surgeon. Two hundred eighty-two patients were administered ASA 325 mg PO BID and 361 patients were administered ASA 81 mg PO BID for 1 month...
January 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28214254/normothermia-in-arthroplasty
#10
REVIEW
Mark W Allen, David J Jacofsky
Since the initial design of surgical theaters, the thermal environment of the operating suite itself has been an area of concern and robust discussion. In the 1950s, correspondence in the British Medical Journal discussed the most suitable design for a surgeon's cap to prevent sweat from dripping onto the surgical field. These deliberations stimulated questions about the effects of sweat-provoking environments on the efficiency of the surgical team, not to mention the effects on the patient. Although these benefits translate to implant-based orthopedic surgery, they remain poorly understood and, at times, ignored...
January 17, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28214101/endophthalmitis-reduction-with-intracameral-moxifloxacin-prophylaxis-analysis-of-600%C3%A2-000-surgeries
#11
Aravind Haripriya, David F Chang, Ravilla D Ravindran
PURPOSE: To compare the postoperative endophthalmitis rate before and after initiation of intracameral (IC) moxifloxacin prophylaxis for both phacoemulsification and sutureless, manual small-incision cataract surgery (M-SICS), as well as in patients with posterior capsular rupture (PCR). DESIGN: Retrospective, clinical registry. PARTICIPANTS: All cataract surgeries (617 453) performed during the 29-month period from January 2014 to May 2016 at the 10 regional Aravind eye hospitals were included...
February 14, 2017: Ophthalmology
https://www.readbyqxmd.com/read/28214053/standardization-of-oncoplastic-breast-conserving-surgery
#12
REVIEW
W P Weber, S D Soysal, I Fulco, M Barandun, D Babst, D Kalbermatten, D J Schaefer, D Oertli, E A Kappos, M Haug
The emphasis on esthetic outcomes and quality of life after breast cancer surgery has motivated surgeons to develop oncoplastic breast conserving surgery (OPS). Training programs are still rare in most countries, and there is little standardization, which challenges the scientific evaluation of the techniques. The present article attempts to standardize OPS nomenclature, indications, and reconstruction choice selection embedded in a thorough review of the literature. We propose four breast conserving surgery (BCS) categories: Conventional tumorectomy, oncoplastic mastopexy, oncoplastic tumorectomy and oncoplastic reduction mammoplasty...
January 31, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28213996/three-dimensional-computed-tomography-for-preoperative-assessment-of-the-pulmonary-artery-in-patients-undergoing-endoscopic-lobectomy-or-segmentectomy
#13
Amaia Ojanguren, José Luis Recuero, Marina Pardina, Lucía Milla, Maite Santamaría
BACKGROUND: The interest for endoscopic pulmonary anatomic resections has grown exponentially during the last decade. During thoracoscopic procedures surgeons cannot rely on digital handling and operative field is viewed on a two-dimensional video monitor, thus frequently encountering anatomical difficulties. The hypothesis is that foreknowledge of the anatomy of each patient would greatly contribute to the safety and accuracy of the operation. The aim of the study was to evaluate the effectiveness of 3dimensional multidetector computed tomography (3D-MDCT) software to identify the pulmonary artery branching pattern during the preoperative study of endoscopic lobectomies and segmentectomies...
February 14, 2017: Cirugía Española
https://www.readbyqxmd.com/read/28213934/transverse-process-anatomy-as-a-guide-to-vertebral-artery-exposure-during-anterior-cervical-spine-approach-a-cadaveric-study
#14
Ali Nourbakhsh, Jinping Yang, Howard McMahan, Kim Garges
INTRODUCTION: Safe exposure of the vertebral artery (VA) is needed during resection of tumors close to the artery and during repair of lacerations. We defined the anatomy of the anterior root of each transverse process (TP) from C3 to C6 for identification and exposure of the VA during the anterior approach. MATERIALS AND METHODS: We examined the anatomy of the TP and assessed two approaches for safe identification of the VA, lateral to medial and medial to lateral dissection of the TP, in 20 cadavers...
February 18, 2017: Clinical Anatomy
https://www.readbyqxmd.com/read/28213925/rotator-cuff-disease-opinion-regarding-surgical-criteria-and-likely-outcome
#15
Alison Thorpe, Mark Hurworth, Peter O'Sullivan, Tim Mitchell, Anne Smith
BACKGROUND: Clinical guidelines for the management of rotator cuff disease are not clear. Surgeon surveys in the USA and UK lack agreement regarding surgical indications. Physical examination tests aid surgical decision-making but also lack robust evidence. Study aims were to evaluate: Western Australian orthopaedic surgeons' perceptions about surgical indications; utility of physical examination tests; findings at surgery predictive of outcome and surgeon opinion of a successful surgical outcome...
February 17, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28213861/peri-operative-allogeneic-blood-transfusion-and-outcomes-after-radical-cystectomy-a-population-based-study
#16
D Robert Siemens, Melanie T Jaeger, Xuejiao Wei, Francisco Vera-Badillo, Christopher M Booth
INTRODUCTION: To describe factors associated with peri-operative blood transfusion (PBT) at radical cystectomy (RC) for patients with bladder cancer and evaluate its association on both early and late outcomes. METHODS: Electronic records of treatment and surgical pathology reports were linked to the population-based Ontario Cancer Registry to identify all patients who underwent RC between 2000 and 2008. Modified Poisson regression model was used to determine the factors associated with PBT...
February 17, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/28213856/inferior-vena-cava-system-anomalies-surgical-implications
#17
REVIEW
Javier González, Jeffrey J Gaynor, Luis F Albéniz, Gaetano Ciancio
PURPOSE OF REVIEW: The inferior vena cava (IVC) system is the major venous collecting blood network of the human body. This structure is formed in a complicated series of developmental stages between the fourth and eighth weeks of intrauterine life. Alterations in the developing process of the IVC system give rise to an array of different congenital variants or developmental anomalies. RECENT FINDINGS: IVC anomalies are uncommon, usually of little physiological consequence, and mostly discovered incidentally during cross-sectional imaging in otherwise healthy individuals...
February 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28213663/a-historical-glance-at-the-arabo-islamic-surgical-instruments-during-the-ages
#18
Gregory Tsoucalas, Markos Sgantzos
Arabo-Islamic physicians demonstrated exceptional skill and innovation in surgery, by having used the instruments introduced by ancient Greeks and Greco-Roman surgeons. In many cases they have manufactured their own innovative designs promoting further the success of the difficult surgical operations of their era. The surgical instruments and the surgeon's boxes, used to regularise the plethora of the metallic items, were decorated with fine designs, in order to depict the Arab civilisation. For the first time surgery became a separate medical art, while Arabo-Islamic medicine re-introduced ancient Greek and Byzantine surgery to the world...
February 17, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28213639/prechiasmatic-sulcus-and-optic-strut-an-anatomic-study-in-dry-skulls
#19
Vasiliki Kanellopoulou, Evgenia Efthymiou, Vasiliki Thanopoulou, Dimitra Kozompoli, Dimitrios Mytilinaios, Maria Piagkou, Elizabeth O Johnson
BACKGROUND: Although safe surgical access to the cavernous sinus is related to understanding the anatomical and ethnic variants of the prechiasmatic sulcus and the optic strut, there remains a paucity of studies of the morphology and the bony relationships in the region. The present study provides a systematic morphological and morphometric analysis of the sulcal region and the optic strut anatomy and their relations in a Greek population. METHODS: The interoptic distance, length of planum sphenoidale, sulcal length and sulcal angle was determined in 96 Greek adult dry skulls...
February 17, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28213633/associations-between-pain-catastrophizing-and-cognitive-fusion-in-relation-to-pain-and-upper-extremity-function-among-hand-and-upper-extremity-surgery-patients
#20
Sezai Özkan, Emily L Zale, David Ring, Ana-Maria Vranceanu
BACKGROUND: Patients who present to hand surgery practices are at increased risk of psychological distress, pain, and disability. Greater catastrophic thinking about pain is associated with greater pain intensity, and initial evidence suggest that, together, catastrophic thinking about pain and cognitive fusion (i.e., interpretation of thoughts as true) are associated with poorer pain outcomes. PURPOSE: We tested whether cognitive fusion or catastrophic thinking interacts in relation to pain and upper extremity physical function among patients seeking care from a hand surgeon...
February 17, 2017: Annals of Behavioral Medicine: a Publication of the Society of Behavioral Medicine
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