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Adverse events in surgery

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https://www.readbyqxmd.com/read/29333595/implanted-closed-loop-gastric-electrical-stimulation-clges-system-with-sensor-based-feedback-safely-limits-weight-regain-at-24%C3%A2-months
#1
S Morales-Conde, I Alarcón Del Agua, L Busetto, F Favretti, M Anselmino, G M Rovera, M Socas-Macias, A Barranco-Moreno, R Province-Azalde, A J Torres
BACKGROUND: Weight regain following bariatric surgery is not uncommon. Safe, effective weight loss treatment up to 1 year has been reported with the closed-loop gastric electrical stimulation (CLGES) system. Continuous recording of eating and activity behavior by onboard sensors is one of the novel features of this closed-loop electrical stimulation therapy, and may provide improved long-term weight maintenance by enhancing aftercare. METHODS: Four centers participating in a 12-month prospective multicenter randomized study monitored all implanted participants (n = 47) up to 24 months after laparoscopic implantation of a CLGES system...
January 15, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29332348/sorafenib-combined-with-radiofrequency-ablation-as-treatment-for-patients-with-hepatocellular-carcinoma-a-systematic-review-and-meta-analysis
#2
Lin Chen, Xingming Ma, Xin Liu, Xiaomeng Cui
PURPOSE: To evaluate the safety and efficacy of a combination of sorafenib and radiofrequency ablation (RFA) in patients with hepatocellular carcinoma (HCC). METHODS: A systematic literature search was conducted using PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure (CNKI), China Biology Medicine disc (CBMdisc), WanFang Database, for all years up to January 2017. Pooled analyses of overall survival (OS), tumor- free survival, recurrence rates and adverse events were performed...
November 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/29330272/spontaneous-splenic-rupture-as-a-rare-complication-of-g-csf-injection
#3
Soraya Benguerfi, Fanny Thepault, Hervé Lena, Charles Ricordel
Splenic rupture is an infrequent and underdiagnosed side effect of granylocyte colony-stimulating factor (G-CSF). We report the case of a 54-year-old woman with brain and bone metastasis in a lung adenocarcinoma who was admitted for faintness 28 days after a G-CSF injection. Abdominal CT scan confirmed the diagnosis of splenic rupture. A conservative treatment was chosen using a peritoneal cleansing during laparoscopic surgery. Clinicians should be aware of this rare toxicity as it could be severe, but easily reversible using appropriate surgical treatment...
January 12, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29330080/use-of-a-pulsed-radiofrequency-energy-device-peak-plasmablade%C3%A2-in-neuromodulation-implant-revisions
#4
I Ughratdar, K A Kawsar, R Mitchell, R Selway, K Ashkan
BACKGROUND: Battery replacement or revision surgery for neuromodulation implants is conventionally performed using sharp dissection. Meticulous dissection within thick scar tissue is vital to avoid damage to surrounding lead(s) which could result in more extensive revision surgery. Traditional electrosurgery devices are contraindicated as the emitted energy can be transferred to the hardware resulting in implant or tissue damage with severe consequent complications. OBJECTIVE: We report our experience and potential applications of a novel, pulsed monopolar radiofrequency energy device (PEAK PlasmaBlade™, Medtronic plc) which facilitates dissection around implants without the risk of damaging or transmitting energy through the system...
January 9, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29329975/risk-of-suicide-and-non-fatal-self-harm-after-bariatric-surgery-results-from-two-matched-cohort-studies
#5
Martin Neovius, Gustaf Bruze, Peter Jacobson, Kajsa Sjöholm, Kari Johansson, Fredrik Granath, Johan Sundström, Ingmar Näslund, Claude Marcus, Johan Ottosson, Markku Peltonen, Lena M S Carlsson
BACKGROUND: Bariatric surgery reduces mortality, but might have adverse effects on mental health. We assessed the risk of suicide and self-harm after bariatric surgery compared with non-surgical obesity treatment. METHODS: Suicide and non-fatal self-harm events retrieved from nationwide Swedish registers were examined in two cohorts. The non-randomised, prospective Swedish Obese Subjects (SOS) study compared bariatric surgery (n=2010; 1369 vertical-banded gastroplasty, 376 gastric banding, and 265 gastric bypass) with usual care (n=2037; recruitment 1987-2001)...
January 9, 2018: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/29329493/a-randomized-double-blind-controlled-trial-of-intravenous-meloxicam-in-the-treatment-of-pain-following-dental-impaction-surgery
#6
Steven E Christensen, Stephen A Cooper, Randall J Mack, Stewart W McCallum, Wei Du, Alex Freyer
This randomized, controlled phase 2 study was conducted to evaluate the analgesic efficacy, safety, and tolerability of single intravenous (IV) doses of 15 mg, 30 mg, and 60 mg meloxicam compared with oral ibuprofen 400 mg and placebo after dental impaction surgery. The primary efficacy end point was the sum of time-weighted pain intensity differences for 0-24 hours postdose. Among 230 evaluable subjects, meloxicam IV 60 mg produced the greatest reduction in pain, followed by the 30-mg and 15-mg doses. Statistically significant differences in summed pain intensity differences over 24 hours were demonstrated for each active-treatment group vs placebo (favoring active treatment) and for meloxicam IV 30 mg and 60 mg vs ibuprofen 400 mg (favoring meloxicam IV)...
January 12, 2018: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29328000/conscious-sedation-with-dexmedetomidine-compared-with-asleep-awake-asleep-craniotomies-in-glioma-surgery-an-analysis-of-180-patients
#7
Eric Suero Molina, Stephanie Schipmann, Isabelle Mueller, Johannes Wölfer, Christian Ewelt, Matthias Maas, Benjamin Brokinkel, Walter Stummer
OBJECTIVE Awake craniotomies have become a feasible tool over time to treat brain tumors located in eloquent regions. Different techniques have been applied in neurooncology centers. Both "asleep-awake-asleep" (asleep) and "conscious sedation" were used subsequently at the authors' neurosurgical department. Since 2013, the authors have only performed conscious sedation surgeries, predominantly using the α2-receptor agonist dexmedetomidine as the anesthetic drug. The aim of this study was to compare both mentioned techniques and evaluate the clinical use of dexmedetomidine in the setting of awake craniotomies for glioma surgery...
January 12, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29327570/the-detour-procedure-no-more-need-for-conventional-bypass-surgery
#8
Dainis Krievins, Janis Savlovskis, Natalija Ezite, Andrew Hill, Kaspars Kisis, Marcis Gedins, Edgars Zellans, Andrew Holden
BACKGROUND: Long segment occlusive disease in the superficial femoral artery remains a treatment challenge despite advances in open surgical and endovascular approaches. We report initial clinical results of an entirely new procedure to perform femoropopliteal bypass using the DETOUR System to create a stentgraft bypass which originates in the SFA, travels through the femoral vein, and ends in the popliteal artery, bypassing the diseased segment. METHODS: Review the initial results of the first five patients at a single site enrolled in IRB-approved, prospective clinical study using the DETOUR System...
January 9, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29327147/post-operative-catheterization-interventions-at-the-site-of-surgery-an-application-of-the-crisp-scoring-system
#9
Katie Mowers, Toby Rockefeller, David Balzer, Ramzi Nicolas, Shabana Shahanavaz
Catheter-based interventions in the early post-operative period are performed with caution due to concerns for increased procedural risk, particularly across fresh suture lines. The recently published CRISP scoring system provides prospective risk stratification based on pre-procedural criterion. In an effort to refine the assessment of risk in patients undergoing post-operative catheter-based interventions, the predicted risk of an adverse event based on CRISP scores was compared to actual adverse event rates...
January 12, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29327055/comparing-neoadjuvant-nab-paclitaxel-vs-paclitaxel-both-followed-by-anthracycline-regimens-in-women-with-erbb2-her2-negative-breast-cancer-the-evaluating-treatment-with-neoadjuvant-abraxane-etna-trial-a-randomized-phase-3-clinical-trial
#10
Luca Gianni, Mauro Mansutti, Antonio Anton, Lourdes Calvo, Giancarlo Bisagni, Begoña Bermejo, Vladimir Semiglazov, Marc Thill, Jose Ignacio Chacon, Arlene Chan, Serafin Morales, Isabel Alvarez, Arrate Plazaola, Milvia Zambetti, Andrew D Redfern, Christian Dittrich, Rebecca Alexandra Dent, Domenico Magazzù, Raffaella De Fato, Pinuccia Valagussa, Ignacio Tusquets
Importance: Studies of neoadjuvant chemotherapy regimens using anthracyclines followed by taxanes have reported a doubling of pathological complete remission (pCR) rates compared with anthracycline-based regimens alone. A reverse sequence did not reduce activity. Nab-paclitaxel is an albumin-bound nanoparticle of paclitaxel that allows for safe infusion without premedication, and its use led to a significantly higher rate of pCR in the GeparSepto trial. Objective: To determine whether nab-paclitaxel improves the outcomes of early and locally advanced human epidermal growth factor receptor 2 (ERBB2/HER2)-negative breast cancer compared with paclitaxel when delivered in a neoadjuvant setting...
January 11, 2018: JAMA Oncology
https://www.readbyqxmd.com/read/29327045/serial-in-office-intralesional-steroid-injections-in-airway-stenosis
#11
Caitlin Bertelsen, Hagit Shoffel-Havakuk, Karla O'Dell, Michael M Johns, Lindsay S Reder
Importance: Endoscopic dilation is the mainstay treatment strategy for subglottic and proximal tracheal stenosis (SGS/PTS). Its major limitation is restenosis requiring repeated surgery. Intralesional steroid injection (ISI) is a promising adjunctive treatment aimed at prolonging the effects of dilation. Objective: To evaluate the association of serial in-office ISI after endoscopic dilation with surgery-free interval (SFI) in adults with SGS/PTS. Design, Setting, and Participants: A retrospective study of adults with SGS/PTS who underwent at least 2 consecutive in-office ISI at the University of Southern California, Keck School of Medicine, over a 3-year period was conducted...
January 11, 2018: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29326112/epidemiology-of-new-onset-atrial-fibrillation-following-coronary-artery-bypass-graft-surgery
#12
Giovanni Filardo, Ralph J Damiano, Gorav Ailawadi, Vinod H Thourani, Benjamin D Pollock, Danielle M Sass, Teresa K Phan, Hoa Nguyen, Briget da Graca
OBJECTIVES: Postoperative atrial fibrillation (AF) following coronary artery bypass graft surgery (CABG) is significantly associated with reduced survival, but poor characterisation and inconsistent definitions present barriers to developing effective prophylaxis and management. We sought to address this knowledge gap. METHODS: From 2002 to 2010, 11 239 consecutive patients without AF underwent isolated CABG at five sites. Clinical data collected for the Society of Thoracic Surgeons (STS) Database were augmented with details on AF detected via continuous in-hospital ECG/telemetry monitoring to assess new-onset post-CABG AF (adjusted for STS risk of mortality); time to first AF; durations of first and longest AF episodes; total in-hospital time in AF; number of in-hospital AF episodes; operative mortality; stroke; discharge in AF; and length of stay (LOS)...
January 11, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29326029/neoadjuvant-treatment-with-trastuzumab-and-pertuzumab-plus-palbociclib-and-fulvestrant-in-her2-positive-er-positive-breast-cancer-na-pher2-an-exploratory-open-label-phase-2-study
#13
Luca Gianni, Giancarlo Bisagni, Marco Colleoni, Lucia Del Mastro, Claudio Zamagni, Mauro Mansutti, Milvia Zambetti, Antonio Frassoldati, Raffaella De Fato, Pinuccia Valagussa, Giuseppe Viale
BACKGROUND: In the neoadjuvant setting, blockade of HER2 plus use of an aromatase inhibitor in patients with HER2-positive and oestrogen receptor (ER)-positive breast cancer leads to a pathological complete response in 21% of patients. Convergence of HER2 and ER signals on RB1 suggests that a combined pharmacological intervention directed to these targets could be synergistic. To test this approach, we combined palbociclib to block RB1, fulvestrant to block ER, and trastuzumab with pertuzumab to block HER2 in patients with HER2-positive, ER-positive breast cancer...
January 8, 2018: Lancet Oncology
https://www.readbyqxmd.com/read/29325521/adjuvant-treatment-of-resectable-biliary-tract-cancer-with-cisplatin-plus-gemcitabine-a-prospective-single-center-phase-ii-study
#14
Alexander R Siebenhüner, Heike Seifert, Helga Bachmann, Burkhardt Seifert, Thomas Winder, Jonas Feilchenfeldt, Stefan Breitenstein, Pierre-Alain Clavien, Roger Stupp, Alexander Knuth, Bernhard Pestalozzi, Panagiotis Samaras
BACKGROUND: Biliary tract cancer (BTC) is a dismal disease, even after curative intent surgery. We conducted this prospective, non-randomized phase II study to evaluate the feasibility and efficacy of cisplatin and gemcitabine as adjuvant treatment in patients with resected BTC. METHODS: Patients initially received gemcitabine 1000 mg/m2 alone on days 1, 8 and 15 every 28-days for a total of six cycles (single agent cohort), and after protocol amendment a combination therapy with gemcitabine 1000 mg/m2 and cisplatin 25 mg/m2 on days 1 and 8 was administered every 21 days for a total of eight cycles (combined regimen cohort)...
January 11, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29324496/efficacy-of-ultrasound-guided-serratus-plane-block-on-postoperative-quality-of-recovery-and-analgesia-after-video-assisted-thoracic-surgery-a-randomized-triple-blind-placebo-controlled-study
#15
Do-Hyeong Kim, Young Jun Oh, Jin Gu Lee, Donghun Ha, Young Jin Chang, Hyun Jeong Kwak
BACKGROUND: The optimal regional technique for analgesia and improved quality of recovery after video-assisted thoracic surgery (a procedure associated with considerable postoperative pain) has not been established. The main objective in this study was to compare quality of recovery in patients undergoing serratus plane block (SPB) with either ropivacaine or normal saline on the first postoperative day. Secondary outcomes were analgesic outcomes, including postoperative pain intensity and opioid consumption...
January 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29322607/stenting-of-the-inter-atrial-septum-in-infants-and-small-children-indications-techniques-and-outcomes
#16
Gur Mainzer, Sebastian Goreczny, Gareth J Morgan, Shakeel Qureshi, Thomas Krasemann, Pawel Dryzek, Jadwiga A Moll, Tomasz Moszura, Eric Rosenthal
OBJECTIVES: To evaluate the procedural success and outcome of inter-atrial stenting. BACKGROUND: Inter-atrial stenting has been shown to be an effective way to maintain inter-atrial blood flow, however it is considered a high risk procedure, usually performed urgently in patients with significant hemodynamic compromise. METHODS: Between September 2004 and August 2016, inter-atrial stenting was attempted in 29 children. Procedural, clinical, and follow-up data were collected retrospectively...
January 11, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29322017/clinical-profile-and-long-term-follow-up-of-32-patients-with-postoperative-permanent-hypoparathyroidism
#17
Leyre Lorente-Poch, Juan J Sancho, Leticia Carballo, Antonio Sitges-Serra
Background: Parathyroid failure is the most common complication after total thyroidectomy but permanent impairment of the parathyroid function is unusual. Limited data is available assessing long-term follow-up, quality of life and complications occurring in patients with permanent hypoparathyroidism (PH). We aimed to assess the incidence of complications derived from PH status, their influence on the quality of life perceived by PH patients and its relation to standard medical treatment with calcium salts and active vitamin D analogues...
December 2017: Gland Surgery
https://www.readbyqxmd.com/read/29321066/perioperative-management-of-antiplatelet-therapy-in-patients-undergoing-non-cardiac-surgery-following-coronary-stent-placement-a-systematic-review
#18
Christopher P Childers, Melinda Maggard-Gibbons, Jesus G Ulloa, Ian T MacQueen, Isomi M Miake-Lye, Roberta Shanman, Selene Mak, Jessica M Beroes, Paul G Shekelle
BACKGROUND: The correct perioperative management of antiplatelet therapy (APT) in patients undergoing non-cardiac surgery (NCS) is often debated by clinicians. American College of Cardiology (ACC) and American Heart Association (AHA) guidelines recommend postponing elective NCS at least 3 months after stent implantation. Regardless of the timing of surgery, ACC/AHA guidelines recommend continuing at least ASA throughout the perioperative period and ideally continuing dual APT (DAPT) therapy "unless surgery demands discontinuation...
January 10, 2018: Systematic Reviews
https://www.readbyqxmd.com/read/29317974/global-risk-score-and-clinical-syntax-score-as-predictors-of-clinical-outcomes-of-patients-undergoing-unprotected-left-main-percutaneous-catheter-intervention
#19
Lucky Cuenza, Marianne P Collado, James Ho Khe Sui
Background: Risk stratification is an important component of left main percutaneous catheter intervention (PCI) which has emerged as a feasible alternative to cardiac surgery. We sought to compare the clinical SYNTAX score and the global risk score in predicting outcomes of patients undergoing unprotected left main PCI in our institution. Methods: Clinical, angiographic and procedural characteristics of 92 patients who underwent unprotected left main PCI (mean age 62 ± 12...
December 2017: Cardiology Research
https://www.readbyqxmd.com/read/29317808/clinical-utility-of-the-revised-cardiac-risk-index-in-older-chinese-patients-with-known-coronary-artery-disease
#20
Lu Che, Li Xu, Yuguang Huang, Chunhua Yu
Objectives: The revised Cardiac Risk Index (RCRI) is the most widely used risk prediction tool for postoperative cardiac adverse events. We aim to explore the predictive ability of the RCRI in older Chinese patients with coronary artery disease (CAD) undergoing noncardiac surgery, which has not been previously evaluated. Methods: We performed a multicenter, prospective study. We enrolled a total of 1,202 patients, aged >60 years, with a history of CAD who underwent noncardiac surgery...
2018: Clinical Interventions in Aging
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