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Early recovery after surgery

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https://www.readbyqxmd.com/read/27926560/using-modified-frailty-index-to-predict-safe-discharge-within-48-hours-of-ileostomy-closure
#1
Yuxiang Wen, Murad A Jabir, Eslam M G Dosokey, Dongjin Choi, Clayton C Petro, Justin T Brady, Scott R Steele, Conor P Delaney
BACKGROUND: Enhanced recovery pathways allow for safe discharge and optimal outcomes within 48 hours after ileostomy closure. Unfortunately, some patients undergoing ileostomy closure have prolonged hospital stays. We have shown previously that the Modified Frailty Index can help predict patients who will fail early discharge after laparoscopic colorectal surgery. OBJECTIVE: The purpose of this study was to use the Modified Frailty Index to identify patients who were safe for early discharge after ileostomy closure...
January 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/27924202/randomized-trial-of-subfascial-infusion-of-ropivacaine-for-early-recovery-in-laparoscopic-colorectal-cancer-surgery
#2
Sang Hyun Lee, Woo-Seog Sim, Go Eun Kim, Hee Cheol Kim, Joo Hyun Jun, Jin Young Lee, Byung-Seop Shin, Heejin Yoo, Sin-Ho Jung, Joungyoun Kim, Seung Hyeon Lee, Deok Kyu Yo, Yu Ri Na
BACKGROUND: There is a need for investigating the analgesic method as part of early recovery after surgery tailored for laparoscopic colorectal cancer (LCRC) surgery. In this randomized trial, we aimed to investigate the analgesic efficacy of an inverse 'v' shaped bilateral, subfascial ropivacaine continuous infusion in LCRC surgery. METHODS: Forty two patients undergoing elective LCRC surgery were randomly allocated to one of two groups to receive either 0.5% ropivacaine continuous infusion at the subfascial plane (n = 20, R group) or fentanyl intravenous patient controlled analgesia (IV PCA) (n = 22, F group) for postoperative 72 hours...
December 2016: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/27924170/use-of-a-respiratory-volume-monitor-to-assess-respiratory-competence-in-cardiac-surgery-patients-after-extubation
#3
Stephan Ianchulev, Diane Ladd, C Marshall MacNabb, Lizeng Qin, Nathan Marengi, Jenny Freeman
BACKGROUND: Patients who have undergone cardiac surgery are generally mechanically ventilated postoperatively. Early postoperative extubation is currently recommended in anesthesia guidelines. No current technology can accurately, non-invasively, measure respiratory competence after extubation. Pulse oximetry has been helpful, but this is a late indicator of respiratory compromise. A novel, non-invasive, respiratory volume monitor (RVM) has been shown to deliver accurate continuous, real-time minute ventilation (MV), tidal volume (TV) and respiratory rate (RR) measurements and provide an objective measure of respiratory competence...
January 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/27923622/factors-predicting-quadriceps-femoris-muscle-atrophy-during-the-first-12weeks-following-anterior-cruciate-ligament-reconstruction
#4
T Grapar Žargi, Matej Drobnič, Renata Vauhnik, Jadran Koder, Alan Kacin
BACKGROUND: Factors predicting quadriceps femoris muscle (QF) atrophy during the early period after arthroscopic ACL reconstruction have not been extensively studied. It is also yet to be confirmed whether muscle atrophy is a key determinant of postoperative QF weakness. METHODS: Mean changes in QF volume, MVIC torque and isometric endurance time were analysed in 25 patients prior to and at four and 12 weeks after surgery. A multivariable regression model of change in QF volume was made from combination of several parameters of preoperative QF size and strength and postoperative joint recovery...
December 3, 2016: Knee
https://www.readbyqxmd.com/read/27917662/validating-a-benchmarking-tool-for-audit-of-early-outcomes-after-operations-for-head-and-neck-cancer
#5
D Tighe, I Sassoon, M McGurk
INTRODUCTION In 2013 all UK surgical specialties, with the exception of head and neck surgery, published outcome data adjusted for case mix for indicator operations. This paper reports a pilot study to validate a previously published risk adjustment score on patients from separate UK cancer centres. METHODS A case note audit was performed of 1,075 patients undergoing 1,218 operations for head and neck squamous cell carcinoma under general anaesthesia in 4 surgical centres. A logistic regression equation predicting for all complications, previously validated internally at sites A-C, was tested on a fourth external validation sample (site D, 172 operations) using receiver operating characteristic curves, Hosmer-Lemeshow goodness of fit analysis and Brier scores...
December 5, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27906936/analgesic-effect-of-nalbuphine-when-added-to-intravenous-regional-anesthesia-a-randomized-control-trial
#6
Mohamed Hassan Bakri, Eman Ahmed Ismail, Sayed Kaoud Abd-Elshafy
BACKGROUND: Different adjuvant drugs are currently added to lidocaine for intravenous regional anesthesia (IVRA) to decrease tourniquet and postoperative pain. OBJECTIVE: The aim of the study was to examine the effect of nalbuphine when added toIVRA. STUDY DESIGN: Prospective, randomized, double-blind, controlled clinical trial. SETTING: Assiut University Hospitals. METHODS: One hundred-six adult patients scheduled for unilateral hand surgery under IVRA were randomized into 2 equal groups...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27904720/clinical-results-of-lateral-unicompartmental-knee-arthroplasty-minimum-2-year-follow-up
#7
Kyung Tae Kim, Song Lee, Jeehyoung Kim, Jin Woo Kim, Min Su Kang
BACKGROUND: We investigated the clinical results and early complications after lateral unicompartmental knee arthroplasty (UKA) using the Zimmer unicompartmental high-flex knee (ZUK) prosthesis with a minimum follow-up of 2 years. METHODS: Twenty-seven patients (30 cases) who underwent lateral UKA with the ZUK prosthesis between January 2011 and February 2014 were selected for this study. The mean age of the patients was 63.3 years at the time of surgery, and the mean followup was 3 years and 2 months (range, 24 to 48 months)...
December 2016: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/27903590/anterior-cruciate-ligament-derived-stem-cells-transduced-with-bmp2-accelerate-graft-bone-integration-after-acl-reconstruction
#8
Yohei Kawakami, Koji Takayama, Tomoyuki Matsumoto, Ying Tang, Bing Wang, Yutaka Mifune, James H Cummins, Ryan J Warth, Ryosuke Kuroda, Masahiro Kurosaka, Freddie H Fu, Johnny Huard
BACKGROUND: Strong graft-bone integration is a prerequisite for successful graft remodeling after reconstruction of the anterior cruciate ligament (ACL) using soft tissue grafts. Novel strategies to accelerate soft tissue graft-bone integration are needed to reduce the need for bone-tendon-bone graft harvest, reduce patient convalescence, facilitate rehabilitation, and reduce total recovery time after ACL reconstruction. HYPOTHESIS: The application of ACL-derived stem cells with enhanced expression of bone morphogenetic protein 2 (BMP2) onto soft tissue grafts in the form of cell sheets will both accelerate and improve the quality of graft-bone integration after ACL reconstruction in a rat model...
November 30, 2016: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/27888148/a-pilot-study-of-a-multimodal-treatment-paradigm-to-accelerate-drug-evaluations-in-early-stage-metastatic-prostate-cancer
#9
Matthew J O'Shaughnessy, Sean M McBride, Hebert Alberto Vargas, Karim A Touijer, Michael J Morris, Daniel C Danila, Vincent P Laudone, Bernard H Bochner, Joel Sheinfeld, Erica S Dayan, Lawrence P Bellomo, Daniel D Sjoberg, Glenn Heller, Michael J Zelefsky, James A Eastham, Peter T Scardino, Howard I Scher
OBJECTIVE: To evaluate a multimodal strategy aimed at treating all sites of disease that provides a rapid readout of success or failure in men presenting with noncastrate metastatic prostate cancers that are incurable with single modality therapy. PATIENTS AND METHODS: Twenty selected men with oligometastatic M1a (extrapelvic nodal disease) or M1b (bone disease) at diagnosis were treated using a multimodal approach that included androgen deprivation, radical prostatectomy plus pelvic lymphadenectomy (retroperitoneal lymphadenectomy in the presence of clinically positive retroperitoneal nodes), and stereotactic body radiotherapy to osseous disease and/or the primary site...
November 22, 2016: Urology
https://www.readbyqxmd.com/read/27888077/subcortical-low-intensity-lesions-on-fluid-attenuated-inversion-recovery-images-after-revascularization-surgery-for-moyamoya-disease
#10
Toshio Machida, Shigeki Nakano, Satoshi Ishige, Junichi Ono, Atsushi Fujikawa
OBJECTIVE: Although uncommon, subcortical low-intensity (SCLI) changes on fluid-attenuated inversion recovery (FLAIR) images are observed in various pathologies, including cerebral ischemia. Here we aimed to clarify the incidence and clinical implications of SCLI changes after revascularization surgery for moyamoya disease (MMD), focusing on the correlation with postoperative transient neurological events (TNEs). METHODS: In this retrospective case series analysis, we included 10 hemispheres from 9 adults with MMD who underwent revascularization surgery...
November 22, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27882156/clinical-effects-of-joint-application-of-%C3%AE-sodium-aescinate-and-mannitol-in-treating-early-swelling-after-upper-limb-trauma-surgery
#11
Bin Wang, Ruixiang Yang, Qing Ju, Shaofeng Liu, Yongchun Zhang, Yong Ma
The aim of the present study was to examine the clinical merits of joint application of β-sodium aescinate and mannitol for the treatment of early swelling of upper limb trauma after surgery. We verified whether the expression of serum aquaporin 1 (AQP-1) was involved in swelling mechanism. A total of 102 patients with swelling after upper limb trauma surgery were enrolled into the study and divided randomly into 3 groups (n=34 cases per group). Group A was treated with β-sodium aescinate; group B was treated with with mannitol and group C was treated with both β-sodium aescinate and mannitol...
November 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27882029/effects-of-comprehensive-rehabilitation-training-in-combination-with-multi-mode-analgesia-on-body-function-recovery-after-tumor-type-knee-replacement
#12
Junjuan Zhang, Yahan Wang, Guangyu Yang, Jing Liu, Junjie Wang
OBJECTIVE: To discuss the significance of comprehensive rehabilitation training combined with multimodal analgesia (MMA) for the early knee function recovery of patients with knee bone tumor who underwent prosthesis replacement operation. METHODS: Sixty patients with knee bone tumor who underwent prosthesis replacement operation were selected and randomly divided into two groups according to rehabilitation training and postoperative analgesic methods, namely, observation group and control group, 30 cases in each group...
September 2016: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/27881294/comparison-of-outcomes-with-arthroscopic-repair-of-acute-on-chronic-within-6-months-and-chronic-rotator-cuff-tears
#13
Jeung Yeol Jeong, Seung Yeop Song, Jae Chul Yoo, Keun Min Park, Sang Min Lee
BACKGROUND: The purpose of this study was to define preoperative and intraoperative findings of acute-on-chronic rotator cuff tears (RCTs). This study also compared the functional and clinical outcomes with acute-on-chronic RCTs and chronic RCTs. METHODS: This study was conducted between December 2007 and December 2013. An acute-on-chronic full-thickness RCT was diagnosed with preoperative and intraoperative findings on arthroscopy. The study group consisted of 36 patients with preoperative and intraoperative findings (surgery performed within 6 months of trauma) indicative of an acute-on-chronic RCT...
November 21, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27878754/efficiency-and-safety-effects-of-applying-eras-protocols-to-bariatric-surgery-a-systematic-review-with-meta-analysis-and-trial-sequential-analysis-of-evidence
#14
REVIEW
Preet Mohinder Singh, Rajesh Panwar, Anuradha Borle, Basavana Goudra, Anjan Trikha, Bart A van Wagensveld, Ashish Sinha
Application of the enhanced recovery after surgery (ERAS) to the bariatric surgical procedures is at its early stages with little consolidated evidence. This meta-analysis evaluates present literature and indicates pathways for development of evidence-based standardized ERAS protocols for bariatric surgery. Comparative trials between ERAS and conventional bariatric surgery published till June 2016 were searched in the medical database. Comparisons were made for length of stay (LOS), readmission, complications (major/minor), and reoperation rates...
November 23, 2016: Obesity Surgery
https://www.readbyqxmd.com/read/27875094/laparoscopic-radical-gastrectomy-for-resectable-advanced-gastric-cancer-within-enhanced-recovery-programs-a-prospective-randomized-controlled-trial
#15
Xia Mingjie, Zhang Luyao, Tang Ze, Zhao YinQuan, Wang Quan
BACKGROUND: Enhanced recovery programs have become an important focus of perioperative management. A few studies have demonstrated the efficacy of an enhanced recovery after surgery (ERAS, which includes optimized pain control, restricted I.V. fluids, early initiation of postoperative oral feeding, and enforced mobilization) protocol in patients undergoing radical gastrectomy. We investigated the feasibility and safety of laparoscopic radical gastrectomy within ERAS programs. METHODS: In this single-center prospective randomized controlled trial conducted between September 2013 and August 2014, 149 consecutive locally advanced gastric cancer patients (T2-4, any N, M0) diagnosed by the CT scanning were allocated to either ERAS group (N = 73) or conventional pathway group (N = 76)...
November 22, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27871549/a-multicenter-study-of-the-analgesic-effects-of-epidural-chloroprocaine-after-lower-limb-orthopedic-surgery
#16
Hongwei Xu, Huiping Li, Yunxia Zuo, Baxian Yang, Yuke Tian, Qulian Guo, Jianguo Xu, Chaoran Wu
STUDY OBJECTIVE: To investigate the effects and optimal concentration of chloroprocaine for epidural analgesia after lower limb orthopedic surgery. DESIGN: Prospective, randomized, observational, multicenter clinical study. SETTING: Operating room, postoperative recovery area, university hospital. PATIENTS: One hundred and twenty patients from 4 hospitals were enrolled and randomized into 5 groups after lower limb orthopedic surgery under epidural anesthesia with lidocaine...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871509/a-cross-sectional-study-of-preoperative-medication-adherence-and-early-postoperative-recovery
#17
Anthony P Notaras, Elisabeth Demetriou, Jessica Galvin, Erez Ben-Menachem
STUDY OBJECTIVE: To quantify the impact of preoperative medication adherence on recovery length of stays and complication rates. DESIGN: Cross-sectional analytical study. SETTING: Postanesthetic care unit (PACU) of a single-center tertiary hospital. PATIENTS: Surgical patients admitted for surgery at our institution over a 4-month period. INTERVENTION: A data collection tool was used to collect demographic data, length of stay in recovery, prespecified conditions likely to impact on PACU recovery (chronic pain, insulin-dependent diabetes, epilepsy, hypertension, on a methadone program, and Parkinson disease), medication compliance, and complications in PACU...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27867569/does-11-5-mm-guided-single-port-surgery-has-clinical-advantage-than-multi-port-thoracoscopic-surgery-in-spontaneous-pneumothorax
#18
Hyun Woo Jeon, Young-Du Kim
BACKGROUND: Video-assisted thoracoscopic surgery (VATS) has been widely used for spontaneous pneumothorax (SP). In recent years, thoracic surgeons have attempted single incision or single port surgery with the development of surgical technology and skills. Theoretically, single port surgery is expected to provide benefits such as less pain and early recovery. The purpose of this study was to determine the benefits of single port surgery in SP. METHODS: The 107 patients with SP who underwent surgery, between July 2013 and May 2015, were reviewed retrospectively...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27866345/comparison-of-rabbit-rib-defect-regeneration-with-and-without-graft
#19
Feng-Zhen Liu, Da-Wei Wang, Yu-Jue Zhang, Zhao Yong Lv, Xiao-Dan Sun, Ke-Yi Li, Bin Zhang, Xiu-Mei Wang, Fu-Zhai Cui
Rib segment, as one of the most widely used autologous boneresources for bone repair, is commonly isolated with an empty left in the defect. Although defective rib repair is thought to be unnecessary traditionally, it's of vital importance actually to promote rib regeneration for patients with better postoperative recovery and higher life quality. Comparative investigations on rabbit rib bone regeneration with and without graft were reported in this article. A segmental defect was performed on the 8th rib of 4-month-old male New Zealand rabbits...
January 2017: Journal of Materials Science. Materials in Medicine
https://www.readbyqxmd.com/read/27863944/how-to-introduce-a-program-of-enhanced-recovery-after-surgery-the-experience-of-the-capio-group
#20
J-F Verrier, C Paget, F Perlier, F Demesmay
The traditional model of hospital care has been challenged by the development of a care-management process that allows early patient autonomy (outpatient surgery, Enhanced Recovery after Surgery). Hospitalization has been transformed in response to this development, based on innovative medical and organizational strategies. Within a surgical service, the deployment of these processes requires the creation of a support structure, with re-organization of existing structures, analysis of potential obstacles, implementation of management tools, and ongoing follow-up of organizational function, clinical results, organizational and patient satisfaction...
November 15, 2016: Journal of Visceral Surgery
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