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Early recovery after surgery

Marc A Furrer, Antoni Vilaseca, Renato B Corradi, Silvan Boxler, George N Thalmann, Daniel P Nguyen
BACKGROUND: A growing number of men undergo repeat biopsies prior to radical prostatectomy for prostate cancer. However, the long-term impact of repeat biopsies on functional outcomes in this patient population remains unelucidated. Thus, we compared functional outcomes between patients who underwent single biopsy versus repeat biopsies before radical prostatectomy. METHODS: From 1996 to 2015, 1015 consecutive patients underwent radical prostatectomy, and subsequently had urinary continence and erectile function assessed for >2 years follow-up...
March 14, 2018: Prostate
R J Cong, J F Liu, Y Jiang, Duolikun Dilixiati, X D Hou, L P Zheng
Objective: To explore the influence of the lower extremity abnormal alignment and the joint surface, and to explore the surgical skills. Methods: Twenty-two cases of tibial plateau Schatzker Ⅵ fracture internal fixation failure revision from January 2012 to January 2017 in Department of Orthopedics, Shanghai 10(th) Hospital.One year follow-up after initial surgery to make sure of failure.Three-dimensional CT scan, radiography, infection index, gait analysis, knee joint ROM, femur tibia angle, tibial plateau tibial shaft angle and posterior slope if tibial plateau were observed...
March 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Natalia Pascuali, Leopoldina Scotti, Mariana Di Pietro, Gonzalo Oubiña, Diana Bas, María May, Antonio Gómez Muñoz, Patricia S Cuasnicú, Débora J Cohen, Marta Tesone, Dalhia Abramovich, Fernanda Parborell
STUDY QUESTION: Is ceramide-1-phosphate (C1P) an ovarian protective agent during alkylating chemotherapy? SUMMARY ANSWER: Local administration of C1P drastically reduces ovarian damage induced by cyclophosphamide (Cy) via protection of follicular reserve, restoration of hormone levels, inhibition of apoptosis and improvement of stromal vasculature, while protecting fertility, oocyte quality and uterine morphology. WHAT IS KNOWN ALREADY: Cancer-directed therapies cause accelerated loss of ovarian reserve and lead to premature ovarian failure (POF)...
March 9, 2018: Human Reproduction
Tuo Pan, Dan Li, Shoujun Li, Jun Yan, Xu Wang
OBJECTIVES: Postoperative fluid overload is common in children after cardiac surgery, especially for those with right ventricular outflow tract obstruction, which is associated with poor outcomes. This study was conducted to investigate whether early peritoneal dialysis (PD) was associated with improved outcomes in these children at high risk of fluid overload. METHODS: Between January 2010 and January 2015, a total of 2555 consecutive patients with right ventricular outflow tract obstruction underwent anatomical repair...
March 9, 2018: Interactive Cardiovascular and Thoracic Surgery
Robert M Van Haren, Reza J Mehran, Arlene M Correa, Mara B Antonoff, Carla M Baker, Ta Charra Woodard, Wayne L Hofstetter, Gabriel E Mena, Jack A Roth, Boris Sepesi, Stephen G Swisher, Ara A Vaporciyan, Garrett L Walsh, David C Rice
BACKGROUND: Enhanced recovery after surgery (ERAS) pathways aim to improve postoperative recovery through evidence-based practices including early ambulation, multimodal opioid-sparing analgesia, and reduction of surgical stress. The purpose of this study was to evaluate outcomes following implementation of ERAS in patients undergoing resection for pulmonary malignancy. METHODS: A retrospective review compared outcomes for patients undergoing pulmonary resection for primary lung cancer...
March 9, 2018: Annals of Thoracic Surgery
Michael J Taunton, Robert T Trousdale, Rafael J Sierra, Ken Kaufman, Mark W Pagnano
BACKGROUND: The choice of surgical approach for THA remains controversial. Some studies suggest that the direct anterior approach (DAA) leads to less muscle damage than the miniposterior approach (MPA), but there is little high-quality evidence indicating whether this accelerates recovery, or whether this approach-which may be technically more demanding-is associated with component malposition or more complications. QUESTIONS/PURPOSES: (1) Does the DAA result in faster return to activities of daily living than the MPA? (2) Does the DAA have superior patient-reported outcome measures than the MPA? (3) Does the DAA result in improved radiographic outcomes than the MPA? (4) Does the DAA have a higher risk of complications than the MPA? METHODS: Between March 1, 2013, and May 31, 2016, 116 patients undergoing primary unilateral THA were randomized to either the DAA or MPA; 15 patients withdrew after randomization, and one died 6 months after surgery from a stroke unrelated to the procedure...
February 2018: Clinical Orthopaedics and related Research
Vinayak Narayan, Nasser Mohammed, Amey R Savardekar, Devi Prasad Patra, Anil Nanda
INTRODUCTION: Spinal tuberculosis [TB] is a common infectious disease prevalent in developing countries and a rising disaster in developed countries. The association of tuberculosis with spondylolisthesis is rarely reported in literature. The aim of our review is to analyse the clinical features and radiologic characteristics of TB spondylolisthesis along with providing a concise update on its surgical management, based on current literature. METHODS: A systematic review is performed after conducting a thorough search in the PubMed database...
March 8, 2018: World Neurosurgery
Akio Kanda, Kazuo Kaneko, Osamu Obayashi, Atsuhiko Mogami, Itaru Morohashi
INTRODUCTION: In total hip arthroplasty via a direct anterior approach, the femur must be elevated at the time of femoral implant placement. For adequate elevation, division of the posterior soft tissues is necessary. However, if we damage and separate the posterior muscle tissue, we lose the benefits of the intermuscular approach. Furthermore, damage to the posterior soft tissue can result in posterior dislocation. We investigate that protecting the posterior soft tissue increases the joint stability in the early postoperative period and results in a lower dislocation rate...
March 9, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Christine Decanter, Marc Cloquet, Audrey Dassonneville, Emmanuelle D'Orazio, Audrey Mailliez, Pascal Pigny
The relationship between early recovery of menstrual activity and blood anti-Müllerian hormone (AMH) concentrations were investigated within the first year post-chemotherapy in 32 young patients with breast cancer. All were treated by surgery and the same chemotherapy protocol (three cycles of FEC100 plus three cycles of taxanes). Menstrual activity, blood AMH (using picoAMH ELISA) and FSH concentrations were measured longitudinally before, during and up to 12 months after the end of chemotherapy (six samples per patient)...
March 2, 2018: Reproductive Biomedicine Online
Patricia Lavand'homme
PURPOSE OF REVIEW: Cesarean section is the most common surgical procedure performed in the world. Postoperative pain management remains a challenge, particularly in a context of enhanced recovery after surgery. Several barriers related to the specific condition of 'postpartum recovery' may prevent application of effective analgesia in this population. The present review focuses on novel approaches of cesarean section postoperative pain assessment, beyond pain-rating intensity, including objective patient-centered recovery parameters...
March 7, 2018: Current Opinion in Anaesthesiology
Linda M Huynh, Kathryn Osann, Douglas Skarecky, Thomas E Ahlering
OBJECTIVE: To introduce a patient-reported erection fullness scale (% fullness) following robot-assisted radical prostatectomy as a qualitative adjunct to the IIEF-5 and as a 90-day predictor of two-year potency outcomes. PATIENTS AND METHODS: Prospective data was collected from 540 men with preoperative IIEF-5 22-25 who underwent RARP by a single surgeon, of which 299 had complete data at all time points up to 2 years. In addition to standard assessment tools (IIEF-5 and erections sufficient for intercourse), patients were asked to "indicate the fullness you are able to achieve in erections compared to before surgery?" (0-10…100%)...
March 9, 2018: BJU International
José Luis Muñoz, María Oliva Alvarez, Vicent Cuquerella, Elena Miranda, Carlos Picó, Raquel Flores, Marta Resalt-Pereira, Pedro Moya, Ana Pérez, Antonio Arroyo
BACKGROUND: C-reactive protein (CRP) and procalcitonin (PCT) have been described as good predictors of anastomotic leak after colorectal surgery, obtaining the highest diagnostic accuracy on the 5th postoperative day. However, if an enhanced recovery after surgery (ERAS) program is performed, early predictors are needed in order to ensure a safe and early discharge. The aim of this study was to investigate the efficacy of CRP, PCT, and white blood cell (WBC) count determined on first postoperative days, in predicting septic complications, especially anastomotic leak, after laparoscopic colorectal surgery performed within an ERAS program...
March 8, 2018: Surgical Endoscopy
Tong Yu, Yao Wang, Xi-Wen Zhang, Zhen-De Jiang, Xiu-Jie Zhu, Qi-Yao Jiang, Jian-Wu Zhao
This study aims to evaluate the application of multimodal intraoperative monitoring (MIOM) in surgical treatment for spine burst fracture and dislocation (SBFD) patients.Eleven patients who underwent posterior reduction and instrumentation (PRI) for SBFD from June 2014 to July 2016 were included into the study. The function of the spinal cord was monitored by MIOM. The muscle strength of the lower extremities and American Spinal Injury Association (ASIA) scores were, respectively, evaluated (before surgery, and at 1, 3, 6, and 12 months after surgery)...
March 2018: Medicine (Baltimore)
Donghai Li, Jinhai Zhao, Zhouyuan Yang, Pengde Kang, Bin Shen, Fuxing Pei
Low doses of corticosteroids have been proved to be effective in decreasing the inflammatory cytokines and relieving the pain. However, the optimal dosage of corticosteroids in total knee arthroplasty (TKA) is undetermined. A total of 103 patients were randomly divided into three groups. Group A containing 32 patients received normal saline. Group B including 36 patients used two doses of 100 mg hydrocortisone, given 2 hours before and 8 hours after surgery. Group C involving 35 patients received four doses of 100 mg hydrocortisone, 8 hours apart...
March 7, 2018: Journal of Knee Surgery
Linda Martin, Bethany Sarosiek, Meredith Harrison, Traci Hedrick, James Isbell, Alexander Krupnick, Christine Lau, Hunter Mehaffey, Robert Thiele, Dustin Walters, Randal Blank
BACKGROUND: To minimize the stress of surgery, improve the patient experience, reduce variability and optimize resource utilization, we implemented a thoracic Enhanced Recovery After Surgery (ERAS) protocol and evaluated progress after one year. METHODS: Two protocols were developed: video assisted thoracic surgery (ERAS-VATS) and thoracotomy (ERAS-T). Each incorporated preoperative patient education, carbohydrate loading, opioid-sparing analgesia, conservative fluid management, and early ambulation...
March 3, 2018: Annals of Thoracic Surgery
Jenny Ringblom, Ingrid Wåhlin, Marie Proczkowska
BACKGROUND: Emergence delirium and emergence agitation have been a subject of interest since the early 1960s. This behavior has been associated with increased risk of injury in children and dissatisfaction with anesthesia care in their parents. The Pediatric Anesthesia Emergence Delirium Scale is a commonly used instrument for codifying and recording this behavior. AIMS: The aim of this study was to psychometrically evaluate the Pediatric Anesthesia Emergence Delirium scale, focusing on the factor structure, in a sample of children recovering from anesthesia after surgery or diagnostic procedures...
March 6, 2018: Paediatric Anaesthesia
F Baggi, Luiz Felipe Nevola Teixeira, S Gandini, M C Simoncini, E Bonacossa, F Sandrin, M Sciotto Marotta, G Lanni, P Dadda, D Colpani, A Luini
BACKGROUND: Surgical procedure for breast cancer is not without its side effects and one such side effect is axillary web syndrome (AWS), characterized by palpable fibrotic-like cords in the operated arm. As physical evaluation is the only gold standard method used, our study aims to assess the incidence and early detection of AWS with a self-assessment questionnaire. METHODS: From July 2013 to July 2014, 370 breast cancer patients were enrolled. AWS incidence was 51...
March 5, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Sebastian A Müller, Christopher H Evans, Patricia E Heisterbach, Martin Majewski
BACKGROUND: The role of the paratenon in tendon healing is unknown. The present study compares healing in the presence or absence of the paratenon in an Achilles tendon defect model in rats. HYPOTHESIS: Resection of the paratenon impairs tendon healing. STUDY DESIGN: Controlled laboratory study. METHODS: Sixty skeletally mature Sprague Dawley rats were randomly assigned to either a resected paratenon (RP) group or an intact paratenon (IP) group...
March 1, 2018: American Journal of Sports Medicine
Mohammad Naeem Ur Razaq, Bahadar Ali, Muhammad Zahid Khan, Muhammad Waqar, Abdul Satar, Muhammad Arif Khan
BACKGROUND: Spinal injuries are the most devastating injuries and affect every aspect of patients' lives. This may cause lifelong disability due to spinal cord injury. Recovery of neurological functions is highly desirable. Early or late surgical intervention is still debatable, but majority recommend early intervention. The result of late surgical intervention in term of neurological recovery is not clear. This study focuses on neurological recovery after late surgical intervention. The objective of this study was to assess neurological recovery in term of ASIA grading in patients with traumatic spinal cord injury...
January 2018: Journal of Ayub Medical College, Abbottabad: JAMC
Kallol Kumar Roy, Netra Gc, Seema Singhal, Juhi Bharti, Sunesh Kumar, Dipendra K Mitra, Ruma Ray, Jyoti Meena, Perumal Vanamail
OBJECTIVE: Laparoscopic surgery is associated with reduced surgical stress response, lesser post- operative immune function, and consequent early recovery compared with conventional open surgery. There is a lack of evidence regarding the inflammatory stress response with the use of different energy devices. The present study was conducted to evaluate and compare the inflammatory response in total laparoscopic hysterectomy (TLH) using three different energy devices. MATERIAL AND METHODS: A prospective randomized controlled study was conducted in 60 women with abnormal uterine bleeding undergoing TLH...
March 1, 2018: Journal of the Turkish German Gynecological Association
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