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https://www.readbyqxmd.com/read/28815081/robot-assisted-minimally-invasive-thoraco-laparoscopic-esophagectomy-for-esophageal-cancer-in-the-upper-mediastinum
#1
Sylvia van der Horst, Teun Johannes Weijs, Jelle Pieter Ruurda, Nadia Haj Mohammad, Stella Mook, Lodewijk Adriaan Anton Brosens, Richard van Hillegersberg
BACKGROUND: Patients with upper third esophageal cancer or esophageal cancer with upper mediastinal paratracheal lymph node metastases are often precluded from surgery because of technical difficulties. With the aid of robotic surgery, an excellent overview and reach of the thoracic inlet can be accomplished. In this way, patients with upper mediastinal esophageal cancer are eligible for esophageal resection with curative intent. The aim of this study was to review the results of a consecutive series of patients who underwent robot-assisted minimally invasive esophagectomy (RAMIE) for tumors of the upper 1/3 of the esophagus or positive lymph nodes in the upper mediastinum...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28812150/respiratory-complications-after-colonic-procedures-in-chronic-obstructive-pulmonary-disease-does-laparoscopy-offer-a-benefit
#2
Sarath Sujatha-Bhaskar, Reza Fazl Alizadeh, Colette S Inaba, Christina Y Koh, Mehraneh D Jafari, Steven D Mills, Joseph C Carmichael, Michael J Stamos, Alessio Pigazzi
BACKGROUND: Patients with severe chronic obstructive pulmonary disease (COPD) are at a higher risk for postoperative respiratory complications. Despite the benefits of a minimally invasive approach, laparoscopic pneumoperitoneum can substantially reduce functional residual capacity and raise alveolar dead space, potentially increasing the risk of respiratory failure which may be poorly tolerated by COPD patients. This raises controversy as to whether open techniques should be preferentially employed in this population...
August 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28808520/gallstone-ileus-dilemma-in-the-management
#3
Girish D Bakhshi, Rajesh G Chincholkar, Jasmine R Agarwal, Madhukar R Gupta, Prachiti S Gokhe, Amogh R Nadkarni
Gallstone ileus is a mechanical intestinal obstruction caused due to impaction of a large gallstone within the bowel. The ideal treatment of gallstone ileus remains controversial, with the main dilemma being between a one-stage and a two-stage surgical procedure. A 69-year old male patient presented with gallstone ileus. A one-stage procedure with enterolithotomy and primary closure of duodenal fistula was done. His immediate postoperative recovery was uneventful, but after 3 weeks of surgery, he developed respiratory complications and expired of multi-organ failure...
June 7, 2017: Clinics and Practice
https://www.readbyqxmd.com/read/28806210/risk-stratification-for-major-postoperative-complications-in-patients-undergoing-intra-abdominal-general-surgery-using-latent-class-analysis
#4
Minjae Kim, Melanie M Wall, Guohua Li
BACKGROUND: Preoperative risk stratification is a critical element in assessing the risks and benefits of surgery. Prior work has demonstrated that intra-abdominal general surgery patients can be classified based on their comorbidities and risk factors using latent class analysis (LCA), a model-based clustering technique designed to find groups of patients that are similar with respect to characteristics entered into the model. Moreover, the latent risk classes were predictive of 30-day mortality...
August 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28804862/oncological-patients-in-the-intensive-care-unit-prognosis-decision-making-therapies-and-end-of-life-care
#5
Ewelina Biskup, Fengfeng Cai, Marcus Vetter, Stephan Marsch
The effectiveness of intensive care unit (ICU) care for cancer patients remains controversial. Advances in antitumour and supportive care led to major improvements in outcomes of oncological patients in the ICU. Improved cancer therapies and supportive management of organ dysfunctions have contributed to improved survival rates. As a consequence, the number of cancer patients requiring ICU admission is rising. Frequently, cancer patients have a poor performance status and are vulnerable. It is a heterogeneous population, where the nature and curability of the neoplasm and the severity of critical illness cause a plethora of issues about ICU admissions...
August 14, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28799855/surgical-management-of-cervical-spine-deformity-in-chondrodysplasia-punctata
#6
Nobuhito Morota, Satoshi Ihara, Hideki Ogiwara, Goichiro Tamura
OBJECTIVE Chondrodysplasia punctata (CDP), a rare skeletal dysplasia, can lead to cervical spine instability and deformity. However, an optimal neurosurgical intervention has yet to be established. Thus, a retrospective study was conducted to assess the efficacy of various surgical interventions for children with CDP. METHODS The authors retrospectively reviewed 9 cases of CDP in which cervical decompression with or without posterior fusion was performed between April 2007 and May 2016. Patient demographics, preoperative clinical conditions, radiographic findings, surgical procedures, and the postoperative course were analyzed in detail...
August 11, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28796065/a-scoring-system-to-predict-mortality-in-infants-with-esophageal-atresia-a-case-control-study
#7
Xiao-Wen Li, Ya-Jun Jiang, Xue-Qiu Wang, Jia-Lin Yu, Lu-Quan Li
Esophageal atresia (EA) is a rare anomaly that mandates surgical intervention. Patients with EA often have complicated medical courses due to both esophageal anomalies and related comorbidities. Although several prognostic classification systems have been developed to decrease the mortality rate in EA, most systems focus only on the influence of the major anomaly, and external risk factors that could be influenced by the neonatal caregivers to a certain extent are not included. The aim of this study was to investigate the risk factors for in-hospital mortality in neonates with EA and develop a scoring model to predict mortality...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28790297/-techniques-for-preventing-postoperative-complication-in-esophageal-salvage-surgery
#8
Mitsuru Iwama, Takushi Yasuda, Osamu Shiraishi, Hiroaki Kato, Yoko Hiraki, Yumiko Tanaka, Atsushi Yasuda, Masayuki Shinkai, Motohiro Imano, Yutaka Kimura, Haruhiko Imamoto
Patients with esophageal cancer are often treated with definitive chemoradiotherapy (dCRT). Regardless of arrival at dCRT, the risk of local/regional recurrence during follow-up is significant. Many patient are faced with limited options for therapy once dCRT has failed. Salvage surgery is the only way for complete cure of patients with local/regional recurrent esophageal cancer after dCRT. However, salvage surgery has a significant high risk of fatal complications. We examine our preventive measures to reduce the incidence of postoperative complications after salvage surgery for thoracic esophageal cancer...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28790280/-perioperative-management-of-patients-with-pulmonary-comorbidities-undergoing-lung-resection
#9
Sumiko Maeda
Chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD) are 2 major pulmonary comorbidities of primary lung cancer patients. The COPD patients are at risk for respiratory failure after a major lung resection when lung resection exceeds the patient's pulmonary reserve. It is important to assess a postoperative risk based on the patient's cardiopulmonary function. Cardiac risks are initially evaluated for all the candidates for lung resection, then, ppoFEV1% and ppoDLco% are calculated...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28767805/incidence-and-risk-factors-for-postoperative-pulmonary-complications-in-patients-undergoing-thoracic-and-abdominal-surgeries
#10
Ana Carolina de Ávila, Romero Fenili
Objective: to determine the incidence of postoperative pulmonary complications in patients undergoing abdominal and thoracic surgery and investigate the risk factors for their occurrence. Methods: we conducted a prospective, observational and analytical study with all the patients undergoing thoracic and abdominal surgeries at the Santo Antônio Hospital in Blumenau, SC. We collected data from medical records and structured interviews with patients, regarding the characteristics of patients and procedures...
May 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28764231/large-isolated-major-aortopulmonary-collateral-artery-causing-severe-pulmonary-hypertension-in-an-infant-a-rare-and-challenging-diagnosis
#11
Brajesh Kumar Kunwar, Snigdha Paddalwar, Mahesh Ghogare
Major Aortopulmonary Collateral Artery (MAPCA) as an isolated congenital anomaly, without evidence of any structural heart disease, is a very rare observation. Previously published reports indicate that symptomatic infants with large isolated MAPCA usually present with congestive heart failure or recurrent respiratory tract infections. To the best of our knowledge, the present case of an infant with large isolated MAPCA is a unique case with a diagnostic dilemma due to presentation with severe pulmonary hypertension as a predominant sign...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28761643/a-prospective-randomised-trial-of-isolated-pathogens-of-surgical-site-infections-ssi
#12
Konstantinos Alexiou, Ioannis Drikos, Maria Terzopoulou, Nikolaos Sikalias, Argyrios Ioannidis, Nikolaos Economou
BACKGROUND: Every surgical wound is colonized by bacteria, but only a small percentage displays symptoms of infection. The distribution of pathogens isolated in surgical site infections has not significantly changed over the last decades. Staph. Aureus, Coag(-) Staphylococci, Enterococcus spp and E. Coli are the main strains appearing. In addition, a continuously rising proportion of surgical site infections caused by resistant bacterial species (MRSA, C. Albicans) has been reported...
September 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28753141/atrial-esophageal-fistula-secondary-to-ablation-for-atrial-fibrillation-a-case-series-and-review-of-the-literature
#13
Lily K Fatula, William D Bolton, Allyson L Hale, Barry R Davis, James E Stephenson, Sharon Ben-Or
This article describes 2 patients who presented to our institution with left atrial esophageal fistula after atrial fibrillation ablation; it also compares our experience with other atrial esophageal fistula cases reported in the literature. We performed a retrospective review of 2 patients who presented to our hospital between July 2015 and September 2015 with atrial esophageal fistula. Patient A, a 57-year-old man, presented 31 days postablation with a fever and right-sided weakness. A chest computed tomography showed gas in the left atrium and esophagus; an echocardiogram confirmed the diagnosis of atrial esophageal fistula...
July 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28751632/extracorporeal-membrane-oxygenation-support-for-rituximab-induced-acute-respiratory-distress-syndrome-in-an-abo-incompatible-living-donor-liver-transplant-recipient-successful-management-of-a-rare-complication-and-a-review-of-the-literature
#14
Ping-Chun Li, Ashok Thorat, Shih-Chao Hsu, Kin-Shing Poon, Horng-Ren Yang, Te-Hung Chen, Chun-Chieh Yeh, Long-Bin Jeng
BACKGROUND Rituximab is commonly used to reduce the agglutinin titer in ABO-incompatible liver transplant recipients. Although well-tolerated, rituximab infusion therapy may result in severe pulmonary adverse effects such as drug-induced pneumonitis, leading to acute respiratory distress syndrome (ARDS), which has a high mortality rate. Management of such rare cases in an ABO-incompatible patient has never been described before. Herein, we present successful use of extracorporeal membrane oxygenation (ECMO) support for rituximab-induced ARDS in an ABO-incompatible living donor liver transplantation (LDLT) recipient...
July 28, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28747940/surgical-treatment-for-pulmonary-aspergilloma-early-and-long-term-results
#15
Mariusz Kasprzyk, Kornel Pieczyński, Krystian Mania, Piotr Gabryel, Cezary Piwkowski, Wojciech Dyszkiewicz
INTRODUCTION: Pulmonary aspergilloma is a difficult therapeutic problem due to the low effectiveness of conservative treatment and high surgical morbidity. AIM: To analyze the early and late results of surgical treatment for pulmonary aspergilloma. MATERIAL AND METHODS: From 2005 to 2015, 49 patients were treated surgically for pulmonary aspergilloma. Symptoms occurred in 85.7% of cases, including recurrent hemoptysis in 53%. A history of immunosuppressive therapy or chemotherapy was noted in 24...
June 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28735736/postoperative-pulmonary-complications-following-laparoscopy
#16
REVIEW
P G Paul, Thampi Mathew, Hemant Shintre, Saumya Bulusu, George Paul, Sumina Mannur
Postoperative pulmonary complications unrelated to anesthesia, especially hydropneumothorax, after gynecological laparoscopy is rare. Hydropneumothorax can cause respiratory failure and be life-threatening. Awareness, prompt diagnosis, and timely intervention are important for clinical management. We review the literature for postoperative pulmonary complications including pneumothorax, hydrothorax, hydropneumothorax, and pleural effusion following laparoscopy along with a recent case of hydropneumothorax at our institution...
July 20, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28732354/influence-of-body-mass-index-on-postoperative-complications-after-thymectomy-in-myasthenia-gravis-patients
#17
Xu-Dong Liu, Ming-Rui Shao, Lei Sun, Lin Zhang, Xin-Shan Jia, Wen-Ya Li
OBJECTIVES: It is not clear whether being overweight or obese influences postoperative complications in myasthenia gravis (MG) patients. We retrospectively investigated an association between body mass index (BMI) and postoperative complications in MG. MATERIALS AND METHODS: Fifty-nine MG patients who had undergone transsternal thymectomy were classified as low or high BMI based on the criteria for Asian-Pacific populations. An association between BMI and complications was analyzed...
July 12, 2017: Oncotarget
https://www.readbyqxmd.com/read/28703300/a-point-based-prediction-model-for-cardiovascular-risk-in-orthotopic-liver-transplantation-the-car-olt-score
#18
Lisa B VanWagner, Hongyan Ning, Maureen Whitsett, Josh Levitsky, Sarah Uttal, John T Wilkins, Michael M Abecassis, Daniela P Ladner, Anton I Skaro, Donald M Lloyd-Jones
Cardiovascular disease (CVD) complications are important causes of morbidity and mortality after orthotopic liver transplantation (OLT). There is currently no preoperative risk assessment tool that allows physicians to estimate the risk for CVD events following OLT. We sought to develop a point-based prediction model (risk score) for CVD complications after OLT, the CAR-OLT risk score, among a cohort of 1024 consecutive patients aged 18-75 years who underwent first OLT in a tertiary-care teaching hospital (2002-2011)...
July 13, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28699426/management-of-hemothorax-after-thoracic-endovascular-aortic-repair-for-ruptured-aneurysms
#19
Mila H Ju, Michael J Nooromid, Heron E Rodriguez, Mark K Eskandari
Background Thoracic aortic aneurysm rupture is often a fatal condition. Emergent thoracic endovascular aortic repair (TEVAR) has emerged as a suitable treatment option. Unfortunately, respiratory complications from hemothorax continue to be an important cause of morbidity and mortality even after successful management of the aortic rupture. We hypothesize that early hemothorax decompression after TEVAR for ruptured aneurysms decreases the rate of postoperative respiratory complications. Methods Single-center, retrospective eight-year review of ruptured thoracic aneurysms treated with TEVAR...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28698424/-aortic-valve-replacement-via-a-partial-sternotomy-in-an-ankylosing-skeletal-hyperostosis-patient-after-prophylactic-tracheostomy-report-of-a-case
#20
Shogo Saito, Yoshio Misawa, Soki Kurumisawa, Kei Aizawa, Koji Kawahito
A 77-year-old man presented with exertional dyspnea. The patient had a history of ankylosing skeletal hyperostosis and sleep apnea syndrome. Echocardiographic examination revealed severe aortic valve regurgitation. The patient underwent a prophylactic tracheostomy 2 weeks before cardiac surgery to decrease his risk of perioperative respiratory failure. He successfully underwent aortic valve replacement through a lower partial sternotomy. His postoperative course was uneventful, and the tracheostoma was closed 6 months after the cardiac surgery...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
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