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John R Miklos, Orawee Chinthakanan, Robert D Moore, Deborah R Karp, Gladys M Nogueiras, G Willy Davila
STUDY OBJECTIVE: Synthetic mesh utilized to treat stress urinary incontinence (SUI) and pelvic organ prolapse (POP) can often result in postoperative complications. The objectives of this study were to determine: 1) the most common indications for mesh removal; 2) the incidences of the removal of specific mesh procedures (such as suburethral sling [SUS], transvaginal mesh [TVM], or sacrocolpopexy); and 3) the idences and types of surgical complications associated with mesh removal. DESIGN: This was a retrospective study...
October 26, 2016: Surgical Technology International
Orawee Chinthakanan, John R Miklos, Robert D Moore, Deborah R Karp, Gladys M Nogueiras, G Willy Davila
INTRODUCTION AND HYPOTHESIS: 1) Evaluate the most common indication for sling removal in patients with synthetic mesh slings; 2) identify the location of pain for each of the three types of synthetic sling procedures including retropubic (RP) sling, transobturator (TOT) sling, and single incision slings (SIS), and 3) describe the surgical approach to each of the above and its associated complications. MATERIALS AND METHODS: A retrospective chart review of all patients who underwent surgical removal of a sling due to a mesh-related complications from 2011 to 2013 at three referral centers...
October 26, 2016: Surgical Technology International
Richard J Cassidy, Yuan Liu, Kirtesh Patel, Jim Zhong, Conor E Steuer, David A Kooby, Maria C Russell, Theresa W Gillespie, Jerome C Landry
BACKGROUND: Stage II and III rectal cancers have been effectively treated with neoadjuvant chemoradiotherapy (NCRT) followed by definitive resection. Advancements in surgical technique and systemic therapy have prompted investigation of neoadjuvant multiagent chemotherapy (NMAC) regimens with the elimination of radiation (RT). The objective of the current study was to investigate factors that predict for the use of NCRT versus NMAC and compare outcomes using the National Cancer Data Base (NCDB) for select stage II and III rectal cancers...
October 25, 2016: Cancer
Andrew B Schenkel, Ivy Peltz, Analia Veitz-Keenan
BACKGROUND: Resin-based composite (RBC) is currently accepted as a viable material for the restoration of caries for posterior permanent teeth requiring surgical treatment. Despite the fact that the thermal conductivity of the RBC restorative material closely approximates that of natural tooth structure, postoperative hypersensitivity is sometimes still an issue. Dental cavity liners have historically been used to protect the pulp from the toxic effects of some dental restorative materials and to prevent the pain of thermal conductivity by placing an insulating layer between restorative material and the remaining tooth structure...
October 25, 2016: Cochrane Database of Systematic Reviews
Hui Zhao, Nainan Hei, Yiling Wu, Winston Chan, Xiudong Lei, Carrie Cameron, Shine Chang, Mariana Chavez-MacGregor, Sharon H Giordano
BACKGROUND: The National Surgical Adjuvant Breast and Bowel Project B35 and International Breast Cancer Intervention Studies II Ductal Carcinoma In Situ trials showed similar treatment effects of anastrozole and tamoxifen in reducing cancer recurrence risk among ductal carcinoma in situ (DCIS) patients. Studies have shown low levels of hormone therapy drug initiation for DCIS patients, but the current body of literature lacks information on the 5-year adherence rates for these drugs from population-based studies...
October 25, 2016: Cancer
Robert Westermann, Chris A Anthony, Kyle R Duchman, Yubo Gao, Andrew J Pugely, Carolyn M Hettrich, Ned Amendola, Brian R Wolf
Infection following anterior cruciate ligament reconstruction (ACLR) is rare. Previous authors have concluded that diabetes, tobacco use, and previous knee surgery may influence infection rates following ACLR. The purpose of this study was to identify a cohort of patients undergoing ACLR and define (1) the incidence of infection after ACLR from a large multicenter database and (2) the risk factors for infection after ACLR. We identified patients undergoing elective ACLRs in the American College of Surgeons National Surgical Quality Improvement Program database between 2007 and 2013...
October 25, 2016: Journal of Knee Surgery
Clayton W Nuelle, Jeffrey L Milles, Ferris M Pfeiffer, James P Stannard, Patrick A Smith, Mauricio Kfuri, James L Cook
No surgical technique recreates native posterior cruciate ligament (PCL) biomechanics. We compared the biomechanics of five different PCL reconstruction techniques versus the native PCL. Cadaveric knees (n = 20) were randomly assigned to one of five reconstruction techniques: Single bundle all-inside arthroscopic inlay, single bundle all-inside suspensory fixation, single bundle arthroscopic-assisted open onlay (SB-ONL), double bundle arthroscopic-assisted open inlay (DB-INL), and double bundle all-inside suspensory fixation (DB-SUSP)...
October 25, 2016: Journal of Knee Surgery
Alessandra Gasior, Giulia Brisighelli, Karen Diefenbach, Victoria Alison Lane, Carlos Reck, Richard J Wood, Marc Levitt
Introduction Functional constipation is a common problem in children. It usually can be managed with laxatives but a small subset of patients develop intolerable cramps and need to be temporarily treated with enemas. The senior author has previously reported: 1) open sigmoid resection as a surgical option, but this did not sufficiently reduce the laxative need, then 2) a transanal approach (with resection of rectosigmoid), but this led to a high rate of soiling due to extensive stretching of the anal canal and loss of the rectal reservoir...
October 25, 2016: European Journal of Pediatric Surgery
Sarah B Bateni, Frederick J Meyers, Richard J Bold, Robert J Canter
BACKGROUND: The impact of surgery on end of life care for patients with disseminated malignancy (DMa) is incompletely characterized. The purpose of this study was to evaluate postoperative outcomes impacting quality of care among DMa patients, specifically prolonged length of hospital stay, readmission, and disposition. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for years 2011-2012. DMa patients were matched to non-DMa patients with comparable clinical characteristics and operation types...
2016: PloS One
Wei-Hung Chan, Meei-Shyuan Lee, Chin Lin, Chang-Chieh Wu, Hou-Chuan Lai, Shun-Ming Chan, Chueng-He Lu, Chen-Hwan Cherng, Zhi-Fu Wu
We conducted a retrospective study to investigate the anesthesia-controlled time and factors that contribute to prolonged extubation in open colorectal surgery. Using our hospital database, demographic data, various time intervals (waiting for anesthesia time, anesthesia time, surgical time, emergence time, exit from operating room after extubation, total operating room time, and post-anesthesia care unit stay time), and incidence of prolonged extubation (≥ 15 mins), were compared between patients who received desflurane/fentanyl-based anesthesia and total intravenous anesthesia via target-controlled infusion with fentanyl/propofol...
2016: PloS One
Marek Krawczyk, Michał Grąt, Rene Adam, Wojciech G Polak, Jurgen Klempnauer, Antonio Pinna, Fabrizio Di Benedetto, Franco Filipponi, Norbert Senninger, Aksel Foss, Sebastian Rufián-Peña, William Bennet, Johann Pratschke, Andreas Paul, Utz Settmacher, Giorgio Rossi, Mauro Salizzoni, Carlos Fernandez-Selles, Santiago T Martínez de Rituerto, Miguel A Gómez-Bravo, Jacques Pirenne, Olivier Detry, Pietro E Majno, Petr Nemec, Wolf O Bechstein, Michael Bartels, Silvio Nadalin, Francois R Pruvot, Darius F Mirza, Luigi Lupo, Michele Colledan, Giuseppe Tisone, Jan Ringers, Jorge Daniel, Ramón Charco Torra, Enrique Moreno González, Rafael Bañares Cañizares, Valentin Cuervas-Mons Martinez, Fernando San Juan Rodríguez, Sezai Yilmaz, Piotr Remiszewski
BACKGROUND: Liver transplantation is the most extreme form of surgical management of patients with hepatic trauma, with very limited literature data supporting its use. The aim of this study was to assess the results of liver transplantation for hepatic trauma. METHODS: This retrospective analysis based on European Liver Transplant Registry comprised data of 73 recipients of liver transplantation for hepatic trauma performed in 37 centers in the period between 1987 and 2013...
November 2016: Transplantation
Benjamin Assouline, Martin R Tramèr, Lukas Kreienbühl, Nadia Elia
Ketamine is often added to opioids in patient-controlled analgesia devices. We tested whether in surgical patients, ketamine added to an opioid patient-controlled analgesia decreased pain intensity by ≥25%, cumulative opioid consumption by ≥30%, the risk of postoperative nausea and vomiting by ≥30%, the risk of respiratory adverse effects by ≥50%, and increased the risk of hallucination not more than 2-fold. In addition, we searched for evidence of dose-responsiveness. Nineteen randomized trials (1349 adults, 104 children) testing different ketamine regimens added to various opioids were identified through searches in databases and bibliographies (to 04...
August 29, 2016: Pain
Sandeep Kandregula, Amey R Savardekar, B N Nandeesh, A Arivazhagan, Malla Bhaskar Rao
Giant hypothalamic hamartomas (GHH) are extremely rare lesions in infants and usually intrinsically epileptogenic. We present the case of a 10-month-old girl child presenting with drug-resistant seizures and a giant hypothalamic lesion that was confirmed as hamartoma on histopathology. Surgical decompression and disconnection from the hypothalamus was performed with the intent of controlling her seizures. Unfortunately, the patient developed right middle cerebral artery and posterior cerebral artery territory infarction, possibly due to vasospasm or thrombosis of the vessels...
October 26, 2016: Pediatric Neurosurgery
Farees Ricky Tavangari, Michael Batech, J Craig Collins, Talar Tejirian
Though conventionally not considered standard of care, nonoperative management of patients with small bowel obstruction (SBO) without previous abdominal operations, so called "virgin abdomens," (VA) is presently being practiced. We aimed to determine outcomes of patients with VA undergoing operative and nonoperative management of SBO. A retrospective review of patients with SBO was performed; outcomes of patients with VA were analyzed. SBO with a VA was found in 103 patients over a 5-year period. With a mean follow-up of 4...
October 2016: American Surgeon
David Santos, Yi-Ju Chiang, Brian Badgwell
Appendectomy is standard of care for uncomplicated appendicitis, but cancer patients may not be optimal surgical candidates. Interval appendectomy is controversial, and appendiceal malignancy is rare. Study objectives were to review the role of surgery, observation, and interventional radiology (IR)-guided drainage in patients with appendicitis and advanced malignancy. Retrospective review was performed on cancer patients presenting to a tertiary academic cancer center from January 1, 2001 to December 31, 2014...
October 2016: American Surgeon
Jan P Kamiński, Emily Miraflor, Karen Zaghiyan, Phillip Fleshner
Treatment of Crohn's disease (CD) relies on medical therapy with surgery reserved for medically refractory cases. This study measured pharmaceutical therapies that CD patients receive before surgery. Prospective data were collected on 558 patients undergoing surgery for medically refractory CD from November 1999 through June 2014. Patient demographics and preoperative medical therapies were tabulated, including types and number of doses of aminosalicylic acid, corticosteroids, immunomodulators, and biologic therapies...
October 2016: American Surgeon
Jessica A Zagory, Jamie Golden, Kathleen Holoyda, Natalie Demeter, Nam X Nguyen
The optimal management of pilonidal disease in the pediatric population is still debated. We conducted a retrospective review of patients 21 years old and younger who underwent surgical management for pilonidal disease between 2009 and 2013 at a single pediatric institution. Sixty patients (41.7% male) were included in the analysis, with a mean age of 15.0 years (range, 13-20). Twelve (20%) had a prior drainage procedure for pilonidal abscess before the definitive operative treatment. After excision to the presacral fascia, 36 (60%) had primary closure, 17 (28...
October 2016: American Surgeon
Kyle G Cologne, Sean Byers, David R Rosen, Grace S Hwang, Adrian E Ortega, Glenn T Ault, Sang W Lee
A prospectively maintained database of 415 patients undergoing colectomy was evaluated. We performed a logistic regression analysis to identify factors associated with 1) length of stay (LOS) of 2 days or less and 2) LOS of 10 days or more. Investigated variables included demographics, American Society of Anesthesiology (ASA) score, diagnosis, operative procedure, approach and time, transfusion requirements, and occurrence of any complications. Factors associated with a LOS of two days or less included ASA [odds ratio (OR): 0...
October 2016: American Surgeon
Rose Pedersen, Michael Sung, Andrew L DiFronzo
Prior studies of laparoscopic liver resection (LLR) have evaluated long-term outcomes in terms of cancer survival, but few have evaluated nononcologic outcomes. This study analyzes long-term nondisease-specific complications associated with LLR and open liver resection (OLR). We performed a retrospective single-institution review of patients undergoing liver resection for any reason from January 2005 to December 2014. Long-term complication was defined as any complication not related to the primary disease process, and occurring more than 90 days after surgery, emphasizing incisional hernia (IH) and small bowel obstruction (SBO)...
October 2016: American Surgeon
Karen E Burtt, Alexis D Rounds, Hyuma A Leland, Ram K Alluri, Ketan M Patel, Joseph N Carey
Infections in the traumatized lower extremity are a significant source of morbidity and expense. Outcomes after vascularized soft tissue reconstruction were analyzed to determine impact on infection rates. A retrospective review of a prospectively maintained database was performed, including 114 trauma patients requiring soft tissue reconstruction of lower extremity injuries at an urban Level I tertiary referral center from 2008 to 2015. Patient characteristics and perioperative outcomes were analyzed. After trauma, 39 (34...
October 2016: American Surgeon
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