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https://www.readbyqxmd.com/read/27909230/the-protective-role-of-sex-hormones-in-females-and-exercise-prehabilitation-in-males-on-sternotomy-induced-cranial-hypoperfusion-in-aortic-banded-mini-swine
#1
T Dylan Olver, Jessica A Hiemstra, Jenna C Edwards, Brian S Ferguson, Harold Laughlin, Craig A Emter
During cardiac surgery, specifically sternotomy, cranial hypoperfusion is linked to cerebral ischemia, increased risk of perioperative watershed stroke and other neurocognitive complications. The purpose of this study was to retrospectively examine the effect of sex hormones in females and exercise prehabilitation in males on median sternotomy-induced changes in cranial perfusion in a large animal model of heart failure. Cranial blood flow (CBF) before, 10- and 60 min post-sternotomy was analyzed in eight groups of Yucatan mini-swine: female-control, aortic-banded, ovariectomized, and ovariectomized+aortic-banded; male-control, aortic-banded, aortic-banded+continuous exercise trained, and aortic-banded+interval exercise trained...
December 1, 2016: Journal of Applied Physiology
https://www.readbyqxmd.com/read/27908636/impact-of-neoadjuvant-chemotherapy-on-complications-of-minimally-invasive-radical-cystectomy
#2
D Lizée, R S Salas, E Barret, M Galiano, E Di Trapani, F Montorsi, X Cathelineau
BACKGROUND: Neoadjuvant chemotherapy (NC) before minimally invasive radical cystectomy (MIRC) is considered a standard of care in muscle-invasive bladder cancer or recurrent high-risk non-muscle-invasive bladder cancer. OBJECTIVE: To evaluate the impact of NC on morbidity and mortality after MIRC. DESIGN, SETTING, AND PARTICIPANTS: We prospectively evaluated 135 patients who underwent MIRC (laparoscopic: n=100; robotic: n=35) between 2007 and 2013 with ≥90 days of follow-up (median age: 66 year)...
November 28, 2016: Actas Urologicas Españolas
https://www.readbyqxmd.com/read/27908634/systematic-review-of-perioperative-outcomes-and-complications-after-open-laparoscopic-and-robot-assisted-radical-cystectomy
#3
A Palazzetti, R Sanchez-Salas, P Capogrosso, E Barret, N Cathala, A Mombet, D Prapotnich, M Galiano, F Rozet, X Cathelineau
Radical cystectomy and regional lymph node dissection is the standard treatment for localized muscle-invasive and for high-risk non-muscle-invasive bladder cancer, and represents one of the main surgical urologic procedures. The open surgical approach is still widely adopted, even if in the last two decades efforts have been made in order to evaluate if minimally invasive procedures, either laparoscopic or robot-assisted, might show a benefit compared to the standard technique. Open radical cystectomy is associated with a high complication rate, but data from the laparoscopic and robotic surgical series failed to demonstrate a clear reduction in post-operative complication rates compared to the open surgical series...
November 28, 2016: Actas Urologicas Españolas
https://www.readbyqxmd.com/read/27907939/intraoperative-intermittent-blocking-of-the-common-iliac-arteries-in-cases-of-placenta-percreta-without-the-use-of-fluoroscopy
#4
S Heinze, B Filsinger, G Kastenholz, R J Schröder
Background: The number of patients with placenta accreta, percreta and increta is increasing. The morbidity and mortality are higher mostly due to hemorrhage. Therefore, new methods to reduce the risk of severe bleeding are necessary. Methods: Three patients were treated in collaboration by obstetricians, urologists, anesthesiologists, and radiologists. An MRI of the pelvis was performed and the diameters and lengths of the iliac arteries were measured to avoid fluoroscopy during the preoperative placement of catheter balloons into the iliac arteries...
December 2016: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
https://www.readbyqxmd.com/read/27907923/association-between-the-surgical-apgar-score-and-perioperative-complications-after-radical-prostatectomy
#5
Matthias Orberger, Jüri Palisaar, Florian Roghmann, Ludger Mittelstädt, Petra Bischoff, Joachim Noldus, Björn Löppenberg
OBJECTIVE: To evaluate whether the Surgical Apgar Score (SAS) can identify patients who are at risk for perioperative adverse events (PAE) following radical prostatectomy for prostate cancer. PATIENTS AND METHODS: At a single academic institution, 994 patients undergoing radical prostatectomy between 2010 and 2013 were analyzed retrospectively. The SAS was calculated from anesthesia records, evaluated to predict PAE within a 30-day time period postoperatively; these events were classified according to standardized classification systems...
December 2, 2016: Urologia Internationalis
https://www.readbyqxmd.com/read/27907053/the-effect-of-diabetes-on-the-perioperative-outcomes-of-colorectal-cancer-surgery-patients
#6
Raymond Yap, Simon Wilkins, Margaret Staples, Karen Oliva, Paul J McMurrick
There are approximately 1.3 million patients in Australia with diabetes. Conflicting reports exist in the literature as to the effect of diabetes on the outcomes of colorectal cancer patients. We hypothesized that patients with diabetes would have poorer perioperative outcomes, and that diabetes was an independent risk factor for both 30-day mortality and perioperative morbidity. The aim of this study was to assess the impact of diabetes on perioperative colorectal cancer surgery outcomes, as compared to a diabetes-free reference population, and to examine factors affecting perioperative risk...
2016: PloS One
https://www.readbyqxmd.com/read/27906739/posterior-vertebral-column-resection-with-intraoperative-manual-retraction-for-the-treatment-of-posttubercular-kyphosis-in-upper-thoracic-spine-or-cervicothoracic-junction
#7
Yuqiao Chen, Guohua Lü, Bing Wang, Lei Li, Lei Kuang
STUDY DESIGN: This is a case-series. OBJECTIVE: To evaluate the clinical and radiologic outcomes of posterior vertebral column resection (PVCR) for treatment of posttubercular kyphosis in upper thoracic spine and cervicothoracic junction (CTJ). SUMMARY OF BACKGROUND DATA: Surgical management of severe posttubercular kyphosis in upper thoracic spine or CTJ is challenging. A new technique that combines PVCR and intraoperative manual traction in a single procedure, was developed to maximize the correction rate and minimize the risk of dural buckling and spinal cord injury...
November 30, 2016: Clinical Spine Surgery
https://www.readbyqxmd.com/read/27906721/preoperative-evaluation-and-preparation-of-the-morbidly-obese-patient
#8
Andreas B Böhmer, Frank Wappler
PURPOSE OF REVIEW: This review aims to familiarize with the most current findings regarding preoperative evaluation and preparation of morbidly obese patients prior to elective, noncardiac surgery. In the light of the increasing number of surgical patients being morbidly obese, the knowledge of evidence-based preoperative evaluation strategies is profound for a rational approach. RECENT FINDINGS: Preoperative evaluation should be carried out with sufficient time before the day of surgery to allow modification of the perioperative management...
November 30, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27906717/spectrum-of-postoperative-complications-in-pulmonary-hypertension-and-obesity-hypoventilation-syndrome
#9
Roop K Kaw
PURPOSE OF REVIEW: The purpose of this review is to identify chronic pulmonary conditions which may often not be recognized preoperatively especially before elective noncardiac surgery and which carry the highest risk of perioperative morbidity and mortality. RECENT FINDINGS: This review discusses some of the most recent studies that highlight the perioperative complications, and their prevention and management strategies. SUMMARY: Pulmonary hypertension is a well recognized risk factor for postoperative complications after cardiac surgery but the literature surrounding noncardiac surgery is sparse...
November 30, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27905691/is-volume-important-in-aneurysm-treatment-outcome
#10
Athanasios Katsargyris, Chris Klonaris, Eric L Verhoeven
Several studies have suggested that surgical procedures performed at high-volume centers may result in superior outcome. Technically more demanding procedures such as aortic aneurysm repair appear to demonstrate a stronger relationship with volume. The present chapter reviewed the literature using the MEDLINE database to identify studies investigating the effect of volume in aortic aneurysm repair outcomes. The great majority of studies identified shows an advantage for high-volume hospitals with regard to perioperative mortality of abdominal (AAA), thoracic (TAA) and thoracoabdominal (TAAA) aortic aneurysm repair...
December 1, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27905060/perioperative-risk-adjustment-for-total-shoulder-arthroplasty-are-simple-clinically-driven-models-sufficient
#11
David N Bernstein, Aakash Keswani, David Ring
BACKGROUND: There is growing interest in value-based health care in the United States. Statistical analysis of large databases can inform us of the factors associated with and the probability of adverse events and unplanned readmissions that diminish quality and add expense. For example, increased operating time and high blood urea nitrogen (BUN) are associated with adverse events, whereas patients on antihypertensive medications were more likely to have an unplanned readmission. Many surgeons rely on their knowledge and intuition when assessing the risk of a procedure...
November 30, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27905017/an-evaluation-of-preparedness-delivery-and-impact-of-surgical-and-anesthesia-care-in-madagascar-a-framework-for-a-national-surgical-plan
#12
Emily Bruno, Michelle C White, Linden S Baxter, Vaonandianina Agnès Ravelojaona, Hasiniaina Narindria Rakotoarison, Hery Harimanitra Andriamanjato, Kristin L Close, Alison Herbert, Nakul Raykar, Saurabh Saluja, Mark G Shrime
BACKGROUND: The Lancet Commission on Global Surgery (LCoGS) described the lack of access to safe, affordable, timely surgical, and anesthesia care. It proposed a series of 6 indicators to measure surgery, accompanied by time-bound targets and a template for national surgical planning. To date, no sub-Saharan African country has completed and published a nationwide evaluation of its surgical system within this framework. METHOD: Mercy Ships, in partnership with Harvard Medical School and the Madagascar Ministry of Health, collected data on the 6 indicators from 22 referral hospitals in 16 out of 22 regions of Madagascar...
November 30, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27904903/prediction-of-severe-bleeding-after-coronary-surgery-the-will-bleed-risk-score
#13
Fausto Biancari, Debora Brascia, Francesco Onorati, Daniel Reichart, Andrea Perrotti, Vito G Ruggieri, Giuseppe Santarpino, Daniele Maselli, Giovanni Mariscalco, Riccardo Gherli, Antonino S Rubino, Marisa De Feo, Giuseppe Gatti, Francesco Santini, Magnus Dalén, Matteo Saccocci, Eeva-Maija Kinnunen, Juhani K E Airaksinen, Paola D'Errigo, Stefano Rosato, Francesco Nicolini
Severe perioperative bleeding after coronary artery bypass grafting (CABG) is associated with poor outcome. An additive score for prediction of severe bleeding was derived (n=2494) and validated (n=1250) in patients from the E-CABG registry. Severe bleeding was defined as E-CABG bleeding grades 2-3 (transfusion of >4 units of red blood cells or reoperation for bleeding). The overall incidence of severe bleeding was 6.4 %. Preoperative anaemia (3 points), female gender (2 points), eGFR <45 ml/min/1.73 m(2) (3 points), potent antiplatelet drugs discontinued less than five days (2 points), critical preoperative state (5 points), acute coronary syndrome (2 points), use of low-molecular-weight heparin/fondaparinux/unfractionated heparin (1 point) were independent predictors of severe bleeding...
December 1, 2016: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/27904852/analysis-of-in-hospital-mortality-and-long-term-survival-excluding-in-hospital-mortality-after-open-surgical-repair-of-ruptured-abdominal-aortic-aneurysm
#14
Jun Gyo Gwon, Tae-Won Kwon, Yong-Pil Cho, Young Jin Han, Min Su Noh
PURPOSE: The aim of this study was to confirm the factors that affect the mortality associated with the open surgical repair of ruptured abdominal aortic aneurysm (rAAA) and to analyze the long-term survival rates. METHODS: A retrospective review was performed on a prospectively collected database that included 455 consecutive patients who underwent open surgical repair for AAA between January 2001 and December 2012. We divided our analysis into in-hospital and postdischarge periods and analyzed the risk factors that affected the long-term survival of rAAA patients...
December 2016: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/27903931/comparison-of-perioperative-outcomes-in-endovascular-versus-open-repair-for-juxtarenal-and-pararenal-aortic-aneurysms-a-propensity-matched-analysis
#15
Nathan T Orr, Daniel L Davenport, David J Minion, Eleftherios S Xenos
OBJECTIVE: Endoluminal aortic aneurysm repair is suitable within certain anatomic specifications. This study aims to compare 30-day outcomes of endovascular versus open repairs for juxtarenal and pararenal aortic aneurysms (JAA/PAAs). METHODS: The ACS-NSQIP database was queried from 2012 to 2015 for JAA/PAA repairs. Procedures characterized as emergent were included in the study; however, failed prior repairs and ruptured aneurysms were excluded. The preoperative and perioperative patient characteristics, operative techniques, and outcome variables were compared between the open aortic repair and the endovascular aortic repair groups...
November 30, 2016: Vascular
https://www.readbyqxmd.com/read/27903337/-risk-factors-for-perioperative-stroke-in-aged-patients-undergoing-nonneurologic-and-noncardiovascular-surgery
#16
B L Jiang, L Yao, Y Feng, J H Liu
Objective: To assess the incidence, risk factors, and outcomes of perioperative stroke in aged patients undergoing nonneurologic and noncardiovascular surgery. Methods: A total of 21 419 in-patients who were older than 65 years undergoing nonneurologic and noncardiovascular surgery in Peking University People's Hospital from January 2010 to May 2016 were retrospectively recruited in this study.The patients were divided into two groups: patients with perioperative stroke were allocated in stroke group, and the other patients were in the non-stroke group...
November 22, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27902826/association-of-a-frailty-screening-initiative-with-postoperative-survival-at-30-180-and-365-days
#17
Daniel E Hall, Shipra Arya, Kendra K Schmid, Mark A Carlson, Pierre Lavedan, Travis L Bailey, Georgia Purviance, Tammy Bockman, Thomas G Lynch, Jason M Johanning
Importance: As the US population ages, the number of operations performed on elderly patients will likely increase. Frailty predicts postoperative mortality and morbidity more than age alone, thus presenting opportunities to identify the highest-risk surgical patients and improve their outcomes. Objective: To examine the effect of the Frailty Screening Initiative (FSI) on mortality and complications by comparing the surgical outcomes of a cohort of surgical patients treated before and after implementation of the FSI...
November 30, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27902607/perioperative-complications-following-preoperative-cessation-of-antithrombotic-agents-for-total-knee-arthroplasty-a-retrospective-study
#18
Jin-Young Hwang, Sohee Oh, Chong-Soo Kim, Jee-Eun Chang, Seong-Won Min
The number of elderly patients undergoing total knee arthroplasty (TKA) has steadily increased. Elderly patients undergoing TKA usually have underlying diseases, and some of them take antithrombotic agents for the prevention or treatment of these co-morbidities, including cardiovascular, cerebrovascular, or thromboembolic diseases. When these patients are scheduled to undergo TKA, preoperative cessation of antithrombotic agents is considered on the basis of its risks and benefits. This study was aimed to evaluate the impact of discontinuing antithrombotic agents for primary total knee arthroplasty (TKA) on perioperative complications...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27902502/zika-virus-and-patient-blood-management
#19
Lawrence T Goodnough, Marisa B Marques
Sporadic Zika virus infections had only occurred in Africa and Asia until an outbreak in Micronesia (Oceania) in 2007. In 2013 to 2014, several outer Pacific Islands reported local outbreaks. Soon thereafter, the virus was likely introduced in Brazil from competing athletes from French Polynesia and other countries that participated in a competition there. Transmission is thought to have occurred through mosquito bites and spread to the immunologically naive population. Being also a flavivirus, the Zika virus is transmitted by the Aedes mosquito that is endemic in South and Central America that is also the vector of West Nile virus, dengue, and chikungunya...
November 29, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27901350/blood-transfusion-requirement-and-not-preoperative-anaemia-is-associated-with-perioperative-complications-following-intracorporeal-robotic-assisted-radical-cystectomy
#20
Wei Shen Tan, Benjamin Wilfrid Lamb, Pramit Khetrapal, Mae-Yen Tan, Melanie El Tan, Ashwin Sridhar, Elizabeth Cervi, Simon Rodney, Gerald Busuttil, Senthil Nathan, John Hines, Greg Shaw, Anna Mohammed, Hilary Baker, Timothy P Briggs, Andrew Klein, Toby Richards, John D Kelly
OBJECTIVES: To assess the prevalence of preoperative anaemia and the impact of preoperative anaemia and blood transfusion requirement on 30- and 90-day complications in a cohort of patients undergoing robotic assisted radical cystectomy with intracorporeal urinary diversion (iRARC). PATIENTS & METHODS: IRARC was performed on 166 patients between June 2011-March 2016. Prospective data was collected for patient demographics, clinical and pathological characteristics, perioperative variables, transfusion requirements and hospital length of stay...
November 30, 2016: Journal of Endourology
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