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https://www.readbyqxmd.com/read/29156839/the-benefit-of-immunonutrition-in-patients-undergoing-hepatectomy-a-systematic-review-and-meta-analysis
#1
Chengshuo Zhang, Baomin Chen, Ao Jiao, Feng Li, Bowen Wang, Ning Sun, Jialin Zhang
Perioperative immunonutrition in liver resection remains doubtful. A systematic review and meta-analysis was conducted to compare postoperative outcomes between patients undergoing hepatectomy who received perioperative immunonutrition and those who did not.A PubMed, Embase, Cochrane Central Register of Controlled Trials, and Web of Knowledge database search was performed to retrieve all of the randomized controlled trials (RCTs) evaluating the value of perioperative immunonutrition in patients undergoing hepatectomy until the end of September 2016...
October 17, 2017: Oncotarget
https://www.readbyqxmd.com/read/29156482/-how-to-reduce-the-rate-of-postoperative-complications-in-frail-patients
#2
Rudolf Mörgeli, Tobias Wollersheim, Claudia Spies, Felix Balzer, Susanne Koch, Sascha Treskatsch
Frail patients are more prone to develop complications during and after surgery. As the syndrome becomes more common, recognition and special management of frail patients in the perioperative setting is becoming crucial to improve short- and long-term outcomes. Based on current literature and guidelines, we present a compilation of strategies that could be employed to reduce postoperative complication rates in frail patients. Due to their impaired response to stressors, potential perioperative hazards to frail patients are identified and discussed...
November 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29156184/bariatric-surgery-for-obesity
#3
REVIEW
Carel W le Roux, Helen M Heneghan
In this review, the authors discuss the indications for and the published outcomes of commonly performed bariatric procedures, including weight loss, perioperative morbidity and mortality, late complications, as well as the impact of bariatric surgery on comorbidities, cardiovascular risk, and mortality. They also briefly discuss the mechanisms by which bariatric/metabolic surgery causes such significant weight loss and health gain.
January 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29156018/risk-factors-of-myasthenic-crisis-after-thymectomy-for-thymoma-patients-with-myasthenia-gravis
#4
Liang Xue, Lin Wang, Jihong Dong, Yunfeng Yuan, Hong Fan, Yi Zhang, Qun Wang, Jianyong Ding
OBJECTIVES: Total thymectomy should be performed on thymoma patients with myasthenia gravis. The aim of the present study was to investigate the risk factors of postoperative myasthenic crisis (POMC) occurrence in these patients. METHODS: The clinical records of 127 thymoma patients with myasthenia gravis (68 men, 59 women; median age, 50 years) who underwent total thymectomy at our institution from 2005 to 2014 were retrospectively reviewed. The following factors were analysed in relation to POMC: gender, age, duration of symptoms, bulbar symptoms, smoking history, history of myasthenic crisis, comorbidities, perioperative pyridostigmine and prednisolone therapy, spirometric and blood gas parameters, Osserman stage, operation approach, major complications, World Health Organization (WHO) histologic classification, Masaoka stage and use of immunoglobulins or plasmapheresis...
October 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29155340/ambulatory-anterior-cervical-discectomy-and-fusion-is-associated-with-a-higher-risk-of-revision-surgery-and-perioperative-complications-an-analysis-of-a-large-nationwide-database
#5
Armin Arshi, Christopher Wang, Howard Y Park, Gideon W Blumstein, Zorica Buser, Jeffrey C Wang, Arya N Shamie, Don Y Park
BACKGROUND CONTEXT: With the changing landscape of healthcare, outpatient spine surgery is being more commonly performed to reduce cost and improve efficiency. Anterior cervical discectomy and fusion (ACDF) is one of the most common spine surgeries performed and demand is expected to increase with an aging population. PURPOSE: To determine the nationwide trends and relative complication rates associated with outpatient ACDF. STUDY DESIGN/SETTING: Large-scale retrospective case control study PATIENT SAMPLE: Humana-insured patients who underwent 1-2 level ACDF as either outpatients or inpatients from 2011-2016 OUTCOME MEASURES: Incidence and adjusted odds ratio (OR) of postoperative medical and surgical complications within one year of the index surgery METHODS: A retrospective review was performed of the PearlDiver® Humana insurance records database to identify patients undergoing 1-2 level ACDF (CPT-22551 AND ICD-9-816...
November 16, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29155253/the-association-of-inflammatory-bowel-disease-and-immediate-postoperative-outcomes-following-lumbar-fusion
#6
Joseph E Tanenbaum, Stephanie T Kha, Edward C Benzel, Michael P Steinmetz, Thomas E Mroz
BACKGROUND CONTEXT: The United States Centers for Disease Control estimates the prevalence of inflammatory bowel disease (IBD) at over 3.1 million people. As diagnostic techniques and treatment options for IBD improve, the prevalence of IBD is expected to increase. For spine surgeons, patients with IBD have a unique complication profile because IBD patients may present with poor nutritional status and because the medications used to manage IBD have been associated with poor vertebral bone mineralization and immunosuppression...
November 15, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29155251/the-rothman-index-as-a-predictor-of-post-discharge-adverse-events-after-elective-spine-surgery
#7
Ryan P McLynn, Nathaniel T Ondeck, Jonathan J Cui, David R Swanson, Blake N Shultz, Patawut Bovonratwet, Jonathan N Grauer
BACKGROUND CONTEXT: The Rothman Index (RI) is a comprehensive rating of overall patient condition in the hospital setting. It is used at many medical centers and calculated based on vital signs, lab values, and nursing assessments in the electronic medical record. Past research has demonstrated an association with adverse events, readmission, and mortality in other fields, but it has not been investigated in spine surgery. PURPOSE: To determine the potential utility of the RI as a predictor of adverse events after discharge following elective spine surgery...
November 15, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29155191/ultrasound-guided-pudendal-block-is-a-viable-alternative-to-caudal-block-for-hypospadias-surgery-a-single-surgeon-pilot-study
#8
Sarah Hecht, Jorge Piñeda, Aaron Bayne
OBJECTIVE: To evaluate pudendal nerve block as an alternative to caudal block for hypospadias surgery. METHODS: Data were obtained by chart review. Children who underwent hypospadias repair between 2012 and 2016 by a single surgeon at an academic institution were included. Patients received ultrasound-guided pudendal block (n=21) or caudal block (n=19) as a regional adjunct to general anesthesia. Primary outcomes included analgesic requirement and postoperative length of stay in the recovery unit...
November 16, 2017: Urology
https://www.readbyqxmd.com/read/29154243/internal-hernia-following-laparoscopic-colorectal-surgery-single-center-experience
#9
Melina Svraka, Michał Wilhelmsen, Orhan Bulut
Although internal hernias are rare complications of laparoscopic colorectal surgery, they can lead to serious outcomes and are associated with a high mortality of up 20 %. AIM OF THE STUDY: The aim of this study was to describe our experience regarding internal herniation following laparoscopic colorectal surgery. MATERIALS AND METHODS: From 2009 to 2015, more than 1,093 laparoscopic colorectal procedures were performed, and 6 patients developed internal herniation...
October 31, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/29154237/results-of-home-parenteral-nutrition-in-patients-with-severe-inflammatory-bowel-disease-an-alternative-for-surgery-of-malnourished-patients
#10
Maryla Turkot, Jacek Sobocki
INTRODUCTION: In the world, the inflammatory bowel disease affects an increasing number of younger and younger patients, and in some of them parenteral nutrition is an alternative to high-risk surgical intervention due to advancement of the disease and malnutrition. AIM: The aim of the study was to assess the results of home parenteral nutrition in patients with severe bowel inflammatory disease, in whom surgical treatment is associated with high risk of complications...
October 31, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/29154042/oncological-outcomes-of-laparoscopic-nephroureterectomy-versus-open-radical-nephroureterectomy-for-upper-tract-urothelial-carcinoma-an-european-association-of-urology-guidelines-systematic-review
#11
REVIEW
Benoit Peyronnet, Thomas Seisen, Jose-Luis Dominguez-Escrig, Harman Max Bruins, Cathy Yuhong Yuan, Thomas Lam, Steven Maclennan, James N'dow, Marko Babjuk, Eva Comperat, Richard Zigeuner, Richard J Sylvester, Maximilian Burger, Hugh Mostafid, Bas W G van Rhijn, Paolo Gontero, Joan Palou, Sharokh F Shariat, Morgan Roupret
CONTEXT: Most series have suggested better perioperative outcomes of laparoscopic radical nephroureterectomy (RNU) over open RNU. However, the oncological safety of laparoscopic RNU remains controversial. OBJECTIVE: To systematically review all relevant literature comparing oncological outcomes of open versus laparoscopic RNU. EVIDENCE ACQUISITION: A systematic literature search using the Medline, Embase, and Cochrane databases and clinicaltrial...
November 15, 2017: European Urology Focus
https://www.readbyqxmd.com/read/29153918/nursing-music-protocol-and-postoperative-pain
#12
REVIEW
Michael J Poulsen, Jeffrey Coto
Pain has always been a major concern for patients and nurses during the postoperative period. Therapies, medicines, and protocols have been developed to improve pain and anxiety but have undesirable risks to the patient. Complementary and alternative medicine therapies have been studied but have not been applied as regular protocols in the hospital setting. Music is one type of complementary and alternative medicine therapy that has been reported to have favorable results on reducing postoperative pain, anxiety, and opioid usage...
November 16, 2017: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29152936/gastric-ultrasound-to-guide-anesthetic-management-in-elective-surgical-patients-non-compliant-with-fasting-instructions-a-retrospective-cohort-study
#13
Peter van de Putte, Jonathan van Hoonacker, Anahi Perlas
BACKGROUND: Perioperative aspiration leads to significant morbidity and mortality. Standard fasting periods are used to ensure an empty stomach in patients. Anesthesiologists are frequently confronted with cases of dubious adherence to these guidelines. Point-of-care gastric ultrasound is a diagnostic tool that offers information on the type and volume of gastric contents. METHODS: We performed a retrospective analysis of a departmental database containing clinical and sonographic information on elective surgical patients who had been non- compliant to the fasting guidelines...
November 17, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29152709/perioperative-gastrointestinal-problems-in-the-icu
#14
Annika Reintam Blaser, Joel Starkopf, Pieter-Jan Moonen, Manu L N G Malbrain, Heleen M Oudemans-van Straaten
Gastrointestinal (GI) problems after surgery are common and are not limited to patients undergoing abdominal surgery. GI function is complicated to monitor and is not included in organ dysfunction scores widely used in the ICUs. In most cases, it recovers after surgery, if systemic and local inflammation and perfusion improve, gut oedema resolves, and analgosedation is reduced. However, perioperative GI problems may have severe consequences and increase the risk of death if not recognized and managed in a timely manner...
November 20, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29151453/diastolic-dysfunction-is-a-risk-of-perioperative-myocardial-injury-assessed-by-high-sensitivity-cardiac-troponin-t-in-elderly-patients-undergoing-non-cardiac-surgery
#15
Hironobu Toda, Kazufumi Nakamura, Koji Nakagawa, Atsuyuki Watanabe, Toru Miyoshi, Nobuhiro Nishii, Kazuyoshi Shimizu, Masao Hayashi, Hiroshi Morita, Hiroshi Morimatsu, Hiroshi Ito
BACKGROUND: High-sensitivity cardiac troponin T (hs-cTnT) is useful for detecting myocardial injury and is expected to become a prognostic marker in patients undergoing non-cardiac surgery. The aim of this pilot study evaluating the efficacy of β-blocker therapy in a perioperative setting (MAMACARI study) was to assess perioperative myocardial injury (PMI) in elderly patients with preserved ejection fraction (EF) undergoing non-cardiac surgery.Methods and Results:In this prospective observational cohort study of 151 consecutive patients with preserved EF and aged >60 years who underwent non-cardiac surgery, serum levels of hs-cTnT were measured before and on postoperative days 1 and 3 after surgery...
November 18, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29151010/same-day-discharge-after-total-joint-arthroplasty-the-future-may-be-now
#16
Vinay Aggarwal, Savyasachi Thakkar, Kristopher Collins, Jonathan Vigdorchik
Total joint arthroplasty has traditionally been performed as an inpatient procedure to mitigate the risks of perioperative complications, limited mobility, and pain control issues. Reducing readmissions and complications is increasingly important with the push toward outcomes based reimbursement. Nonetheless, there is a definite trend toward not only shortening postoperative length of stay but also toward considering a same day discharge arthroplasty model in appropriately selected patients. In this review, we outline the literature evidence regarding same day discharge in total joint arthroplasty and discuss our own institutional guidelines for appropriate patient selection as well as contraindications...
December 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29150779/perioperative-transesophageal-echocardiography-for-non-cardiac-surgery
#17
REVIEW
Ashraf Fayad, Sasha K Shillcutt
PURPOSE: The use of transesophageal echocardiography (TEE) has evolved to include patients undergoing high-risk non-cardiac procedures and patients with significant cardiac disease undergoing non-cardiac surgery. Implementation of basic TEE education in training programs has increased across a broad spectrum of procedures in the perioperative arena. This paper describes the use of perioperative TEE in non-cardiac surgery and provides an overview of the basic TEE examination. PRINCIPAL FINDINGS: Perioperative TEE is used to monitor hemodynamic parameters in non-cardiac procedures where there is a high risk of hemodynamic instability...
November 17, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29150035/thoracic-surgery-considerations-in-obese-patients
#18
REVIEW
Douglas Z Liou, Mark F Berry
The obesity epidemic in the United States has increased greatly over the past several decades, and thoracic surgeons are likely to see obese patients routinely in their practices. Obesity has direct deleterious health effects such as metabolic disorder and cardiovascular disease, and is associated with many cancers. Obese patients who need thoracic surgery pose practical challenges to many of the routine elements in perioperative management. Preoperative assessment of obesity-related comorbid conditions and risk stratification for surgery, thorough intraoperative planning for anesthesia and surgery, and postoperative strategies to optimize pulmonary hygiene and mobility minimize the risk of adverse outcomes...
February 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/29150031/thoracic-surgery-in-the-pregnant-patient
#19
REVIEW
Brian Whang
Thoracic surgeons are sometimes asked to consult on the management of a patient who is pregnant. Conditions commonly encountered are empyema, spontaneous pneumothorax, and diaphragmatic hernia. Lung cancer is rarely seen in pregnancy, but its incidence is rising. Diagnostic imaging and perioperative management involve the navigation of fetal risks and nuances in maternal physiology. Shared decision making within a multidisciplinary framework will optimally guide the course of management.
February 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/29149970/thromboelastography-as-a-predictor-of-outcomes-following-liver-transplantation
#20
C L Trautman, W C Palmer, C B Taner, J M Canabal, T Getz, A Goldman, M G Heckman, N N Diehl, D D Lee, F F Stancampiano
BACKGROUND: Thromboelastography (TEG) has been used perioperatively during liver transplantation (LT) to provide a real-time global hemostasis assessment for targeted blood product replacement. We aimed to analyze the relationship between post-LT TEG results and outcomes. METHODS: We retrospectively analyzed patients undergoing LT from November 2008 to December 2014 at Mayo Clinic Florida. All 441 single-organ 1st-time LT patients aged ≥18 years requiring post-LT intensive care unit management were included...
November 2017: Transplantation Proceedings
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