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https://www.readbyqxmd.com/read/28535554/anesthetic-considerations-and-perioperative-management-of-spinal-cord-stimulators-literature-review-and-initial-recommendations
#1
Michael E Harned, Brandon Gish, Allison Zuelzer, Jay S Grider
BACKGROUND: Patients with implanted spinal cord stimulators (SCS) present to the anesthesia care team for management at many different points along the care continuum. Currently, the literature is sparse on the perioperative management. What is available is confusing; monopolar electrocautery is contraindicated but often used, full body magnetic resonance imaging (MRI) is safe with particular systems but with other manufactures only head and specific extremities exams are safe. Moreover, there are anesthetizing locations outside of the operating room where implanted SCS can interact with surrounding medical equipment and pose significant risk to patient and device...
May 2017: Pain Physician
https://www.readbyqxmd.com/read/28534559/-gastric-volvulus-an-infrequent-cause-of-acute-abdominal-pain
#2
D Ruiz-Clavijo García, A Zuñiga Ripa, L Casanova Ortíz, I García de Eulate Martín-Moro, B González de la Higuera Carnicer, J Urman Fernández
Gastric volvulus (GV) is characterized by the abnormal rotation of a portion of the stomach around a horizontal or vertical axis that can cause obstruction, vascular disorder and even strangulation, and may evolve into necrosis or even perforation. It can be classified according to its aetiology into primary or secondary GV, according to its anatomy into axial organ or into axial mesenteric GV, and according to its presentation into chronic or acute GV. Both types of volvulus require treatment; however, in spite of the classic treatment being open surgery, there is no standard treatment, nor is there consensus on the alternative of choice at present...
April 30, 2017: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/28534361/impact-of-perioperative-blood-transfusion-on-survival-of-patients-undergoing-laparoscopic-gastrectomy-for-gastric-cancer
#3
Rong Gui, Hao Tang, Meng Gao, Jing Liu, Rong Huang, Guosheng Zhao, Jinqi Ma, Mengqing Yi, Fengxia Liu, Yunfeng Fu
PURPOSE: Previous studies have suggested that perioperative blood transfusion is associated with poor prognosis in patients undergoing radical gastrectomy for gastric cancer. The purpose of this study was to evaluate the impact of blood transfusion on the long-term survival of such patients. METHODS: Short- and long-term outcomes were retrieved from a prospectively collected database of patients who underwent laparoscopic gastrectomy with radical intent for gastric cancer...
March 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/28534175/-aseptic-loosening-of-total-ankle-replacement-two-stage-revision-with-bone-augmentation-of-osseous-defects-and-secondary-prosthesis-implantation
#4
A Barg, M Wiewiorski, V Valderrabano
OBJECTIVE: To remove loosened ankle prosthesis components, perform osseous defect augmentation, and reimplant definitive prosthesis components to preserve ankle range of motion. INDICATIONS: Aseptic loosening of the tibial and/or talar ankle prosthesis components with substantial bone defect. CONTRAINDICATIONS: General surgical/anesthesiological risks, infections, critical soft tissue conditions, nonmanageable hindfoot instability, neurovascular impairment of the lower extremity, neuroarthropathy, substantial nonreconstructable osseous defects with or without cysts on the tibial and/or talar side, noncompliance, primary total ankle replacement (TAR) using intramedullary fixation (stem fixation), severely reduced bone quality, insulin-dependent diabetes mellitus, smoking, unrealistic patients' expectations, high activity in sports...
May 22, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28532910/impact-of-elderly-age-on-complications-and-clinical-outcomes-following-anterior-lumbar-interbody-fusion-surgery
#5
Kevin Phan, Vignesh Ramachandran, Tommy Tran, Steven Phan, Prashanth J Rao, Ralph J Mobbs
BACKGROUND: Anterior Lumbar Interbody Fusion (ALIF) is a surgical technique used to treat patients with a variety of lumbar pathologies. Identification of risk factors leading to complication following ALIF surgery may allow surgeons to better judge candidacy and optimize care for high-risk patients. METHODS: A retrospective analysis was conducted on a prospectively collected database of 137 patients who all underwent ALIF surgery by a single primary spine surgeon...
May 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28532576/-tobacco-and-plastic-surgery-an-absolute-contraindication
#6
C Matusiak, A De Runz, H Maschino, M Brix, E Simon, F Claudot
INTRODUCTION: Smoking increases perioperative risk regarding wound healing, infection rate and failure of microsurgical procedures. There is no present consensus about plastic and aesthetic surgical indications concerning smoking patients. The aim of our study is to analyze French plastic surgeons practices concerning smokers. METHOD: A questionnaire was send by e-mail to French plastic surgeons in order to evaluate their own operative indications: patient information about smoking dangers, pre- and postoperative delay of smoking cessation, type of intervention carried out, smoking cessation supports, use of screening test and smoking limit associated to surgery refusing were studied...
May 19, 2017: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/28532265/encephaloduroarteriosynangiosis-edas-in-young-patients-with-cerebrovascular-complications-of-sickle-cell-disease-single-institution-experience
#7
Michael Winstead, Peter P Sun, Kenneth Martin, Janice Earl, Lynne Neumayr, Carolyn Hoppe, Elliott Vichinsky
Moyamoya syndrome occurs in sickle cell disease (SCD) as a secondary complication of large-artery stenosis. Moyamoya increases the risk of stroke, but its optimal management in SCD is not established.  Encephaloduroarteriosynangiosis (EDAS) is a neurosurgical revascularization procedure for moyamoya whose use has been reported in SCD patients. We report the outcomes of 11 patients with SCD systematically evaluated for EDAS by a multidisciplinary team and compare the rate of stroke in patients who received EDAS to those who did not...
May 22, 2017: Pediatric Hematology and Oncology
https://www.readbyqxmd.com/read/28530768/perioperative-management-of-rheumatoid-medications-in-orthopedic-surgery
#8
Kunal Sindhu, Brian Cohen, Joseph A Gil
Rheumatoid arthritis (RA) is a chronic, systemic autoimmune disorder known to cause progressive joint destruction. Over time, untreated RA can lead to pain and increasing disability, making orthopedic intervention necessary. The treatment of RA revolves around a variety of medications that blunt the overall immune response. However, this may increase the risk of infection and impair wound healing. Given the nature of this disease, orthopedists frequently encounter patients with RA in the operative setting. To optimize surgical outcomes, orthopedists must carefully manage and pay special attention to the adverse side effects of the complicated medication regimens of these patients perioperatively...
May 20, 2017: Orthopedics
https://www.readbyqxmd.com/read/28530213/-the-model-of-perioperative-risk-assessment-in-elderly-patients-interim-analysis
#9
Izabela Grabowska, Lucyna Ścisło, Szymon Pietruszka, Elzbieta Walewska, Agata Paszko, Benita Siarkiewicz, Piotr Richter, Andrzej Budzyński, Antoni M Szczepanik
Demographic changes in contemporary society require implementation of proper perioperative care of elderly patients due to an increased risk of perioperative complications in this group. Preoperative assessment of health status identifies risks and enables preventive interventions, improving outcomes of surgical treatment. The Comprehensive Geriatric Assessment contains numerous diagnostic tests and consultations, which is expensive and difficult to use in everyday practice. The development of a simplified model of perioperative assessment of elderly patients will help identifying the group of patients who require further diagnostic workup...
April 21, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28529107/is-there-a-role-for-preoperative-iron-supplementation-in-patients-preparing-for-a-total-hip-or-total-knee-arthroplasty
#10
Stephen M Petis, Brent A Lanting, Edward M Vasarhelyi, Douglas D R Naudie, Fiona E Ralley, James L Howard
BACKGROUND: Several treatment modalities exist for the treatment of perioperative anemia. We determined the effect of oral iron supplementation on preoperative anemia, and the use of blood-conserving interventions before total hip arthroplasty (THA) and total knee arthroplasty (TKA). METHODS: A total of 3435 total joint arthroplasties (1461 THAs and 1974 TKAs) were analyzed during 2 phases of a blood conservation program. The first phase used erythropoietin alfa (EPO) or intravenous (IV) iron for patients at risk for perioperative anemia...
April 27, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28529103/the-importance-of-lymph-node-ratio-for-locoregional-recurrence-of%C3%A2-squamous-cell-carcinoma-of-the-tongue
#11
Ali-Farid Safi, Andrea Grandoch, Hans-Joachim Nickenig, Joachim E Zöller, Matthias Kreppel
INTRODUCTION: Locoregional recurrence plays a key role in treatment failure of patients with squamous cell carcinoma of the tongue. In a large amount of studies lymph node ratio could be demonstrated as a promising parameter to stratify risk of patients with oral cavity cancer. However data on the influence of lymph node ratio on locoregional recurrence of tongue squamous cell carcinoma is very rare. MATERIAL AND METHODS: Retrospective chart review of 130 patients with treatment naive squamous cell carcinoma of the tongue...
April 22, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28528662/carotid-stenting-in-patients-with-high-risk-versus-standard-risk-for-open-carotid-endarterectomy-real-1-trial
#12
Joaquin De Haro, Ignacio Michel, Silvia Bleda, Cristina Cañibano, Francisco Acin
Carotid stenting (CAS) has been mainly offered to those patients considered at "high risk" for open carotid endarterectomy based on available data from large randomized clinical trials. However, several recent studies have called medical "high risk" into question for CAS indication. The REAL-1 trial evaluated the safety and perioperative and long-term effectiveness in patients with significant carotid artery stenosis with "high-risk" criteria treated with CAS and proximal protection device (MOMA) compared with those with standard surgical-risk features...
April 26, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28528188/the-impact-of-perioperative-fluid-therapy-on-short-term-outcomes-and-5-year-survival-among-patients-undergoing-colorectal-cancer-surgery%C3%A2-a-prospective-cohort-study-within-an-eras-protocol
#13
D Asklid, J Segelman, C Gedda, F Hjern, K Pekkari, U O Gustafsson
BACKGROUND: Restricted perioperative fluid therapy is one of several interventions in the enhanced recovery after surgery (ERAS) protocol, designed to reduce morbidity and hospital stay after surgery. The impact of this single intervention on short and long term outcome after colorectal surgery is unknown. PATIENTS AND METHODS: This cohort study includes all consecutive patients operated with abdominal resection of colorectal cancer 2002-2007 at Ersta Hospital, Stockholm, Sweden...
May 3, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28527931/predictors-of-surgical-site-infection-after-open-lower-extremity-revascularization
#14
Frank M Davis, Danielle C Sutzko, Scott F Grey, M Ashraf Mansour, Krishna M Jain, Timothy J Nypaver, Greg Gaborek, Peter K Henke
OBJECTIVE: Surgical site infection (SSI) after open lower extremity bypass (LEB) is a serious complication leading to an increased rate of graft failure, hospital readmission, and health care costs. This study sought to identify predictors of SSI after LEB for arterial occlusive disease and also potential modifiable factors to improve outcomes. METHODS: Data from a statewide cardiovascular consortium of 35 hospitals were used to obtain demographic, procedural, and hospital risk factors for patients undergoing elective or urgent open LEB between January 2012 and June 2015...
June 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28527930/outcomes-of-open-and-endovascular-lower-extremity-revascularization-in-active-smokers-with-advanced-peripheral-arterial-disease
#15
Samuel L Chen, Matthew D Whealon, Nii-Kabu Kabutey, Isabella J Kuo, Michael D Sgroi, Roy M Fujitani
OBJECTIVE: Concern over perioperative and long-term durability of lower extremity revascularizations among active smokers is a frequent deterrent for vascular surgeons to perform elective lower extremity revascularization. In this study, we examined perioperative outcomes of lower extremity endovascular (LEE) revascularization and open lower extremity bypass (LEB) in active smokers with intermittent claudication (IC) and critical limb ischemia (CLI). METHODS: Active smokers undergoing LEE or LEB from 2011 to 2014 were identified in the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) targeted vascular data set...
June 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28527929/new-predictors-of-complications-in-carotid-body-tumor-resection
#16
Gloria Y Kim, Peter F Lawrence, Rameen S Moridzadeh, Kate Zimmerman, Alberto Munoz, Kuauhyama Luna-Ortiz, Gustavo S Oderich, Juan de Francisco, Jorge Ospina, Santiago Huertas, Leonardo R de Souza, Thomas C Bower, Steven Farley, Hugh A Gelabert, Marcus R Kret, E John Harris, Giovanni De Caridi, Francesco Spinelli, Matthew R Smeds, Christos D Liapis, John Kakisis, Anastasios P Papapetrou, Eike S Debus, Christian-A Behrendt, Edgar Kleinspehn, Joshua D Horton, Firas F Mussa, Stephen W K Cheng, Mark D Morasch, Khurram Rasheed, Matthew E Bennett, Jean Bismuth, Alan B Lumsden, Christopher J Abularrage, Alik Farber
OBJECTIVE: This study examined the relationship between two new variables, tumor distance to base of skull (DTBOS) and tumor volume, with complications of carotid body tumor (CBT) resection, including bleeding and cranial nerve injury. METHODS: Patients who underwent CBT resection between 2004 and 2014 were studied using a standardized, multi-institutional database. Demographic, perioperative, and outcomes data were collected. CBT measurements were determined from computed tomography, magnetic resonance imaging, and ultrasound examination...
June 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28527755/perioperative-neurologic-complications-during-spinal-fusion-surgery-incidence-and-trends
#17
Parthasarathy Thirumala, James Zhou, Piruthiviraj Natarajan, Jeffrey Balzer, Edward Dixon, David Okonkwo, D K Hamilton
BACKGROUND CONTEXT: Perioperative neurologic complications after spine surgery may increase morbidity and healthcare costs related to the procedure. PURPOSE: We estimate the national incidence of perioperative neurologic complications following anterior cervical discectomy and fusion (ACDF), posterior cervical fusion, and thoracolumbar fusion procedures using the Nationwide Inpatient Sample (NIS) data from 1999 to 2011. Additionally, we identify risk factors for developing perioperative neurologic complications and the effects of these injuries on quantifiable patient outcomes...
May 17, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28527678/patient-reported-quality-of-life-after-endovascular-repair-of-thoracoabdominal-aortic-aneurysms
#18
Andrew J Meltzer, Peter H Connolly, Sharif Ellozy, Darren B Schneider
OBJECTIVE: The purpose of this study was to assess patient-reported physical and emotional well-being during follow-up after endovascular repair of TAAA. METHODS: All patients were treated in the context of a physician-sponsored investigational device exemption clinical study for patients at high risk for open TAAA repair. The SF-36 instrument was administered preoperatively, and at 1, 6, and 12 months. Results were analyzed using paired t-tests, with sub-group comparisons to assess impact of adverse events and technical results on quality of life...
May 17, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28526942/development-of-a-new-risk-nomogram-of-perioperative-major-adverse-cardiac-events-for-chinese-patients-undergoing-colorectal-carcinoma-surgery
#19
Juhong Zhang, Ying Xiao, Daya Yang, Xiaodong Zhuang, Ling Wang, Xiuren Gao, Zhibin Huang
PURPOSE: The purpose of this study is to create a new risk nomogram to predict perioperative major adverse cardiac events in patients undergoing colorectal carcinoma surgery. METHODS: A total of 1899 patients who underwent colorectal carcinoma surgery at a tertiary teaching hospital in China between 2007 and 2012 were recruited. Logistic regression analysis was used to define risk factors for major adverse cardiac events. A nomogram-predicting model was built based on the logistic regression model and discrimination was tested by receiver operating characteristic curves...
May 19, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28526648/somatosensory-evoked-potentials-during-temporary-arterial-occlusion-for-intracranial-aneurysm-surgery-predictive-value-for-perioperative-stroke
#20
Ahmed I Kashkoush, Brian T Jankowitz, Paul Gardner, Robert M Friedlander, Yue-Fang Chang, Donald J Crammond, Jeffrey R Balzer, Parthasarathy D Thirumala
BACKGROUND: Temporary arterial occlusion (TAO) is a valuable tool for minimizing intraoperative rupture risk during intracranial aneurysm microsurgery; however, it may also be associated with ischemic injury. OBJECTIVE: This study aims to identify surgical and intraoperative neurophysiological monitoring (IONM) factors that predict perioperative stroke risk after TAO. METHODS: We performed a retrospective chart review of 177 intracranial aneurysm surgeries at our institution, in which TAO was performed before the placement of a permanent clip under monitoring with somatosensory evoked potentials (SSEPs) and electroencephalography (EEG)...
May 16, 2017: World Neurosurgery
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