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Urology, surgery, gynaecology

Suzanne Forsyth Herling, Bjørn Dreijer, Gitte Wrist Lam, Thordis Thomsen, Ann Merete Møller
BACKGROUND: Rapid implementation of robotic transabdominal surgery has resulted in the need for re-evaluation of the most suitable form of anaesthesia. The overall objective of anaesthesia is to minimize perioperative risk and discomfort for patients both during and after surgery. Anaesthesia for patients undergoing robotic assisted surgery is different from anaesthesia for patients undergoing open or laparoscopic surgery; new anaesthetic concerns accompany robotic assisted surgery. OBJECTIVES: To assess outcomes related to the choice of total intravenous anaesthesia (TIVA) or inhalational anaesthesia for adults undergoing transabdominal robotic assisted laparoscopic gynaecological, urological or gastroenterological surgery...
April 4, 2017: Cochrane Database of Systematic Reviews
Abhilasha Williams, Anuradha Bhatia, Bimal Kanish, Paulina Rose Chaudhary, Clarence James Samuel
INTRODUCTION: The importance of dermatology inpatient consultation is of significant importance yet is not well documented. AIM: To retrospectively analyse the spectrum of dermatology inpatient consultations from the various departments and to document the most commonly occurring dermatological disorders from each speciality. MATERIALS AND METHODS: This study was done in an 800 bedded premier teaching hospital in Ludhiana, Punjab, North Western India...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
Alain Landais, Morgane Morel, Jacques Goldstein, Jerôme Loriau, Annie Fresnel, Corinne Chevalier, Gilles Rejasse, Pascal Alfonsi, Claude Ecoffey
OBJECTIVE: Perioperative goal-directed therapy (PGDT) has been demonstrated to improve postoperative outcomes and reduce the length of hospital stays. The objective of our analysis was to evaluate the cost of complications, derived from French hospital payments, and calculate the potential cost savings and length of hospital stay reductions. METHODS: The billing of 2388 patients who underwent scheduled high-risk surgery (i.e. major abdominal, gynaecologic, urological, vascular, and orthopaedic interventions) over three years was retrospectively collected from three French hospitals (one public-teaching, one public, and one private hospital)...
January 16, 2017: Anaesthesia, Critical Care & Pain Medicine
Steven J Edwards, Fay Crawford, Michelle Helena van Velthoven, Andrea Berardi, George Osei-Assibey, Mariana Bacelar, Fatima Salih, Victoria Wakefield
BACKGROUND: Fibrin sealants are used in different types of surgery to prevent the accumulation of post-operative fluid (seroma) or blood (haematoma) or to arrest haemorrhage (bleeding). However, there is uncertainty around the benefits and harms of fibrin sealant use. OBJECTIVES: To systematically review the evidence on the benefits and harms of fibrin sealants in non-emergency surgery in adults. DATA SOURCES: Electronic databases [MEDLINE, EMBASE and The Cochrane Library (including the Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects, the Health Technology Assessment database and the Cochrane Central Register of Controlled Trials)] were searched from inception to May 2015...
December 2016: Health Technology Assessment: HTA
Iain M Goodhart, John C Andrzejowski, Georgina L Jones, Mireille Berthoud, Andy Dennis, Gary H Mills, Stephen C Radley
BACKGROUND: Worldwide, guidelines support the routine use of anaesthetic preoperative assessment (POA), a process that is frequently supported by pro formas and unvalidated questionnaires. Electronic questionnaires can provide reliable data. A local initiative has seen the development of a computerised electronic Personal Assessment Questionnaire (ePAQ). OBJECTIVE: To develop and validate a novel electronic instrument for POA. DESIGN: The content and face validity were evaluated in 30 patients...
April 2017: European Journal of Anaesthesiology
N F M Corrêa, M J A de Brito, M M de Carvalho Resende, M F P Duarte, F S Santos, G M Salomé, L M Ferreira
OBJECTIVE: To assess the impact of surgical wound dehiscence on health-related quality of life and mental health. Dehiscence of surgical wounds is a serious postoperative complication associated with high morbidity and mortality. METHOD: Sixty-one adult patients, who had undergone neurological, general, colorectal, orthopaedic, gynaecological, plastic, cardiovascular, urological or neurological surgery in a university hospital in Brazil, were assessed between 30 and 180 days after surgery...
October 2, 2016: Journal of Wound Care
M Mrkobrada, M D Hill, M T V Chan, A Sigamani, D Cowan, A Kurz, D I Sessler, M Jacka, M Graham, M Dasgupta, V Dunlop, D J Emery, I Gulka, G Guyatt, D Heels-Ansdell, J Murkin, S Pettit, D J Sahlas, M Sharma, M Sharma, S Srinathan, P St John, S Tsai, A W Gelb, M O'Donnell, D Siu, P W Y Chiu, V Sharath, A George, P J Devereaux
BACKGROUND: Overt stroke after non-cardiac surgery has a substantial impact on the duration and quality of life. Covert stroke in the non-surgical setting is much more common than overt stroke and is associated with an increased risk of cognitive decline and dementia. Little is known about covert stroke after non-cardiac, non-carotid artery surgery. METHODS: We undertook a prospective, international cohort study to determine the incidence of covert stroke after non-cardiac, non-carotid artery surgery...
August 2016: British Journal of Anaesthesia
Laserina O Connor
AIMS AND OBJECTIVES: To determine the effectiveness of an improvement methodology initiative, directed at refining the quality of acute pain management of patients in the first 24 hours post major surgery using the Revised American Pain Society Patient Outcome Questionnaire, pre- and post development of a 'subject matter experts' acute pain programme. BACKGROUND: Accurately measuring effectiveness of acute pain management post major surgery is intertwined with measuring overall patient satisfaction...
September 2016: Journal of Clinical Nursing
Andreia Albuquerque, Eduardo Pereira
Transperineal ultrasound is an inexpensive, safe and painless technique that dynamically and non-invasively evaluates the anorectal area. It has multiple indications, mainly in urology, gynaecology, surgery and gastroenterology, with increased use in the last decade. It is performed with conventional probes, positioned directly above the anus, and may capture images of the anal canal, rectum, puborectalis muscle (posterior compartment), vagina, uterus, (central compartment), urethra and urinary bladder (anterior compartment)...
April 28, 2016: World Journal of Radiology
Pernille Tine Jensen, Ligita Paskeviciute Froeding
BACKGROUND: During the past decade there has been considerable progress in developing new radiation methods for cancer treatment. Pelvic radiotherapy constitutes the primary or (neo) adjuvant treatment of many pelvic cancers e.g., locally advanced cervical and rectal cancer. There is an increasing focus on late effects and an increasing awareness that patient reported outcomes (PROs) i.e., patient assessment of physical, social, psychological, and sexual functioning provides the most valid information on the effects of cancer treatment...
April 2015: Translational Andrology and Urology
Heinrich Vinz, Markward von Bülow, Johann Neu
From 2000 to 2012, 447 panel proceedings concerning acute appendicitis were evaluated. 271 cases (57 %) were related to alleged diagnostic malpractice. This was confirmed in 176 cases (67 %). The following medical specialities were involved (m = quote of malpractice): general surgery 33 %, m = 51 %; paediatric surgery 3 %, m = 44 %; general practitioner and prehospital emergency services 24 %, m = 62 %; internal medicine 19 %, m = 70 %; paediatrics 13 %, m = 57 %; gynaecology 3 %, m = 91 %; urology 2 %, m = 17 %...
2015: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
Mohammed S ElSheemy, Hisham Ghamrawy, Hesham Fathy, Hussein A Hussein, Eman A Hussein, Ahmed Aly, Sherif Abdel Rahman
OBJECTIVE: To evaluate the safety and efficacy of a procedure using surgeon-tailored polypropylene mesh (STM) through a needle-less single-incision technique for treating stress urinary incontinence (SUI), aiming to decrease the cost of treatment, which is important in developing countries. PATIENTS AND METHODS: In all, 43 women diagnosed using a cough stress test were treated from January 2011 to June 2013 at the Urology and Gynaecology Departments (dual-centre), Cairo University Hospitals...
September 2015: Arab Journal of Urology
Allison Muller, Joel Leroy, Thierry Hénon, Isabelle Patry, Emmanuel Samain, Catherine Chirouze, Xavier Bertrand
OBJECTIVE: To assess surgical antibiotic prophylaxis (SAP) practices in a university hospital in order to identify risk factors associated with non-compliance. STUDY DESIGN: Retrospective monocentric study conducted over a 4-month period. PATIENTS AND METHODS: Data were collected from the software used in the operating theatre. Practice non-compliance was evaluated in comparison with the 2010 version of the French national recommendations...
October 2015: Anaesthesia, Critical Care & Pain Medicine
Sara Kehlet Watt, Henrik Loft Jakobsen, Rasmus Vogelsang, Bjarne Kromann-Andersen, Connie Palle, Ligita Paskeviciute Frøding, Bjørn Dreijer, Ismail Gögenur
INTRODUCTION: We describe the initiation of a multidisciplinary centre for robotic surgery including the implementation of robotic-assisted procedures as standard procedure for the majority of cancer operations in urology, gynaecology and gastrointestinal surgery. METHODS: All robotic procedures performed from 2008 to 2013 were included. The information gathered included body mass index, the American Society of Anesthesiologists' physical status classification value (ASA), age, sex, time and type of surgery, duration of procedure, conversion to open surgery, length and type of anaesthesia, re-operations, length of hospital stay and 30-day mortality...
July 2015: Danish Medical Journal
Christophe Dadure, Anaïs Marie, Fabienne Seguret, Xavier Capdevila
UNLABELLED: Anaesthesia has evolved in France since the last epidemiologic survey in 1996. The national database program for medical information systems (the PMSI) can be used to track specific knowledge concerning anaesthesia for a selected period of time. The goal of this study was to perform a contemporary epidemiological description of anaesthesia in France for the year 2010. METHODS: The data concerning private or public hospital stays were collected from the national PMSI database...
August 2015: Anaesthesia, Critical Care & Pain Medicine
E Thinggaard, F Bjerrum, J Strandbygaard, I Gögenur, L Konge
BACKGROUND: Box trainer systems have been developed that include advanced skills such as suturing. There is still a need for a portable, cheap training and testing system for basic laparoscopic techniques that can be used across different specialties before performing supervised surgery on patients. The aim of this study was to establish validity evidence for the Training and Assessment of Basic Laparoscopic Techniques (TABLT) test, a tablet-based training system. METHODS: Laparoscopic surgeons and trainees were recruited from departments of general surgery, gynaecology and urology...
August 2015: British Journal of Surgery
J C Simpson, S R Moonesinghe, M P W Grocott, M Kuper, A McMeeking, C M Oliver, M J Galsworthy, M G Mythen
BACKGROUND: The UK Department of Health Enhanced Recovery Partnership Programme collected data on 24 513 surgical patients in the UK from 2009-2012. Enhanced Recovery is an approach to major elective surgery aimed at minimizing perioperative stress for the patient. Previous studies have shown Enhanced Recovery to be associated with reduced hospital length of stay and perioperative morbidity. METHODS: In this national clinical audit, National Health Service hospitals in the UK were invited to submit patient-level data...
October 2015: British Journal of Anaesthesia
Diana Kang, Julia Han, Molly M Neuberger, M Louis Moy, Sheila A Wallace, Pablo Alonso-Coello, Philipp Dahm
BACKGROUND: Transurethral radiofrequency collagen denaturation is a relatively novel, minimally invasive device-based intervention used to treat individuals with urinary incontinence (UI). No systematic review of the evidence supporting its use has been published to date. OBJECTIVES: To evaluate the efficacy of transurethral radiofrequency collagen denaturation, compared with other interventions, in the treatment of women with UI.Review authors sought to compare the following...
2015: Cochrane Database of Systematic Reviews
Torben Schütt, Arne Carstens, Jan-Hendrik Egberts, Carsten Maik Naumann, Jan Höcker
Robot-assisted surgery, as a development of laparoscopic surgery, has an increasing field of application. Beside urology, this technique has also been implemented in visceral and thoracic surgery and gynaecology. For the surgeon an enhanced view of the surgical field and a better mobility of the instruments are the most important advantages. Thus, it is possible to work more accurate and prevent inadvertent tissue damage. For the anaesthesiologist several characteristics are of importance. Limited access to the patient as a result of a special positioning requires adequate anaesthetic preparation...
February 2015: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Paul Hilton, Natalie Armstrong, Catherine Brennand, Denise Howel, Jing Shen, Andrew Bryant, Douglas G Tincello, Malcolm G Lucas, Brian S Buckley, Christopher R Chapple, Tara Homer, Luke Vale, Elaine McColl
BACKGROUND: The position of invasive urodynamic testing in the diagnostic pathway for urinary incontinence (UI) is unclear. Systematic reviews have called for further trials evaluating clinical utility, although a preliminary feasibility study was considered appropriate. OBJECTIVES: To inform the decision whether or not to proceed to a definitive randomised trial of invasive urodynamic testing compared with clinical assessment with non-invasive tests, prior to surgery in women with stress UI (SUI) or stress predominant mixed UI (MUI)...
February 2015: Health Technology Assessment: HTA
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