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https://www.readbyqxmd.com/read/29774824/technique-of-percutaneous-nephrolithotomy
#1
Ahmed Ibrahim, Daniel Wollin, Glenn Preminger, Sero Andonian
According to the latest American and European Urological Association guidelines, percutaneous nephrolithotomy (PNL) is the current gold standard treatment for patients presenting with symptomatic large or complex renal stones ≥2 cm. This review chapter and accompanying videos will review the latest literature on indications, preoperative preparations, different patient positions, in addition to step by step explanations for the technique of PNL. Postoperative care and troubleshooting tips are provided. Furthermore, latest reported outcomes are reviewed...
May 2018: Journal of Endourology
https://www.readbyqxmd.com/read/29774822/partial-nephrectomy-in-central-renal-tumors
#2
Sohrab Arora, Craig Rogers
Nephron-sparing surgery, especially through a minimally invasive approach, is increasingly being performed for incidentally detected renal masses with excellent outcomes. Tumors in central location remain a surgical challenge during nephron-sparing surgery. In this chapter, we discuss the minimally invasive management of these tumors, which include complex hilar tumors and endophytic central tumors, with a focus on surgical technique. The key to management of these tumors is to maintain good preoperative hydration, achieving adequate exposure of tumor, and the use of intraoperative ultrasound to plan the resection plane...
May 2018: Journal of Endourology
https://www.readbyqxmd.com/read/29774819/midurethral-slings
#3
Joao P Zambon, Catherine Ann Matthews, Gopal H Badlani
Urinary incontinence (UI) is a common symptom affecting almost one-third of adult women. UI can occur because of hypermobility or intrinsic sphincter deficiency of the urethra. Regardless its etiology, it is associated with poor quality of life and most of the incontinent women develop symptoms such as anxiety, depression, and social isolation over time. The synthetic midurethral sling (MUS) was first introduced in 1995 and quickly became the gold standard treatment for women with stress UI because of intrinsic sphincter deficiency and/or urethral hypermobility...
May 2018: Journal of Endourology
https://www.readbyqxmd.com/read/29774810/procedural-module-flexible-cystoscopy
#4
Shoaib Safiullah, Daniel J Lama, Roshan Patel, Ralph V Clayman
INTRODUCTION: Cystoscopy is a basic urologic skill necessary for the endoscopic evaluation of the urethra and bladder. Presented is a step-by-step guide for flexible cystoscopy of the male and female patient. MATERIALS/METHODS: Routine flexible cystoscopy was performed on a male patient with a history of upper tract urothelial carcinoma and a female patient as part of a hematuria evaluation. The male patient was positioned supine, and the female patient frog-leg supine...
May 2018: Journal of Endourology
https://www.readbyqxmd.com/read/29774193/predictable-values-of-decompressive-craniectomy-in-patients-with-acute-subdural-hematoma-comparison-between-decompressive-craniectomy-after-craniotomy-group-and-craniotomy-only-group
#5
Hyunjun Kim, Sang-Jun Suh, Ho-Jun Kang, Min-Seok Lee, Yoon-Soo Lee, Jeong-Ho Lee, Dong-Gee Kang
Objective: Patients with traumatic acute subdural hematoma (ASDH) often require surgical treatment. Among patients who primarily underwent craniotomy for the removal of hematoma, some consequently developed aggressive intracranial hypertension and brain edema, and required secondary decompressive craniectomy (DC). To avoid reoperation, we investigated factors which predict the requirement of DC by comparing groups of ASDH patients who did and did not require DC after craniotomy. Methods: The 129 patients with ASDH who underwent craniotomy from September 2007 to September 2017 were reviewed...
April 2018: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/29774188/gadofosveset-enhanced-magnetic-resonance-imaging-as-a-problem-solving-tool-for-diagnosing-colorectal-liver-metastases-a-case-report
#6
Helen Cheung, Paul Karanicolas, Natalie Coburn, Calvin Law, Laurent Milot
Due to significant improvements in morbidity and mortality, surgery with curative intent is now the standard of care for patients with colorectal liver metastases who are surgical candidates. As a result, highly accurate preoperative per-lesion diagnosis is crucial. However, in some instances, this remains limited with standard techniques, including magnetic resonance imaging (MRI) with conventional contrast agents. Delayed retention of contrast of fibrotic liver metastases on MRI with extracellular contrast agents may mimic the late retention of contrast in hemangiomas and represent a diagnostic pitfall that limits diagnosis...
April 2018: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/29773431/preoperative-frailty-assessment-predicts-loss-of-independence-after-vascular-surgery
#7
Graham W Donald, Amir A Ghaffarian, Farid Isaac, Larry W Kraiss, Claire L Griffin, Brigitte K Smith, Mark R Sarfati, Julie L Beckstrom, Benjamin S Brooke
OBJECTIVE: Frailty, a clinical syndrome associated with loss of metabolic reserves, is prevalent among patients who present to vascular surgery clinics for evaluation. The Clinical Frailty Scale (CFS) is a rapid assessment method shown to be highly specific for identifying frail patients. In this study, we sought to evaluate whether the preoperative CFS score could be used to predict loss of independence after major vascular procedures. METHODS: We identified all patients living independently at home who were prospectively assessed using the CFS before undergoing an elective major vascular surgery procedure (admitted for >24 hours) at an academic medical center between December 2015 and December 2017...
May 14, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29771804/preemptive-analgesia-decreases-pain-following-anorectal-surgery-a-prospective-randomized-double-blinded-placebo-controlled-trial
#8
Justin T Van Backer, Matthew R Jordan, Danielle T Leahy, Jesse S Moore, Peter Callas, Timothy Dominick, Peter A Cataldo
BACKGROUND: Postoperative pain is a frequent cause for delayed discharge following outpatient procedures, including anorectal surgery. Both central and peripheral pain receptor sensitization are thought to contribute to postoperative pain. Blocking these receptors and preempting sensitization prevents hyperalgesia leading to lower pain medication requirements. Studies in the orthopedic, urologic, and gynecologic literature support this practice, but the use of preemptive analgesia in anorectal surgery is understudied...
May 15, 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29771695/scheduling-the-nonoperating-room-anesthesia-suite
#9
Mary E Warner, David P Martin
PURPOSE OF REVIEW: Nonoperating room anesthesia (NORA) and procedural services often are associated with dispersed geographic settings and small volumes of cases. These lead to scheduling challenges that, if not managed well, result in decreased patient and healthcare team satisfaction and reduced efficiency. This review describes recent studies and provides examples on how NORA scheduling issues have been addressed. RECENT FINDINGS: Increased use of blocked time for consolidated NORA services can lead to sufficiently large volumes of cases that allow improved scheduling and maintain patient and healthcare team satisfaction and better efficiency of care...
May 15, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29770791/effects-of-laparoscopic-and-conventional-methods-on-lung-functions-in-colorectal-surgery
#10
Sebahattin Celik, Eyüp M Yılmaz
BACKGROUND We aimed to compare the lung functions, complication rates, and durations of the hospital and intensive care unit stays of patients who had undergone laparoscopic colorectal resection and open colorectal resection. MATERIAL AND METHODS In this study, data were collected prospectively and then evaluated retrospectively. The study was carried out between January 2015 and November 2016 in 2 university hospitals. Pulmonary function tests (PFT) and chest radiography were performed in all patients preoperatively...
May 17, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29770294/three-dimensional-modelling-and-three-dimensional-printing-in-pediatric-and-congenital-cardiac-surgery
#11
REVIEW
Laszlo Kiraly
Three-dimensional (3D) modelling and printing methods greatly support advances in individualized medicine and surgery. In pediatric and congenital cardiac surgery, personalized imaging and 3D modelling presents with a range of advantages, e.g., better understanding of complex anatomy, interactivity and hands-on approach, possibility for preoperative surgical planning and virtual surgery, ability to assess expected results, and improved communication within the multidisciplinary team and with patients. 3D virtual and printed models often add important new anatomical findings and prompt alternative operative scenarios...
April 2018: Translational Pediatrics
https://www.readbyqxmd.com/read/29769089/left-upper-division-segmentectomy-with-a-simultaneous-displaced-bronchus-and-pulmonary-arteriovenous-anomalies-a-case-report
#12
Kazuki Hayashi, Makoto Motoishi, Kanna Horimoto, Satoru Sawai, Jun Hanaoka
BACKGROUND: A displaced bronchus is a rare disorder of the left upper lobe. Displaced bronchi are often accompanied by an anomaly of a pulmonary artery, but rarely of a pulmonary vein. CASE PRESENTATION: We here present a patient with primary lung cancer and simultaneous migration abnormalities of the pulmonary artery and vein in a displaced bronchus of the left upper lobe. Previous reports and our findings indicate that anomalies of the pulmonary artery and vein combined with a displaced bronchus of the left upper lobe have the following characteristics: (1) the left main pulmonary artery does not cross the dorsal side of the displaced bronchus; (2) V1 + 2 returns to the inferior pulmonary vein; and (3) there is an accessory fissure (aberrant fissure) in the segments dominated by the displaced bronchus...
May 16, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29768364/comparative-effectiveness-of-fragility-fracture-integrated-rehabilitation-management-for-elderly-individuals-after-hip-fracture-surgery-a-study-protocol-for-a-multicenter-randomized-controlled-trial
#13
Sang Yoon Lee, Jaewon Beom, Bo Ryun Kim, Seung-Kyu Lim, Jae-Young Lim
INTRODUCTION: Although it is essential to provide comprehensive rehabilitation after hip fracture to restore the patient to preoperative physical functioning, feasibility issues remain. Here, we describe a protocol for a randomized controlled trial (RCT) to evaluate the effectiveness of fragility fracture integrated rehabilitation management (FIRM) for elderly individuals after hip fracture surgery. We also examine the feasibility of applying FIRM in a chronic-care hospital or community-based setting...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29767333/laparoscopic-adhesiolysis-not-for-all-patients-not-for-all-surgeons-not-in-all-centres
#14
Salomone Di Saverio, Arianna Birindelli, Richard Ten Broek, Justin R Davies, Matteo Mandrioli, Ville Sallinen
ASBO is a common cause of emergency surgery and the use of laparoscopy for the treatment of these patients is still under debate and conflicting results have been published, in particular regarding the high risk of iatrogenic bowel injury. In fact, although over the last few years there has been an increasing enthusiasm in the surgical community about the advantages and potential better outcomes of laparoscopic management of adhesive small bowel obstruction (ASBO), recently published studies have introduced a significant word of caution...
May 16, 2018: Updates in Surgery
https://www.readbyqxmd.com/read/29765819/complications-in-salvage-surgery-for-nasal-and-paranasal-malignant-tumors-involving-the-skull-base
#15
Masanori Teshima, Hirotaka Shinomiya, Naoki Otsuki, Hidehito Kimura, Masaaki Taniguchi, Kazunobu Hashikawa, Eiji Kohmura, Ken-Ichi Nibu
Objective  Nasal and paranasal malignant tumors invading the skull base are rare and poorly studied. We evaluated postoperative complications in patients undergoing salvage surgery for such tumors. Design  Retrospective study. Setting  Kobe University Hospital. Participants  Among 48 patients who underwent surgery for tumors involving the skull base between 1993 and 2015, 21 patients had squamous cell carcinoma, 13 had olfactory neuroblastoma, 5 had adenocarcinoma, 2 had sarcoma, 2 had adenoid cystic carcinoma, and 1 each had malignant melanoma, poorly differentiated carcinoma, undifferentiated carcinoma, myoepithelial carcinoma, and malignant peripheral nerve sheath tumor...
June 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29763977/transforming-care-to-evidence-based-practice-with-scripted-messages-an-improvement-project-for-pain-management-in-outpatient-surgical-patients
#16
Lanell M Bellury, Karen Mullinax, Judi Mozingo, Berta Dantzler, Nancy McGee
BACKGROUND: Outpatient surgeries are common and most patients experience pain postoperatively requiring nursing attention to pain management. Scripting, recommended for consistent, targeted communication to improve patient satisfaction, has limited evidence to support its use. AIMS: To explore the effect of scripted messages on self-reported pain control and patient satisfaction with care in outpatient surgical patients. METHODS: A retrospective medical record review pre- and postintervention evaluated a pain management scripted message delivered at two time points (preoperatively and postoperatively)...
May 15, 2018: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/29762454/correction-of-tuberous-nipple-areolar-complex-deformity-in-gynecomastia-the-deformity-that-can-get-forgotten
#17
Yvette Godwin
The desired end point of surgical reduction of gynecomastia is a masculine breast appearance and symmetry. This article concentrates on the tuberous deformity of the nipple areolar complex (NAC) that can present in gynecomastia and is sometimes overlooked at surgical correction.This deformity can be corrected at primary surgery if it is recognized preoperatively. If missed, or not adequately corrected, the postoperative result of primary reduction may be deemed incomplete by the patient and they will request revision...
May 14, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29762115/effects-of-accreditation-council-for-graduate-medical-education-duty-hour-regulations-on-clinical-preparedness-of-first-year-orthopaedic-attendings-a-survey-of-senior-orthopaedic-surgeons
#18
Steven T DiSegna, Timothy D Kelley, Deborah M DeMarco, Abhay R Patel
It is unclear how the Accreditation Council for Graduate Medical Education (ACGME) resident duty hour restriction has affected attending orthopaedic surgeons in their first year of practice. The purpose of this study was to compare the clinical preparedness of first-year orthopaedic attending surgeons who trained with ACGME duty hour regulations versus those trained without regulations. Senior orthopaedic surgeons with greater than 10 years of experience were surveyed and results indicate that first-year attendings who trained with ACGME duty hour regulations required more supervision reviewing cases preoperatively, required more assistance completing operative cases, had inferior technical skills, had more major operative complications, had poorer physical exam skills, and delivered an inferior quality of care...
2018: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/29759883/minimally-invasive-plate-osteosynthesis-for-tibial-derotation-osteotomies-in-children-with-cerebral-palsy
#19
Ilker Abdullah Sarikaya, Ali Seker, Ozan Ali Erdal, Mehmet Ali Talmac, Muharrem Inan
OBJECTIVE: Tibial derotation osteotomy can be used in the treatment of rotational deformities in case of ineffective conservative management. Our aim was to evaluate the results of the patients who underwent minimal invasive plate osteosynthesis for tibial derotation osteotomies. METHODS: Total of 16 patients (17 procedures) were included in this study. Mean age was 11.5 (3-25) years. We clinically assessed the tibial torsion by measuring the thigh-foot angle (TFA)...
May 11, 2018: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/29759287/comprehensive-preoperative-assessment-and-global-optimization
#20
REVIEW
Neil N Shah, Thomas R Vetter
To successfully deliver greater perioperative value-based care and to effectively contribute to sustained and meaningful perioperative population health management, the scope of existing preoperative management and its associated services and care provider skills must be expanded. New models of preoperative management are needed, which rely extensively on continuously evolving evidence-based best practice, as well as telemedicine and telehealth, including mobile technologies and connectivity. Along with conventional comorbidity optimization, prehabilitation can effectively promote enhanced postoperative recovery...
June 2018: Anesthesiology Clinics
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