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Preoperative care

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https://www.readbyqxmd.com/read/29346472/a-revised-estimate-of-costs-associated-with-routine-preoperative-testing-in-medicare-cataract-patients-with-a-procedure-specific-indicator
#1
Catherine L Chen, Theodore H Clay, Stephen McLeod, Han-Ying Peggy Chang, Adrian W Gelb, R Adams Dudley
Importance: Routine preoperative medical testing is not recommended for patients undergoing low-risk surgery, but testing is common before surgery. A 30-day preoperative testing window is conventionally used for study purposes; however, the extent of routine testing that occurs prior to that point is unknown. Objective: To improve on existing cost estimates by identifying all routine preoperative testing that takes place after the decision is made to perform cataract surgery...
January 18, 2018: JAMA Ophthalmology
https://www.readbyqxmd.com/read/29344102/should-preoperative-showering-or-cleansing-with-chlorhexidine-gluconate-chg-be-part-of-the-surgical-care-bundle-to-prevent-surgical-site-infection
#2
Charles E Edmiston, David Leaper
Showering preoperatively with chlorhexidine gluconate is an issue that continues to promote debate; however, many studies demonstrate evidence of surgical site infection risk reduction. Methodological issues have been present in many of the studies used to compile guidelines and there has been a lack of standardisation of processes for application of the active agents in papers pre-2009. This review and commentary paper highlights the potential for enhancing compliance with this low-risk and low-cost intervention and provides some guidance for enhancing implementation of preoperative showering with both chlorhexidine in solution and impregnated wipes...
November 2017: Journal of Infection Prevention
https://www.readbyqxmd.com/read/29344100/surgical-site-infection-prevention-an-analysis-of-compliance-with-good-practice-in-a-teaching-hospital
#3
Adriana Cristina de Oliveira, Camila Sarmento Gama
Background: Surgical teams play a critical role in reducing surgery-related risks during preoperative and intraoperative phases. Aim: To analyse the preoperative and intraoperative practices adopted by surgical teams in surgical site infections prevention. Methods: This was a cross-sectional study conducted during April-September 2013 in a large university hospital in Belo Horizonte, Minas Gerais, Brazil. It was conducted through observation of the surgical practice during preoperative and intraoperative phases of procedures used by a gastroenterological, cardiovascular and paediatric surgical team...
November 2017: Journal of Infection Prevention
https://www.readbyqxmd.com/read/29344022/role-of-body-mass-index-in-acute-kidney-injury-patients-after-cardiac-surgery
#4
Zhouping Zou, Yamin Zhuang, Lan Liu, Bo Shen, Jiarui Xu, Zhe Luo, Jie Teng, Chunsheng Wang, Xiaoqiang Ding
Background/Aims: To explore the association of body mass index (BMI) with the risk of developing acute kidney injury after cardiac surgery (CS-AKI) and for AKI requiring renal replacement therapy (AKI-RRT) after cardiac surgery. Methods: Clinical data of 8,455 patients undergoing cardiac surgery, including demographic preoperative, intraoperative, and postoperative data were collected. Patients were divided into underweight (BMI <18.5), normal weight (18.5≤ BMI <24), overweight (24≤ BMI <28), and obese (BMI ≥28) groups...
December 2017: Cardiorenal Medicine
https://www.readbyqxmd.com/read/29343246/influence-of-preoperative-life-satisfaction-on-recovery-and-outcomes-after-colorectal-cancer-surgery-a-prospective-pilot-study
#5
B Romain, O Rohmer, S Schimchowitsch, M Hübner, J B Delhorme, C Brigand, S Rohr, D Guenot
BACKGROUND: Colorectal surgery has an important impact on a patient's quality of life, and postoperative rehabilitation shows large variations. To enhance the understanding of recovery after colorectal cancer, health-related quality of life has become a standard outcome measurement for clinical care and research. Therefore, we aimed to correlate the influence of preoperative global life satisfaction on subjective feelings of well-being with clinical outcomes after colorectal surgery. METHODS: In this pilot study of consecutive colorectal surgery patients, various dimensions of feelings of preoperative life satisfaction were assessed using a self-rated scale, which was validated in French...
January 17, 2018: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/29340924/impact-of-preoperative-opioid-use-after-emergency-general-surgery
#6
Young Kim, Alexander R Cortez, Koffi Wima, Vikrom K Dhar, Krishna P Athota, Jason J Schrager, Timothy A Pritts, Michael J Edwards, Shimul A Shah
BACKGROUND: Preoperative exposure to narcotics has recently been associated with poor outcomes after elective major surgery, but little is known as to how preoperative opioid use impacts outcomes after common, emergency general surgical procedures (EGS). METHODS: A high-volume, single-center analysis was performed on patients who underwent EGS from 2012 to 2013. EGS was defined as the seven emergent operations that account for 80% of the national burden. Preoperative opioid use was defined as having an active opioid prescription within 7 days prior to surgery...
January 16, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29340818/changes-in-plasma-albumin-levels-in-early-detection-of-infectious-complications-after-laparoscopic-colorectal-cancer-surgery-with-eras-protocol
#7
Mateusz Wierdak, Magdalena Pisarska, Beata Kuśnierz-Cabala, Jan Witowski, Jadwiga Dworak, Piotr Major, Piotr Małczak, Piotr Ceranowicz, Andrzej Budzyński, Michał Pędziwiatr
BACKGROUND: Combination of laparoscopic approach with ERAS protocol in colorectal surgery allows for an early discharge. However there is a risk that some of the discharged patients are developing, asymptomatic at the time, infectious complications. This may lead to a delay in diagnostics and proper treatment introduction. We aimed to assess the usefulness of preoperative plasma albumin concentration and their changes as indicators of infectious complications in patients undergoing colorectal cancer surgery...
January 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29339844/the-risk-of-deep-vein-thrombosis-in-total-joint-patients-compared-to-orthopaedic-trauma-patients-need-for-new-prevention-guidelines
#8
Michelle Shen, Norele J Cutrera, Ashley C Dodd, Christopher Wallace, Frank R Avilucea, Craig Melbourne, Alex A Jahangir, Hassan H Mir, William T Obremskey, Manish K Sethi
Background: The development of Deep Vein Thrombosis (DVT) is a major concern following orthopaedic surgery. No study has yet to compare the rate and risk factors for DVT between total joint and orthopaedic trauma patients. To evaluate if DVT prophylaxis for trauma should differ from total joints, we explored the rate and risk factors for DVT between both cohorts. Methods: Using a CPT code search from 2005 to 2013 in the ACS-NSQIP database, 150,657 orthopaedic total joint patients and 44,594 orthopaedic trauma patients were identified...
November 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29339660/laparoscopic-surgery-for-gallbladder-cancer-an-expert-consensus-statement
#9
Ho-Seong Han, Yoo-Seok Yoon, Anil K Agarwal, Giulio Belli, Osamu Itano, Andrew A Gumbs, Dong Sup Yoon, Chang Moo Kang, Seung Eun Lee, Toshifumi Wakai, Roberto I Troisi
BACKGROUND: Despite the increasing number of reports on the favorable outcomes of laparoscopic surgery for gallbladder cancer (GBC), there is no consensus regarding this surgical procedure. OBJECTIVE: The study aimed to develop a consensus statement on the application of laparoscopic surgery for GBC based on expert opinions. METHODS: A consensus meeting among experts was held on September 10, 2016, in Seoul, Korea. RESULTS: Early concerns regarding port site/peritoneal metastasis after laparoscopic surgery have been abated by improved preoperative recognition of GBC and careful manipulation to avoid bile spillage...
January 16, 2018: Digestive Surgery
https://www.readbyqxmd.com/read/29338996/incidence-and-predictors-of-postoperative-need-for-high-dose-inotropic-support-in-patients-undergoing-cardiac-surgery-for-infective-endocarditis
#10
Alessandro Belletti, Stephan Jacobs, Giovanni Affronti, Alexander Mladenow, Giovanni Landoni, Volkmar Falk, Felix Schoenrath
OBJECTIVE: Patients with infective endocarditis undergoing cardiac surgery are a high-risk population. Few data on incidence and predictors of need for high-dose inotropic support in this setting are currently available. DESIGN: Retrospective study. SETTING: Tertiary-care hospital. PARTICIPANTS: Ninety consecutive patients undergoing cardiac surgery for infective endocarditis. INTERVENTIONS: None...
December 11, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29338859/renal-function-and-outcome-after-heart-transplantation
#11
Oscar Kolsrud, Kristjan Karason, Erik Holmberg, Sven-Erik Ricksten, Marie Felldin, Ola Samuelsson, Göran Dellgren
OBJECTIVES: To investigate whether measured glomerular filtration rate (mGFR) is a risk factor for death and/or end-stage renal disease (ESRD) after heart transplantation (HTx). METHODS: All adult patients (n = 416) who underwent HTx between 1988 and 2010 were included. mGFR was performed both preoperatively and postoperatively as annual follow-up. Eight patients received a concomitant kidney transplant (KTx), and 15 underwent late KTx due to chronic renal failure after HTx...
December 14, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29337650/the-association-of-external-transfer-status-with-adverse-outcomes-in-otolaryngology
#12
Krish Suresh, Christopher J Gouveia, Robert C Kern, John D Cramer
Objective To compare rates of morbidity and mortality in patients treated by otolaryngologists who undergo interhospital transfers vs those who do not and to quantify conditions requiring interhospital transfers in this population. Study Design Cohort study. Setting American College of Surgeons National Surgical Quality Improvement Program. Subjects and Methods We identified patients requiring surgery by otolaryngologists in the National Surgical Quality Improvement Program database from 2006 to 2013. We compared patients who were transferred from an outside institution to those admitted from home...
January 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29336894/preoperative-surveillance-rectal-swab-is-associated-with-an-increased-risk-of-infectious-complications-in-pancreaticoduodenectomy-and-directs-antimicrobial-prophylaxis-an-antibiotic-stewardship-strategy
#13
Matteo De Pastena, Salvatore Paiella, Anna M Azzini, Giovanni Marchegiani, Giuseppe Malleo, Debora Ciprani, Annarita Mazzariol, Erica Secchettin, Deborah Bonamini, Clizia Gasparini, Ercole Concia, Claudio Bassi, Roberto Salvia
BACKGROUND: Despite improvements in the perioperative care, the morbidity rate after pancreaticoduodenectomy (PD) is still higher than 50%. The aim of this study was twofold: first, to assess the correlation between preoperative rectal swab (RS) and intraoperative bile cultures; to examine the impact of RS isolates on postoperative course after PD. METHODS: An observational study was conducted analyzing all consecutive PD performed from January 2015 to July 2016...
January 11, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/29336756/risk-factors-for-elevated-preoperative-alkaline-phosphatase-in-patients-with-refractory-secondary-hyperparathyroidism
#14
Meng Yang, Ling Zhang, Linping Huang, Xiaoliang Sun, Haoyang Ji, Yao Lu
Elevated preoperative levels of alkaline phosphatase (ALP) in patients with refractory secondary hyperparathyroidism are correlated with postoperative hypocalcemia and mortality. The aim of this study was to identify the predictors of preoperative ALP in patients with secondary hyperparathyroidism. From April 2012 to December 2015, 220 patients with refractory secondary hyperparathyroidism undergoing total parathyroidectomy without autotransplantation were reviewed. A total of 164 patients presented with elevated preoperative ALP...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29336515/expectations-and-experiences-of-patients-with-osteoarthritis-undergoing-total-joint-arthroplasty-an-integrative-review
#15
Min Ting Alicia See, Yanika Kowitlawakul, Apphia Jia Qi Tan, Sok Ying Liaw
BACKGROUND: The effectiveness of educational interventions for osteoarthritic patients undergoing total joint arthroplasty remains inconclusive. It is essential to understand the educational needs of these patients from their perspectives. AIM: The aim of this study was to systematically summarize and synthesize osteoarthritic patients' expectations and experiences in undergoing total joint arthroplasty to identify their educational needs. DESIGN: An integrative review was conducted...
January 16, 2018: International Journal of Nursing Practice
https://www.readbyqxmd.com/read/29336389/a-randomized-controlled-trial-comparing-the-myocardial-protective-effects-of-isoflurane-with-propofol-in-patients-undergoing-elective-coronary-artery-bypass-surgery-on-cardiopulmonary-bypass-assessed-by-changes-in-n-terminal-brain-natriuretic-peptide
#16
Balaji Kuppuswamy, Kirubakaran Davis, Raj Sahajanandan, Manickam Ponniah
OBJECTIVE: The objective of the study is to compare the myocardial protective effects of isoflurane with propofol in patients undergoing elective coronary artery bypass surgery on cardiopulmonary bypass (CPB), the cardio protection been assessed by changes in N-terminal brain natriuretic peptide (NT proBNP). Methodology and Design: This study is designed as a participant blinded, prospective randomized clinical trial. SETTING: Christian Medical College Hospital, Vellore, India...
January 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29335903/anterior-cervical-corpectomy-and-fusion-versus-posterior-laminoplasty-for-the-treatment-of-oppressive-myelopathy-owing-to-cervical-ossification-of-posterior-longitudinal-ligament-a-meta-analysis
#17
Rongqing Qin, Xiaoqing Chen, Pin Zhou, Ming Li, Jie Hao, Feng Zhang
PURPOSE: The purpose of this research is to compare the clinical efficacy, postoperative complication and surgical trauma between anterior cervical corpectomy and fusion versus posterior laminoplasty for the treatment of oppressive myelopathy owing to cervical ossification of the posterior longitudinal ligament (OPLL). STUDY DESIGN: Systematic review and meta-analysis. METHODS: An comprehensive search of literature was implemented in three electronic databases (Embase, Pubmed, and the Cochrane library)...
January 15, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29335101/outcomes-and-complication-rates-of-primary-resident-performed-cataract-surgeries-at-a-large-tertiary-care-county-hospital
#18
Cameron Clarke, Shazia F Ali, Michael Murri, Saagar N Patel, Li Wang, Marie Tuft, Mitchell P Weikert, Zaina Al-Mohtaseb
PURPOSE: To identify the preoperative risk factors, intraoperative events, and postoperative complications increasing the risk for poor visual outcomes in resident-performed cataract surgeries at a tertiary-care county hospital. SETTING: Ben Taub General Hospital, Houston, Texas, USA. DESIGN: Retrospective case series. METHODS: Resident-performed cataract surgeries were analyzed for risk factors, comorbidities, and intraoperative and postoperative complications...
December 2017: Journal of Cataract and Refractive Surgery
https://www.readbyqxmd.com/read/29333010/sinusoidal-obstruction-syndrome-during-treatment-for-wilms-tumor-a-life-threatening-complication
#19
Sidharth Totadri, Amita Trehan, Deepak Bansal, Richa Jain
Context: Survival rates exceed 90% in Wilms' tumor (WT). Actinomycin-D (ACT-D) which is indispensable in the management of WT is associated with the development of sinusoidal obstruction syndrome (SOS), a potentially fatal complication. Aims: The aim is to study the presentation, management, and outcome of SOS complicating ACT-D administration in WT. Settings and Design: Retrospective file review conducted in a Pediatric Hematology-Oncology unit...
October 2017: Indian Journal of Medical and Paediatric Oncology
https://www.readbyqxmd.com/read/29332913/early-extubation-in-the-operating-room-after-congenital-open-heart-surgery
#20
Takuma Fukunishi, Norihiko Oka, Takeshi Yoshii, Kensuke Kobayashi, Nobuyuki Inoue, Tetsuya Horai, Tadashi Kitamura, Hirotsugu Okamoto, Kagami Miyaji
Early extubation in the operating room after congenital open-heart surgery is feasible, but extubation in the intensive care unit after the operation remains common practice at many institutions. The purpose of this study was to evaluate retrospectively the adequacy of our early-extubation strategy and exclusion criteria through analysis based on the Risk Adjustment in Congenital Heart Surgery method (RACHS-1).This retrospective analysis included 359 cases requiring cardiopulmonary bypass (male, 195; female, 164; weight > 3...
January 15, 2018: International Heart Journal
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