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Emergent surgery

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https://www.readbyqxmd.com/read/28731950/totally-laparoscopic-resection-for-low-sigmoid-and-rectal-cancer-using-natural-orifice-specimen-extraction-techniques
#1
Hideharu Shimizu, Kensuke Adachi, Hideo Ohtsuka, Itaru Osaka, Kunio Takuma, Kijuro Takanishi, Jun Matsumoto
BACKGROUND: A minilaparotomy for specimen extraction during laparoscopy occasionally results in postoperative wound complications. We have performed a totally laparoscopic resection for early colorectal cancer using the natural orifice specimen extraction technique. METHODS: From 2008 to 2013, we have performed a totally laparoscopic resection for clinical stage I and IIA low sigmoid colon and rectal cancers. A prospectively maintained database was reviewed to assess the outcomes after surgery...
July 20, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28731404/jackson-pratt-drainage-in-pediatric-craniofacial-reconstructive-surgery-is-it-helping-or-hurting
#2
Kumar Vasudevan, Ahyuda Oh, R Shane Tubbs, David Garcia, Andrew Reisner, Joshua J Chern
OBJECTIVE Jackson-Pratt drains (JPDs) are commonly employed in pediatric craniofacial reconstructive surgery (CRFS) to reduce postoperative wound complications, but their risk profile remains unknown. Perioperative blood loss and volume shifts are major risks of CFRS. The goal of this study was to evaluate the risks of JPD usage in CFRS, particularly with regard to perioperative blood loss, hyponatremia, intensive care unit (ICU) length of stay, and postoperative wound complications. METHODS The authors performed a retrospective review of data obtained in pediatric patients who underwent CFRS at a single institution, as performed by multiple surgeons between January 2010 and December 2014...
July 21, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28731402/twenty-four-hour-emergency-intervention-versus-early-intervention-in-aneurysmal-subarachnoid-hemorrhage
#3
Joseph R Linzey, Craig Williamson, Venkatakrishna Rajajee, Kyle Sheehan, B Gregory Thompson, Aditya S Pandey
OBJECTIVE Recent observational data suggest that ultra-early treatment of ruptured aneurysms prevents rebleeding, thus improving clinical outcomes. However, advances in critical care management of patients with ruptured aneurysms may reduce the rate of rebleeding in comparison with earlier trials, such as the International Cooperative Study on the Timing of Aneurysm Surgery. The objective of the present study was to determine if an ultra-early aneurysm repair protocol will or will not significantly reduce the number of incidents of rebleeding following aneurysmal subarachnoid hemorrhage (SAH)...
July 21, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28730300/health-related-quality-of-life-in-paediatric-patients-with-congenital-heart-defects-association-with-the-type-of-heart-defect-and-the-surgical-technique
#4
A Heusch, H J Kahl, K O Hensel, G Calaminus
The aim of the study was to investigate the impact of a number of surgical interventions for a various congenital cardiac defects (CHDs) on self-reported HRQoL. METHODS: Patients who had received corrective surgery of several congenital heart defects (surgical VSD closure, Fallot, TGA after atrial or arterial switch or Fontan-type circulation for univentricular AV-connection) were interviewed in the office of their home peadiatric cardiologist. HRQoL in children along 7 dimensions was assessed using a standardised questionnaire (PEDQoL); information on the medical case history of each respondent was also collected...
July 20, 2017: Quality of Life Research
https://www.readbyqxmd.com/read/28730232/implications-of-inflammation-and-remodeling-of-the-enteric-glial-cells-in-colorectal-adenocarcinoma
#5
Elena Anca Târtea, Cristina Florescu, IonuŢ Donoiu, Daniel Pirici, Alexandru Radu Mihailovici, Valeria Carmen Albu, Tudor Adrian Bălşeanu, Maria Iancău, Carmen Daniela Badea, Cristin Constantin Vere, Veronica Sfredel
AIM: The aim of our study was to assess glial fibrillary acidic protein (GFAP) glial cell phenotype in the enteric nervous system (ENS) in colorectal adenocarcinoma of different tumor grading and, also, to establish correlations between these changes and the tumor proliferative activity and the tumor-infiltrating leukocytes. PATIENTS, MATERIALS AND METHODS: We ran an observational, prospective study on a group of 52 patients diagnosed with colorectal adenocarcinoma...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28729097/post-caesarean-section-surgical-site-infection-surveillance-using-an-online-database-and-mobile-phone-technology
#6
Eliana Castillo, Corrine McIsaac, Bhreagh MacDougall, Douglas Wilson, Rosemary Kohr
BACKGROUND: Obstetric surgical site infections (SSIs) are common and expensive to the health care system but remain under reported given shorter postoperative hospital stays and suboptimal post-discharge surveillance systems. SSIs, for the purpose of this paper, are defined according to the Center for Disease Control and Prevention (1999) as infection incurring within 30 days of the operative procedure (in this case, Caesarean section [CS]). PRIMARY OBJECTIVE: Demonstrate the feasibility of real-life use of a patient driven SSIs post-discharge surveillance system consisting of an online database and mobile phone technology (surgical mobile app - how2trak) among women undergoing CS in a Canadian urban centre...
August 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28728520/in-and-out-hospital-mortality-rate-in-surgical-patients
#7
Philippe Dony, Magali Pirson, Jean G Boogaerts
BACKGROUND: Death rates after surgery are increasingly analysed for clinical audit and quality assessment. Many studies commonly provide information only on deaths that occur during hospital stay, known as in-hospital death rates. By using hospital data set linked to death certificate registry, we recorded in- and out-hospital deaths within 30 and 60 post-operative days. METHODS: The study included all consecutive surgical procedures (denominator) under general or locoregional anaesthesia in adult patients admitted for elective or non-elective inpatient surgery...
July 20, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28728489/idarucizumab-for-the-treatment-of-hemorrhage-and-dabigatran-reversal-in-patients-requiring-urgent-surgery-or-procedures
#8
Ovidiu Vornicu, Anne-Sophie Larock, Anne-Sophie Dincq, Jonathan Douxfils, Jean-Michel Dogné, François Mullier, Sarah Lessire
Idarucizumab is a specific antagonist for dabigatran etexilate (DE). The recent market authorization of idarucizumab in Europe and the USA may reassure prescribers of DE, as it can increase the safety of the emergency management of patients taking this anticoagulant. However, idarucizumab use should be limited to specific indications to avoid unnecessary risks to patients and costs to healthcare systems. Areas covered: The authors provide an overview of idarucizumab development and its pharmacokinetic and pharmacodynamic properties...
July 20, 2017: Expert Opinion on Biological Therapy
https://www.readbyqxmd.com/read/28728167/long-term-outcomes-of-patients-with-10-or-more-colorectal-liver-metastases
#9
M A Allard, R Adam, F Giuliante, R Lapointe, C Hubert, J N M Ijzermans, D F Mirza, D Elias, C Laurent, T Gruenberger, G Poston, C Letoublon, H Isoniemi, V Lucidi, I Popescu, J Figueras
BACKGROUND: Although the number of colorectal liver metastases (CLM) is decreasingly considered as a contraindication to surgery, patients with 10 CLM or more are often denied liver surgery. This study aimed to evaluate the outcome after liver surgery and to identify prognostic factors of survival in such patients. METHODS: The study population consisted of a multicentre cohort of patients with CLM (N=12 406) operated on, with intention to resect, from January 2005-June 2013 and whose data were prospectively collected in the LiverMetSurvey registry...
July 20, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28728102/uterine-necrosis-following-a-combination-of-uterine-compression-sutures-and-vascular-ligation-during-a-postpartum-hemorrhage-a-case-report
#10
Saad Benkirane, Hanane Saadi, Badr Serji, Ahmed Mimouni
INTRODUCTION: The Postpartum bleeding is the first cause of maternal mortality in Morocco. It is an obstetrical emergency that requires a fast multimodal management including medical care, interventional procedure and in few cases a salvatory surgery. CLINICAL CASE: We report a rare case of uterine necrosis following postpartum hemorrhage, refractory to medical therapy, and which was controlled by a combination of uterine hemostatic techniques and vascular ligation three days after surgery, the patient developed a fever (39°C)...
July 10, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28727632/a-prospective-randomized-controlled-trial-comparing-quality-of-life-following-endoscopic-totally-extraperitoneal-tep-versus-open-stoppa-inguinal-hernioplasty
#11
Jitendra K Kushwaha, Loreno E Enny, Akshay Anand, Abhinav A Sonkar, Awanish Kumar, Harvinder S Pahwa
In inguinal hernia surgery, quality of life (QOL) has emerged as a striking issue. Evidence suggests better QOL of patients operated with laparoscopic procedure as compared with open anterior hernia repairs. However data are scarce with relation to open posterior repair in terms of QOL issues. A prospective randomized single-blind study from November 2014 to October 2015 including all patients who underwent elective primary endoscopic [totally extraperitoneal (TEP)] or open Stoppa inguinal hernia repair was undertaken...
July 19, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28727191/anterior-pericardial-access-to-facilitate-electrophysiology-study-and-catheter-ablation-of-ventricular-arrhythmias-a-single-tertiary-center-experience
#12
Ali R Keramati, Deeptankar DeMazumder, Satish Misra, Jonathan Chrispin, Fabrizio R Assis, Chava Raghuram, Swati Dey, Hugh Calkins, Harikrishna Tandri
INTRODUCTION: Epicardial ablation is becoming an important part of management in patients with ventricular tachycardia (VT). Posterior epicardial access via the Sosa or Needle-in-Needle (NIN) approach for epicardial VT ablation is considered to be the method of choice for most electrophysiologists. Anterior epicardial access as an alternative technique has recently been proposed, but there is limited data about its safety, efficacy and the rate of immediate complications. In this study, we report our experience with anterior epicardial access between 2009 and 2016...
July 20, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28726139/assessing-trends-in-laparoscopic-colostomy-reversal-and-evaluating-outcomes-when-compared-to-open-procedures
#13
Kevin Y Pei, Kimberly A Davis, Yawei Zhang
BACKGROUND: Laparoscopic colostomy reversal has emerged as a viable option for Hartmann's reversal but the trends in national adoption and postoperative complications are unknown. This study evaluates the practice trends for laparoscopic colostomy and compares complications, length of stay, and operative times between laparoscopic and open colostomy reversal. METHODS: All patients who had open or laparoscopic colostomy reversal surgery (current procedure codes: 44227 and 44626) between 2005 and 2014 were identified from the American College of Surgeons National Surgical Quality Improvement Program...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28725564/post-partum-streptococcal-toxic-shock-syndrome-associated-with-necrotizing-fasciitis
#14
Wei Chuan Chua, Mohd Zulfakar Mazlan, Saedah Ali, Sanihah Che Omar, Wan Mohd Nazaruddin Wan Hassan, S Praveena Seevaunnantum, Rhendra Hardy Mohd Zaini, Mohd Hasyizan Hassan, Alwi Muhd Besari, Zaidah Abd Rahman, Zeti Norfidiyati Salmuna Ayub, Sabrina Abd Ghani, Normalinda Yaacob, Wan Rosilawati Wan Rosli
We report a fatal case of post-partum streptococcal toxic shock syndrome in a patient who was previously healthy and had presented to the emergency department with an extensive blistering ecchymotic lesions over her right buttock and thigh associated with severe pain. The pregnancy had been uncomplicated, and the mode of delivery had been spontaneous vaginal delivery with an episiotomy. She was found to have septicemic shock requiring high inotropic support. Subsequently, she was treated for necrotizing fasciitis, complicated by septicemic shock and multiple organ failures...
2017: IDCases
https://www.readbyqxmd.com/read/28725494/apixaban-for-treatment-of-confirmed-heparin-induced-thrombocytopenia-a-case-report-and-review-of-literature
#15
Daniel E Ezekwudo, Rebecca Chacko, Bolanle Gbadamosi, Syeda Batool, Sussana Gaikazian, Theodore E Warkentin, Jo-Ann I Sheppard, Ishmael Jaiyesimi
BACKGROUND: Heparin-induced thrombocytopenia (HIT) is a life and limb-threatening condition caused by the binding of platelet-activating antibodies (IgG) to multimolecular platelet factor 4 (PF4)/heparin complexes because of heparin exposure. The by-product of this interaction is thrombin formation which substantially increases the risk of venous and/or arterial thromboembolism. Currently, only one anticoagulant, argatroban, is United States Food and Drug Administration-approved for management of HIT; however, this agent is expensive and can only be given by intravenous infusion...
2017: Experimental Hematology & Oncology
https://www.readbyqxmd.com/read/28723795/comparison-of-postoperative-pain-between-laparoscopic-and-robot-assisted-partial-nephrectomies-for-renal-tumors-a-propensity-score-matching-analysis
#16
Seok-Joon Jin, Jun-Young Park, Doo-Hwan Kim, Syn-Hae Yoon, Eunkyul Kim, Jai-Hyun Hwang, Cheryn Song, Young-Kug Kim
Robot-assisted partial nephrectomy (RAPN) has emerged as an alternative to laparoscopic partial nephrectomy (LPN) for removal of renal tumors. Several advantages of robotic surgery have been reported, but there is no comparative study on postoperative pain between the 2 techniques. Therefore, we compared the postoperative numerical rating scale (NRS) of pain intensity between patients who underwent LPN and those who underwent RAPN.We included 705 patients who underwent either LPN (n = 200) or RAPN (n = 505) for renal tumors between January 2000 and September 2016...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28723697/the-history-and-future-of-ablative-neurosurgery-for-major-depressive-disorder
#17
Matthew Volpini, Peter Giacobbe, G Rees Cosgrove, Anthony Levitt, Andres M Lozano, Nir Lipsman
BACKGROUND: There is an urgent need to develop safe and effective treatments for patients with treatment-resistant depression (TRD). Several neurosurgical procedures have been developed to treat the dysfunctional brain circuits implicated in major depression. OBJECTIVES: This review describes the most common ablative procedures used to treat major depressive disorder: anterior cingulotomy, subcaudate tractotomy, limbic leucotomy, and anterior capsulotomy. The efficacy and safety of each are discussed and compared with other current and emerging modalities, including deep brain stimulation (DBS) and MR-guided focused ultrasound (MRgFUS)...
July 20, 2017: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/28723281/imaging-correlates-of-adult-glioma-genotypes
#18
Marion Smits, Martin J van den Bent
Primary brain tumors, most commonly gliomas, are histopathologically typed and graded as World Health Organization (WHO) grades I-IV according to increasing degrees of malignancy. These grades provide prognostic information and guidance on treatment such as radiation therapy and chemotherapy after surgery. Despite the confirmed value of the WHO grading system, results of a multitude of studies and prospective interventional trials now indicate that tumors with identical morphologic criteria can have highly different outcomes...
August 2017: Radiology
https://www.readbyqxmd.com/read/28722299/cost-and-health-care-utilization-implications-of-bariatric-surgery-versus-intensive-lifestyle-and-medical-intervention-for-type-2-diabetes
#19
Souvik Banerjee, Louis P Garrison, David R Flum, David E Arterburn
OBJECTIVE: The aim of this study was to compare the cost and health care utilization of patients with obesity and type 2 diabetes mellitus (T2DM) randomized into either Roux-en-Y gastric bypass (RYGB) surgery or an intensive lifestyle and medical intervention (ILMI). METHODS: This analysis (N = 745) is based on 2-year follow-up of a small randomized controlled trial (RCT); adult patients with obesity and T2DM were recruited between 2011 and 2012 from Kaiser Permanente Washington...
July 19, 2017: Obesity
https://www.readbyqxmd.com/read/28722231/bacteria-antibiotic-resistance-new-challenges-and-opportunities-for-implant-associated-orthopaedic-infections
#20
Bingyun Li, Thomas J Webster
There has been a dramatic increase in the emergence of antibiotic resistant bacterial strains, which has made antibiotic choices for infection control increasingly limited and more expensive. In the U.S. alone, antibiotic resistant bacteria cause at least 2 million infections and 23,000 deaths a year resulting in a $55-70 billion per year economic impact. Antibiotics are critical to the success of surgical procedures including orthopaedic prosthetic surgeries, and antibiotic resistance is occurring in nearly all bacteria that infect people, including the most common bacteria that cause orthopaedic infections, such as Staphylococcus aureus (S...
July 19, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
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