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Postop sepsis

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https://www.readbyqxmd.com/read/28930036/role-for-laparoscopy-in-the-management-of-bile-duct-injuries
#1
Vaibhav Gupta, Shiva Jayaraman
Common bile duct (CBD) injury is the most serious complication of laparoscopic cholecystectomy. Recently, laparoscopic techniques have been used in the management of postoperative bile leak and CBD injury; this literature has not been reviewed. We reviewed the literature on CBD injury, the approach to its diagnosis and management, and reports of laparoscopic management techniques. We combined this review with our experience in laparoscopic methods to highlight diagnostic and therapeutic options. Laparoscopic techniques can be used to prevent, diagnose and treat CBD injuries...
September 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28924483/thyroidectomy-for-the-treatment-of-graves-thyrotoxicosis-in-thioamide-induced-agranulocytosis-and-sepsis
#2
Colin L Knight, Shamil D Cooray, Jaideep Kulkarni, Michael Borschmann, Mark Kotowicz
A 51 year old man presented with sepsis in the setting of thioamide-induced agranulocytosis. Empiric broad-spectrum antibiotics was followed by directed narrow-spectrum antibiotics, and his neutrophil count recovered with support from granulocyte-colony stimulating factor (G-CSF) analogue transfusions. After a brief period of multi-modal therapy for nine days including potassium iodide (Lugol's iodine), cholestyramine, propanolol and lithium to temper his persisting hyperthyroidism, a total thyroidectomy was performed while thyroid hormone levels remained at thyrotoxic levels...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28906305/risk-of-knee-sepsis-following-treatment-of-open-tibia-fractures-a-multicenter-comparison-of-suprapatellar-and-infrapatellar-approaches
#3
Geoffrey S Marecek, Luke T Nicholson, Frances H Broghammer, Michael Talerico, Caroline Tougas, Derek J Donegan, John A Scolaro
OBJECTIVES: The suprapatellar approach for medullary nailing of the tibia is increasing. This requires intra-articular passage of instruments, which theoretically places the knee at risk for postoperative sepsis in the setting of open fracture. We hypothesized that the risk of knee sepsis is similar after suprapatellar or infrapatellar nailing of open tibia fractures. DESIGN: Retrospective, multicenter. SETTING: Three urban Level-1 trauma centers PATIENTS:: All patients treated with medullary nailing for open diaphyseal tibia fractures (OTA 42) from 2009 to 2015...
September 11, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28902473/preoperative-biliary-drainage-for-malignant-biliary-obstruction-results-from-a-national-database
#4
Yasser Shaib, Mahmoud A Rahal, Mohammad O Rammal, Aurelie Mailhac, Hani Tamim
INTRODUCTION: The impact of preoperative biliary drainage (PBD) on postoperative morbidity and mortality in patients with malignant biliary obstruction is still unclear. We examined short-term surgical outcomes among drained and non-drained patients. METHODS: We identified patients who underwent surgical resection for their malignancies with biliary obstruction using the American College of Surgeons National Surgical Quality Improvement Program Participant Use Files, from 2014 to 2015...
September 13, 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/28900830/transhiatal-vs-transthoracic-esophagectomy-a-nsqip-analysis-of-postoperative-outcomes-and-risk-factors-for-morbidity
#5
Francisco Schlottmann, Paula D Strassle, Marco G Patti
BACKGROUND: Both transhiatal esophagectomy (THE) and transthoracic esophagectomy (TTE) are accepted procedures for esophageal resection. We aimed to compare postoperative outcomes between these procedures and identify risk factors for morbidity. METHODS: A retrospective analysis was performed using the American College of Surgeons National Surgical Quality Improvement Program database. Adult patients who underwent THE or TTE between 2005 and 2014 were included. Postoperative morbidity, length of stay, and 30-day mortality were compared...
September 12, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28894682/frailty-is-predictive-of-adverse-postoperative-events-in-patients-undergoing-lumbar-fusion
#6
Dante M Leven, Nathan J Lee, Jun S Kim, Parth Kothari, Jeremy Steinberger, Javier Guzman, Branko Skovrlj, John I Shin, Kevin Phan, John M Caridi, Samuel K Cho
STUDY DESIGN: Retrospective study of prospectively collected data. OBJECTIVE: To analyze the modified frailty index (mFI) as a predictor of adverse postoperative events following posterior lumbar fusion. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database including all adult patients undergoing posterior lumbar interbody fusion or transforaminal lumbar interbody fusion between 2005 and 2012...
September 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28893257/preoperative-single-ventricle-function-determines-early-outcome-after-second-stage-palliation-of-single-ventricle-heart
#7
Jacek Pająk, Michał Buczyński, Piotr Stanek, Grzegorz Zalewski, Marek Wites, Lesław Szydłowski, Bogusław Mazurek, Lidia Tomkiewicz-Pająk
BACKGROUND: Second-stage palliation with hemi-Fontan or bidirectional Glenn procedures has improved the outcomes of patients treated for single-ventricle heart disease. The aim of this study was to retrospectively analyze risk factors for death after second-stage palliation of single-ventricle heart and to compare therapeutic results achieved with the hemi-Fontan and bidirectional Glenn procedures. MATERIAL AND METHODS: We analyzed 60 patients who had undergone second-stage palliation for single-ventricle heart...
September 11, 2017: Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/28891912/postoperative-complications-affecting-survival-after-cardiac-arrest-in-general-surgery-patients
#8
Minjae Kim, Guohua Li
BACKGROUND: Postoperative cardiac arrest is uncommon but associated with a high mortality risk in general surgery patients and is often preceded by postoperative complications. The relationships between previous complications and mortality after cardiac arrest in general surgery patients have not been completely evaluated. METHODS: retrospective, observational cohort of general surgery in patients with cardiac arrest occurring after postoperative day (POD) #0 (and up to POD #30) was obtained from the 2012-2013 American College of Surgeons National Surgical Quality Improvement Program...
September 7, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28891032/the-need-for-unique-risk-adjustment-for-surgical-site-infections-at-a-high-volume-tertiary-care-center-with-inherent-high-risk-colorectal-procedures
#9
E Gorgun, C Benlice, J Hammel, T Hull, L Stocchi
BACKGROUND: The aim of the present study was to create a unique risk adjustment model for surgical site infection (SSI) in patients who underwent colorectal surgery (CRS) at the Cleveland Clinic (CC) with inherent high risk factors by using a nationwide database. METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was queried to identify patients who underwent CRS between 2005 and 2010. Initially, CC cases were identified from all NSQIP data according to case identifier and separated from the other NSQIP centers...
September 11, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28889824/differences-in-clinical-outcomes-and-cost-between-complex-and-simple-arterial-switches
#10
Eric R Griffiths, Nelangi M Pinto, Aaron W Eckhauser, Ragheed Al-Dulaimi, Angela P Presson, David K Bailly, Phillip T Burch
BACKGROUND: This study evaluates the morbidity, mortality, and cost differences between patients who underwent either a simple or a complex arterial switch operation. METHODS: A retrospective study of patients undergoing an arterial switch operation at a single institution was performed. Simple cases were defined as patients with d-transposition of the great arteries with usual coronary anatomy or circumflex artery originating from the right with either intact ventricular septum or ventricular septal defect...
September 11, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28887240/temporal-trends-determinants-and-outcomes-of-inpatient-versus-outpatient-arteriovenous-fistula-operations
#11
Caitlin W Hicks, Michael Bronsert, Karl E Hammermeister, William G Henderson, Douglas R Gibula, James H Black, Natalia O Glebova
ObjectivesAs high health care costs are increasing scrutinized, a movement toward reducing patient hospital admissions and lengths of stay has emerged, particularly for operations that may be performed safely in the outpatient setting. Our aim is to describe recent temporal trends in the proportion of dialysis access procedures performed on an inpatient vs. outpatient basis, and to determine the effects of these changes on perioperative morbidity and mortality. MethodsThe 2005-2008 ACS NSQIP database was queried for all primary arteriovenous fistula (AVF) procedures using CPT codes...
September 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28876642/outcome-of-liver-resection-for-carcinoid-neuroendocrine-metastases
#12
M D Polkinghorne, J E J Krige, E Jonas, U K Kotze, M M Bernon
BACKGROUND: Gastrointestinal carcinoid tumours, despite their low malignant potential, frequently metastasize to the liver. While liver resection improves survival and provides symptomatic relief, multifocal bilobar disease complicates surgical management. METHOD: All patients with carcinoid liver secondaries managed by resection from 1990-2015 were identified from a prospective departmental database. Demographic data, operative management, morbidity using the Accordion classification and mortality were analysed...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28875126/postoperative-deep-shoulder-infections-following-rotator-cuff-repair
#13
REVIEW
Kivanc Atesok, Peter MacDonald, Jeff Leiter, Sheila McRae, Greg Stranges, Jason Old
Rotator cuff repair (RCR) is one of the most commonly performed surgical procedures in orthopaedic surgery. The reported incidence of deep soft-tissue infections after RCR ranges between 0.3% and 1.9%. Deep shoulder infection after RCR appears uncommon, but the actual incidence may be higher as many cases may go unreported. Clinical presentation may include increasing shoulder pain and stiffness, high temperature, local erythema, swelling, warmth, and fibrinous exudate. Generalized fatigue and signs of sepsis may be present in severe cases...
August 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28873411/preoperative-asymptomatic-leukocytosis-and-postoperative-outcome-in-cardiac-surgery-patients
#14
Eitezaz Mahmood, Ziyad O Knio, Feroze Mahmood, Rabia Amir, Sajid Shahul, Bilal Mahmood, Yanick Baribeau, Ariel Mueller, Robina Matyal
BACKGROUND: Despite showing a prognostic value in general surgical patients, preoperative asymptomatic elevated white blood cell (WBC) count is not considered a risk factor for cardiac surgery. Whereas there is sporadic evidence of its value as a preoperative risk marker, it has not been looked at methodically as a specific index of outcome during cardiac surgery. Using a national database we sought to determine the relationship between preoperative WBC count and postoperative outcome in cardiac surgical patients...
2017: PloS One
https://www.readbyqxmd.com/read/28870746/incidence-risk-factors-and-impact-of-clostridium-difficile-colitis-following-primary-total-hip-and-knee-arthroplasty
#15
Patawut Bovonratwet, Daniel D Bohl, Rohil Malpani, Denis Nam, Craig J Della Valle, Jonathan N Grauer
BACKGROUND: An improved understanding of Clostridium difficile is important as it is used as a measure of hospital quality and is associated with substantial morbidity. This study utilizes the National Surgical Quality Improvement Program to determine the incidence, timing, risk factors, and clinical implications of C difficile colitis in patients undergoing primary total hip or knee arthroplasty (THA or TKA). METHODS: Patients who underwent primary THA or TKA as part of the 2015 National Surgical Quality Improvement Program were identified...
August 12, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28870681/the-association-of-venous-thromboembolism-chemoprophylaxis-timing-on-venous-thromboembolism-after-major-vascular-surgery
#16
Danielle C Sutzko, Patrick E Georgoff, Andrea T Obi, Mark A Healy, Nicholas H Osborne
OBJECTIVE: Venous thromboembolism (VTE) is reported to occur in up to 33% of patients undergoing major vascular surgery. Despite this high incidence, patients inconsistently receive timely VTE chemoprophylaxis. The true incidence of VTE among patients receiving delayed VTE chemoprophylaxis is unknown. We sought to identify the association of VTE chemoprophylaxis timing on VTE risk, postoperative transfusion rates, and 30-day mortality and morbidity in patients undergoing major open vascular surgery...
September 1, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28870057/-clinical-analysis-of-34-cases-with-sepsis-and-systemic-capillary-leak-syndrome
#17
H X Ma, X J Shi, Y R Liang, H D Shi, H Wang, Y S Zhao
Objective: To study the clinical characteristics of sepsis with systemic capillary leak syndrome(SCLS) and to evaluate the therapeutic effect and clinical significance of fluid therapy adjusted timely in these patients. Methods: The clinical data of 34 patients with sepsis and SCLS in the Department of Hepatobiliary Surgery ICU of General Hospital of People's Liberation Army General Hospital from July 2014 to January 2016 were retrospectively analyzed.There were 21 males and 13 females, aged from 21 to 74 years, with an average age of 56...
September 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28865996/comparative-perioperative-outcomes-in-septuagenarians-and-octogenarians-undergoing-radical-cystectomy-for-bladder-cancer-do-outcomes-differ
#18
Tyler D Haden, Megan C Prunty, Alexander B Jones, Chelsea B Deroche, Katie S Murray, Naveen Pokala
BACKGROUND: Treatment choice for muscle invasive bladder cancer continues to be radical cystectomy. However, radical cystectomy carries a relatively high risk of morbidity and mortality compared with other urological procedures. OBJECTIVE: To compare surgical complications following radical cystectomy in septuagenarians and octogenarians. DESIGN, SETTING, AND PARTICIPANTS: The National Surgical Quality Improvement Program database (2009-2013) was used to identify patients who were 70 yr and older and underwent radical cystectomy...
August 30, 2017: European Urology Focus
https://www.readbyqxmd.com/read/28864848/lessons-learned-from-300-consecutive-pancreaticoduodenectomies-over-a-25-year-experience-the-safety-net-improves-the-outcomes-beyond-surgeon-skills
#19
Roberto Santoro, Roberto Luca Meniconi, Pasquale Lepiane, Giovanni Vennarecci, Gianluca Mascianà, Marco Colasanti, Eugenio Santoro, Giuseppe Maria Ettorre
Pancreaticoduodenectomy (PD) is associated with high postoperative morbidity. The management of postoperative complications is paramount for reducing the mortality rate. The aim of this study was to evaluate the importance of surgical and hospital experience on outcomes by comparing postoperative results in three different hospitals with increasing resources for supporting the same surgical team. Patients data and surgical outcome of 300 consecutive patients undergoing PD were collected prospectively in the department database and divided into three periods (A = 1990-2000, B = 2001-March 2007, C = April 2007-2015)...
September 1, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28860018/comparison-of-in-hospital-outcomes-of-transcatheter-aortic-valve-implantation-versus-surgical-aortic-valve-replacement-in-obese-body-mass-index%C3%A2-%C3%A2-%C3%A2-30%C3%A2-kg-m2-patients
#20
Tomo Ando, Emmanuel Akintoye, Naveen Trehan, Tesfaye Telila, Alexandros Briasoulis, Hisato Takagi, Cindy L Grines, Luis Afonso
The comparative outcomes of transcatheter aortic valve implantation (TAVI) versus surgical aortic valve replacement (SAVR) in obese (body mass index ≥ 30 kg/m(2)) patients are underexplored. Nationwide Inpatient Sample database was queried from 2011 to 2014, and those who underwent TAVI or SAVR with obesity were identified. A complete case analysis with multivariate analysis was performed to adjust for the difference in underlying co-morbidities. We identified a total of 12,525 patients (989 TAVI and 11,536 SAVR)...
August 7, 2017: American Journal of Cardiology
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